bluuebunny/crossref_metadata_2025 huggingface dataset:
The Theodicy of Natural Disasters
Authors: Chester D. K.
Published: January 2009

In 1993 Frank Press, President of the United States Academy of Sciences estimated that in a typical year ie. one without a major catastrophe on the scale of the Kobe earthquake or Sahel droughts, some 250,000 people will die and losses of US$40 billion will result from natural disasters (Press 1993). In recent years much has been written about the physical causes of and human responses to natural disasters (see: Hewitt, 1983a, 1983b; Alexander, 1993; Chester 1993; Blaikieet al.1994 and Chesteret al.1996, for extensive bibliographies), and this vast literature reflects increasing concern over disaster losses and a growing realization that most losses are preventable. Prompted by this concern the United Nations has designated the nineteen-nineties theInternational Decade for Natural Disaster Reduction, or IDNDR. With the exception of a training manual for foreign mission workers published by the EvangelicalInterchurch Relief and Development Alliance(Davis and Wall 1992), trenchant reflections by Austin Farrer (1966) and limited treatment in works focusing on wider ecotheological issues (eg. Russell 1994: 35–50), theologians have been conspicuous by their absence from what is now a global debate on natural disasters and their mitigation.
Christ, Nature, Sociality: Dietrich Bonhoeffer for an Ecological Age
Authors: Scott Peter
Published: January 2009

Two general tendencies can be detected in theological enquiries on nature, ecology and the environment. The first tendency stresses the inadequacy of ‘traditional’ or mainstream Christianity to engage with the crisis in human relations with non-human nature. The positions under this tendency draw on other resources—process thought, the writings of Teilhard de Chardin, the ‘common creation story’ of the natural sciences—to construct anew the Christian contribution to the healing of our relations with damaged nature. For this tendency, standard Christian responses such as reinterpretations of dominion as stewardship presuppose the distinction of humanity from non-human nature. Such unrevised constructs thereby remain part of the problem rather than part of the resolution.
Universal Salvation and a Soteriology of Divine Punishment
Authors: Ludlow Morwenna
Published: January 2009

Critics of the idea of universal salvation have frequently raised issues such as biblical evidence, human free will, and divine justice; however, somewhat less attention has been paid to the problems surrounding the concept of punishment used by some universalists. Since most universalists recognise the obvious objection that many (if not most) people appear not to be in a position in this life to be saved, there have been various suggestions as to how salvation can occur after the death of the individual. Many have taken the view that a period of post-mortem punishment will cleanse individuals of their sin. In other words, these universalists are not so much denying hell altogether, as denying an eternal hell. Whilst this idea may seem preferable to that of an eternal hell, there are various important theological and philosophical difficulties associated with it.
Are Aging OECD Welfare States on the Path to Gerontocracy?
Authors: TEPE MARKUS , VANHUYSSE PIETER
Published: January 2009

Since 1990 the age of the average OECD median voter has increased three times faster than in the preceding 30 years. We use panel data from 1980–2002 to investigate the effects of population aging on both the program size and the benefit generosity of public pensions in 18 OECD countries. Population aging is accompanied by cutting smaller slices out of larger cakes: it increases aggregate spending on pensions but freezes or decreases the generosity of individual benefits. Controlling for political, institutional and time-period effects, we find that public pension efforts are significantly mediated by welfare regime type. Moreover, since the late 1980s pension effort has more fully adopted a retrenchment logic. It is the politics of fiscal and electoral straitjackets, not gerontocracy, which shape public pension spending today. While population aging is accelerating, contrary to alarmist political economy predictions democracies are not yet dominated by a new distributive politics of elderly power.
Comparing the Dynamics of Change in Food Safety and Pharmaceutical Policy in Spain
Authors: CHAQUÉS LAURA , PALAU ANNA
Published: January 2009

Comparative analysis shows that while policy windows and policy entrepreneurs are important, they are insufficient to account for policy change. An understanding of the institutional setting is key to explaining the speed and the magnitude of policy dynamics. In both food safety and pharmaceutical policy in Spain, a redefinition of policy image has involved a transformation of the policy subsystem. In the case of food safety such a paradigm shift has represented a dramatic change, in the case of pharmaceuticals it has meant a gradual process that has developed over a decade. Periods of stability in the pharmaceutical sector reflect the ability of a closed policy community to control problem framing. By contrast, rapid changes in food safety policies are the result of crisis situations governed by a relatively loose policy network. The European Union has been a key policy venue that can transform an institutional framework towards one that is more pluralistic and expert oriented.
LIMIT THEORY FOR COINTEGRATED SYSTEMS WITH MODERATELY INTEGRATED AND MODERATELY EXPLOSIVE REGRESSORS
Authors: Magdalinos Tassos , Phillips Peter C.B.
Published: January 2009

An asymptotic theory is developed for multivariate regression in cointegrated systems whose variables are moderately integrated or moderately explosive in the sense that they have autoregressive roots of the form ρni = 1 + ci/nα, involving moderate deviations from unity when α ∈ (0, 1) and ci ∈ ℝ are constant parameters. When the data are moderately integrated in the stationary direction (with ci < 0), it is shown that least squares regression is consistent and asymptotically normal but suffers from significant bias, related to simultaneous equations bias. In the moderately explosive case (where ci > 0) the limit theory is mixed normal with Cauchy-type tail behavior, and the rate of convergence is explosive, as in the case of a moderately explosive scalar autoregression (Phillips and Magdalinos, 2007, Journal of Econometrics 136, 115–130). Moreover, the limit theory applies without any distributional assumptions and for weakly dependent errors under conventional moment conditions, so an invariance principle holds, unlike the well-known case of an explosive autoregression. This theory validates inference in cointegrating regression with mildly explosive regressors. The special case in which the regressors themselves have a common explosive component is also considered.
REGRESSION-BASED SEASONAL UNIT ROOT TESTS
Authors: Smith Richard J. , Taylor A.M. Robert , del Barrio Castro Tomas
Published: January 2009

The contribution of this paper is threefold. First, a characterization theorem of the subhypotheses comprising the seasonal unit root hypothesis is presented that provides a precise formulation of the alternative hypotheses associated with regression- based seasonal unit root tests. Second, it proposes regression-based tests for the seasonal unit root hypothesis that allow a general seasonal aspect for the data and are similar both exactly and asymptotically with respect to initial values and seasonal drift parameters. Third, limiting distribution theory is given for these statistics where, in contrast to previous papers in the literature, in doing so it is not assumed that unit roots hold at all of the zero and seasonal frequencies. This is shown to alter the large-sample null distribution theory for regressiont-statistics for unit roots at the complex frequencies, but interestingly to not affect the limiting null distributions of the regressiont-statistics for unit roots at the zero and Nyquist frequencies and regressionF-statistics for unit roots at the complex frequencies. Our results therefore have important implications for how tests of the seasonal unit root hypothesis should be conducted in practice. Associated simulation evidence on the size and power properties of the statistics presented in this paper is given that is consonant with the predictions from the large-sample theory.
Did nature also choose arsenic?
Authors: Wolfe-Simon Felisa , Davies Paul C.W. , Anbar Ariel D.
Published: January 2009

All known life requires phosphorus (P) in the form of inorganic phosphate (PO43−or Pi) and phosphate-containing organic molecules. Piserves as the backbone of the nucleic acids that constitute genetic material and as the major repository of chemical energy for metabolism in polyphosphate bonds. Arsenic (As) lies directly below P on the periodic table and so the two elements share many chemical properties, although their chemistries are sufficiently dissimilar that As cannot directly replace P in modern biochemistry. Arsenic is toxic because As and P are similar enough that organisms attempt this substitution. We hypothesize that ancient biochemical systems, analogous to but distinct from those known today, could have utilized arsenate in the equivalent biological role as phosphate. Organisms utilizing such ‘weird life’ biochemical pathways may have supported a ‘shadow biosphere’ at the time of the origin and early evolution of life on Earth or on other planets. Such organisms may even persist on Earth today, undetected, in unusual niches.
Ricci iterations on Kähler classes
Authors: Keller Julien
Published: January 2009

In this paper we consider the dynamical system involved by the Ricci operator on the space of Kähler metrics of a Fano manifold. Nadel has defined an iteration scheme given by the Ricci operator and asked whether it has some non-trivial periodic points. First, we prove that no such periodic points can exist. We define the inverse of the Ricci operator and consider the dynamical behaviour of its iterates for a Fano Kähler–Einstein manifold. Then we define a finite-dimensional procedure to give an approximation of Kähler–Einstein metrics using this iterative procedure and apply it on ℂℙ2 blown up in three points.
Enzymes musculaires et exercice physique
Authors: Gojanovic  , Feihl  , Gremion  , Waeber
Published: January 2009

Sportliche Betätigung führt klassischerweise nach ein bis zwei Tagen zu Gliederschmerzen, allgemein bekannt als Muskelkater. Gleichzeitig sind die Muskelenzyme und -proteine im Serum erhöht, was zur Beeinträchtigung der Nierenfunktion führen kann. Die Konzentration der Kreatinkinase (CK) ist am vierten Tag am höchsten und die Höhe ist von der Art der sportlichen Betätigung und von individuellen Faktoren abhängig. Durch regelmässige sportliche Aktivität kommt es zu einer Gewöhnung und damit zu einer Abschwächung dieser Muskelreaktionen. Metabolische Komplikationen sind selten. Um umfangreiche Abklärungen bezüglich einer metabolischen Störung oder einer Medikamentennebenwirkung (insbesondere Statine) zu vermeiden, ist es wichtig, sich zu vergegenwärtigen, dass die geschilderten Reaktionen schon nach gewöhnlichen körperlichen Aktivitäten auftreten. Ein erhöhter CK-Wert kann erst anhand einer Kontrollmessung nach sieben Tagen ohne sportliche Betätigung richtig interpretiert werden.
Das Verhalten der Körpermasse bei einem 81-jährigen Läufer an einem 100-km-Lauf
Authors: Knechtle  , Wirth  , Knechtle  , Kohler
Published: January 2009

Ein 81-jähriger Läufer mit Status nach aortokoronarem Bypass bei bekannter koronarer Herzkrankheit hat einen 100-km-Lauf in 19 h und 45 min erfolgreich beendet. Vor und unmittelbar nach dem Lauf wurden Fett- und Muskelmasse nicht-invasiv sowohl mit der bioelektrischen Impedanzanalyse als auch mit der klassischen Hautfaltenmethode bestimmt. Zusätzlich wurden Blut- und Urinproben zur Beurteilung des Flüssigkeitshaushaltes genommen und eine ¹H-NMR-Spektroskopie des Urins zum Nachweis eines erhöhten Kohlenhydrat-, Fett- oder Eiweissstoffwechsels durchgeführt. Das Körpergewicht nahm um 1.9 kg ab. Während die errechnete Muskelmasse um 0.1 kg zunahm, nahm die errechnete Fettmasse um 0.2 kg (anthropometrische Methode) resp. 3.1 kg (BIA) ab. Das errechnete Körperwasser nahm um 1.2 l zu. Während Hämatokrit, Harnstoff und spezifisches Gewicht des Urins zunahmen, sank das Natrium im Blut ab. Das Plasmavolumen nahm um 19% ab. Die ¹H-NMR-Spektroskopie des Urins zeigte nach der Belastung einen Anstieg der Ketonkörper. Um einen Abbau der Muskelmasse objektivieren zu können, muss der Ausgangswert des Körperwassers abgewartet werden, um keine Fehlinterpretation aufgrund der Methoden zu machen. Unklar bleibt, wieso es zu einer Einlagerung von Wasser kam. In weiteren Untersuchungen könnten zusätzliche Methoden wie DEXA, Muskelbiopsien und Bestimmung von weiteren Blut- und Urinparametern Auskunft geben, ob effektiv und wie viel Muskelmasse abgebaut wird und ob Abbauprodukte der Muskulatur die Nierenfunktion einschränken und somit zu einer Wasserretention führen.
The carboxy-terminal domain of complexin I stimulates liposome fusion
Authors: Malsam Jörg , Seiler Florian , Schollmeier Yvette , Rusu Patricia , Krause Jean Michel , Söllner Thomas H.
Published: January 2009

Regulated exocytosis requires tight coupling of the membrane fusion machinery to a triggering signal and a fast response time. Complexins are part of this regulation and, together with synaptotagmins, control calcium-dependent exocytosis. Stimulatory and inhibitory functions have been reported for complexins. To test if complexins directly affect membrane fusion, we analyzed the 4 known mammalian complexin isoforms in a reconstituted fusion assay. In contrast to complexin III (CpxIII) and CpxIV, CpxI and CpxII stimulated soluble
N
-ethylmaleimide-sensitive factor attachment protein receptor (SNARE)-pin assembly and membrane fusion. This stimulatory effect required a preincubation at low temperature and was specific for neuronal t-SNAREs. Stimulation of membrane fusion was lost when the carboxy-terminal domain of CpxI was deleted or serine 115, a putative phosphorylation site, was mutated. Transfer of the carboxy-terminal domain of CpxI to CpxIII resulted in a stimulatory CpxIII-I chimera. Thus, the carboxy-terminal domains of CpxI and CpxII promote the fusion of high-curvature liposomes.
Tensions in Localising Welfare to Work to Britain's Cities
Authors: Crighton Matthew , Turok Ivan , Leleux Charles
Published: January 2009

The paper explores two interrelated tensions at the heart of UK welfare to work policy: (i) between competition and cooperation in delivering employment services, and (ii) between centralisation and localisation of policy control. It examines their potential impact on employment programmes at the level of the city through the DWPs Cities Strategy and its Commissioning Strategy. At this early stage it appears that while the Cities Strategy is building capacity for local planning and management, the contracting out of DWPs own programmes is centralised and prioritises competition rather than local integration and alignment. It remains to be seen whether the two approaches can be brought together pragmatically on the ground to deliver better services and get welfare to work, particularly in the difficult current economic climate.
The ‘Welfare Market’ and the Flexible New Deal: Lessons from Other Countries
Authors: Finn Dan
Published: January 2009

Recent British welfare reform involves the creation of a managed welfare market for the delivery of employment programmes. This article critically reviews evidence on the development and impacts of such markets in Australia, the USA and the Netherlands. It considers the emergence of problems with ‘creaming’ and ‘parking’ of participants and the challenges that ‘market makers’ must meet if they are to secure anticipated improvements in service delivery and outcomes.
Patient‐rated changes in fatigue over a 12‐month period predict poor outcome in chronic heart failure
Authors: Smith Otto R.F. , Denollet Johan , Schiffer Angélique A. , Kupper Nina , Gidron Yori
Published: January 2009

Aims

Little is known about the factors that are associated with changes in fatigue in chronic heart failure (CHF). Moreover, it is unclear whether these changes have prognostic impact. The aim of this study was to examine these issues.

Methods and results

Three hundred and eighty‐seven CHF patients were assessed twice (at baseline and at 12‐month follow‐up) for exertion and general fatigue. Regression models were developed to assess whether baseline characteristics predicted changes in fatigue and to assess the effect of changes in fatigue on cardiac events occurring beyond 12‐months of follow‐up. An increase in exertion fatigue over a 12‐month period was predicted by higher left ventricular ejection fraction (P = 0.02) and cognitive‐affective depressive symptoms (P = 0.03) at baseline, and not having a biventricular pacemaker shortly after baseline (P = 0.02), whereas an increase in general fatigue was only predicted by cognitive‐affective depressive symptoms (P = 0.002). One hundred and forty‐three patients (37%) experienced an event (readmitted, 117; death, 26). An increase in exertion fatigue was associated with a near two‐fold increased risk of events beyond 12‐months of follow‐up (hazard ratio = 1.78; 95% confidence interval 1.18–2.68, P = 0.006), while controlling for standard cardiac risk factors.

Conclusion

Baseline clinical and psychosocial factors predicted changes in fatigue. Increased exertion fatigue independently predicted an increased risk of cardiac re‐admission or death.
Semantically enhanced provenance capture for chamber model development with a master chemical mechanism
Authors: Martin Chris J , Haji Mohammed H , Dew Peter M , Pilling Michael J , Jimack Peter K
Published: January 2009

The development and maintenance of benchmark databases within scientific communities is reliant on interactions with database users. We explore the role of semantically enhanced provenance for computational modelling processes that make use of one such database: the master chemical mechanism, a key resource within the atmospheric chemistry community.
Lessons in scientific data interoperability: XML and the
e
Minerals project
Authors: White T.O.H , Bruin R.P , Chiang G.-T , Dove M.T , Tyer R.P , Walker A.M
Published: January 2009

A collaborative environmental eScience project produces a broad range of data, notable as much for its diversity, in source and format, as its quantity. We find that extensible markup language (XML) and associated technologies are invaluable in managing this deluge of data. We describe F
o
X, a toolkit for allowing Fortran codes to read and write XML, thus allowing existing scientific tools to be easily re-used in an XML-centric workflow.
GODIVA2: interactive visualization of environmental data on the Web
Authors: Blower J.D , Haines K , Santokhee A , Liu C.L
Published: January 2009

GODIVA2is a dynamic website that provides visual access to several terabytes of physically distributed, four-dimensional environmental data. It allows users to explore large datasets interactively without the need to install new software or download and understand complex data. Through the use of open international standards, GODIVA2 maintains a high level of interoperability with third-party systems, allowing diverse datasets to be mutually compared. Scientists can use the system to search for features in large datasets and to diagnose the output from numerical simulations and data processing algorithms. Data providers around Europe have adopted GODIVA2 as an INSPIRE-compliant dynamic quick-view system for providing visual access to their data.
Taxonomy as an eScience
Authors: Clark Benjamin R , Godfray H. Charles J , Kitching Ian J , Mayo Simon J , Scoble Malcolm J
Published: January 2009

The Internet has the potential to provide wider access to biological taxonomy, the knowledge base of which is currently fragmented across a large number of ink-on-paper publications dating from the middle of the eighteenth century. A system (the CATE project) is proposed in which consensus or consolidated taxonomies are presented in the form of Web-based revisions. The workflow is designed to allow the community to offer, online, additions and taxonomic changes (‘proposals’) to the consolidated taxonomies (e.g. new species and synonymies). A means of quality control in the form of online peer review as part of the editorial process is also included in the workflow. The CATE system rests on taxonomic expertise and judgement, rather than using aggregation technology to accumulate taxonomic information from across the Web. The CATE application and its system and architecture are described in the context of the wider aims and purpose of the project.
Developing the next-generation climate system models: challenges and achievements
Authors: Slingo Julia , Bates Kevin , Nikiforakis Nikos , Piggott Matthew , Roberts Malcolm , Shaffrey Len , Stevens Ian , Vidale Pier Luigi , Weller Hilary
Published: January 2009

Although climate models have been improving in accuracy and efficiency over the past few decades, it now seems that these incremental improvements may be slowing. As tera/petascale computing becomes massively parallel, our legacy codes are less suitable, and even with the increased resolution that we are now beginning to use, these models cannot represent the multiscale nature of the climate system. This paper argues that it may be time to reconsider the use of adaptive mesh refinement for weather and climate forecasting in order to achieve good scaling and representation of the wide range of spatial scales in the atmosphere and ocean. Furthermore, the challenge of introducing living organisms and human responses into climate system models is only just beginning to be tackled. We do not yet have a clear framework in which to approach the problem, but it is likely to cover such a huge number of different scales and processes that radically different methods may have to be considered. The challenges of multiscale modelling and petascale computing provide an opportunity to consider a fresh approach to numerical modelling of the climate (or Earth) system, which takes advantage of the computational fluid dynamics developments in other fields and brings new perspectives on how to incorporate Earth system processes. This paper reviews some of the current issues in climate (and, by implication, Earth) system modelling, and asks the question whether a new generation of models is needed to tackle these problems.
The NERC DataGrid services
Authors: Latham S.E , Cramer R , Grant M , Kershaw P , Lawrence B.N , Lowry R , Lowe D , O'Neill K , Miller P , Pascoe S , Pritchard M , Snaith H , Woolf A
Published: January 2009

This short paper outlines the key components of the NERC DataGrid: a discovery service, a vocabulary service and a software stack deployed both centrally to provide a data discovery portal, and at data providers to provide local portals and data and metadata services.
The evolution of the Web and implications for eResearch
Authors: Hall Wendy , De Roure David , Shadbolt Nigel
Published: January 2009

The hypertext visionaries foresaw the potential of richly interlinked global information systems for advancing human knowledge. The Web provided the infrastructure to enable those ideas to become a reality, and it quickly became a platform for collaborative research and data sharing. As the Web has evolved, new ways of using it for eResearch have emerged, such as the social networking facilities enabled by Web 2.0 technologies. The next generation of the Web—the so-called Semantic Web—is now on the horizon, which will again enable new types of collaborative research to emerge. If we are to understand and anticipate these new modes of collaboration, we need a discipline that studies the Web as a whole. Web science is this discipline.
The functional importance of telomere clustering: Global changes in gene expression result from SIR factor dispersion
Authors: Taddei Angela , Van Houwe Griet , Nagai Shigeki , Erb Ionas , van Nimwegen Erik , Gasser Susan M.
Published: January 2009

Budding yeast telomeres and cryptic mating-type loci are enriched at the nuclear envelope, forming foci that sequester silent information regulators (SIR factors), much as heterochromatic chromocenters in higher eukaryotes sequester HP1. Here we examine the impact of such subcompartments for regulating transcription genome-wide. We show that the efficiency of subtelomeric reporter gene repression depends not only on the strength of SIR factor recruitment by cis-acting elements, but also on the accumulation of SIRs in such perinuclear foci. To monitor the effects of disrupting this subnuclear compartment, we performed microarray analyses under conditions that eliminate telomere anchoring, while preserving SIR complex integrity. We found 60 genes reproducibly misregulated. Among those with increased expression, 22% were within 20 kb of a telomere, confirming that the nuclear envelope (NE) association of telomeres helps repress natural subtelomeric genes. In contrast, loci that were down-regulated were distributed over all chromosomes. Half of this ectopic repression was SIR complex dependent. We conclude that released SIR factors can promiscuously repress transcription at nontelomeric genes despite the presence of “anti-silencing” mechanisms. Bioinformatic analysis revealed that promoters bearing the PAC (RNA Polymerase A and C promoters) or Abf1 binding consenses are consistently down-regulated by mislocalization of SIR factors. Thus, the normal telomeric sequestration of SIRs both favors subtelomeric repression and prevents promiscuous effects at a distinct subset of promoters. This demonstrates that patterns of gene expression can be regulated by changing the spatial distribution of repetitive DNA sequences that bind repressive factors.
Ontogeny of odor-LiCl vs. odor-shock learning: Similar behaviors but divergent ages of functional amygdala emergence
Authors: Raineki Charlis , Shionoya Kiseko , Sander Kristin , Sullivan Regina M.
Published: January 2009

Both odor-preference and odor-aversion learning occur in perinatal pups before the maturation of brain structures that support this learning in adults. To characterize the development of odor learning, we compared three learning paradigms: (1) odor-LiCl (0.3M; 1% body weight, ip) and (2) odor-1.2-mA shock (hindlimb, 1sec)—both of which consistently produce odor-aversion learning throughout life and (3) odor-0.5-mA shock, which produces an odor preference in early life but an odor avoidance as pups mature. Pups were trained at postnatal day (PN) 7–8, 12–13, or 23–24, using odor-LiCl and two odor-shock conditioning paradigms of odor-0.5-mA shock and odor-1.2-mA shock. Here we show that in the youngest pups (PN7–8), odor-preference learning was associated with activity in the anterior piriform (olfactory) cortex, while odor-aversion learning was associated with activity in the posterior piriform cortex. At PN12–13, when all conditioning paradigms produced an odor aversion, the odor-0.5-mA shock, odor-1.2-mA shock, and odor-LiCl all continued producing learning-associated changes in the posterior piriform cortex. However, only odor-0.5-mA shock induced learning-associated changes within the basolateral amygdala. At weaning (PN23–24), all learning paradigms produced learning-associated changes in the posterior piriform cortex and basolateral amygdala complex. These results suggest at least two basic principles of the development of the neurobiology of learning: (1) Learning that appears similar throughout development can be supported by neural systems showing very robust developmental changes, and (2) the emergence of amygdala function depends on the learning protocol and reinforcement condition being assessed.
Twenty Years on: The Implementation of the UN Convention on the Rights of the Child in the United Kingdom
Authors: Payne Lisa
Published: January 2009

Since ratification of the Convention on the Rights of the Child in 1991, the UK Government has submitted three reports to the UN Committee on the Rights of the Child. This article explains the reporting process and provides an overview of the most recent recommendations from the Committee.
Community pharmacists and tobacco in Great Britain: from selling cigarettes to smoking cessation services
Authors: Anderson Stuart
Published: January 2009

Aims  To illustrate the ways in which community pharmacists in Great Britain have been able to benefit from a close association with tobacco and smoking from its initial importation to the present time.

Design  An analysis of relevant texts and documents, together with brief transcripts from an oral history investigation of community pharmacy in Great Britain.

Setting  Community pharmacies in Great Britain during the 20th century.

Participants  Retired and practising community pharmacists with experience of the sale of tobacco products during the period.

Measurements  Oral testimony of retired and practising community pharmacists about the use and sale of tobacco products, and quantitative analysis of commercially available products designed to help people stop smoking during the period.

Findings  Community pharmacists have been involved continuously with the tobacco habit since its first introduction into Britain. During the course of the 20th century the emphasis shifted from the sale of tobacco products to the sale of medicines intended to help people to give up smoking. Smoking cessation initiatives continue to be an important part of the business of many pharmacies.

Conclusions  The paper illustrates the continuing tension that exists between pharmacy as business and pharmacy as profession. The sale of tobacco products and, more recently, products to help people give up smoking, has been a small but significant part of the business of many community pharmacists throughout the centuries.
Use of more nicotine lozenges leads to better success in quitting smoking
Authors: Shiffman Saul
Published: January 2009

Aims and design  The finding that smokers who used more pieces of nicotine gum achieved better treatment outcomes has been interpreted to indicate that the use of more pieces of gum leads to better treatment outcomes. However, these correlational findings are subject to at least three alternate explanations: (1) reverse causation; (2) a confounding third variable; or (3) behavioral processes. We tested these alternative explanations in secondary analyses of data from a clinical trial of nicotine lozenges.

Participants and methods  Subjects (n = 1030) who quit smoking for at least 2 weeks in a placebo‐controlled trial of nicotine lozenges were studied. Lozenge use was recorded daily; outcome was assessed as carbon monoxide (CO)‐verified 28‐day continuous abstinence at 6 weeks.

Findings  To refute the reverse causation hypothesis we analyzed data on compliance during a period when subjects were abstinent: high use of active lozenge was associated with greater success; for each additional lozenge used, the odds of success increased by 10%. The third variable and behavioral processes hypotheses both predict that high lozenge use will be associated with improved outcomes even in the placebo condition. However, our analyses showed that this was not the case. Further, greater use of lozenges increased the active–placebo difference, as would be expected under a pharmacological explanation of compliance effects.

Conclusion  The analyses rebut the alternative explanations, and suggest that use of more nicotine lozenges is causally associated with better quit rates.
The role of substance use in young adult divorce
Authors: Collins Rebecca L. , Ellickson Phyllis L. , Klein David J.
Published: January 2009

Aim  To test the relationships between various forms of substance use during marriage and subsequent divorce among US young adults.

Design  Three waves of survey data collected at approximately ages 18, 23 and 29 years were used. Using multivariate logistic regression and controlling for factors present at the two early waves, we tested for prospective relationships between substance use at the second assessment and divorce by the third.

Participants  A longitudinal panel following adolescents on the west coast of the United States into young adulthood. The analytic subsample consisted of the 454 individuals currently married at the age 23 survey.

Measurements  Predictors were past‐year frequency of alcohol intoxication, marijuana use and cigarette use, as well as any hard drug use in the past year. Covariates included substance use prior to marriage, demographic and socio‐economic factors, marital discord and religiosity.

Findings  Controlling for other factors, more frequent alcohol intoxication during marriage was an independent predictor of later divorce. Frequency of marijuana use had a significant bivariate relationship with divorce that was not significant in the multivariate model.

Conclusion  These data are consistent with the notion that alcohol intoxication is related causally to divorce among young adults.
Adolescent salvia substance abuse
Authors: Singh Sundeep
Published: January 2009

Background  Salvia divinorum is a non‐water‐soluble hallucinogen that is becoming increasingly popular among adolescents. Salvia is a highly selective full agonist of primate and cloned human cerebral kappa‐opioid receptors, although its psychotomimetic effects are similar to serotonergic agonists and NMDA glutamate antagonists. Salvia has been associated with depersonalization, laughter, feelings of levitation and self‐consciousness. These effects resolve within 30 minutes following use. Salvia has been banned in many countries, although it remains legal and easily assessable over the internet in the United States.

Case description  A 15‐year‐old man with a history of salvia and marijuana use presented to psychiatric emergency services with acute onset of mental status changes characterized by paranoia, déjà vu, blunted affect, thought blocking and slow speech of 3 days' duration.

Conclusion  There is limited literature discussing the clinical effects of salvia use. Based on this case presentation, salvia use may be associated with many undocumented long‐term effects such as déjà vu. The ease of use and increasing popularity of salvia requires further investigation into the clinical effects of salvia use.
The impact of pharmaceutical company funding on results of randomized trials of nicotine replacement therapy for smoking cessation: a meta‐analysis*
Authors: Etter Jean‐François , Burri Mafalda , Stapleton John
Published: January 2009

Aims  To assess whether source of funding affected the results of trials of nicotine replacement therapy (NRT) for smoking cessation.

Methods  We reviewed all randomized controlled trials included in the Cochrane review. There were insufficient non‐industry trials of the newer products for these to be included. We included 90 trials of either the nicotine gum (52) or nicotine patch (38). They comprised 18 238 treatment and 16 235 control participants. Forty‐nine showed evidence of industry support (18 gum, 31 patch).

Results  Industry (31 of 49, 63%) compared with non‐industry (seven of 41, 17%, P < 0.001) supported a higher proportion of nicotine patch studies and had larger sample sizes (479 versus 268, P = 0.04). Twenty‐five (51%) industry trials reported statistically significant (P < 0.05) results, compared with nine (22%) non‐industry trials (OR = 3.70, 95% CI = 1.46–9.35). This difference was not explained by trial characteristics. Industry‐supported trials had a pooled odds ratio of 1.90 (1.67–2.16), compared with 1.61 (1.43–1.80) for other studies (χ2 = 3.6, P = 0.058). There was evidence of funnel‐plot asymmetry among industry trials (t = 4.35, P < 0.001), but not among other trials, indicating that several small null‐effect industry trials may not have reached publication. After imputation adjustment, the odds ratio for industry trials reduced to 1.64 (1.43–1.89) and the overall NRT odds ratio reduced from 1.73 (1.60–1.90) to 1.62 (1.49–1.77).

Conclusions  Compared with independent trials, industry‐supported trials were more likely to produce statistically significant results and larger odds ratios. These differences persisted after adjustment for basic trial characteristics. Although we had no data on the amount of funding for each trial, it is possible that more resources led to higher treatment compliance and therefore greater efficacy in industry‐supported trials. Differences can also possibly be explained by publication bias with several small, null‐effect industry studies not having reached publication. After adjustment for this possible bias, results for industry trials were lower and similar to non‐industry results. Similarly, the overall estimate of the net effect for these products reduces to about 5% attributable 1‐year successes. This remains of considerable public health benefit. Registration of clinical trials has become mandatory in many countries since most of the trials considered here were conducted, and this should reduce the potential for publication bias in future.
Inverse association between hepatic stellate cell apoptosis and fibrosis in chronic hepatitis C virus infection
Authors: Gonzalez S. A. , Fiel M. I. , Sauk J. , Canchis P. W. , Liu R.‐C. , Chiriboga L. , Yee H. T. , Jacobson I. M. , Talal A. H.
Published: January 2009

Summary. Perisinusoidal hepatic stellate cells (HSC) are the principal fibrogenic cells in the liver. In animal models, HSC apoptosis is the predominant clearance mechanism of activated HSC, although data evaluating whether the same processes occur in humans are limited. We conducted a cross‐sectional study to evaluate the association between HSC apoptosis and fibrosis stage in subjects with chronic hepatitis C virus (HCV) infection (n = 44) and HCV‐negative controls with normal liver histology (n = 9). We used immunohistochemical techniques to identify activated (α‐smooth muscle actin+), proliferative (Ki‐67+) and apoptotic (terminal deoxynucleotidyl transferase [TdT]‐mediated dUTP nick end‐labelling+) HSC in liver biopsy specimens from all subjects. The same pathologist enumerated positive cells per high‐power field (HPF, ×200) in 20 periportal/lobular areas. HSC apoptosis was decreased in HCV‐positive subjects compared with controls (median 0.4, range 0.0–3.1vs1.1, 0.2–3.5 cells/HPF,P = 0.02). Among HCV‐positive subjects, HSC apoptosis was decreased in those with moderate to advanced fibrosis (P = 0.04) compared with those with mild fibrosis. By multivariate analysis, HSC apoptosis decreased by an average of 0.14 cells/HPF (95% confidence interval 0.01–0.28 cells/HPF) per increase in fibrosis stage (P = 0.04). While the number of activated and proliferative HSC was significantly increased in HCV‐infected subjects compared with that in uninfected controls, the numbers of these cells did not differ between HCV‐infected subjects with mildvsmoderate/advanced fibrosis. In conclusion, the number of apoptotic HSC was significantly decreased in HCV‐infected subjects with advanced fibrosis. In chronic HCV infection, inhibition of HSC apoptosis may be one mechanism by which fibrosis progresses.
Changes of non‐invasive markers and FibroScan values during HCV treatment
Authors: Vergniol J. , Foucher J. , Castéra L. , Bernard P.‐H. , Tournan R. , Terrebonne E. , Chanteloup E. , Merrouche W. , Couzigou P. , De Lédinghen V.
Published: January 2009

Summary.  The recent advent of non‐invasive methods for assessment of fibrosis allows serial assessments in all patients with hepatitis C. The aim of this prospective study was to evaluate changes in liver fibrosis, as measured with non‐invasive methods, in a large cohort of HCV‐infected patients with and without treatment. From May 2003 through March 2006, all previously untreated HCV‐infected patients were enrolled in this study. Liver fibrosis was staged with FibroScan and Fibrotest at inclusion, then every year in untreated patients, and at the end of treatment and 6 months later in treated patients. The study population consisted of 416 patients, of whom 112 started treatment after enrolment. In the treatment group, FibroScan and Fibrotest values were significantly higher before and after treatment than in untreated patients at baseline and after 1 year. However, there was no significant difference between treated and untreated patients at the end of follow‐up. FibroScan and Fibrotest values fell in all treated patients, whatever their virological response. In multivariate analysis, treatment was the only factor independently associated with a fall in the FibroScan value. In conclusion, whatever the virological response, treatment for HCV infection is associated with an improvement of FibroScan and Fibrotest values. Further studies are needed to compare these non‐invasive methods with liver biopsy. These non‐invasive methods, and especially FibroScan, should be useful for assessing treatment efficacy in clinical trials of new drugs.
Defining the role of surgery for complications after pancreatoduodenectomy
Authors: Shukla Parul J , Barreto S. G. , Mohandas K. M. , Shrikhande S. V.
Published: January 2009

Background:  Although mortality rates following pancreatoduodenectomy have drastically reduced over the last few decades, high morbidity rates have continued to trouble pancreatic surgeons across the world. Interventional radiology has reduced the need for re‐exploration for complications following pancreatoduodenectomy. There remain specific indications for re‐exploration in such scenarios. It is thus pertinent to identify those clinical scenarios where surgery still has a role in managing complications of pancreatoduodenectomy. The aim of the study was to define the role of surgery for dealing with complications following pancreatoduodenectomy.

Methods:  One hundred and fifty‐seven consecutive pancreatoduodenectomies carried out at a single institution between 1 January 2001 and 28 February 2007, were analysed. The database was looked into to identify patients who underwent re‐exploration for complications and to define the indications for the exploration in these patients.

Results:  Out of the 157 pancreatoduodenectomies, there were, in all, 39 complications (24.2%) in 38 patients. Most of these complications were successfully managed conservatively and with the help of interventional radiology. Seventeen patients had to be re‐explored (10.8%). The indications were primarily for haemorrhage, clinically significant pancreatic leaks, biliary leaks, adhesive intestinal obstruction and burst abdomen. The overall mortality rate was 3.1%. The mortality rate in the patients undergoing re‐exploration was 11.7%.

Conclusion:  Early haemorrhage (from the pancreatic stump or anastomotic line), clinically significant pancreatic anastomotic leak with discharge from the main wound and an early biliary anastomotic leak are prime indications for re‐exploration in patients with complications following pancreatoduodenectomy.
Death by midgut infarction: clinical lessons from 88 post‐mortems in Auckland, New Zealand
Authors: Gregory O’Grady , Ghambir Shanu , Koelmeyer Timothy D.
Published: January 2009

Background:  Mortality rates from acute arterial mesenteric ischaemia remain high. Early diagnosis is of prognostic importance; however, early features are often non‐specific, necessitating a high index of suspicion and knowledge of the at‐risk patient. This study reviewed three decades of fatal cases in Auckland, New Zealand, to identify risk factors and associated pathologies that might help guide early diagnosis. Diagnostic delay was also evaluated.

Methods:  Cases were identified through a pathology database maintained from 1977 to 2006. Autopsy reports were assessed together with available clinical detail.

Results:  Eighty‐eight cases were recovered. Mean age was 75.4 years, with women predominating (57%). Thromboembolic occlusion was the leading cause, followed by thrombotic occlusion. Embolic sources included atrial disease, aortic disease and myocardial infarction. Patients routinely showed extensive comorbidities, especially cardiovascular. Pain was the most constant presenting symptom, but features were often subtle and clinicians frequently misdiagnosed more minor ailments. Of operated patients, 36% received operations within 6 h of admission, 33% within 24 h, 17% at between 1 and 2 days, and the remainder between 2 and 12 days.

Conclusion:  Knowledge of risk factors defined here is important to guide early diagnosis of mesenteric ischaemia. Diagnostic delay is again shown to be significant and case experience gathered in this series may improve doctors’ discernment when meeting this condition.
Functional impairment after latissimus dorsi flap
Authors: Koh Cherry E. , Morrison Wayne A.
Published: January 2009

Background:  Available published reports suggest that loss of latissimus dorsi muscle following latissimus myocutaneous flap does not lead to functional impairment. However, significant functional impairment has been observed in clinical practice, prompting this study to evaluate the functional deficit in patients who had undergone reconstruction using latissimus dorsi muscle.

Methods:  A retrospective review was undertaken between 1998 and 2003. Patients were identified from the audit of the plastic surgery unit at St Vincent’s Hospital and recruited by direct telephone contact. They were assessed using the Disability of Arm, Shoulder and Hand questionnaire.

Results:  There were 25 participants. Eighteen completed their questionnaires. Six of 18 patients reported scores of 30 or more, which corresponded to a global moderate functional deficit. These patients were severely limited in their ability to carry out housework. Major postoperative complications were associated with high Disability of Arm, Shoulder and Hand scores (P = 0.028). Three of five patients involved with sports reported impaired performance in sports. The subgroup of four patients who underwent bilateral latissimus dorsi flaps also experienced significant morbidity with all four reporting moderate to severe impairment in their ability to return to gardening and/or sports.

Conclusion:  Patients undergoing this procedure should be fully informed of potential sequelae. Athletic patients and patients undergoing bilateral latissimus dorsi flaps should also be warned of possible reduced performance in sports. Alternatively, perforator cutaneous flaps, which preserve the latissimus muscle, should be chosen when feasible.
Audit of the Douglas Hocking Research Institute bone bank: ten years of non‐irradiated bone graft
Authors: Love David , Pritchard Michael , Burgess Tanya , Van Der Meer Gavin , Page Richard , Williams Simon
Published: January 2009

Background:  An audit performed in the use of non‐irradiated femoral head bone graft at the Geelong Hospital over a 10‐year period. While it is thought the non‐irradiated bone graft provides a better structural construct there is theoretical increased risk of infection transmission.

Methods:  We performed a retrospective review of prospectively collected data in the use of non‐irradiated bone allograft used from the Geelong Hospital Douglas Hosking Research Institute bone bank over a 10‐year period. The review was performed using data collected from the bone bank and correlating it with the patient’s medical record. All complications, including infections, related to the use of the allograft were recorded.

Results:  We found that over the 10 years to 2004 that 811 femoral heads were donated, with 555 being used over 362 procedures in 316 patients. We identified a total of nine deep infections, of which seven were in joint replacements. Overall this was a 2.5% deep infection rate, which was lowered to 1.4% if the previously infected joints that were operated on were excluded.

Conclusion:  The use of non‐irradiated femoral head bone graft was safe in a regional setting.