bluuebunny/crossref_metadata_2025 huggingface dataset:
Do quantitative cultures of protected brush specimens modify the initial empirical therapy in ventilated patients with suspected pneumonia?
Authors: Rodriguez de Castro F , Sole-Violan J , Aranda Leon A , Blanco Lopez J , Julia-Serda G , Cabrera Navarro P , Bolanos Guerra J
Published: July 2003

The real contribution of the protected specimen brush (PSB) to guide the choice of antimicrobial therapy in ventilated patients with severe pneumonia is not well established. This study aimed to assess how data obtained by PSB changed the initial empirical therapy. One hundred and ten ventilated patients with suspected pneumonia were entered into a prospective study. All patients underwent fibreoptic bronchoscopy within the first 24 h after clinical suspicion of pneumonia. Specimens were obtained by PSB and were processed for quantitative cultures using standard methods. When patients were started on empirical antibiotics, a standard therapeutic regimen was followed. The decision to introduce, withdraw, maintain, or modify antibiotic therapy, according to the PSB culture results, was left to the attending physician. Pneumonia was the final diagnosis in 45 (41%) of the 110 patients. Pneumonia was excluded in 47 (43%) patients and in the remaining 18 (16%) the diagnosis was uncertain. The initial therapeutic plans were considered to be adequate in 40 patients (36%) and inadequate in 37 cases (34%). In 17 patients (15%), therapeutic changes were made based on the results of PSB cultures. In one case appropriate antibiotics were introduced; in nine cases the therapeutic regimen was reduced to select a narrower and rational therapy; and in seven patients therapy was changed because the prescribed antimicrobial agents were ineffective against the organisms recovered. This study shows that therapeutic changes were made based on the results of PSB cultures in 38% of the patients with pneumonia. In contrast, the PSB technique has no impact on antimicrobial therapy of patients without pneumonia.
Minimal dose of aerosolized interferon-alpha in human subjects: biological consequences and side-effects
Authors: Giosue S , Casarini M , Ameglio F , Alemanno L , Saltini C , Bisetti A
Published: July 2003

Interferon-alpha (IFN-alpha) is a leucocyte-derived cytokine with pleiotropic effects on the cells of the immune system, including the ability to promote viral and microbial killing. This study was designed to evaluate the biologically active dosage of aerosolized lymphoblastoid IFN-alpha, in normal subjects and patients with chronic bronchitis, using serum 2'-5' oligoadenylate synthetase (OAS) as a marker of IFN-alpha activity. Three groups of subjects were included: two healthy groups and one of patients with chronic bronchitis. Group A (controls, n = 5) was studied in order to determine the minimal IFN-alpha dose able to induce biological effects without side-effects. IFN-alpha was given in a dose escalation trial including 0, 0.3 x 10(6), 1.0 x 10(6) and 3.0 x 10(6) IU.day-1 (5 day administration). Only the administration of 3.0 x 10(6) IU.day-1 of IFN-alpha induced a significant biological activity, increasing serum levels of OAS. Group B (controls, n = 5) and C (chronic bronchitis, n = 5) were given 3.0 x 10(6) IU.day-1 (10 day administration) in order to study serum, bronchoalveolar lavage fluid (BALF) and BALF cell modifications, after treatment. OAS serum levels and nitroblue tetrazolium (NBT) reduction tests, the latter used as a measure of phagocyte cell activity, increased both in normal subjects and in patients with chronic bronchitis. No significant change of serum IFN-alpha levels was found. It is concluded that aerosolized IFN-alpha administration to the lung is well-tolerated at biologically active doses. The activity can be monitored by quantifying OAS serum levels through a simple blood test.
Pulmonary sarcoidosis: patterns of cytokine release in vitro
Authors: Prior C , Knight RA , Herold M , Ott G , Spiteri MA
Published: July 2003

This study was designed to investigate the ability of bronchoalveolar and blood mononuclear cells to produce inflammatory mediators in vitro in pulmonary sarcoidosis. Seventeen patients with pulmonary sarcoidosis (stage I n = 8; stage II/III n = 9) and 10 normal controls were investigated. Bronchoalveolar and peripheral blood mononuclear cells were cultured in serum-free medium, without stimulant, for 24 h, and the supernatants analysed for concentrations of interleukin (IL)-1 beta (IL-1 beta), IL-2, IL-6, tumour necrosis factor-alpha (TNF-alpha), granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-gamma (IFN-gamma) and neopterin. Bronchoalveolar lavage cells (BALC) of sarcoid patients released significantly higher amounts of TNF-alpha, IL-6, IFN-gamma and neopterin in comparison to normal controls. When smokers were excluded, there was also an increased release of IL-1 beta and GM-CSF. In the sarcoid group, the levels of IL-1 beta, IL-6, TNF-alpha and GM-CSF showed highly significant correlations between each other, but not with IL-2, IFN-gamma or neopterin. Sarcoid patients whose BALC released more TNF-alpha or GM-CSF had higher percentage counts of alveolar macrophages but fewer lavage lymphocytes. In sarcoid patients, peripheral blood mononuclear cells (PBMNC) also released higher amounts of IL-1 beta, TNF-alpha, IL-6 and GM-CSF but less neopterin than normal controls. Patients whose PBMNC produced more IL-1 beta, IL-6 and GM-CSF had higher absolute and relative lavage neutrophil counts. No relationships were observed between cytokine release and radiographic or physiological markers of disease severity. We conclude from this study that sarcoid inflammation is associated with an increased and concerted release of monocyte/macrophage-derived cytokines not only in the lung but also in the peripheral blood. We speculate that the lymphokines, IFN-gamma and IL-2, are not the primary triggers.
Effects of home rehabilitation on physical performance in patients with chronic obstructive pulmonary disease (COPD)
Authors: Wijkstra PJ , van der Mark TW , Kraan J , van Altena R , Koeter GH , Postma DS
Published: July 2003

We investigated whether 12 weeks of rehabilitation at home in patients with chronic obstructive pulmonary disease (COPD) had a beneficial effect on lactate production, metabolic gas exchange data, workload of the inspiratory muscles, and dyspnoea during a maximal bicycle ergometer test. A second aim was to assess whether a change in dyspnoea was related to a change of inspiratory muscle workload. Forty three COPD patients with severe airways obstruction were included in the study: mean forced expiratory volume in one second (FEV1) 1.3 +/- 0.4 L (44% predicted), mean FEV1/inspiratory vital capacity (IVC) 37 +/- 8%. Twenty eight patients started a rehabilitation programme, whilst 15 patients received no rehabilitation. Rehabilitation was carried out at home; patients were supervised by a general practitioner, a physiotherapist and a nurse. Exercise tolerance was measured by means of a 6 min walking distance test (6MWD) and maximal workload (Wmax) during an incremental symptom-limited cycle ergometer test. Inspiratory muscle workload at Wmax was assessed with the Tension Time Index (TTI), and dyspnoea at Wmax with the Borg scale. After 12 weeks, the rehabilitation group showed a significantly larger increase in 6MWD (from 438 to 447 m) and in Wmax (from 70 to 78 W) compared with the control group. A significant improvement in oxygen consumption (V1O2) (from 1.0 to 1.1 L), lactate level (from 3.7 to 3.1 mEq.L(-1)), dyspnoea (from 6.0 to 4.5) and TTI (from 0.10 to 0.08) at Wmax occurred in the rehabilitation group during the programme. The reduction in TTI was not significantly correlated with the fall in dyspnoea, as assessed by the Borg scale. We conclude that 12 weeks of rehabilitation at home in COPD patients increases symptom-limited V1O2 in combination with an increased Wmax. At this significantly higher Wmax, there was a reduction in dyspnoea, lactate level and inspiratory muscle workload. The reduction in dyspnoea was not related to a decreased inspiratory muscle workload. This study shows that rehabilitation at home can produce beneficial physiological improvements during exercise in patients with chronic obstructive pulmonary disease.
Predictive value of clinical features for the obstructive sleep apnoea syndrome
Authors: Deegan PC , McNicholas WT
Published: July 2003

The advantage of being a National Referral Centre for patients with suspected obstructive sleep apnoea (OSA) was used to seek clinical factors predictive of OSA, and thus determine if the number of polysomnography tests required could be reduced. Patients were mainly primary referrals, from an island population of 3.5 million. Two hundred and fifty consecutive patients underwent clinical assessment, full polysomnography, and a detailed self-administered questionnaire. This represents one of the largest European studies, so far, utilizing full polysomnography. Fifty four percent (n = 134) had polysomnographic evidence of OSA (apnoea/hypopnoea index (AHI) > or = 15 events.h-1 sleep). Patients with OSA were more likely to be male, and had a significantly greater prevalence of habitual snoring, sleeping supine, wakening with heartburn, and dozing whilst driving. Alcohol intake, age and body mass index (BMI) were significant independent correlates of AHI. After controlling for BMI and age, waist circumference correlated more closely with AHI than neck circumference among males, while the opposite was true among females. No single factor was usefully predictive of obstructive sleep apnoea. However, combining clinical features and oximetry data, where appropriate, approximately one third of patients could be confidently designated as having obstructive sleep apnoea or not. The remaining two thirds of patients would still require more detailed sleep studies, such as full polysomnography, to reach a confident diagnosis.
Visual and different automatic scoring profiles of respiratory variables in the diagnosis of sleep apnoea-hypopnoea syndrome
Authors: Carrasco O , Montserrat JM , Lloberes P , Ascasco C , Ballester E , Fornas C , Rodriguez-Roisin R
Published: July 2003

The purpose of our study was to explore the diagnostic accuracy of different methods of scoring night time recording of respiratory variables (NTRRV) for the diagnosis of the sleep apnoea-hypopnoea syndrome (SAHS). Within a 2 week period, we performed a partially attended night time recording of respiratory variables and a full polysomnography (PSG) for reference in patients with suspected SAHS. Night time recording of respiratory variables was carried out using equipment which records, and continuously displays on a monitor, oximetry, airflow, chest and abdominal motion and body position. Night time recording of respiratory variables was scored manually and automatically, according to different combinations of the parameters described previously. Full polysomnography was performed in the Sleep Laboratory following conventional standards. Thirty six patients were studied. Visual analysis and different automatic scoring profiles of night time recording of respiratory variables were compared to full polysomnography in terms of agreement, sensitivity and specificity. Visual scoring of night time recording of respiratory variables gave the finest agreement-sensitivity-specificity relationship. Automatic scoring of nighttime recording of respiratory variables showed a trend to underestimate the apnoea-hypopnoea index (AHI) with respect to full polysomnography due mainly to underrecognition of hypopnoeas. Agreement-sensitivity-specificity relationships of automatic night time recording of respiratory variables with respect to full polysomnography varied depending on the automatic profile used. Some had a good agreement and sensitivity whilst others had a good specificity. These findings show that visual scoring of night time recording of respiratory variables is the most accurate method of analysis when compared to full polysomnography. The usefulness of the automatic methods of scoring of respiratory variables depends on the end-point chosen and is not reliable enough to be used in all situations. Night time recording of respiratory variables represents a real complement to conventional full polysomnography in clinical practice.
Snoring: analysis, measurement, clinical implications and applications
Authors: Dalmasso F , Prota R
Published: July 2003

Snoring was described in literature even before medicine. Common definitions do not consider acoustic measurements of snoring. In this paper we discuss the main pathophysiological aspects of snoring and the snoring-sleep relationship as the generating mechanisms. Snoring can be analysed and measured by the following methods: 1) Leq-Equivalent Continuous Sound Level, which only quantifies noisiness, annoyance, and damage to the partner's and snorer's hearing; 2) Power Spectrum, with frequency values, formantic structure data and typical shape, which can help to distinguish simple snoring from heavy snoring with obstructive sleep apnoea syndrome (OSAS); 3) Linear Prediction Code (LPC) method, which can define the cross-sectional area (CSA) of the upper airways and which locates sites of obstruction. Simulated snoring analysis with LPC and with simultaneous fluoroscopy permits the definition of CSA and the identification of three snoring patterns: nasal, oral and oronasal. Snoring is an important sign of sleep-related breathing disorders (SRBD), of the upper airway resistance syndrome (UARS), and of the OSAS. Snoring is a symptom of nasal obstruction and is associated with cardiovascular diseases and nocturnal asthma as a trigger or causative factor; however, its acoustic features in these disorders are not well-defined. Home monitoring of snoring is very useful for epidemiology and is mandatory, together with heart rate and arterial oxygen saturation (Sa,O2), to screen SRBD.
Allergic bronchopulmonary aspergillosis in lung allograft recipients
Authors: Egan JJ , Yonan N , Carroll KB , Deiraniya AK , Webb AK , Woodcock AA
Published: July 2003

Following lung transplantation for end-stage cystic fibrosis, two male patients presented with shortness of breath, peripheral blood eosinophilia and segmental lung collapse. At bronchoscopy, each had bronchial mucous plugging containing Aspergillus fumigatus. This finding was associated with a systemic eosinophilia and skin test positivity to Aspergillus. Augmented steroid therapy resulted in the successful resolution of the symptoms. We believe that these are the first reported cases of allergic bronchopulmonary aspergillosis in lung allograft recipients.
Rasburicase for the Treatment and Prevention of Hyperuricemia
Authors: Yim Barbara T , Sims-McCallum Rosalyn P , Chong Pang H
Published: June 2003

OBJECTIVE:

To review the information currently available on rasburicase for treatment and prevention of hyperuricemia.

DATA SOURCES:

MEDLINE (1966–August 2002) was searched for primary and review articles.

STUDY SELECTION/DATA EXTRACTION:

Studies evaluating rasburicase, including abstracts and proceedings, were considered for inclusion. English-language literature was evaluated for the pharmacology, pharmacodynamics, pharmacokinetics, therapeutic use, and adverse effects of rasburicase.

DATA SYNTHESIS:

Rasburicase, a recombinant urate oxidase, has been shown to be effective in lowering uric acid and preventing uric acid accumulation in patients with hematologic malignancies who had hyperuricemia or who were at high risk for developing hyperuricemia. It has been approved for pediatric use in the US.

CONCLUSIONS:

In addition to allopurinol, hydration, and urinary alkalinization, rasburicase is a new alternative for the treatment and prevention of hyperuricemia in patients with hematologic malignancies. Its rapid onset of action and the ability to lower preexisting elevated uric acid levels are the advantages of rasburicase compared with allopurinol. It may allow the patient to receive chemotherapy treatment without delay.
Acamprosate for the Adjunctive Treatment of Alcohol Dependence
Authors: Overman Gerald P , Teter Christian J , Guthrie Sally K
Published: June 2003

OBJECTIVE:

To review the literature related to the treatment of alcohol dependence with acamprosate, a synthetic compound structurally similar to the naturally occurring amino acid, homotaurine.

DATA SOURCES:

Primary literature and review articles were identified by MEDLINE search (1966–June 2003). Abstracts from recent meetings were also reviewed.

DATA SYNTHESIS:

Acamprosate has been marketed in 24 countries. Although the precise mechanism of acamprosate in the treatment of alcohol-dependent patients is unclear, it may restore the balance between inhibitory and excitatory neurotransmission in the central nervous system. European trials have shown consistent increases in abstinence rates compared with placebo when acamprosate use was paired with appropriate psychosocial and behavioral therapies. Decreased direct and indirect healthcare costs associated with acamprosate treatment have also been reported.

CONCLUSIONS:

Acamprosate is a promising medication for the treatment of alcohol dependence in the US.
A Simplified Analytical Procedure for the Determination of Organically Bound Halogens in Salt‐containing Water Samples
Authors: Borsdorf Helko , Fiedler Petra , Wilke Dorit , Weiß Holger
Published: July 2003

A method was developed for the determination of organic halogens in water samples with the aim of minimizing matrix effects and simplifying the sample preparation technique commonly used. The method is based on the adsorption of organic halogens in modified hydrophilic divinylbenzene polymer columns and their elution with methanol. The adsorbent used enables rapid adsorption and desorption due to comparatively high operating flow rates and minimized solvent amounts. Furthermore, no additional reconcentration steps are needed. The methanol extract obtained is combusted with a standard EOX (extractable organic halogen) analyzer and the concentration of organically bound halogens is determined by microcoulometric analysis. The matrix effects are considerably reduced compared to the standard procedure (EN 1485) commonly used. A detection limit of 13 μg/L was established.
Myristyl Dimethylamine Oxide Surfactant Solutions: Model Systems for Rheological Research
Authors: Pflaumbaum Manuela , Rehage Heinz
Published: July 2003

Aqueous surfactant solutions of entangled, rod‐shaped micelles are often characterized by monoexponential stress‐relaxation processes. This special phenomenon leads to relatively simple theoretical descriptions, and viscoelastic surfactant solutions can, therefore, also be used as simple model systems for studying fundamental principles of flow. Herein, we present a detailed study of the nonlinear rheological properties of aqueous myristyl dimethylamine oxide surfactant solutions. In the regime of small deformations, shear stresses, or shear rates, the dynamic features of the viscoelastic solutions are characterized by the simple equations of a Maxwell material. At elevated values of shear stresses or deformations, however, this simple model fails and nonlinear features, such as normal stresses, stress overshoots, or shear‐thinning properties occur. All these phenomena can be described by a Maxwell‐type differential constitutive equation, which was first proposed by Giesekus. It turns out that the experimental results are in fairly good agreement with the theoretical predictions, if the anisotropy factor α is equal to 0.5. Besides transient data and nonlinear steady‐state measurements, many semiempirical laws, such as the Cox–Merz rule, the Yamamoto relation, the Laun equation, and the Gleißle mirror relationships are approximately satisfied. The dynamic properties discussed in this paper are of general importance and they are equally observed in different materials such as polymer, dye, or protein solutions.
A Half‐Century with Solar Neutrinos (Nobel Lecture)
Authors: Davis, Jr. Raymond
Published: July 2003

The Sun derives its energy from fusion reactions in which hydrogen is transformed into helium. Every time four protons are turned into a helium nucleus, two neutrinos are produced. These neutrinos take only two seconds to reach the surface of the Sun and another eight minutes or so to reach the Earth. Thus, neutrinos tell us what happened in the center of the Sun eight minutes ago. The Sun produces one‐third as many neutrinos as predicted by the standard solar model of particle physics. The author's pioneering work proved that nothing was wrong with the experiments or the theory; something was “wrong” with the neutrinos, in the sense that they behave in ways beyond the standard model.
Derivatization of inorganic ions in capillary electrophoresis
Authors: Padarauskas Audrius
Published: July 2003

This review gives a short overview of the main approaches to the derivatization of inorganic ions in capillary electrophoresis (CE) with emphasis on the most recent works. Various derivatization procedures and detection methods are discussed. A brief account of their advantages and limitations is given. More specific areas such as microchip CE, simultaneous separation of anions and cations, and speciation analysis are also briefly discussed.
How Investment Bankers Determine the Offer Price and Allocation of New Issues
Authors: Benveniste Lawrence M. , Spindt Paul A.
Published: July 2003

The authors investigate how investment bankers use indications of interest from their client investors to price and allocate new issues. They model the process as an auction constructed to induce asymmetrically informed investors to reveal what they know to the underwriter. The analysis yields a number of empirical implications, including that new issues will be underpriced and that distributional priority will be given to an underwriter’s regular investors. The authors also find that tension between an underwriter’s propensity to presell an issue and an issuing firm’s desire to obtain maximum proceeds affects the type of underwriting contract chosen. Journal of Financial Economics, Vol. 24,No.2(October 1989),pp.343-361.(Reprinted withpermission of the Journal of Economic Literature.)
International Investment Restrictions and Closed-End Country Fund Prices
Authors: Bonser-Neal Catherine , Brauer Greggory , Neal Robert , Wheatley Simon
Published: July 2003

Some closed-end country funds trade at large premiums relative to their net asset values. This paper examines whether international investment restrictions raise country fund price-net asset value ratios by segmenting international capital markets. The authors test whether a relation exists between announcements of changes in investment restrictions and changes in these ratios using weekly data from May 1981 to January 1989. The results provide evidence that some foreign markets are at least partially segmented from the U.S. capital markets. Journalof Finance, Vol. 45, No. 2 (June 1990), pp. 523-547. (Reprinted with permission of the Journal of Economic Literature.)
An Examination of the Super Bowl Stock Market Predictor
Authors: Krueger Thomas M. , Kennedy William F.
Published: July 2003

Few prediction schemes have been more accurate, and at the same time more perplexing than the Super Bowl Stock Market Predictor, which asserts that the league affiliation of the Super Bowl winner predicts stock market direction. In this study, the authors examine the record and statistical significance of this anomaly and demonstrate that an investor would have clearly outperformed the market by reacting to Super Bowl game outcomes. JournaZ of Finance, Vol. 45, No. 2 (June 1990) pp. 69 l-697. (Reprinted with permission of the Journal of Economic Literature.)
The Wealth Tax
Authors: Dugger William M.
Published: July 2003

In the 198Os, wealthy U.S. taxpayers have enjoyed soaring interest and dividend incomes. At the same time, the higher income tax brackets have been eliminated. Furthermore, interest payments on the national debt have crowded out a rising proportion of useful public programs from available public revenues. Government has been borrowing from wealthy taxpayers instead of taxing them. A tax on wealth is proposed to return government to fairness and to fiscal responsibility. The details of a wealth tax are explained, a particular form of wealth tax is proposed, and the issues involved in wealth taxation are discussed. Journal of Economic Issues, Vol. 24, No. 1 (March 1990), pp. 133-144. (Reprinted with permission of the Journal of Economic Literature.)
An Exact Solution to a Dynamic Portfolio Choice Problem under Transaction Costs
Authors: Dumas Bernard , Luciano Elisa
Published: July 2003

The presence of any friction in financial markets qualitatively changes the nature of the optimization problem faced by an investor. It requires one to either act or do nothing, an issue which, of course, does not arise in frictionless situations. The investor considered here accumulates wealth without consuming until some terminal point in time when he consumes all. His objective is to maximize the expected utility derived from that terminal consumption. We postpone the terminal point far into the future to obtain a stationary portfolio rule. The portfolio policy is in the form of two control barriers between which portfolio proportions are allowed to fluctuate. We show how to calculate them. Trle.Iournal @-Finance, Vol. XLVI, No. 2 (June 1991), pp. 577-95. (Reprinted with permission of The Journal ofFinance.)
Tax Evasion and Portfolio Decisions
Authors: Landskroner Y. , Paroush, J. , Swary I.
Published: July 2003

This paper extends the literature on tax evasion under uncertainty by consider- ing not only the uncertain prospect of an audit, but also a risky capital asset. Tax evasion is considered as a risky investment and the decision about it is part of a portfolio decision of the individual. The individual decides about an investment in a riskless financial asset, a risky financial asset, as well as tax evasion. The effect of risk, risk aversion, the income tax rate, and “enforcement” parameters are consid- ered. PublicFinance, Vol. 45, No. 3 (1990), pp. 409-422. (Reprinted with permis- sion of Public Finance.)
Investor Tax-Trading Opportunities and Discounts on Closed-End Mutual Funds,
Authors: Kim Chang-Soo
Published: July 2003

Discounts on closed-end mutual funds are a puzzle to financial economists because arbitrage activities should eliminate discounts in a perfect capital market. In this paper I develop a model that explains discounts, using Merton’s option pricing theorem. By holding shares of a closed-end mutual fund, investors lose valuable tax-trading opportunities asso- ciated with the constituent securities of the closed-end mutual fund’s portfolio. However, investors can take advantage of all tax-trading opportunities by directly holding the closed- end mutual fund’s portfolio. I also show that both variances of the individual securities and correlations among securities in the portfolio are important factors in determining the magnitude of discounts. The Journal of Financial Research, Spring 1994, XVII( 1): 65-75. (Reprinted with permission of The Journul of Financial Research.)
Overreaction and Reverse Anticipation: Two Related Puzzles?
Authors: Liang Youguo , Mullineaux Donald J.
Published: July 2003

In this article we investigate stock price behavior before and after surprise events. We form four base portfolios and sixteen control portfolios, taking into consideration the event direction, the magnitude of event-day surprises, the potentially confounding effects due to calendar regularities in stock returns, and the ex-post outlier month of October 1987. Using capital market data from 1964 to 1989, we find a pre-event stock price behavior pattern that we call the reverse anticipation puzzle. We also confirm the existence of the overreaction pattern. The pre- and post-event stock price behavior patterns are found to be similar. The Journal of Financial Research, Spring 1994, XVII(I): 31-43. (Reprinted with permission of The Journul of Financial Research.)
Interest and limitations of projective techniques in the assessment of personality disorders
Authors: Petot J.M.
Published: July 2003

Assessing personality disorders (PD) remains a difficult task because of persistent problems linked to concurrent validity of existing instruments, which are all structured interviews or self-report inventories. It has been advocated that indirect methods, projective techniques in particular, can strengthen PD assessment methods. The thematic apperception test (TAT) may be a significant adjuvant method of PD assessment.
Antibiotic prescribing for children. Too much and too little? Retrospective observational study in primary care
Authors: Ekins‐Daukes Suzie , McLay James S. , Taylor Michael W. , Simpson Colin R. , Helms Peter J.
Published: July 2003

Aims  To investigate the extent of dose‐related off‐label antibiotic paediatric prescribing in primary care and to identify any potential clinical effects, particularly of lower than recommended dose prescribing.

Methods  Assessment of antibiotic prescribing in 168 396 children aged 0–16 years for the year 1999–2000 from data retrieved from 158 general practices using the national Scottish primary care computer system GPASS. The setting was general practices in Scotland.

Results  During the study period at least one course of antibiotics was prescribed to 23 911 children (14.2%). A total of 4582 (19.2%) children were prescribed an antibiotic dose of less than that recommended in the Summary of Product Characteristics (SPC). The number of children prescribed an antibiotic at less than recommended dose increased with age from 1154 (11.8%) aged 0–4 years to 1827 (30.0%) in the 12–16 years age group. For each antibiotic, prescribing lower than recommended dose occurred most frequently at those ages at which a dose increase was recommended in the SPC. Antibiotic prescribing at less than the recommended dose was not associated with an increased return rate for further antibiotic prescriptions during the following month, but in 5–11‐year‐olds was associated with a significant 48% increase in the total number of antibiotic courses prescribed during the study year {mean = 2.09 [95% confidence interval (CI) 1.79, 2.39]vs. 1.41 [95% CI 1.35, 1.47]}. Antibiotic prescribing at doses higher than recommended occurred less frequently (1.6%) and decreased steadily with age.

Conclusions  Off‐label prescribing of antibiotics at less than the recommended dose in children is common in primary care and occurs primarily as the result of a failure to increase antibiotic dosage with age in line with SPC recommendations. Adoption of a uniform approach to SPC age banding for antibiotic dose increments would reduce the frequency of dose‐related off‐label antibiotic prescribing in children and help minimize the potential for the development of antibiotic resistance.
The evolution of the randomized controlled trial and its role in evidence‐based decision making
Authors: Devereaux P. J. , Yusuf S.
Published: July 2003

Abstract.  Devereaux PJ, Yusuf S (McMaster University, Hamilton, Ontario, Canada). The evolution of the randomized controlled trial and its role in evidence‐based decision making (Clinical Trials). J Intern Med 2003; 254: 105–113.

The randomized controlled trial has been used in medical research for a little over half a century. This manuscript provides an overview of some of the history and evolution of the randomized controlled trial during this period. There exists hierarchies of evidence for therapeutic, diagnostic and prognostic questions, and the randomized controlled trial is at the top of the therapeutic hierarchy. Despite being at the top of the therapeutic hierarchy randomization in itself does not guarantee the trial results approximate the true effect. Issues that result in systematic and nonsystematic deviations from the truth in randomized controlled trials must also be considered. We present a model for evidence‐based decision making that includes the following components: the clinical state, patient preferences, research evidence from a range of studies and clinical expertise. We discuss the role of the randomized controlled trial within evidence‐based decision making.
A novel procedure for gentle isolation and separation of intact infected and uninfected protoplasts from the central tissue of Vicia faba L. root nodules
Authors: PEITER E. , IMANI J. , YAN F. , SCHUBERT S.
Published: July 2003

The central tissue of Vicia faba L. root nodules is composed of cells infected with Rhizobium bacteroids and uninfected cells. For the study of various processes, such as plasma membrane transport, it is essential to separate both cell types. Initial attempts to isolate protoplasts according to protocols described in the literature resulted in non‐spherical and osmotically inactive material, which is in agreement with previous descriptions. In the study reported herein, it was shown that the plasma membrane of non‐spherical infected protoplasts is not intact. A new isolation and separation protocol was developed, based on dissection of the nodule prior to cell wall digestion, non‐shaking digestion in hypertonic medium, and a combined procedure for release of protoplasts into slightly hypotonic medium and separation of protoplast fractions by isopycnic density gradient centrifugation. Infected and uninfected protoplasts that were isolated according to this protocol were spherical, osmotically active and excluded propidium iodide, confirming the intactness of their plasma membrane. The common fluorescein diacetate test was shown to be artefactual in infected cells, since viable bacteroids also stain in defective cells. Light and electron microscopic examination of infected protoplasts showed that protoplasts still contained starch after isolation and bacteroids in intact protoplasts had unusually high amounts of polyhydroxybutyrate. The vacuoles of infected protoplasts contained protein and membrane‐enclosed structures, and were of non‐acid pH; traits that are typical of protein storage vacuoles.
Micronutrient fortification of plants through plant breeding: can it improve nutrition in man at low cost?
Authors: Bouis Howarth E.
Published: July 2003

Can commonly-eaten food staple crops be developed that fortify their seeds with essential minerals and vitamins? Can farmers be induced to grow such varieties? If so, would this result in a marked improvement in human nutrition at a lower cost than existing nutrition interventions? An interdisciplinary international effort is underway to breed for mineral- and vitamin-dense varieties of rice, wheat, maize, beans and cassava for release to farmers in developing countries. The biofortification strategy seeks to take advantage of the consistent daily consumption of large amounts of food staples by all family members, including women and children as they are most at risk for micronutrient malnutrition. As a consequence of the predominance of food staples in the diets of the poor, this strategy implicitly targets low-income households. After the one-time investment is made to develop seeds that fortify themselves, recurrent costs are low and germplasm may be shared internationally. It is this multiplier aspect of plant breeding across time and distance that makes it so cost-effective. Once in place, the biofortified crop system is highly sustainable. Nutritionally-improved varieties will continue to be grown and consumed year after year, even if government attention and international funding for micronutrient issues fades. Biofortification provides a truly feasible means of reaching malnourished populations in relatively remote rural areas, delivering naturally-fortified foods to population groups with limited access to commercially-marketed fortified foods that are more readily available in urban areas. Biofortification and commercial fortification are, therefore, highly complementary. Breeding for higher trace mineral density in seeds will not incur a yield penalty. Mineral-packed seeds sell themselves to farmers because, as recent research has shown, these trace minerals are essential in helping plants resist disease and other environmental stresses. More seedlings survive and initial growth is more rapid. Ultimately, yields are higher, particularly in trace mineral-‘deficient’ soils in arid regions.
Advanced machine vision systems and application examples
Authors: Ranky Paul G.
Published: July 2003

According to a recent study by Active‐Media Research, USA, total sales in advanced vision systems, including vision‐guided mobile devices/robots are expected to soar from US $665 million in the year 2000 to more than US $17 billion by 2005. The key technologies contributing to this massive growth include major advancements in vision imaging science and control, integrated with increasingly “machine intelligent” and robust industrial robotics. This article gives an overview of key machine vision advancements, and demonstrates some advanced vision application examples.
Short‐ and Long‐Run Effects of Environmental Degradation: A Structuralist Approach
Authors: Chakraborty Rabindra Nath
Published: July 2003

The model presented in this paper distinguishes an industrial and an agricultural sector within a developing economy, which interact predominantly through the goods market. Investment determines saving through the Keynesian mechanism of effective demand. Environmental degradation results from the overexploitation of a renewable resource due to a common pool externality, which causes agricultural productivity to decline. The analysis shows that environmental degradation can reduce growth in the short run but increases growth (measured by the stock of industrial capital per capita) in the long run. Simulations reveal that the period of decline can be as long as 40 years. This suggests that the short‐term effects in this model may be more relevant for policy than the long‐run equilibria.
Estimating the Impact of the Minimum Wage Using Geographical Wage Variation*
Authors: Stewart Mark B.
Published: July 2003

This paper evaluates the impact on employment of the UK's introduction of a minimum wage in 1999 by exploiting the geographical variation in wages, which meant that the minimum wage's ‘bite’ into an area's wage distribution differed considerably across the country. The results indicate that, although the minimum wage had differential wage‐distribution effects across the 140 areas of the country, employment growth after its introduction was not significantly lower in areas of the country with a high proportion of low‐wage workers, whose wages had to be raised to comply, from that in areas with a low proportion of such workers.
Antigen Capture Enzyme-Linked Immunosorbent Assay for Specific Detection of Reston Ebola Virus Nucleoprotein
Authors: Ikegami Tetsuro , Niikura Masahiro , Saijo Masayuki , Miranda Mary E. , Calaor Alan B. , Hernandez Marvin , Acosta Luz P. , Manalo Daria L. , Kurane Ichiro , Yoshikawa Yasuhiro , Morikawa Shigeru
Published: July 2003

Antigen capture enzyme-linked immunosorbent assay (ELISA) is one of the most useful methods to detect Ebola virus rapidly. We previously developed an antigen capture ELISA using a monoclonal antibody (MAb), 3-3D, which reacted not only to the nucleoprotein (NP) of Zaire Ebola virus (EBO-Z) but also to the NPs of Sudan (EBO-S) and Reston Ebola (EBO-R) viruses. In this study, we developed antigen capture ELISAs using two novel MAbs, Res2-6C8 and Res2-1D8, specific to the NP of EBO-R. Res2-6C8 and Res2-1D8 recognized epitopes consisting of 4 and 8 amino acid residues, respectively, near the C-terminal region of the EBO-R NP. The antigen capture ELISAs using these two MAbs detected the EBO-R NP in the tissues from EBO-R-infected cynomolgus macaques. The antigen capture ELISAs using Res2-6C8 and Res2-1D8 are useful for the rapid detection of the NP in EBO-R-infected cynomolgus macaques.
Low-Frequency Collective Motions in Proteins
Authors: Antoniou Dimitri , Schwartz Steven D.
Published: July 2003

There are several kinds of low-frequency collective motions in proteins, which are believed to have a significant effect on their properties. We propose that a new kind of global collective motion in proteins are density fluctuations, which are slowly-varying, long-lived, propagating disturbances. These can be studied using the linear response formalism, which is a dynamical approximation that uses the full anharmonic interatomic potential. We have performed a molecular dynamics simulation of a realistic protein and have found results that are consistent with the theoretical predictions of linear response theory.
Compressibility oftert-Butyl Alcohol-Water Mixtures: The Rism Theory
Authors: Omelyan Igor , Kovalenko Andriy , Hirata Fumio
Published: July 2003

The isothermal compressibility χTof binary mixtures of water and tert-butyl alcohol (TBA) is calculated using the reference interaction site model (RISM) integral equation theory. The calculations are performed over the whole concentration from x = 0 to 1 and a wide temperature from T = 283 to 313 K ranges employing the extended point charge model for water and optimized site–site potentials for TBA molecules. The results obtained are compared versus available experimental data. It is demonstrated that, despite an approximate character of the model potentials and closure relation applied, the theory is able to reproduce qualitatively all main features of the x- and T-dependencies of χTinherent in real experiment. Such features include the decrease of compressibility with increasing T in the low TBA concentration limit x → 0 (pure water), and the increase of χTwith rising T in the opposite regime x → 1 (pure alcohol); the presence of a concentration region where the function χT(x, T) does not depend much on T; as well as the existence of a minimum in χTwith respect to x at each given T. The question of how to achieve a quantitative agreement between the theoretical and experimental values by correcting the closure relation is also discussed.
Confronting Constructionism: Ending India's Naga War
Authors: Baruah Sanjib
Published: July 2003

One of the world's oldest continuing armed conflicts is also one of the least known: the conflict between the government of India and the Nagas. Since 1997, there has been a ceasefire between the Indian government and Naga militants, and there have been intermittent talks to end the conflict. Naga leaders appear to be willing to make concessions on their main demand of independence. But the peace process has stumbled on an unexpected hurdle: the Naga aspiration to the unification of all Naga-inhabited areas. Whether or not some people included in the Naga category should indeed be considered Nagas is in fact a highly contested matter. Since it is impossible to agree on who is a Naga and who is not, it has been difficult to decide what the Naga-inhabited areas are. The issue has generated some new conflicts in the region. As in all ethno-national conflicts, the politics of recognition is an underlying theme in the Naga conflict. But projects about recognition are also projects about constructing identities. The notion of bounded collectivities living in national homelands relies on a very different spatial discourse from the one of overlapping frontiers and hierarchical polities that precedes it. The article argues that the historical relations between hill peoples and the lowland states in this frontier region were premised on an especially complex spatial, cultural, and political dynamic. Saving the faltering Naga peace process will require confronting the constructionism of modern identities by the political actors themselves.
The Employment of IT Personnel
Authors: Peneder Michael
Published: July 2003

The rapid advance and diffusion of new information technologies left pronounced imprints on the formation of human capital. Firstly, it favoured the growth of specific computer related occupations, secondly it raises the demand for higher levels of workforce education. Although IT equipment is the showcase of a general purpose technology, pervading the production process in any kind of economic activity, there is substantial heterogeneity among industries in terms of IT-labour intensity. The article demonstrates that these differences are sufficiently systematic to establish a new sectoral classification, which captures substantial portions of the total variation in the above dimensions. More specifically, the results contrast popular beliefs about a uniform dissemination of new information technologies in all sectors.
The Employment Effects of the ‘New Economy’. A Comparison of the European Union and the United States
Authors: van Ark Bart , Inklaar Robert , McGuckin Robert H. , Timmer Marcel P.
Published: July 2003

This paper provides an analysis of the trends in labour productivity and employment growth at industry level in the European Union and the United States during the 1990s. We analyse relationships for groups of industries, i.e. industries that produce ICT products and services, those that invest strongly in ICT, and those that make less intensive use of ICT. The main findings are that the inverse relationship between employment and productivity growth has been much more prominent in manufacturing industries than in services industries. Secondly, during the 1990s, this relationship has turned positive in many industries, in particular in ICT-producing industries and in ICT-using industries in the service sector. Finally, the employment-reducing effects of productivity growth have remained considerably stronger in Europe than in the US.
Your Home, My Exile: Boundaries and `Otherness' in Antiquity and Now
Authors: Gabriel Yiannis
Published: July 2003

As traveller in perilous seas and storyteller, as trickster and bricoleur, as schemer and as bully, as lover and family man, as a leader of men and reader of situations, Odysseus has woven his way easily into discourses past and present. Focusing on one specific scene from the Odyssey, one in which Odysseus shipwrecked, naked and lost, in serious need of being organized, bursts into the organized routines of Princess Nausicaa, the author argues that the Odyssey offers insights into all encounters with the disorganized Other. Learning to listen to and understand the Other's voice is especially important at a time of ever-proliferating social, organizational and other boundaries.
The Institutional Structuring of Organizational Capabilities: The Role of Authority Sharing and Organizational Careers
Authors: Whitley Richard
Published: July 2003

The development of competitive competences in firms involves the generation of core employee commitment to collective problem solving and the development of firm-specific capabilities. Such commitment is often gained through authority sharing and providing organizational careers that reward contributions to organizational problem-solving routines and goals. However, firms vary considerably in how authoritative coordination of economic activities (both within and between companies) is achieved, and in the extent and scope of organizational careers. These differences affect their development of coordinating, learning and reconfigurational organizational capabilities. Owners and managers are encouraged to adopt varying degrees of authority sharing with groups of employees and business partners, and to invest in organizational careers to varying extents, by different institutional frameworks. In particular, variations in states' coordinating roles, the strength of business associations, the market for corporate control and the organization of training systems affect firms' delegation of discretion and career types. As a result, firms in different institutional frameworks develop distinctive kinds of capabilities that influence how they compete in different sectors and technologies.