bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of activin A on tubulointerstitial fibrosis in diabetic nephropathy
Authors: REN XIAO‐JUN , GUAN GUANG‐JU , LIU GANG , ZHANG TAOYAN , LIU GAO‐HONG
Published: March 2009

Aim:  The effect of activin A on tubulointerstitial fibrosis in diabetic nephropathy (DN) using streptozotocin (STZ)‐induced diabetic rats and high glucose‐cultured HK‐2 cells was investigated.

Methods:  Male Wistar rats were randomized into a normal control group (NC) and diabetes mellitus group (DM). Diabetes was induced by i.p. injection of STZ. Six rats were respectively killed 4, 8, 12 and 16 weeks after model establishment in each group. The changes of kidney weight/bodyweight (KW/BW), urine albumin excretion rate (AER) and creatinine clearance rate (Ccr) were determined. The morphology of tubulointerstitium was observed by light microscopy. Further biochemical analysis was provided using immunohistochemistry and real‐time polymerase chain reaction. The different parameters in high glucose‐cultured HK‐2 cells were monitored by western blotting or enzyme‐linked immunosorbent assay (ELISA) and the intervention of rh‐follistatin on them was investigated.

Results:  Compared with the NC group, there was marked enlargement in the levels of KW/BW, AER, Ccr and interstitial fibrosis index, and the production of P‐Smad2/3 and fibronectin in the DM group from 8 to 16 weeks. Activin βA, mainly located in tubular epithelial cells, was significantly higher in the DM group than that in the NC group throughout the study periods. Follistatin was abundant in the NC group, but was diminished gradually in the DM group. High glucose may facilitate the synthesis of activin βA, transforming growth factor (TGF)‐β, P‐Smad2/3 and fibronectin in HK‐2 cells while rh‐follistatin inhibited them except TGF‐β.

Conclusion:  Activin A is involved in tubulointerstitial fibrosis in DN by inducing the production of fibronectin through Smad signal pathway.
Glutamine‐induced heat shock protein protects against renal ischaemia‐reperfusion injury in rats
Authors: ZHANG YU , ZOU ZUI , LI YING‐KE , YUAN HONG‐BIN , SHI XUE‐YIN
Published: March 2009

Aim:  To find out if a single dose of glutamine can relieve acute renal ischaemia‐reperfusion injury in rats, to explore the role of heat shock protein in this process.

Methods:  Forty‐eight Sprague–Dawley rats were assigned to four groups: saline as control group; glutamine group; quercetin (heat shock protein inhibitor) plus glutamine group; and quercetin plus saline group. The renal ischaemia‐reperfusion rat model was established 1 h after drug administration. Serum creatinine (CR) and blood urea nitrogen (BUN) were analyzed. The kidneys were harvested to evaluate the degree of renal injuries. Heat shock protein expression was detected by immunohistochemistry and western blot. Cell apoptosis was detected by terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) assay and apoptosis index was calculated.

Results:  Statistical data from CR, BUN, haematoxylin–eosin (HE) dyeing and TUNEL assay results showed that ischaemia‐reperfusion injury and cell apoptosis in the glutamine group were significantly milder than those in control group (P < 0.05), while ischaemia‐reperfusion injury and cell apoptosis in the quercetin plus glutamine group and quercetin plus saline group were more severe than those in the control group (P < 0.05). Statistical data from immunohistochemistry and western blot results showed that heat shock protein expression was enhanced in the glutamine group compared with that in the control group (P < 0.01), while it was weaker in the quercetin plus glutamine group and quercetin plus saline group than that in the control group (P < 0.01).

Conclusion:  Our experiment suggested that a single dose of glutamine could relieve renal ischaemia‐reperfusion injury in rats in 24 h, and its mechanism may be associated with enhanced heat shock protein expression. This finding may provide a new alternative for protecting against clinical renal ischaemia‐reperfusion injury.
Review article: Addressing risk factors in chronic kidney disease mineral and bone disorder: Can we influence patient‐level outcomes?
Authors: O'SHEA STACEY , JOHNSON DAVID W
Published: March 2009

Chronic kidney disease mineral and bone disorder (CKD‐MBD), characterized by disturbances of calcium/phosphate/parathyroid hormone, bone abnormalities and vascular and soft tissue calcification, is highly prevalent in CKD and is a strong, independent predictor of bone fracture, cardiovascular disease and death. Clinical practice guidelines, such as the Kidney Disease Outcomes Quality Initiative (KDOQI) and Caring for Australasians with Renal Insufficiency (CARI), support the use of phosphate binders, vitamin D compounds and calcimimetics for treatment of CKD‐MBD and recommend stringent targets for serum calcium, phosphate and parathyroid hormone. However, these recommendations are based primarily on the results of observational cohort studies and randomized controlled trials employing surrogate outcome measures. The aim of this paper is to review the available evidence addressing whether therapeutic strategies targeting CKD‐MBD and its surrogate outcome measures appreciably influence patient‐level outcomes (‘hard’ clinical end‐points).
The choice of estimating equations for glomerular filtration rate significantly affects the prevalence of chronic kidney disease in a multi‐ethnic population during health screening
Authors: TEO BOON W , NG ZHI Y , LI JIALIANG , SAW SHARON , SETHI SUNIL , LEE EVAN JC
Published: March 2009

Background:  Patients present to the National University Hospital of Singapore and select one of several health screening packages after counselling. The prevalence of chronic kidney disease (CKD) in this population when different glomerular filtration rate (GFR) estimating equations are used has not been examined.

Methods:  Demographic data and urinalyses of patients from 2000 to 2005 were extracted from laboratory computer databases and analysed. CKD was classified into stages according to the US National Kidney Foundation guidelines by eGFR (mL/min per 1.73 m2) using the four‐variable Modification of Diet in Renal Disease equation. GFR of ethnic Chinese was also estimated using Ma's equation 8 (cGFR). Stage 1 and normal (eGFR or cGFR > 90) was discriminated by urinary microscopy or dipstick for proteinuria, albuminuria, hematuria or leukocyturia.

Results:  There were 3979 screenings (55.9% males, 61.9% Chinese). Means: age = 47.0 ± 12.3 years, creatinine = 80.1 ± 26.5 µmol/L, eGFR = 89.6 ± 19.7, cGFR = 110.8 ± 23.8 and (eGFR + cGFR) = 102.5 ± 24.9. By eGFR in all patients, the prevalence of CKD was 45.7%, 50.6%, 3.3%, 0.3% and 0.08% for stages normal or 1, 2, 3, 4 and 5, respectively. For Chinese patients only, eGFR and cGFR resulted in a different distribution (eGFR%/cGFR%): 24.9/50.5, 15.2/29.3, 56.8/19.7, 3/0.8, 0.2/0.2, 0/0 for stages ‘Normal’, 1, 2, 3, 4 and 5, respectively (P < 0.001).

Conclusion:  The prevalence of moderate to severe CKD (stage 3 to 5) in patients presenting for health screening in Singapore was 3.7%. Notably, the prevalence of mild to moderate CKD (stages 1, 2 and 3) in Chinese patients was affected significantly by the choice of GFR estimating equation.
New method of predicting dry weight using bioelectrical impedance analysis in haemodialysis patients
Authors: LEE SEOUNG WOO , KIM DEOK YOUNG , LEE SEUNG HEE , CHO HYUNG CHAN , KWON SU HYUN , SONG JOON HO , KIM MOON JAE
Published: March 2009

Aim:  There were significant differences in the slopes of the ultrafiltration (UF) amount removed during haemodialysis (HD) sessions versus the percentage change in the extracellular fluid/total body water ratio for the right lower extremity (ECF/TBWright leg) plot in normohydrated (NH) and overhydrated states. The purpose of this study was to develop and validate a method for predicting dry weight (DW) using these results.

Methods:  It was hypothesized that for patients to become NH, the slope of the UF amount versus the percentage changes in ECF/TBWright leg plot should be same as that of NH patients and a method for predicting DW was developed. To validate the accuracy of this method, the ECF/TBWright leg was measured by eight‐point tactile‐electrode bioelectrical impedance analysis before and after HD in 17 newly enrolled NH patients. Using the current DW (cDW) of subjects as a reference, we compared the accuracies of pDW1 (our devised method) and pDW2 (the normovolaemia/hypervolaemia slope method).

Results:  The mean cDW, pDW1 and pDW2 values were 56.8 ± 7.9, 56.4 ± 7.7 and 56.3 ± 8.0 kg, respectively. No significant differences existed between cDW, pDW1 and pDW2. pDW1 had a lower root mean square error than pDW2 (1.12 vs 1.69). On the Bland–Altman plot, differences between pDW1 and cDW were closer to zero than between pDW2 and cDW.

Conclusion:  A new method was developed of predicting the DW using the relationship between the UF amount and the percentage change in the ECF/TBW ratio of the lower extremities after HD. The devised method appears to be as accurate as the normovolaemia/hypervolaemia slope method.
A survey of medical staff attitudes to an antibiotic approval and stewardship programme
Authors: Bannan A. , Buono E. , McLaws M.‐L. , Gottlieb T.
Published: March 2009

Background: Antibiotic stewardship programmes (ASPs) are advocated to ensure appropriate antimicrobial use; with short‐term evidence they may improve outcomes, limit adverse effects, encourage cost‐effectiveness and reduce antibiotic resistance. At Concord Hospital, a 450‐bed acute care hospital, we have used a telephone‐based ASP for 15 years. There may be differences in attitudes to the ASP by prescribers, which may influence its long‐term efficacy.

Method: A 40‐item self‐administered questionnaire was sent to 190 junior and 250 specialist medical staff. We aimed to elicit medical staff attitudes to the ASP's utility, educational value, effect on patient care and ease of use.

Results: One hundred and sixty‐four completed questionnaires were returned. Most (82%, 95% confidence interval (95%CI) 75–87%) clinicians had used the ASP, 98% of whom believed it to be a reasonable system. Most staff (85%, 95%CI 79–90%) believed that seeking approval made teams think carefully about antibiotic choice, agreed it provided helpful advice (91%, 95%CI 85–95%) and that the approval system provided useful advice and was educational (88%, 95%CI 81–92%). The ASP was felt time‐consuming and detracting from clinical duties by 33% (95%CI 26–41%), while 10% (95%CI 5.8–15.7%) believed it undervalued intuition and experience. Few (19%, 95%CI 13–25%, P < 0.0001) clinicians believed it infringed their autonomy. The advice given through the ASP was believed by most (89%, 95%CI 81–92%) to improve patient outcomes.

Conclusion: The ASP was surprisingly well supported by all levels of staff, and reinforced the benefits of maintaining an ASP policy.
Patients with acute myocardial infarction using ambulance or private transport to reach definitive care: which mode is quicker?
Authors: Song L. , Yan H. , Hu D.
Published: March 2009

Background: One of the main reasons cited by patients with acute myocardial infarction (AMI) for not using an ambulance was quickness of private transport.

Aims: To examine differences in transport times for patients with AMI who used ambulance compared with patients who used private transportation to reach definitive care in Beijing.

Methods: Data were prospectively collected from the 498 patients with ST‐elevation myocardial infarction admitted within 12 h of symptom onset to 19 hospitals in Beijing between 1 November 2005 and 31 December 2006. Elapsed time to definitive care was examined through the use of (i) decision to seek care to hospital arrival (private transport group) versus emergency medical service (EMS) arrival on scene (ambulance transport group), (ii) decision to seek care to hospital arrival, (iii) decision to seek care to reperfusion therapy and (iv) symptom onset to reperfusion therapy for both groups.

Results: Private transportation resulted in faster hospital arrival than using ambulance (median, 35 vs 50 min, P < 0.001). However, if one considers EMS treatment to be initial definitive care, using ambulance resulted in much quicker care than patients using private transportation to the hospital (median, 15 vs 35 min, P < 0.001). In addition, using ambulance resulted in shorter decision‐to‐balloon (173 vs 193 min, P = 0.049) and symptom onset‐to‐balloon (medians, 223 vs 300 min, P < 0.001) times compared with patients using private transportation.

Conclusion: Although private transportation results in a faster trip to the hospital, quicker definitive care is obtained with the use of ambulance.
A link between the North Atlantic Oscillation and measles dynamics during the vaccination period in England and Wales
Authors: Lima Mauricio
Published: March 2009

Ecologists have become aware of the role played by interannual climatic variability on the temporal dynamics of infectious diseases. In this report, I present evidence from data on measles cases in England and Wales showing that during the post‐vaccination period, the interannual variability of winter weather (represented by the North Atlantic Oscillation, NAO) influences the annual dynamics of the disease. Using annual measles data from seven cities and simple logistic models, this study reveals how, after vaccination, NAO increases its effects on measles fluctuations. In addition, this study shows that vaccination may be represented as a simple vertical and lateral perturbation effect (Royama’s classification), by reducing the maximum per capita growth rate and the equilibrium number of infected individuals.The results suggest that vaccination will not lead to outbreaks of measles from regular cyclic to irregular chaotic dynamics. In contrast, because of the reduction in per capita growth rates, the disease dynamics appear to be more stable than during the pre‐vaccination period. The analysis of annual data on infectious diseases may be useful for detecting long‐term effects of climate and complements the classical analyses and modeling based on monthly or seasonal time‐step data.
Climatic drivers of hemispheric asymmetry in global patterns of ant species richness
Authors: Dunn Robert R. , Agosti Donat , Andersen Alan N. , Arnan Xavier , Bruhl Carsten A. , Cerdá Xim , Ellison Aaron M. , Fisher Brian L. , Fitzpatrick Matthew C. , Gibb Heloise , Gotelli Nicholas J. , Gove Aaron D. , Guenard Benoit , Janda Milan , Kaspari Michael , Laurent Edward J. , Lessard Jean‐Philippe , Longino John T. , Majer Jonathan D. , Menke Sean B. , McGlynn Terrence P. , Parr Catherine L. , Philpott Stacy M. , Pfeiffer Martin , Retana Javier , Suarez Andrew V. , Vasconcelos Heraldo L. , Weiser Michael D. , Sanders Nathan J.
Published: March 2009

Although many taxa show a latitudinal gradient in richness, the relationship between latitude and species richness is often asymmetrical between the northern and southern hemispheres. Here we examine the latitudinal pattern of species richness across 1003 local ant assemblages. We find latitudinal asymmetry, with southern hemisphere sites being more diverse than northern hemisphere sites. Most of this asymmetry could be explained statistically by differences in contemporary climate. Local ant species richness was positively associated with temperature, but negatively (although weakly) associated with temperature range and precipitation. After contemporary climate was accounted for, a modest difference in diversity between hemispheres persisted, suggesting that factors other than contemporary climate contributed to the hemispherical asymmetry. The most parsimonious explanation for this remaining asymmetry is that greater climate change since the Eocene in the northern than in the southern hemisphere has led to more extinctions in the northern hemisphere with consequent effects on local ant species richness.
Resilience of tropical rain forests: tree community reassembly in secondary forests
Authors: Norden Natalia , Chazdon Robin L. , Chao Anne , Jiang Yi‐Huei , Vílchez‐Alvarado Braulio
Published: March 2009

Understanding the recovery dynamics of ecosystems presents a major challenge in the human‐impacted tropics. We tested whether secondary forests follow equilibrium or non‐equilibrium dynamics by evaluating community reassembly over time, across different successional stages, and among multiple life stages. Based on long‐term and static data from six 1‐ha plots in NE Costa Rica, we show that secondary forests are undergoing reassembly of canopy tree and palm species composition through the successful recruitment of seedlings, saplings, and young trees of mature forest species. Such patterns were observed over time within sites and across successional stages. Floristic reassembly in secondary forests showed a clear convergence with mature forest community composition, supporting an equilibrium model. This resilience stems from three key factors co‐occurring locally: high abundance of generalist species in the regional flora, high levels of seed dispersal, and local presence of old‐growth forest remnants.
Plant–pollinator networks: adding the pollinator’s perspective
Authors: Bosch Jordi , Martín González Ana M. , Rodrigo Anselm , Navarro David
Published: March 2009

Pollination network studies are based on pollinator surveys conducted on focal plants. This plant‐centred approach provides insufficient information on flower visitation habits of rare pollinator species, which are the majority in pollinator communities. As a result, pollination networks contain very high proportions of pollinator species linked to a single plant species (extreme specialists), a pattern that contrasts with the widely accepted view that plant–pollinator interactions are mostly generalized. In this study of a Mediterranean scrubland community in NE Spain we supplement data from an intensive field survey with the analysis of pollen loads carried by pollinators. We observed 4265 contacts corresponding to 19 plant and 122 pollinator species. The addition of pollen data unveiled a very significant number of interactions, resulting in important network structural changes. Connectance increased 1.43‐fold, mean plant connectivity went from 18.5 to 26.4, and mean pollinator connectivity from 2.9 to 4.1. Extreme specialist pollinator species decreased 0.6‐fold, suggesting that ecological specialization is often overestimated in plant–pollinator networks. We expected a greater connectivity increase in rare species, and consequently a decrease in the level of asymmetric specialization. However, new links preferentially attached to already highly connected nodes and, as a result, both nestedness and centralization increased. The addition of pollen data revealed the existence of four clearly defined modules that were not apparent when only field survey data were used. Three of these modules had a strong phenological component. In comparison to other pollination webs, our network had a high proportion of connector links and species. That is, although significant, the four modules were far from isolated.
SEMIPARAMETRIC REGRESSION AND GRAPHICAL MODELS
Authors: Wand M. P.
Published: March 2009

Semiparametric regression models that use spline basis functions with penalization have graphical model representations. This link is more powerful than previously established mixed model representations of semiparametric regression, as a larger class of models can be accommodated. Complications such as missingness and measurement error are more naturally handled within the graphical model architecture. Directed acyclic graphs, also known as Bayesian networks, play a prominent role. Graphical model‐based Bayesian ‘inference engines’, such asbugsandvibes, facilitate fitting and inference. Underlying these are Markov chain Monte Carlo schemes and recent developments in variational approximation theory and methodology.
Explaining International Differences in Genetically Modified Food Labeling Policies*
Authors: Gruère Guillaume P. , Carter Colin A. , Farzin Y. Hossein
Published: March 2009

Many countries have adopted labeling policies for genetically modified (GM) food, and the regulations vary considerably across countries. We evaluate the importance of political‐economic factors implicit in the choice of GM food labeling regulations. Using an analytical model, we show that production and trade‐related interests play a prominent role in labeling decision‐making. This conclusion is validated by an empirical analysis of GM food labeling policy choices. We find that countries producing GM crops are more likely to have less stringent labeling policies. Food and feed exporters to the European Union (EU) and Japan are more likely to have adopted stricter labeling policies. Labeling regulations in Asia and Europe are similar to those of Japan and the EU. Countries with no labeling policies are less developed, with important rural sectors and are more likely to have ratified the Cartagena Protocol on Biosafety.
Trade, Growth, and Increasing Returns to Infrastructure: The Role of the Sophisticated Monopolist*
Authors: Guha Ashok S. , Guha Brishti
Published: March 2009

Equilibrium in international trade with increasing returns in infrastructure depends on whether the infrastructure provider is “naïve” or sophisticated. A monopolist produces infrastructure under decreasing cost using fixed equipment. Unlike similar work, we derive a unique closed‐economy equilibrium. In a small open economy, with “naïve” infrastructure provider(s), multiple equilibria obtain. The industrial export potential of the economy depends on unexhausted economies of scale, and equilibria are possible where manufactures are exported despite an autarky price higher than the world price. With a sophisticated infrastructure provider, even an open economy has a unique equilibrium, which, at least as long as economies of scale are unexhausted, also involves more industrialization than the “naïve” equilibria. Access to the unlimited world market is necessary for significant industrialization but is not sufficient: one may also require “Schumpeterian” entrepreneurs, monopolists with a panoramic vision of the economy and of their catalytic role in it.
Getting Shut Out of the International Capital Markets: It Doesn't Take Much*
Authors: Flood Robert , Marion Nancy
Published: March 2009

We use a simple model of international lending to show that an emerging market borrower who might default can be shut out of international capital markets without warning. A modest haircut on obligations, for example, can shut down lending.
Effects of Transboundary Pollution on the Mode of International Trade of a Polluting Good*
Authors: Fujiwara Kenji , Matsueda Norimichi
Published: March 2009

By analyzing a strategic interaction between environmentally‐concerned governments, we examine how the competition mode of international polluting oligopoly is determined. We show that a resulting form of competition depends on the magnitudes of marginal damage costs and cross‐border spillover as well as on the degrees of similarities in these environment‐related parameters.
Uncovered Interest Parity at Long Horizons: Evidence on Emerging Economies*
Authors: Mehl Arnaud , Cappiello Lorenzo
Published: March 2009

This paper estimates uncovered interest parity (UIP) at long horizons using bilateral US dollar rates vis‐à‐vis mature economy and emerging market currencies. The paper finds support in favor of UIP for dollar rates vis‐à‐vis major mature economy currencies, but far less against emerging market currencies. There are also signs that political risk and the exchange risk premium help explain the empirical failure of UIP for these latter currencies. This suggests that whether UIP holds depends more on the currency than on the horizon.
Gambling behavior and gambling problems in Norway 2007
Authors: BAKKEN INGER JOHANNE , GÖTESTAM K. GUNNAR , GRÅWE ROLF W. , WENZEL HANNE GRO , ØREN ANITA
Published: March 2009

In Norway, legalized gambling is pervasive, easily accessible and socially accepted, particularly the participation in national lotteries. We conducted a stratified probability sample study during January–March 2007 (age group 16–74 years, N = 3,482, response rate 36.1%) to assess gambling behavior and prevalence of problematic gambling by the NORC Diagnostic Screen (NODS). Overall, 67.9% of the study population had been engaged in past‐year gambling and 0.7% were past‐year problematic gamblers (NODS score 3+). Male gender, low educational level, single marital status, and being born in a non‐Western country were variables positively associated with problematic gambling. Past‐year problematic gamblers indicated the slot machine (34.6%) and Internet gambling (26.9%) as the most important games, while most non‐problematic gamblers pointed out the lotteries (62.3%) as the most important game. The prevalence of self‐reported sleeping disorders, depression and other psychological impairments was significantly higher among problematic gamblers. Gambling problems affect people's lives in multiple ways.
Welfare State Developments in the Russian Federation: Oil‐led Social Policy and ‘The Russian Miracle’
Authors: Cerami Alfio
Published: March 2009

This article investigates the main welfare state developments of the Russian Federation that have occurred since the fall of communism. It argues that the contemporary welfare expansion strictly depends on high oil and gas prices, and that this oil‐led social policy makes the future of the ‘Russian miracle’ highly volatile. The main conclusion is that the Russian welfare state will be able to function properly and to ensure social integration and solidarity only under conditions of sustained oil‐led growth. The article also identifies a variety of different, but equally important, endogenous, as well as exogenous, factors that have influenced the social policy developments in the Russian Federation since 1989. These correspond to the existence of few veto points present in the political arena, the lack of a well‐structured system of interest representation, the presence of informality in the welfare state organization, but also to the presence of national economic vulnerabilities and/or strengths in the now open global economy, as well as to non‐contingent decisions taken in strategic sectors of the state, such as those related to the energy or defence sectors.
Croatian Social Policy: The Legacies of War, State‐building and Late Europeanization
Authors: Stubbs Paul , Zrinščak Siniša
Published: March 2009

This article outlines the differences and commonalities between social policy developments in Croatia and those in Central Europe. In Croatia, issues such as national identities and the redefinition of citizenship, war, state‐building and crisis management have produced a complex mix of statist centralization and parallelism of welfare actors at the central and local level. While subject both to neo‐liberal pressures to privatize provision, and later to European Union influences, both of these came later, and were more mediated, than in Central Europe. Croatia forms a bridge to studying the uneven welfare arrangements of other countries in South‐East Europe, marked as they are by complex governance arrangements and the presence of social development and postwar reconstruction discourses.
Analysing the Welfare State in Poland, the Czech Republic, Hungary and Slovenia: An Ideal‐Typical Perspective
Authors: Aspalter Christian , Jinsoo Kim , Sojeung Park
Published: March 2009

This article applies ideal‐typical welfare state theory in analysing the recent transition and the current position of welfare state systems in Eastern Central Europe, taking the cases of Poland, the Czech Republic, Hungary and Slovenia. The article argues that Eastern Central European welfare state systems have returned to their historical and cultural roots of welfare state formation and development, to the time before the onset of state socialism in Soviet times. First, social security policies and social and labour laws were established when the vast bulk of Eastern Central European countries were member states of the Austro‐Hungarian Empire, sharing the same political economy, legal system and culture. Over the last 20 years, the socialist system of employment‐based social services and benefits has been replaced with Bismarckian‐type social security policy and systems. While there are major alterations here and there – in ideal‐typical perspective – the four countries under scrutiny share all the major traits of Continental European (Christian Democratic) welfare regimes.
Surveying Migrant Households: A Comparison of Census-Based, Snowball and Intercept Point Surveys
Authors: McKenzie David J. , Mistiaen Johan
Published: March 2009

Few representative surveys of households of migrants exist, limiting our ability to study the effects of international migration on sending families. We report the results of an experiment that was designed to compare the performance of three alternative survey methods in collecting data from Japanese–Brazilian families, many of whom send migrants to Japan. The three surveys that were conducted were households selected randomly from a door-to-door listing using the Brazilian census to select census blocks, a snowball survey using Nikkei community groups to select the seeds and an intercept point survey that was collected at Nikkei community gatherings, ethnic grocery stores, sports clubs and other locations where family members of migrants are likely to congregate. We analyse how closely well-designed snowball and intercept point surveys can approach the much more expensive census-based method in terms of giving information on the characteristics of migrants, the level of remittances received and the incidence and determinants of return migration.
Analysing Direct Effects in Randomized Trials with Secondary Interventions: An Application to Human Immunodeficiency Virus Prevention Trials
Authors: Rosenblum Michael , Jewell Nicholas P. , Laan Mark van der , Shiboski Stephen , Straten Ariane van der , Padian Nancy
Published: March 2009

The ‘Methods for improving reproductive health in Africa’ trial is a recently completed randomized trial that investigated the effect of diaphragm and lubricant gel use in reducing infection by the human immunodeficiency virus (HIV) among susceptible women. 5045 women were randomly assigned to either the active treatment arm or not. Additionally, all subjects in both arms received intensive condom counselling and provision, the ‘gold standard’ HIV prevention barrier method. There was much lower reported use of condoms in the intervention arm than in the control arm, making it difficult to answer important public health questions based solely on the intention-to-treat analysis. We adapt an analysis technique from causal inference to estimate the ‘direct effects’ of assignment to the diaphragm arm, adjusting for use of condoms in an appropriate sense. Issues raised in the trial apply to other trials of HIV prevention methods, some of which are currently being conducted or designed.
Nicotinic acetylcholine receptors mediate the hypnotic and analgesic effects of emulsified inhalation anesthetics
Authors: Yan Su , Dai Ti‐Jun , Zeng Yin‐Ming
Published: March 2009

This study was designed to investigate the role of nicotinic acetylcholine receptors (nAChRs) in hypnosis and analgesia induced by emulsified inhalation anesthetics. After having established the mice model of hypnosis and analgesia by intraperitoneal injections of appropriate doses of enflurane, isoflurane or sevoflurane, we intracerebroventricularly or intrathecally injected different doses of nicotine and then observed the effects on the sleeping time using awaken test and the pain threshold in hot‐plate test (HPPT) using hot‐plate test. In the awaken test, 10, 20 and 40 μg of nicotine (intracerebroventricularly) significantly decreased the sleeping time of the mice treated with the three emulsified inhalation anesthetics mentioned above (P < 0.05 or 0.01). In the HPPT, 5, 10 and 15 μg of nicotine (intrathecally) did not affect the HPPT in conscious mice (P > 0.05); in contrast, 5, 10 and 15 μg of nicotine (intrathecally) significantly decreased the HPPT of the mice treated with emulsified inhalation anesthetics (P < 0.05 or 0.01). The data presented in this study suggest that nAChRs may be important targets for the hypnotic and analgesic effects induced by emulsified enflurane, isoflurane and sevoflurane.
Importance of medication adherence from the ONTARGET and TRANSCEND points of view
Authors: Barrios Vivencio , Escobar Carlos , Echarri Rocio
Published: March 2009

Medication adherence is crucial to improve the prognosis of patients with hypertension. Importantly, the variables associated with antihypertensive medication withdrawal do not occur immediately after the cessation, but likely in the following years. Nevertheless, since the current randomized clinical trials are limited to a short or mid follow‐up, the results provided from these studies cannot exactly reflect the importance of the therapy discontinuation. We discuss about two recent examples, the ONTARGET and the TRANSCEND trials, in which the inclusion of the discontinuation rates in the primary analysis change the results of these studies and subsequently, the interpretation of the data.
Retracted: Isolated Subacute Effusive and Nonconstrictive Epicarditis Masquerading as a Right Atrial Mass
Authors: Suma Valentin , Makaryus Amgad N. , Rascon Mario , Doddamani Sanjay , Fan Dali , Boxt Lawrence M.
Published: March 2009

Epicarditis (visceral pericardial inflammation) is a very unique and rare diagnosis. It is almost always associated with parietal pericardial involvement and may occur in medical conditions such as viral, bacterial (mycobacterial) infections and uremia or postoperatively in the setting of cardiac surgery. Frequently, no etiology is found. Most cases are associated with constrictive physiology, and patients present with symptoms and signs of right‐sided heart failure. Effusive epicarditis is often present, and the clinical features may easily be confused with those of pericardial effusion with tamponade. We report a unique case of isolated subacute effusive and nonconstrictive epicarditis mimicking a right atrial mass in a 72‐year‐old patient who was diagnosed with nonmetastatic gastric adenocarcinoma. Our case is unique for several reasons: inflammation was limited to the epicardium (very few cases have been described to date); the patient was asymptomatic, with no clinical or echocardiographic evidence of constriction (this represents a novel finding, explained in part by the more limited extent of inflammation, with no significant fibrotic component and no parietal pericardial involvement); and this is the first report of epicarditis occurring in association with a malignancy, which we hypothesize may represent an inflammatory paraneoplastic process. (ECHOCARDIOGRAPHY, Volume 26, July 2009)
Patent Foramen Ovale: Comparison among Diagnostic Strategies in Cryptogenic Stroke and Migraine
Authors: Zito Concetta , Dattilo Giuseppe , Oreto Giuseppe , Di Bella Gianluca , Lamari Annalisa , Iudicello Raffaella , Trio Olimpia , Caracciolo Giuseppe , Coglitore Sebastiano , Arrigo Francesco , Carerj Scipione
Published: March 2009

Objective: The aim of this study was to compare transthoracic echocardiography (TTE) and transcranial Doppler ultrasonography (TCD) with transesophageal echocardiography (TEE) in order to define the best clinical approach to patent foramen ovale (PFO) detection. Methods: In total, 72 consecutive patients (33 men) with a mean age of 49 ± 13 years were prospectively enrolled. The TEE indication was cryptogenic stroke (36 patients) or migraine (36 patients, 22 with aura). All patients underwent standard TTE, TCD, and TEE examination. For any study, a contrast test was carried on using an agitated saline solution mixed with urea‐linked gelatine (Haemaccel), injected as a rapid bolus via a right antecubital vein. A prolonged Valsalva maneuver was performed to improve test sensitivity. Results: TEE identified a PFO in 65% of the whole population: 56.5% in the migraine cohort and 43.5% in the cryptogenic stroke cohort. TTE was able to detect a PFO in 55% of patients positive at TEE (54% negative predictive value, 100% positive predictive value, 55% sensitivity, and 100% specificity). TCD was able to identify a PFO in 97% of patients positive at TEE (89% negative predictive value, 98% positive predictive value, 94% sensitivity, and 96% specificity). Conclusions: In patients with cryptogenic stroke and migraine, there is a fair concordance (k = 0.89) between TCD and TEE in PFO recognition. Accordingly, TCD should be recommended as a simple, noninvasive, and reliable technique, whereas TEE indication should be restricted to selected patients. TTE is a very specific technique, whose major advantage is the ability to detect a large right‐to‐left shunt, particularly if associated with an atrial septal aneurysm.
Early intervention in patients at ultra high risk of psychosis: benefits and risks
Authors: De Koning M. B. , Bloemen O. J. N. , Van Amelsvoort T. A. M. J. , Becker H. E. , Nieman D. H. , Van Der Gaag M. , Linszen D. H.
Published: March 2009

Objective:  Prediction of transition to psychosis in the prodromal phase of schizophrenia has raised interest in intervention prior to the onset of frank psychosis. The aim of this review was to examine whether interventions in the prodromal phase have a favourable benefit/risk ratio.

Method:  A literature search in PubMed, EMBASE and PsycINFO was performed.

Results:  Three randomized clinical trials with antipsychotic medication and/or cognitive behavioural therapy as clinical intervention suggested a positive effect at the end of treatment, but no significant differences were found at the end of follow‐up periods from 1 to 4 years. Naturalistic studies present a hypothesis about a possible preventive effect of antidepressive medication. The results of eight other studies are more difficult to interpret. Side‐effects of antipsychotic medication and non‐adherence with medication are essential problems.

Conclusion:  At the present time, the data concerning the benefits and risks do not justify prodromal intervention as standard clinical practice.
Rippled‐pattern trichoblastoma with apocrine differentiation arising in a nevus sebaceus: report of a case and review of the literature
Authors: Swick Brian L. , Baum Christian L. , Walling Hobart W.
Published: March 2009

A 36‐year‐old man developed a papular growth in a portion of a nevus sebaceus on the post‐auricular scalp. Excision showed typical histologic changes of nevus sebaceus including epidermal papillomatosis with reduced numbers of hair follicles as well as numerous sebaceous glands high in the dermis that focally emptied directly to the overlying epidermis. Histologic sections of the papular growth at the superior pole of the nevus sebaceus showed a proliferation of cytologically bland basaloid epithelial tumor lobules both in the superficial dermis, with multiple connections to the epidermis, and within the deeper dermis in a nodular growth pattern demonstrating papillary mesenchymal bodies. Ductal structures with apocrine‐type decapitation secretion were present. There was prominent palisading of nuclei in rows parallel to one another, alternating with bands of homogenous eosinophilic stromal material forming a ripple pattern resembling the Verocay bodies of schwannoma. The histologic features resembled those of rippled‐pattern trichoblastoma with apocrine differentiation arising in a nevus sebaceus, an association not previously described. We discuss this case as well as review the literature on rippled‐pattern trichoblastoma.
Rottlerin: a multifaced regulator of keratinocyte cell cycle
Authors: Valacchi Giuseppe , Pecorelli Alessandra , Mencarelli Marzia , Carbotti Paola , Fortino Vittoria , Muscettola Michela , Maioli Emanuela
Published: March 2009

Abstract:  In this study we showed that Rottlerin (also called Kamala or Mallotoxin), a natural product purified from Mallotus phillippinensis, is a potent suppressor of human keratinocytes (HaCaT cell line) proliferation. Following Rottlerin treatment, Thymidine incorporation into DNA and re‐epithelialisation in a scratch wound model was decreased. At the molecular level, Rottlerin hampered the NFkB activation process, causing loss of cyclin D1 and promoting, in a PKCδ‐dependent pathway, ERK activation, which, in turn induced the cell cycle inhibitor p21 Cip1/Kip1. The NFkB‐dependent drop in cyclin D1, along with the PKCδ/ERK‐dependent induction of p21 Cip1/Kip1, is responsible for growth arrest. These results open the way to further investigation on the Rottlerin therapeutic potential against keratinocyte hyper‐proliferative disorders.
Books and Bodies, Bound and Unbound
Authors: Pettitt Thomas
Published: March 2009

A recent trend in literary history, cultural studies and folkloristics has been a ‘corporeal turn’, which focuses on how bodies are constructed and understood in texts and other cultural productions. A significant contribution from Guillemette Bolens identifies two distinct corporal constructions in medieval narrative: the contained body (an envelope vulnerable to penetration) and the articulated body (limbs and joints designed for motion). This perception is here extended to include narrative constructions of the environment (enclosures versus avenues and junctions). Furthermore Bolens’s suggestion that articulated and contained bodies are mainly to be found, respectively, in oral tradition and textual culture, is elaborated to the thesis that the contained constructions will be particularly at home in the printed book, whose dominance is associated with cultural containment from a variety of perspectives. And a shift from predominantly articulated constructions to predominantly contained is indeed discernible in the wonder tale ‘Red Riding Hood’, as it modulates from oral tradition to printed fairy tale. Concluding speculations suggest that if the cultural dominance of the printed book has been a (‘Gutenberg’) parenthesis, the tale should now be reverting to articulated constructions as it escapes from books into the digital media and Internet technology.
Behind the Dream of the Arab. The Non‐Publication of Wordsworth’sThe Prelude
Authors: Simonsen Peter
Published: March 2009

This essay asks why Wordsworth did not publish his autobiographical poem,The Prelude, in 1805 when it was all but completed, but postponed publication indefinitely. It suggests that this is a complex question that needs a complex answer. The answer must take into consideration at least sociological aspects having to do with the literary marketplace, and metaphysical aspects having to do with the extent to which personal ‘presence’ is established in a work in manuscript as opposed to one published as a printed book around 1800. Having dealt with this material in its first part, in its second part the essay suggests that this question and its multiple answers are part of the meaning of one of the poem’s cruxes, the so‐called Dream of the Arab.
Pinpoint papular polymorphous light eruption in Asian skin: a variant in darker‐skinned individuals
Authors: Chiam Lynn Y. T. , Chong Wei‐Sheng
Published: March 2009

Background: Polymorphous light eruption (PMLE) is the most common idiopathic but probably immunologic photodermatosis and has wide morphological variants.

Methods: The photobiological features of all patients diagnosed with the pinpoint papular variant of PMLE at a tertiary dermatology centre in Singapore over a five‐year period were retrospectively examined.

Results: Twenty‐one patients were reviewed from 2003 to 2007. There were 11 (52.4%) Chinese, four (19%) Malays, five (23.8%) Indians and one (4%) Cambodian. 14 (66.7%) were males and seven (33.3%) were females. The face/neck (48%) and arms/forearms (95%) were most often affected. Nineteen (90.5%) had Fitzpatrick skin phototype IV and two (9.5%) had skin phototype V. Six (28.6%) had decreased minimal erythema dose (MED) to ultraviolet B (UVB) light only, one (4.8%) had decreased MED to ultraviolet A (UVA) light only and one had decreased MED to both UVA and UVB. Four patients had photoprovocation test done, of which three had positive testing to UVA and one had negative testing to both UVA and UVB. Two histological subtypes were found in our patients, one showing perivascular dermatitis and the other consistent with lichen nitidus.

Conclusion: Our data suggest that pinpoint papular PMLE is not uncommon in darker‐skinned individuals in our cohort.
Response of vulval lichen sclerosus and squamous hyperplasia to photodynamic treatment using sustained topical delivery of aminolevulinic acid from a novel bioadhesive patch system
Authors: Zawislak Agnieszka A. , McCluggage William G. , Donnelly Ryan F. , Maxwell Peter , Price John H. , Dobbs Stephen P. , McClelland H. Raymond , Woolfson A. David , Mccarron Paul A.
Published: March 2009

This study evaluated the clinical and histopathological responses of vulval lichen sclerosus (LS) and squamous hyperplasia (SH) to photodynamic therapy (PDT). A novel bioadhesive patch containing aminolevulinic acid (ALA) at a dose of (38 mg/cm2) was used to treat 10 patients before irradiation with light of 630 nm. Clinical, histopathological and pathological responses to treatment were assessed at 6 weeks post‐treatment. After 17 cycles of PDT, six patients reported significant symptomatic relief and no cutaneous photosensitivity. Histopathological differences were not demonstrated, but statistically significant induction of apoptosis was seen. It can be concluded that ALA‐PDT patch‐based formulation is pragmatic and primarily offers symptomatic management of vulval LS and SH.
The spontaneous resolution of photosensitivity and contact allergy in a patient with chronic actinic dermatitis
Authors: Rose Rebecca F. , Goulden Victoria , Wilkinson S. Mark
Published: March 2009

Chronic actinic dermatitis (CAD) is an uncommon photodermatosis in which patients typically exhibit photosensitivity together with contact allergy. Improvement of the photosensitivity over time is well recognized in a proportion of patients but the concurrent resolution of contact allergy is rare. We report on a 46‐year‐old female with longstanding CAD who demonstrated resolution of both of these features.
Indoor tanning in North Rhine‐Westphalia Germany: a self‐reported survey
Authors: Dissel Maria , Rotterdam Sebastian , Altmeyer Peter , Gambichler Thilo
Published: March 2009

Background/aims: We examined the prevalence of indoor tanning in North Rhine‐Westphalia and identified correlates of sunbed use.

Methods: During regular skin cancer screening campaigns 1242 subjects completed and returned a structured questionnaire on constitutional parameters and indoor tanning habits.

Results: The regular sunbed user rate (more than 10 exposures/year) was 15.4% (191/1242). Most sunbed users were under 29 years of age. The number of female sunbed users was greater than the number of male users. Respondents with secondary modern school qualification used sunbeds more infrequently than respondents with junior high school and high school qualifications. Respondents with skin type III and IV used sunbeds more frequently. Tanning and preparation for sunny holidays were the main reasons for sunbed use. The most frequently reported positive effects experienced by means of sunbed use were improved appearance and relaxation. Most respondents indicated that they hardly or never had sunburns following indoor tanning. Almost half of respondents consider radiation generated by sunbeds somewhat dangerous.

Conclusions: Use of indoor tanning in North Rhine‐Westphalia has increased and is significantly associated with female gender, younger age, high‐level education, and skin type III and IV. The motivation for sunbed use and benefits experienced are mainly based on the perception of improved appearance due to tan and increased sense of well‐being.