bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Inflammation in the Periodontium in Early Old Age on Mortality at 21‐Year Follow‐Up
Authors: Avlund Kirsten , Schultz‐Larsen Kirsten , Krustrup Ulla , Christiansen Niels , Holm‐Pedersen Poul
Published: June 2009

OBJECTIVES: To analyze whether inflammatory processes in the periodontium in early old age are related to subsequent mortality during 21 years of follow‐up in a nondisabled 70‐year‐old population.

SETTING: Community‐based population in Copenhagen.

DESIGN: The study was based on the Glostrup Aging Study of the 1914 population, with baseline in 1984 when the participants were 70 years old and follow‐up 21 years later.

PARTICIPANTS: Three hundred thirty‐five dentate men and women participated in the clinical oral health examination.

MEASUREMENTS: Severe periodontal inflammation was measured for all teeth present as the number of teeth with inflammation and periodontal pockets 6 mm deep or more. Mortality data were obtained from the Danish Death Register at 21‐year follow‐up. The Cox proportional hazards regression model was used. Covariates were measured at baseline and included number of teeth, caries, sex, education, income, hypertension, diabetes mellitus, osteoarthritis, arteriostenosis, myocardial infarction, comorbidity, fatigue, and ability to brush teeth.

RESULTS: The analyses showed that severe periodontal inflammation in at least three teeth at age 70 was marginally related to mortality during 21‐year follow‐up (crude hazard ratio (HR)=1.17, 95% confidence interval (CI)=0.91–1.78). The estimate increased slightly when adjusted for sex, income, fatigue, and smoking (adjusted HR=1.37, 95% CI=0.97–1.92). The estimates were attenuated when adjusted for the specific diseases, especially arteriostenosis and osteoarthritis.

CONCLUSION: Inflammation in the periodontium in early old age tends to be associated with mortality in older age.
A Systematic Review of Dowel (Post) and Core Materials and Systems
Authors: Theodosopoulou Joanna N. , Chochlidakis Konstantinos M.
Published: June 2009

Purpose: The aim of this systematic review was to determine which dowel (post) and core system is the most successful when used in vivo to restore endodontically treated teeth.

Materials and Methods: A MEDLINE, a Cochrane, and an EMBASE search (three specified searches) were conducted to identify randomized (RCT) and nonrandomized controlled clinical trials (CCT), cohort (CS), and case control studies (CCS) until January 2008, conducted on humans, and published in English, German, and French, relating to dowel and core systems for restoring endodontically treated teeth. Also, a hand search was conducted, along with contact with the authors when needed.

Results: The MEDLINE, Cochrane, and EMBASE searches identified 997, 141, and 25 published articles, respectively. Ten articles from the MEDLINE and seven articles from the Cochrane search (that were also identified in the MEDLINE search) met the inclusion and validity assessment criteria. Six out of the ten studies were RCTs, two were CCTs, and two CSs. The RCT studies suggest that carbon fiber in resin matrix dowels are significantly better than precious alloy cast dowels (number needed to treat, NNT = 8.30). Tapered gold alloy cast dowels are better than ParaPost® gold alloy cast dowels (NNT = 13.15). ParaPost® prefabricated dowels are slightly better than ParaPost® cast dowels (NNT = 175.4). Glass fiber dowels are significantly better than metal screw dowels (NNT = 5.46), but worse than titanium (NNT =−21.73) (moderately). Carbon fiber dowels are worse than gold alloy cast dowels (significantly) (NNT =−5.81) and than amalgam dowels (NNT =−125) (slightly). The CCT studies suggest that metal dowels are better (NNT = 21.73) but also worse than cast dowels (NNT =−33.33) depending on the remaining amount of coronal hard tissue. Quartz fiber dowels show success rates similar to and worse than glass fiber‐reinforced dowels (NNT =−37.03). The results from the CS studies suggest that carbon fiber in resin matrix dowels are better (moderately) than carbon fiber + quartz and quartz fiber dowels. Titanium dowels with a composite build‐up are better (moderately) than gold alloy cast dowels.

Conclusions: According to the studies of the highest levels of evidence, carbon fiber in resin matrix dowels are significantly better than precious alloy cast dowels (RCT). Glass fiber dowels are significantly better than metal screw dowels (RCT) and moderately better than quartz fiber dowels (CCT). Carbon fiber dowels are significantly worse than metal dowels (of precious alloy) (RCT). Prefabricated metal dowels are slightly better than cast dowels (RCT), but moderately worse when no collar of the dentin above the gingiva could be achieved (CCT).
Effects of Ethanol on the Surface and Bulk Properties of a Microwave‐Processed PMMA Denture Base Resin
Authors: Regis Rômulo Rocha , Soriani Natércia Carreira , Azevedo Alessandra Miranda , Silva‐Lovato Cláudia Helena , Oliveira Paranhos Helena Freitas , De Souza Raphael Freitas
Published: June 2009

Purpose: This study evaluated the effect of different concentrations of ethanol on hardness, roughness, flexural strength, and color stability of a denture base material using a microwave‐processed acrylic resin as a model system.

Materials and Methods: Sixty circular (14 × 4 mm) and 60 rectangular microwave‐polymerized acrylic resin specimens (65 × 10 × 3 mm3) were employed in this study. The sample was divided into six groups according to the ethanol concentrations used in the immersion solution, as follows: 0% (water), 4.5%, 10%, 19%, 42%, and 100%. The specimens remained immersed for 30 days at 37°C. The hardness test was performed by a hardness tester equipped with a Vickers diamond penetrator, and a surface roughness tester was used to measure the surface roughness of the specimens. Flexural strength testing was carried out on a universal testing machine. Color alterations (ΔE) were measured by a portable spectrophotometer after 12 and 30 days. Variables were analyzed by ANOVA/Tukey's test (α= 0.05).

Results: For the range of ethanol‐water solutions for immersion (water only, 4.5%, 10%, 19.5%, 42%, and 100%), the following results were obtained for hardness (13.9 ± 2.0, 12.1 ± 0.7, 12.9 ± 0.9, 11.2 ± 1.5, 5.7 ± 0.3, 2.7 ± 0.5 VHN), roughness (0.13 ± 0.01, 0.15 ± 0.07, 0.13 ± 0.05, 0.13 ± 0.02, 0.23 ± 0.05, 0.41 ± 0.19 μm), flexural strength (90 ± 12, 103 ± 18, 107 ± 16, 90 ± 25, 86 ± 22, 8 ± 2 MPa), and color (0.8 ± 0.6, 0.8 ± 0.3, 0.7 ± 0.4, 0.9 ± 0.3, 1.3 ± 0.3, 3.9 ± 1.5 ΔE) after 30 days.

Conclusions: The findings of this study showed that the ethanol concentrations of tested drinks affect the physical properties of the investigated acrylic resin. An obvious plasticizing effect was found, which could lead to a lower in vivo durability associated with alcohol consumption.
Market Uncertainty and Socially Embedded Reputation
Authors: Kim Harris H.
Published: June 2009

Abstract

Both economists and sociologists generally recognize the importance of reputation in coordinating economic transactions. In a perfectly competitive and anonymous market characterized by faceless buyers and sellers, the issue of reputation would be irrelevant and unnecessary. In reality, however, markets are often filled with varying degrees of information asymmetry, which can threaten the very existence of the market system itself. In critical reaction to the standard neoclassical model, some economists, on the one hand, argue that when there is an information problem, reputation serves as a valuable source of market signal of quality. Sociologists of economic life similarly contend that reputation, along with trust, is critical in lowering transaction costs and thereby facilitating various economic activities among individual actors. The purpose of this article is to apply this broad theoretical observation to a specific empirical phenomenon. It does so by highlighting the role of social networks that connect actors on both demand and supply sides of the market. Specifically, this study examines how interpersonal networks in the market for legal services affect the duration of ties between buyers and sellers. Quantitative analysis based on a random sample of Chicago lawyers, a project funded by the American Bar Foundation, reveals thatceteris paribusthe lawyer‐client relations are significantly driven by social network factors.
Private Property and the Law of Nature in Locke's TwoTreatises: The Best Advantage of Life and Convenience
Authors: Reno B. Jeffrey
Published: June 2009

Abstract

The study of policy lies at the intersection of economics and ethics, dealing, to a great extent, with private property. Policy design therefore assumes an understanding of the relationship between property and human nature, a matter of great interest to John Locke. Locke's teaching, however, is far from clear, often composed of a set of dual arguments. Yet close attention to the dualistic arguments is revealing: the two objects Locke associates with property—life and convenience—correspond to the two bases upon which he grounds the right to property: labor and consent. His argument reflects the changing economic nature of property, and also provides insight into the poles within which people behave according to the Law of Nature. Thus, a full explication of the relationship between Locke's Law of Nature and doctrine of property illuminates the economic and ethical principles that ought to inform policymakers and analysts.
The Western Expansion as a Common Pool Problem: The Contrasting Histories of the Brazilian and North American Pioneers
Authors: Zanella Fernando , Westley Christopher
Published: June 2009

Abstract

Before the year 1600, Brazil and the United States were very similar regions in terms of geographic development and colonial status, and yet both countries developed in remarkably different ways. In this article, we apply institutional analysis and the common pool approach to explain differences in the western expansion of Brazil and the United States. We find that (i) such analysis complements much of the previous literature that heretofore explained differences in these regions using sociological and ideological analytical tools, and (ii) the theory that the distinctive behavior between the Brazilianbandeirantesand the North American pioneers is due to sociological factors is refuted.
The Impact of Decentralization on Subnational Government Fiscal Slack in Indonesia
Authors: LEWIS BLANE D. , OOSTERMAN ANDRÉ
Published: June 2009

Since Indonesia began implementing its decentralization program in 2001, subnational unspent balances have grown rapidly and have reached levels that many officials find unreasonably high. But the extent to which subnational government reserves are excessive, in general, is not obvious. A not implausible decrease in the price of oil would reduce transfers to subnationals significantly and, if sustained, could possibly eliminate reserves in a relatively short time. Central government should not take any immediate action to reduce subnational slack resources directly but should instead focus on removing the underlying causes of such.
Community Organizing in Britain: The Political Engagement of Faith–Based Social Capital
Authors: Warren Mark R.
Published: June 2009

Faith–based community organizing in the United States has emerged as one of the most effective ways to rebuild democratic life in urban communities. Scholars have argued that the success of modern community organizing lies in its ability to engage the social capital embedded in religious congregations. I examine this claim through a comparatively set case study of the effort to apply an American community organizing strategy in Britain. Using interviews, observations, and documentary sources, I analyze the experience of the British Citizens Organizing Foundation (COF), which is affiliated to the U.S.–based Industrial Areas Foundation. I find that the COF has attained more national influence than its American counterpart, but its local foundations remain much weaker. the relative weakness of faith–based social capital in Britain only partly explains this result. the orientations of religious institutions toward political engagement also matter, and so does the relative power of local versus national political institutions. I argue for bringing a more institutional approach to our theoretical understanding of community organizing and of the role of social capital in revitalizing democratic life more broadly.
Distortion of Right Superior Pulmonary Vein Anatomy by Balloon Catheters as a Contributor to Phrenic Nerve Injury
Authors: OKUMURA YASUO , HENZ BENHUR D. , BUNCH T. JARED , DALEGRAVE CHARLES , JOHNSON SUSAN B. , PACKER DOUGLAS L.
Published: June 2009

Introduction:
Cryothermal, HIFU, and laser catheter‐based balloon technologies have been developed to simplify ablation for AF. Initial enthusiasm for their widespread use has been dampened by phrenic nerve (PN) injury. The interaction between PN and pulmonary vein (PV) geometry contributing to PN injury is unclear.

Methods and Results:
After right thoracotomy, the PN course along the epicardial right atrial surface was mapped directly in 10 dogs. The location of the PN and its relationship with the right superior (RS) PV, and potential RSPV surface distortions after balloon inflation were established by electroanatomic mapping. In 5 dogs, the PN was captured within the RSPV, but could not be stimulated in the remaining 5 dogs. The distance between the RSPV and the PN was significantly shorter in the captured group than in the noncaptured group (6.3 ± 3.1 mm vs 10.2 ± 3.2 mm, P < 0.001). Importantly, 96% of the captured sites within the RSPV were observed at a distance >5 mm into the PV. The inflated balloon surface anteriorly extended 5.6 ± 3.7 mm outside the PV diameter, with distortion of anatomy narrowing the distance from the balloon surface to the PN to 4.8 ± 2.3 mm. (Distance of the original RSPV‐to‐PN: 9.4 ± 2.7 mm, P < 0.001.)

Conclusion:
PN injury with balloon technologies may stem from anatomic distortion of the PV orifice/PN relationship, through increasing contact or shortening the relative distance between the ablation site and the PN, even without displacement of the balloon into the PV. These data are important in the refinement of these technologies to improve procedural safety.
Use of a Urine Dipstick and Brief Clinical Questionnaire to Predict an Abnormal Serum Creatinine in the Emergency Department
Authors: Firestone Daniel N. , Band Roger A. , Hollander Judd E. , Castillo Edward , Vilke Gary M.
Published: June 2009

Objectives:  Prior data demonstrated that a urine dipstick used alone was a sensitive predictor of abnormal creatinine, but not sufficiently enough to forego screening of serum creatinine prior to administration of contrast for diagnostic studies. The authors hypothesized that a brief historical questionnaire coupled with a urine dipstick would have high sensitivity for renal dysfunction, potentially eliminating the need for a serum creatinine prior to contrast administration.

Methods:  This was a prospective study of a convenience sample of patients at two academic tertiary‐care emergency departments (EDs) during 2006–2007. Subjects included patients who had both a serum creatinine result reported by the laboratory and a urine dipstick result reported in the medical record. Data included triage vital signs, basic demographic data, 14 medical history items, dipstick urinalysis, and serum creatinine results. The main outcome measure was an abnormal serum creatinine, defined as greater than 1.5 mg/dL.

Results:  Complete data sets were collected on 1,354 patient visits. Of these, there were 161 (12%) with a serum creatinine of >1.5 mg/dL. Logistic regression analysis identified the following independent predictors associated with elevated creatinine: age greater than 60 years, known renal insufficiency, diabetes, hypertension, diuretic use, vomiting, and proteinuria. Nearly all patients with abnormal creatinine (98%) had at least one of these seven predictors. A decision tool combining these predictors would have identified 158 of 161 patients with an abnormal creatinine (sensitivity, 98.1%; 95% confidence interval [CI] = 95.8% to 99.9%) and a specificity of 21.2% (95% CI = 18.8% to 23.2%).

Conclusions:  The absence of six historical factors and absence of proteinuria can be safely used to identify patients who are unlikely to have an abnormal creatinine.
Species differences in cannabinoid receptor 2 (CNR2gene): identification of novel human and rodent CB2 isoforms, differential tissue expression and regulation by cannabinoid receptor ligands
Authors: Liu Q.‐R. , Pan C.‐H. , Hishimoto A. , Li C.‐Y. , Xi Z.‐X. , Llorente‐Berzal A. , Viveros M.‐P. , Ishiguro H. , Arinami T. , Onaivi E. S. , Uhl G. R.
Published: June 2009

Cannabinoids, endocannabinoids and marijuana activate two well‐characterized cannabinoid receptors (CB‐Rs), CB1‐Rs and CB2‐Rs. The expression of CB1‐Rs in the brain and periphery has been well studied, but neuronal CB2‐Rs have received much less attention than CB1‐Rs. Many studies have now identified and characterized functional glial and neuronal CB2‐Rs in the central nervous system. However, many features of CB2‐R gene structure, regulation and variation remain poorly characterized in comparison with the CB1‐R. In this study, we report on the discovery of a novel human CB2 gene promoter transcribing testis (CB2A) isoform with starting exon located ca 45 kb upstream from the previously identified promoter transcribing the spleen isoform (CB2B). The 5′ exons of both CB2 isoforms are untranslated 5′UTRs and alternatively spliced to the major protein coding exon of the CB2 gene. CB2A is expressed higher in testis and brain than CB2B that is expressed higher in other peripheral tissues than CB2A. Species comparison found that the CB2 gene of human, rat and mouse genomes deviated in their gene structures and isoform expression patterns. mCB2A expression was increased significantly in the cerebellum of mice treated with the CB‐R mixed agonist, WIN55212‐2. These results provide much improved information about CB2 gene structure and its human and rodent variants that should be considered in developing CB2‐R‐based therapeutic agents.
Epigenetic modulation at birth – altered DNA‐methylation in white blood cells after Caesarean section
Authors: Schlinzig T , Johansson S , Gunnar A , Ekström TJ , Norman M
Published: June 2009

Aim:  Delivery by C‐section (CS) has been associated with increased risk for allergy, diabetes and leukaemia. Whereas the underlying cause is unknown, epigenetic change of the genome has been suggested as a candidate molecular mechanism for perinatal contributions to later disease risk. We hypothesized that mode of delivery affects epigenetic activity in newborn infants.

Methods:  A total of 37 newborn infants were included. Spontaneous vaginal delivery (VD) occurred in 21, and 16 infants were delivered by elective CS. Blood was sampled from the umbilical cord and 3–5 days after birth. DNA‐methylation was analyzed in leucocytes.

Results:  Infants born by CS exhibited higher DNA‐methylation in leucocytes compared with that of those born by VD (p < 0.001). After VD, newborn infants exhibited stable levels of DNA‐methylation, as evidenced by comparing cord blood values with those 3–5 days after birth (p = 0.55). On postnatal days 3–5, DNA‐methylation had decreased in the CS group (p = 0.01) and was no longer significantly different from that of VD (p = 0.10).

Conclusion:  DNA‐methylation is higher in infants delivered by CS than in infants vaginally born. Although currently unknown how gene expression is affected, or whether epigenetic differences related to mode of delivery are long‐lasting, our findings open a new area of clinical research with potentially important public health implications.
Overexpression of Tfam protects mitochondria against β‐amyloid‐induced oxidative damage in SH‐SY5Y cells
Authors: Xu Shangcheng , Zhong Min , Zhang Lei , Wang Yuan , Zhou Zhou , Hao Yutong , Zhang Wenyan , Yang Xuesen , Wei Aimin , Pei Liping , Yu Zhengping
Published: June 2009

There is strong evidence that β‐amyloid (Aβ) causes oxidative stress and induces mitochondrial dysfunction in the pathogenesis of Alzheimer’s disease. Mitochondrial transcription factor A (Tfam) has multiple roles in the maintenance of mtDNA. To study the protective roles of Tfam against amyloid neurotoxicity, we established SH‐SY5Y cell lines stably overexpressing Tfam and exposed them to 10 μm Aβ1‐42 for 24 h. We found that Tfam overexpression attenuated Aβ1‐42‐induced cell viability damage and apoptosis. In addition, Tfam overexpression significantly suppressed the increase in excess reactive oxygen species and reversed the reduction in cytochrome c oxidase activity and ATP production induced by Aβ1‐42. Furthermore, overexpression of ΔC‐Tfam, which has no functional domain for stimulating mtDNA transcription but can still maintain the mtDNA nucleoid formation and mtDNA copy number, also exhibited protective effects against Aβ1‐42 cytotoxicity in SH‐SY5Y cells. Together, our data suggest that Tfam overexpression protects mitochondria against Aβ‐induced oxidative damage in SH‐SY5Y cells. These beneficial effects may be attributable to the roles of Tfam in maintaining mtDNA nucleoid formation and mtDNA copy number.
Influence of Hyperglycaemia on Chemical‐Induced Toxicity: Study with Cyclophosphamide in Rat
Authors: Saandeep Kalavatala , Vikram Ajit , Tripathi Durga Nand , Ramarao Poduri , Jena Gopabandhu
Published: June 2009

Abstract: Diabetes mellitus is a metabolic disorder characterized by elevated level of glucose in the blood. Hyperglycaemia perturbs the critical balance between oxidative stress and anti‐oxidant defence mechanisms in the body and thereby alters the response of biological system towards various toxic chemicals. Cyclophosphamide (CP) is a widely prescribed anticancer drug, well‐known genotoxic agent as well as used in the development of immunocompromised animal models. The present study investigated the modulating effect of diabetes on the cyclophosphamide‐induced cytotoxicity and genotoxicity. The study was performed on male Sprague‐Dawley rats (200 ± 10 g). Cyclophosphamide (10 mg/kg) was administered five consecutive days in a week for 3 weeks to both control and diabetic rats. Thiobarbituric acid reactive substances (TBARS) levels were measured in the plasma, liver, kidney and lung tissues. DNA damaging potential of cyclophosphamide under diabetic condition was evaluated using comet and halo assay as an endpoint. To further ascertain the mode of cell death, terminal deoxynucleotidyl transferase‐mediated dUTP nick end labelling (TUNEL) assay and immunohistochemical evaluation of p53 was performed. Significant increase in DNA damage was revealed by the comet assay parameters, halo assay indicated the level of cytotoxicity and the oxidative stress was measured using the TBARS assay in the diabetic rats receiving cyclophosphamide treatment. The toxic effects were more prominent in diabetic animals as compared to non‐diabetic rats. Cyclophosphamide treatment and diabetic conditionper seled to increase in the p53 + and TUNEL + cells in the liver and kidney of rats. Under diabetic condition, further increase in the p53 + and TUNEL + cells was observed in response to cyclophosphamide. In the present study, we report that hyperglycaemic condition exaggerates the cyclophosphamide‐induced toxicity and the response was found to be tissue specific.
Discovery of a short orbital period in the Supergiant Fast X-ray Transient IGR J16479–4514
Authors: Jain Chetana , Paul Biswajit , Dutta Anjan
Published: June 2009

We report here the discovery of a 3.32 d orbital period in the Supergiant Fast X-ray Transient (SFXT) source IGR J16479–4514. Using the long-term light curve of this source obtained with Swift Burst Alert Telescope (BAT) in the energy range of 15–50 keV, we have clearly detected an orbital modulation including a full eclipse of duration ∼0.6 d. In the hard X-ray band of the BAT instrument, the eclipse ingress and egress are rapid. We have also used the long-term light curve obtained with the Rossi X-ray Timing Explorer (RXTE) All Sky Monitor (ASM) in the energy range of 1.5–12 keV. Taken independently, the detection of orbital modulation in the RXTE–ASM light curve is not significant. However, considering a clear detection of orbital modulation in the BAT light curve, we have used the ASM light curve for a more precise determination of the orbital period. IGR J16479–4514 has the shortest orbital period among the three SFXTs with measured/known orbital period. We discuss the implication of a short orbital period with the various mechanisms proposed to explain the transient nature of this class of sources.
What does a universal initial mass function imply about star formation?
Authors: Goodwin Simon P. , Kouwenhoven M. B. N.
Published: June 2009

We show that the same initial mass function (IMF) can result from very different modes of star formation from very similar underlying core and/or system mass functions. In particular, we show that the canonical IMF can be recovered from very similar system mass functions, but with very different mass ratio distributions within those systems. This is a consequence of the basically lognormal shapes of all of the distributions. We also show that the relationships between the shapes of the core, system and stellar mass functions may not be trivial. Therefore, different star formation in different regions could still result in the same IMF.
IMPROVEMENT OF PHYSICAL PROPERTIES OF NONFAT FERMENTED MILK DRINK BY USING WHEY PROTEIN CONCENTRATE
Authors: OZEN ASLI E. , KILIC MERAL
Published: June 2009

The use of whey protein concentrate (WPC) for the improvement of physical properties of nonfat fermented milk drink was investigated. Drinks were prepared from nonfat milk powder and WPC at different proportions. Rheological properties, serum separation and particle size of the drinks were measured. The effect of WPC on the physical properties of the drinks was evaluated by comparison with those of commonly used stabilizers, including propylene glycol alginate and locust bean gum. WPC addition caused an increase in the consistency coefficient and thixotropy and a decrease in the particle size of the samples. There was no serum separation in the sample with 2% WPC. Large unstable aggregates were observed in the sample with 3% WPC, which also exhibited the highest serum separation. WPC up to a level of 2% positively influenced the physical properties of nonfat fermented milk drink similar to stabilizers.

PRACTICAL APPLICATIONS

Fermented milk drinks are consumed especially for their beneficial health effects. Physical properties of fermented milk drinks influence their quality and consumer acceptability. Hydrocolloid stabilizers are used for the improvement of physical properties of fermented milk products. Whey protein concentrates (WPC) with high protein content can be used to substitute hydrocolloid stabilizers. In this study, the effect of the addition of WPC with 75% protein in place of a part of the nonfat milk powder on the physical properties of nonfat fermented milk drink with 6% dry matter was investigated. Use of an appropriate level of WPC was found to be important for obtaining a desirable effect on the physical properties of nonfat fermented milk drink. The effect of WPC was found to be comparable to those of commonly used hydrocolloid stabilizers. Use of WPC also enhances the nutritional value of the product as whey proteins have a high biological value.
VISCOELASTIC PROPERTIES OF WHEY PROTEIN CONCENTRATE GELS WITH HONEY AND WHEAT FLOUR AT DIFFERENT pH
Authors: YAMUL DIEGO K. , LUPANO CECILIA E.
Published: June 2009

Viscoelasticity of heat‐induced gels from whey protein concentrate, with different contents of honey and wheat flour, and prepared at pH 3.75, 4.2 and 7.0, was studied by using dynamic rheological assays. The elastic modulus of gels prepared at neutral pH was higher than the corresponding to acidic gels, probably due to the fact that sulphydryl‐disulfide interchange reactions are favored at neutral pH. Honey decreased the elastic modulus and increased the viscous modulus and the complex viscosity in all conditions assayed. Wheat flour increased the elastic modulus, and all samples exhibited a gel‐type behavior except at high honey content.

PRACTICAL APPLICATIONS

Honey and wheat flour modifies the properties of whey protein concentrate gels. Both components have opposite effects: honey increases the viscous‐like behavior and wheat flour the solid‐like behavior of gels in all conditions assayed. The different characteristics of gels prepared at different pHs and with different amounts of honey and wheat flour could be used in different formulated foods, as desserts.
THE EFFECT OF TEMPERATURE ON THE RHEOLOGY OF BUTTER, A SPREADABLE BLEND AND SPREADS
Authors: VITHANAGE CHANDRA R. , GRIMSON MALCOLM J. , SMITH BRONWEN G.
Published: June 2009

The texture of lipid‐based food materials is an important topic for investigation. In this study, the rheological properties of five edible fats were determined. A puncture test was performed to investigate the rheological properties of the food materials at 5C and at 19C using a texture analyzer. The force‐displacement measurements were converted to stress–strain by assuming incompressibility of edible fat food materials in a linear viscoelastic region (LVR). Young's modulus of each edible fat was calculated using stress–stain curves in a LVR. Shear elastic moduli of edible fats in a LVR were obtained using a rheometer. Further to that the effect of temperature on storage modulus and loss modulus and creep test were obtained using a rheometer. The tests showed good correlation between Young's modulus and shear elastic modulus for each material. The mechanical properties correlated well with the structural properties of each of the materials.

PRACTICAL APPLICATIONS

The texture of butter, blends and spreads is determined by temperature, rheological properties, processing conditions and the composition of the material. Our research investigated the effect of temperature on the rheological properties of these foods. The results may be used to model the relationship between the microstructure and mechanical properties of the fat crystal network.
Stress‐induced somatization in spouses of deployed and nondeployed servicemen
Authors: Burton Tracy , Farley David , Rhea Anthony
Published: June 2009

Purpose: To compare the level of perceived stress and somatization experienced by spouses of deployed versus nondeployed servicemen, and to determine the relationship between stress and somatization.

Data sources: Using Lazarus and Folkman's theory of Stress and Coping, a descriptive correlational design was used with 130 participants; 68 spouses of nondeployed servicemen and 62 spouses of servicemen deployed to a combat zone. Participants completed a Perceived Stress Scale‐10 and Patient Heath Questionnaire‐15. An independent t‐test was used to determine the level of perceived stress and somatization in each sample. The Pearson's correlation was used to determine the relationship between perceived stress score and level of somatization in the total sample.

Conclusions: Spouses of deployed servicemen had significantly higher perceived stress scores than spouses of nondeployed service members (p <.001). Somatization scores were also significantly higher in spouses of deployed versus nondeployed servicemen (p <.001). A significant positive correlation was found between level of perceived stress and level of somatization (r = .878, p <.001).

Implications for practice: Providers should be familiar with common somatic symptoms, treatments used for somatization and adjunct community resources available to patients with stress‐related somatization.
The mental health needs of refugee children: A review of literature and implications for nurse practitioners
Authors: Crowley Caitlin
Published: June 2009

Purpose: To review the current literature regarding the mental health needs of refugee children resettled in the United States and provide recommendations for clinicians working with refugee children and their families.

Data sources: An extensive review of journal articles published from research conducted in first‐world countries such as the United States, the United Kingdom, Australia, the Netherlands, and Canada.

Conclusions: Review of the current literature suggests that while some refugee children will suffer poor mental health outcomes, such as post‐traumatic stress disorder, depression, and anxiety, others may not. Several groups of researchers concluded that refugee children are actually a high functioning group. Many coping and protective factors as well as risk factors for poor outcomes have been identified by the research.

Implications for practice: Because many refugee children will experience adverse psychosocial outcomes during the resettlement period, it is essential that the mental health screenings be performed during each primary care visit. Nurse practitioners have the unique opportunity to make a difference in the lives of refugee children because they play a pivotal role in the assessment, screening, and referral of children for mental health services.
Quality of life of adult patients with sickle cell disease
Authors: Mann‐Jiles Valerie , Morris Diana Lynn
Published: June 2009

Purpose: The purpose of this descriptive study was to examine quality of life (QOL) in adult patients with sickle cell anemia, hemoglobin SC, or hemoglobin S beta thalassemia.

Data sources: Data were collected from a convenience sample of 62 adult patients (18 years of age and older) with sickle cell disease (SCD) in an outpatient clinic devoted to the care of hematological and oncological disorders. Burckhardt and Anderson's 16‐item self‐report Quality of Life Scale (QOLS) and a demographic questionnaire were used for data collection.

Conclusions: The average QOLS scores for healthy populations are 90. The overall mean QOL score in this study of 83.6 (SD = 13.2) was lower than those of the general population. In this study, scores ranged from 52 to 112. Approximately 35% (n = 22) of participants’ scores ranged from 52 to 75; approximately 35% (n = 22) of participants’ scores ranged from 75 to 85; and approximately 30% (n = 17) of participants’ scores ranged from 85 to 112. Other results were nonsignificant for all variables except the variable that assessed the extent to which participants consider themselves to be spiritual. Future research is needed to further the understanding of the impact of QOL in adults with SCD.

Implications for practice: A better understanding of adult patients with SCD QOL may ultimately improve healthcare services for this population. The findings could lead to future research that can identify factors that most impact the QOL of people living with SCD.
Sensory processing disorder: Any of a nurse practitioner's business?
Authors: Byrne Mary W.
Published: June 2009

Purpose: Children who exhibit the confusing symptom patterns associated with sensory processing deficits are often seen first by primary care providers, including family and pediatric nurse practitioners (NPs). The purpose of this article is to alert NPs to the state of the science for these disorders and to the roles NPs could play in filling the knowledge gaps in assessment, treatment, education, and research.

Data sources: Literature searches using PubMed and MedLine databases and clinical practice observations.

Conclusions: Sensory integration disorders have only begun to be defined during the past 35 years. They are not currently included in the DSM IV standard terminology, and are not yet substantively incorporated into most health disciplines’ curricula or practice, including those of the NP.

Implications for practice: NPs are in a unique position to test hypothesized terminology for Sensory Processing Disorder (SPD) by contributing precise clinical descriptions of children who match as well as deviate from the criteria for three proposed diagnostic groups: Sensory Modulation Disorder (SMD), Sensory Discrimination Disorder (SDD), and Sensory‐Based Motor Disorder (SBMD). Beyond the SPD diagnostic debate, for children with sensory deficit patterns the NP role can incorporate participating in interdisciplinary treatment plans, refining differential diagnoses, providing frontline referral and support for affected children and their families, and making both secondary prevention and critical causal research possible through validation of consistently accepted diagnostic criteria.
Using Patent Data to Assess the Value of Pharmaceutical Innovation
Authors: Kesselheim Aaron S. , Avorn Jerry
Published: June 2009

Only 19 new molecular entities and 3 biologics were approved by the Food and Drug Administration (FDA) in 2007, the lowest rate in 24 years. This disappointing output occurred despite steady clinical trial and regulatory review times, the FDA maintaining high approval rates, and the pharmaceutical industry consistently reporting increasing revenues. A government report suggests that fewer new drug applications have been submitted to the FDA by the pharmaceutical industry in recent years. These data have rekindled the debate as to the origins of pharmaceutical innovation and the comparative importance of public and private sources in contributing to drug discovery. The pharmaceutical industry contends that its research is responsible for most new medicines, and that the primary public institution supporting U.S. biomedical research, the National Institutes of Health (NIH), supports medical innovation “distinct from the process of drug development.”
An Economic Justification for Open Access to Essential Medicine Patents in Developing Countries
Authors: Flynn Sean , Hollis Aidan , Palmedo Mike
Published: June 2009

Not all intellectual property rights grant the right to exclude that is indicative of “property rules,” as that term was used by Guido Calabresi and A. Douglas Melamed in their seminal article. Some intellectual property rights are “liability rules,” in which the right holder has an entitlement to compensation for use of the protected invention, not a right to preclude the use. Although patent laws normally grant a right to exclude others from use of the protected invention as a default, most countries’ laws allow the government to convert the patent property rule into a liability rule through a compulsory license. It has been noted, for example, that by the end of the 1950s, the U.S. had issued compulsory licenses covering 40 to 50 thousand patents, including substantial portions of the patent portfolios of AT&T, General Electric, IBM, and Xerox. The U.S. Supreme Court recently expressed a willingness to accept liability rules over injunctions in some patent infringement cases.
Developing Nations and the Compulsory License: Maximizing Access to Essential Medicines While Minimizing Investment Side Effects
Authors: Bird Robert C.
Published: June 2009

Tens of millions of adults and children die each year from illnesses that are treatable or preventable with existing medicines. Each year over 500 million people are infected with malaria, and the disease kills two million people annually. Hundreds of thousands more die annually from a myriad of lesser known diseases including diphtheria, measles, tetanus, and syphilis. Approximately 30 percent of the world’s population, over 1.7 billion people, has inadequate access or no access at all to essential medicines.

Not surprisingly, the vast majority of these illnesses are contracted in poor countries. Four million lives could be saved annually through prompt diagnosis and treatment of illnesses in Africa and Southeast Asia alone, and access to pharmaceutical drugs could likely save millions more. Many of the health problems facing the developing world do not arise from lack of understanding of complex diseases. Rather, the problem arises from a striking lack of availability of life-saving medicines for the consumers that need these medicines the most.
Compulsory Licensing in Canada and Thailand: Comparing Regimes to Ensure Legitimate Use of the WTO Rules
Authors: Lybecker Kristina M. , Fowler Elisabeth
Published: June 2009

The tension between economic policy and health policy is a longstanding dilemma, but one that was brought to the fore with the World Trade Organization’s (WTO) Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement in 1994. The pharmaceutical industry has long argued that intellectual property protection (IPP) is vital for innovation. At the same time, there are those who counter that strong IPP negatively impacts the affordability and availability of essential medicines in developing countries. However, actors on both sides of the debate were in agreement that something needed to be done to address the HIV/AIDS crisis, especially in developing countries. In response to sustained and significant pressure from civil society groups, members of the World Trade Organization agreed to theDeclaration on the TRIPS Agreement and Public Health(the Doha Declaration) in 2001. The Declaration clarified that countries unable to manufacture the needed pharmaceuticals could obtain more affordable generics elsewhere if necessary.
Wild-Card Patent Extensions as a Means to Incentivize Research and Development of Antibiotics
Authors: Sonderholm Jorn
Published: June 2009

Antibiotic resistance is a serious public health problem on a global scale. In both developed and developing countries, the unpleasant consequences of the phenomenon are being felt. Bacterial diseases that in prior years were relatively easy and cheap to cure are now proving exceedingly difficult and expensive to treat because resistant strains have developed. A number of measures can be implemented in order to minimize the problem of antibiotic resistance. Conservation efforts on the use of antibiotics, educational campaigns about hygienic behavior, “cycling efforts” of antibiotics, efforts to stamp out misuse of antibiotics (of both the over- and under-use kind), and efforts to monitor and share information about the spread of resistant strains are examples of such measures. It is instructive to think of these measures as belonging to the “demand-side conservation response” to the problem of antibiotic resistance.
Comment: Compulsory Licensing of Patented Pharmaceutical Inventions: Evaluating the Options
Authors: Reichman Jerome H.
Published: June 2009

Few topics in international intellectual property law have been as controversial in recent years as the one we are about to examine. In the 1980s and early 1990s, a Diplomatic Conference attempted to revise the oldest international convention providing some protection for patented inventions outside of the domestic laws. Those efforts broke down, largely because developed and developing countries could not agree on the powers that governments should retain to issue compulsory licenses or on the grounds for which these powers could be exercised. The failure of this Conference, held under the auspices of the World Intellectual Property Organization (WIPO), persuaded the technology-exporting countries to link future negotiations concerning international intellectual property protection to the Multilateral Trade Negotiations, known as the Uruguay Round, which got underway in 1986. The end result was Annex IC of the Agreement Establishing the World Trade Organization of 1994, which incorporated a new, comprehensive and relatively elevated set of international minimum standards of patent protection into the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement).
Just a Spoonful of Sugar: Drug Safety for Pediatric Populations
Authors: Noah Barbara A.
Published: June 2009

Children deserve optimal medical care. Although prescription drugs play a prominent and essential role in pediatric health care delivery, health care providers often must make prescribing decisions for their young patients based on imperfect or absent safety and efficacy data for pediatric populations. Until relatively recently, the Food and Drug Administration (FDA) made surprisingly little effort to improve the quality or quantity of clinical research data for this patient group. Despite recent agency efforts to improve the situation, only one-third of drugs prescribed to children currently have been studied for safety and efficacy in pediatric populations. Moreover, recent agency initiatives to encourage pediatric drug research have generated mixed results and unintended consequences. The complex of issues surrounding the testing and prescribing of prescription drugs used for children will require that pharmaceutical companies, the FDA, and health care providers examine current practices, acknowledge their shortcomings, and consider cooperative, creative solutions.
Prizes and Parasites: Incentive Models for Addressing Chagas Disease
Authors: Crager Sara E. , Price Matt
Published: June 2009

Despite the enormous progress made in the advancement of health technologies over the last century, infectious diseases continue to cause significant morbidity and mortality in developing countries. Neglected diseases are a subset of infectious diseases that lack treatments that are effective, simple to use, or affordable. Neglected diseases primarily affect populations in poor countries that do not constitute a lucrative market sector, thus failing to provide incentives for the pharmaceutical industry to conduct R&D for these diseases. Of the treatments that do exist for neglected diseases, most are completely out-dated, with poor side-effect profiles, cumbersome logistics of administration, and inadequate efficacy. Historically, the impetus for a majority of neglected disease research was driven by early 20th-century colonialism, and in the post-colonial era, these diseases have been virtually ignored. Of the 1556 New Chemical Entities (NCEs) brought to market during the 30-year period from 1975 to 2004, only 20 — less than 0.02% — were for neglected diseases.
The Pharmacist's Obligations to Patients: Dependent or Independent of the Physician's Obligations?
Authors: Altilio Jason V.
Published: June 2009

It has been 40 years since the seminal papers on pharmacy’s status as a profession sparked debate about the pharmacist’s role in health care, yet the questions they raised are just as poignant today as they were then. The issue of pharmacy’s status as a profession and its role in health care has again been brought into question, albeit in a roundabout manner, through discussions over the pharmacist’s right to refrain from dispensing emergency contraception. The key to understanding the contemporary pharmacist’s role as part of the health care team, as well as the pharmacist’s alleged right to refrain from dispensing emergency contraception, is to examine a situation that almost every contemporary pharmacist experiences.
Teaching Health Law
Authors: Todres Jonathan
Published: June 2009

With the publication of the Carnegie Foundation’s 2007 report on legal education, law schools are focused again on curriculum reform. The Carnegie report highlighted a number of important issues, one of which is the need to improve the teaching of lawyering skills. This article takes up one subset of the skills package of lawyers – transactional law skills – and suggests that health law courses provide an excellent forum for exploring and teaching such skills.

With their reliance on the case method, law schools historically have done little to introduce students to transactional thinking, practice, or skills. Yet today, transactional work is a significant component of most attorneys’ practices. A common misperception is that transactional law only means “doing deals” while at a large law firm.