bluuebunny/crossref_metadata_2025 huggingface dataset:
Invariance, groups, and non-uniqueness: The discrete case
Authors: Vasco D. W.
Published: December 2006

Lie group methods provide a valuable tool for examining invariance and non-uniqueness associated with geophysical inverse problems. The techniques are particularly well suited for the study of non-linear inverse problems. Using the infinitesimal generators of the group it is possible to move within the null space in an iterative fashion. The key computational step in determining the symmetry groups associated with an inverse problem is the singular value decomposition of a sparse matrix. I apply the methodology to the eikonal equation and examine the possible solutions associated with a crosswell tomographic experiment. Results from a synthetic test indicate that it is possible to vary the velocity model significantly and still fit the reference arrival times. The approach is also applied to data from crosswell surveys conducted before and after a CO2 injection at the Lost Hills field in California. The results highlight the fact that a fault cross-cutting the region between the wells may act as a conduit for the flow of water and CO2.
Combined factor VIII and IX inhibitors in a non‐haemophilic patient: successful treatment with immunosuppressive drugs
Authors: CARMASSI F. , GIANNARELLI C. , DE GIORGI A. , DE NEGRI F.
Published: December 2006

Summary.  A rare case of a patient with Sjogren syndrome and spontaneously acquired inhibitors of both factor VIII and factor IX is reported. Complete remission was obtained by means of immunosuppressive drugs.
Defining ‘full‐length’ recombinant factor VIII: a comparative structural analysis
Authors: JANKOWSKI M. A. , PATEL H. , ROUSE J. C. , MARZILLI L. A. , WESTON S. B. , SHARPE P. J.
Published: December 2006

Summary.  Coagulation factor VIII (FVIII) is an important glycoprotein co‐factor involved in haemostasis, functioning to accelerate activation of factor X by activated factor IX. Insertion of expression vectors containing the full‐length cDNA sequence of human FVIII into mammalian cell lines results in the production of recombinant factor VIII (rFVIII), typically referred to as ‘full‐length’ rFVIII (FLrFVIII). Both FLrFVIII and plasma‐derived FVIII exist primarily as heterodimeric proteins, consisting of a heterogenous light and heavy chain. The objectives of this study were to compare the structural heterogeneity of high‐purity FVIII preparations and further define the term ‘full length’ as it refers to rFVIII protein structure. Five commercially available FVIII concentrates were characterized based on SDS‐PAGE, N‐terminal sequencing, and peptide and domain mapping coupled to mass spectrometry. The major heavy chain species identified in FLrFVIII included various B‐domain‐truncated forms of FVIII, with the predominant species terminating at Arg1313. This study demonstrates that the use of full‐sequence FVIII cDNA for the production of rFVIII does not result in a homogeneous FLrFVIII protein product. Rather, commercially available FLrFVIII represents a heterogenous mixture of various B‐domain‐truncated forms of the molecule, with no evidence of a contiguous, intact B‐domain.
Combined clotting factor deficiencies: experience at a single hemophilia treatment center
Authors: O'BRIEN S. H. , RITCHEY A. K. , RAGNI M. V.
Published: December 2006

Summary.  We describe a series of patients with combined factor deficiencies and von Willebrand's disease (VWD) at one haemophilia treatment centre. Although the incidence of VWD is at least 1% in the general population, combined coagulation defects have been infrequently described in the medical literature and are likely under diagnosed. This entity should be considered in patients with a known factor deficiency and either an unexpectedly severe bleeding phenotype, or bleeding that is unresponsive to factor replacement.
Prevalence of sporadic and familial haemophilia
Authors: KASPER C. K. , LIN J. C.
Published: December 2006

Summary.  In an analysis of 804 haemophilia pedigrees, mild to moderate haemophilia A or B was found to be clearly familial in 70% of cases, severe haemophilia B in 57% of cases and severe haemophilia A in 45% of cases. The rest of the patients were ‘sporadic’ i.e., either isolated cases or brothers in the first affected sibship. In sporadic families, 88% of mothers but only 19% of maternal grandmothers had the relevant mutation in their white blood cells. Among patients with familial haemophilia, half the patients with mild haemophilia and those with severe haemophilia B had a direct male ancestor with haemophilia, but only 28% of patients with severe haemophilia A had such a progenitor.
Pegylated interferon and ribavirin combination therapy for chronic hepatitis C in patients with congenital bleeding disorders: a single‐centre experience
Authors: POSTHOUWER D. , FISCHER K. , DE HEUSDEN N. , MAUSER‐BUNSCHOTEN E. P.
Published: December 2006

Summary.  Chronic hepatitis C is a major comorbidity in patients with haemophilia. Although the current state‐of‐the‐art therapy consists of pegylated interferon (PegIFN) and ribavirin, there are no reports of the efficacy of this combination in the haemophilia population. The aim of this study was to assess the response and side‐effects of PegIFN and ribavirin in patients with inherited bleeding disorders. Patients with chronic hepatitis C were treated with PegIFN alpha‐2b (1.5 μg kg−1 week−1) and ribavirin (800–1200 mg day−1) for 24 (genotype 2 and 3) or 48 weeks (genotype 1) and followed for an additional 24 weeks. In total, 56 patients were enrolled: 31 (55%) had genotype 1, 12 (21%) genotype 2, and 13 (23%) genotype 3. Ten patients (18%) were HIV co‐infected and seven (13%) had been previously treated with IFN‐α with or without ribavirin. The overall response was 55%. In HIV‐negative and treatment‐naïve patients, the sustained virological response was 70%. Successful treatment was associated with genotypes 2 and 3, absence of HIV, absence of previous IFN treatment, and decrease of hepatitis C virus load at weeks 4 and 12. Although many side‐effects occurred, only a minority (11%) discontinued therapy for this reason. Dose reduction of PegIFN was required in 28% and of ribavirin in 35% of patients. Overall, 22% of patients developed a depression requiring antidepressant drugs and one patient developed psychosis. In conclusion, PegIFN and ribavirin is effective in patients with inherited bleeding disorders. Treatment is safe, but severe side‐effects may occur and warrant close monitoring during therapy.
Testis‐specific expression of the β2 tubulin promoter of Aedes aegypti and its application as a genetic sex‐separation marker
Authors: Smith R. C. , Walter M. F. , Hice R. H. , O’Brochta D. A. , Atkinson P. W.
Published: December 2006

Sex‐specific expression of transgenes in pest insects enables novel genetic control strategies, based either on genetic sexing or the spread of transgenes through the germ‐line, to be developed and then tested for implementation. We describe the isolation of the β tubulin genes from the yellow fever mosquito, Aedes aegypti, and the identification of the particular β2 tubulin gene which has expression confined to the testes. We demonstrate that the β2 tubulin promoter of Ae. aegypti can direct the expression of a DsRed genetic marker in the testes and show that labelled sperm can be detected in inseminated spermathecae. The applications for this technology in the genetic control of Ae. aegypti are discussed.
Antennal esterase cDNAs from two pest moths, Spodoptera littoralis and Sesamia nonagrioides, potentially involved in odourant degradation
Authors: Merlin C. , Rosell G. , Carot‐Sans G. , François M.‐C. , Bozzolan F. , Pelletier J. , Jacquin‐Joly E. , Guerrero A. , Maïbèche‐Coisne M.
Published: December 2006

Rapid degradation of odours after interaction with olfactory receptors is a critical step of the signal reception process. However, the implied mechanisms are still largely unknown in vertebrates as well as in insects. Involvement of odourant‐degrading enzymes in odourant degradation within the antennae has been shown in some insect species and, in particular, esterases could play a key role in degradation of sex pheromones from Lepidoptera. Using a PCR‐based strategy, we isolated cDNAs encoding two new esterases from two moths which used acetates as pheromone compounds: the Egyptian armyworm Spodoptera littoralis and the Mediterranean corn borer Sesamia nonagrioides. In antennae, both transcripts were clearly restricted to olfactory sensilla, suggesting their involvement in the degradation of odourant acetate components.
Regulated expression of microinjected DNA in adult Aedes aegypti mosquitoes
Authors: Isoe J. , Kunz S. , Manhart C. , Wells M. A. , Miesfeld R. L.
Published: December 2006

We have developed a novel molecular genetic approach to investigating gene regulation in adult mosquitoes called whole body transfection (WBT). This DNA microinjection method allows for both constitutive and regulated expression of plasmid vectors in the fat body and midgut of adult mosquitoes within 24 h of injection. Using a luciferase reporter gene containing the Aedes aegypti heat shock protein 70 (Hsp70) promoter, we optimized the WBT protocol at various times post‐injection and used these parameters to measure the expression of a vitellogenin‐luciferase reporter gene in response to blood meal feeding. These studies showed that a 843 bp fragment of the Ae. aegypti vitellogenin‐C (VgC) promoter caused a greater than 200‐fold induction of luciferase activity in a strict tissue‐specific manner, and only in response to feeding. Functional mapping of the VgC promoter by WBT identified essential upstream regulatory elements in the region spanning −780 to −182 bp from the transcriptional start site. We also constructed a lipopolysaccharide‐regulated expression vector using a 1096 bp genomic fragment of the Ae. aegypti cecropin B (CecB) promoter. Our data show that four days after WBT injection, the CecB‐luciferase reporter gene could be induced more than 100‐fold in the fat body following lipopolysaccharide injection. Moreover, we found that lipopolysaccharide‐induction of the CecB reporter gene occurred up to 28 days post‐WBT injection. These data suggest that WBT could provide a novel strategy to express recombinant proteins and RNAi constructs in adult mosquitoes using conventional microinjection methods.
Leptin levels in infertile male patients are correlated with inhibin B, testosterone and SHBG but not with sperm characteristics
Authors: Zorn Branko , Osredkar Joško , Meden‐Vrtovec Helena , Majdic Gregor
Published: December 2006

In the present study, differences in leptin levels between different groups of male patients presenting with infertility problems and possible correlations between leptin levels and clinical, spermiological, histological and hormonal characteristics were examined. Two hundred and ten male partners from infertile couples were included in the study. Based on clinical examination, spermiogram and testicular histology results, patients were divided into four groups: 42 men with non‐obstructive azoospermia, 15 men with obstructive azoospermia, 68 men with oligoasthenoteratozoospermia and 85 men with normozoospermia. Serum levels of follicle‐stimulating hormone (FSH), luteinizing hormone (LH), inhibin B, testosterone, sex hormone binding globulin (SHBG) and leptin were measured. After adjustment for body mass index, there was a negative correlation between serum levels of leptin and inhibin B, total testosterone and SHBG (r = −0.189, p = 0.009, r = −0.250, p = 0.001 and r =−0.221, p = 0.003 respectively) but there was no correlation between leptin and classical sperm characteristics. Our results therefore demonstrate a link between leptin and testicular function, independently of FSH and LH, possibly involving testosterone and SHBG through a regulation of Leydig cell function.
Intake of melatonin is associated with amelioration of physiological changes, both metabolic and morphological pathologies associated with obesity: an animal model
Authors: Hussein Mahmoud R. , Ahmed Omyma G. , Hassan Asmaa F. , Ahmed Marwa A.
Published: December 2006

Obesity and its associated metabolic pathologies are the most common and detrimental diseases, affecting over 50% of the adult population. Our knowledge about the protective effects of melatonin against high‐fat diet (HFD)‐induced obesity is still marginal. In this investigation, we hypothesized that melatonin can minimize the metabolic pathologies and morphological changes associated with obesity in animals receiving an HFD. To examine these effects, and to test our hypothesis, an animal model formed of male Boscat white rabbits was established. The animals were divided into three groups: (i) a control group fed regular diet; (ii) an obesity group fed an HFD for 12 weeks; and (iii) a treated group fed HFD for 12 weeks and then treated with melatonin for 4 weeks. The animals were killed and their serum and tissues were evaluated for: (i) lipid profile (cholesterol, triglycerides and low‐density lipoprotein) and glucose; (ii) antioxidant enzyme (serum glutathione peroxidase, GSH‐PX); and (iii) fatty changes (liver, kidney and blood vessels). Compared with the control group, intake of HFD (obesity group) was associated with: (i) a statistically significant increase in blood pressure, heart rate, sympathetic nerve activity, body weight, food consumption, serum lipids, blood glucose levels and atherogenic index; (ii) decreased level of GSH‐PX and high‐density lipoprotein (HDL); and (iii) fatty changes in the liver and kidney as well as atheromatous changes in the blood vessels. Compared with the obesity group, intake of melatonin (treated group) was associated with: (i) a statistically significant decrease in blood pressure, heart rate, sympathetic nerve activity, body weight, food consumption, serum lipids, blood glucose levels and atherogenic index; (ii) increased level of GSH‐PX and HDL; and (iii) disappearance of fatty changes in the liver and kidney as well as atheromatous changes in the blood vessels. The administration of melatonin reduced the metabolic pathologies associated with the intake of HFD, suggesting a protective role. Although the underlying mechanisms are unclear, they may include its antioxidant and receptor‐mediated effects. The clinical ramifications of these effects await further investigations.
Inflammation‐associated remodelling and fibrosis in the lung – a process and an end point
Authors: Wallace William A.H. , Fitch Paul M. , Simpson A. John , Howie Sarah E.M.
Published: December 2006

Fibrosis by common usage in the pathological and clinical literature is the end result of a healing process and synonymous with scarring. We would argue that its use to describe a dynamic series of events which may be reversible is unhelpful and that the term ‘lung remodelling’ is a better description for this process as it reflects changes in tissue organization that may or may not progress to ‘fibrosis’ as a final fixed point. Resolution, through reversal of active lung remodelling, by therapeutic intervention is possible providing the alveolar architecture remains intact. If the lung architecture is lost then healing by permanent fibrosis with loss of organ function is inevitable.
Patterns of genetic differentiation in Thamnophis and Taricha from the Pacific Northwest
Authors: Ridenhour Benjamin J. , Brodie Jr Edmund D. , Brodie III Edmund D.
Published: December 2006

Aim  The co‐evolutionary interaction between the common garter snake, Thamnophis sirtalis, and the rough‐skinned newt, Taricha granulosa, takes place throughout much of the Pacific Northwest (North America). The biogeography of the Pacific Northwest has been heavily influenced by the last Pleistocene glaciation, which reached a maximum as late as 14,000 yr bp. We researched: (1) what type of population structure is present for garter snakes and newts, (2) whether the population structure of these species is consistent with a Pleistocene glaciation hypothesis, and (3) how population structure and migration possibly affect co‐evolution between these species.

Location  The Pacific Northwest of North America, specifically northern California, Oregon and Washington in the USA.

Methods  We sampled approximately 20 populations for each species from three different transects. Using microsatellite markers and tissue samples from both species, we quantified the population structure for both species. Individual‐based assignment tests were used to estimate contemporary migration rates.

Results  Both Th. sirtalis and Ta. granulosa exhibited little genetic differentiation among our study sites, even among those separated by large distances. Significant population structure was detected on multiple geographic scales. Differences in population structure were observed among transects and between garter snake and newt transects. Contemporary migration rate estimates indicate high levels of genetic exchange between populations.

Main conclusions  Prior to this study, little was known about the fine‐scale population structure of either species in this region. Patterns of population structure for garter snakes and newts reflect a shared biogeographical history affected by the Pleistocene glaciation in the Pacific Northwest. Both species apparently migrate frequently between populations, thus potentially retarding the process of adaptive co‐evolution. We find that populations from a northern coastal transect (Washington) are most likely to be locally adapted.
Introducing a new (freeware) tool for palynology
Authors: Bush Mark B. , Weng Chengyu
Published: December 2006

We present a multiple‐access key and searchable data base to Neotropical pollen that is available as freeware. The data base is based on FileMaker 5 and contains c. 6000 images of >1000 taxa. All pollen images are of acetolysed grains collected from vouchered herbarium specimens. The selection of taxa to be included in the data base is predicated upon their probable occurrence in lake sedimentary records, which in turn was based on their flower structure, sexual mechanisms and ecology. The multiple‐access key is a forgiving format as it can be used with incomplete data or where the researcher cannot decide between the choices offered. The data base is downloadable and is compatible with both Mac and PC platforms.
Eroding abodes and vanished bridges: historical biogeography of the substrate specialist pebble‐mound mice (Pseudomys)
Authors: Ford Fred , Johnson Christopher
Published: December 2006

Aim  To determine whether the pronounced ecological importance of pebble mounds to pebble‐mound mice (Pseudomys) is manifest in their continental biogeography.

Location  Northern Australia.

Methods  A GIS‐based comparison was made between the habitats contained within the potential climatic distributions of mice, representing a null hypothesis of no habitat selection, and their actual distributions based on all known location records.

Results  All species had a clear preference for hilly, rocky landscapes with a surficial cover dominated by bedrock. Simple vegetation communities with relatively open eucalypt overstorey and grassy understorey were preferred. Highly degraded rocks and aggradational surfaces and plains were avoided. The extent of the summer monsoon may be important in determining the southern limits of the group's distribution. Major disjunctions between species were attributable to the presence of clay plains and sand sheets.

The behavioural requirement of pebble‐mound mice for mounds determines their population distribution pattern and the distribution of the different species within the genus.

Main conclusions  The behavioural need for pebble mounds drives the distributional pattern of populations and species of pebble‐mound mice. The initial spread of pebble‐mound mice probably occurred during the late Pliocene or earliest Pleistocene. There has predominantly been degradation of the potential distribution of the group since that time due to the stability of Australian landscapes and Pleistocene planation and sand sheet development over large areas of northern Australia. This process is ongoing, and past regions of rocky contact between current distributions have disappeared, while the distributional limits of several species are steadily being reduced by erosion of hills and the spread of dune fields.
An alien in an archipelago: Spathodea campanulata and the geographic variability of its moth (Lepidoptera) communities in the New Guinea and Bismarck Islands
Authors: Bito Darren
Published: December 2006

Aim  This analysis of moth (Lepidoptera) communities colonizing an alien tree invading secondary rain forest vegetation in Melanesia examines the predictability of insect herbivorous communities across distances of tens to thousands of km and the effect of dispersal barriers on community composition in the tropics.

Location  Six secondary rain forest sites were studied within four equidistant yet distinct geographic areas of the New Guinea mainland and the Bismarck Archipelago, including two watershed areas (Madang and Sepik) on mainland New Guinea and the adjacent large island of New Britain and small island of Unea.

Methods  The analysis is based on feeding records obtained by quantitative sampling and rearing of caterpillars from the alien host Spathodea campanulata (Bignoniaceae). It examines the variation in Lepidoptera community composition at six study sites distributed on three adjacent islands ranging in size from 30 to 865,000 km2.

Results  Spathodea campanulata was colonized by 54 folivorous species of Lepidoptera. Most of them were generalists, feeding on > 1 native plant family. However, the three most abundant species representing 83% of all individuals (Acherontia lachesis, Hyblaea puera complex and Psilogramma menephron) were relatively host specific, feeding predominantly on a single native family that is not the Bignoniaceae. Most of the 23 species analysed in detail had a wide geographic distribution, including 13 species spanning the entire 1000‐km study transect. While the Lepidoptera in two New Guinea areas 280 km apart were similar to each other, there was a discontinuity in species composition between New Guinea and the smaller islands. However, no negative effect of small islands on species richness was detected.

Main conclusions  Spathodea campanulata was rapidly colonized by folivorous Lepidoptera communities with species richness and dominance structure indistinguishable from the assemblages feeding on native hosts, despite its phylogenetic isolation from the native vegetation. Although most species were generalists, the highest population densities were reached by relatively specialized species, similar to the communities on native hosts. The species turnover across distances from 10 to 1000 km was relatively low as most of the species had wide geographic ranges.
Plastid and nuclear DNA polymorphism reveals historical processes of isolation and reticulation in the olive tree complex (Olea europaea)
Authors: Besnard G. , Rubio de Casas R. , Vargas P.
Published: December 2006

Aim  The olive tree is considered one of the best indicators of the Mediterranean climate. The species’ distribution is associated with geographical and bioclimatic factors, as well as being influenced by a long period of cultivation. Despite concerted efforts of different research groups, the origin of the Mediterranean olive tree still remains elusive. In the present study, relationships between taxa and populations covering the entire range of Olea europaea were investigated using both maternal (plastid genome) and biparental (nuclear genome) markers to disclose evolutionary patterns in the olive complex. Phylogenetic and phylogeographical results of the two‐genome analyses were interpreted in a biogeographical context.

Location  Mediterranean, temperate and subtropical floristic regions of the Old World.

Methods  Phylogeographical reconstructions of plastid DNA polymorphism were performed using microsatellites, restriction sites and indels on a wide sample of 185 representative trees across the Old World, including 28 herbarium specimens from remote areas. Additionally, the potential utility of one ITS‐1 pseudogene for phylogenetic analyses was explored using Bayesian and maximum parsimony approaches on a subsample of 38 olive trees.

Results  Forty plastid haplotypes were recognized and split into two lineages and seven sublineages. The analysis of ITS‐1 sequences also allowed the identification of seven well differentiated groups. Distribution of plastid and ribosomal DNA lineages was congruent, but particular cases of phylogenetic incongruence were disclosed (particularly in the Sahara and Madeira). Lastly, two divergent ITS‐1 copies were isolated from the same sample of four individuals of different subspecies.

Main conclusions  Phylogenetic congruence of both ITS‐1 and plastid lineages suggested an evolutionary scenario of predominant isolation during the Plio‐Pleistocene in Macaronesia, the Mediterranean, southern Africa, eastern Africa and Asia. The Saharan desert appeared to have played an important role of vicariant barrier between southern and northern African populations in early times. Incongruence of some plastid and nuclear results, as well as intermingled ITS‐1 copies of different lineages in single individuals, was interpreted as a result of recurrent reticulation events in the olive complex. We identified an ancient hybrid zone from the Sahara to north‐eastern African mountains, where divergent plastid and nuclear lineages still co‐exist. Results of this paper, and previous studies, suggest that the cultivated olive originated from a pre‐Quaternary Mediterranean ancestor, with no evidence for a recent hybrid origin. In contrast, a continuous process of olive domestication through local hybridization events of cultivated trees with natural populations may have brought about a remarkably high genomic diversity among cultivated trees across the Mediterranean.
The spatial distribution of birds and carabid beetles in pine plantation forests: the role of landscape composition and structure
Authors: Barbaro Luc , Rossi Jean‐Pierre , Vetillard Fabrice , Nezan Julien , Jactel Hervé
Published: December 2006

Aim To evaluate the joint and independent effects of spatial location, landscape composition and landscape structure on the distribution patterns of bird and carabid beetle assemblages in a mosaic landscape dominated by pine plantation forests.

Location A continuous 3000‐ha landscape mosaic with native maritime pinePinus pinasterplantations of different ages, deciduous woodlands and open habitats, located in the Landes de Gascogne forest of south‐western France.

Methods We sampled breeding birds by 20‐min point counts and carabid beetles by pitfall trapping using a systematic grid sampling of 200 points every 400 m over the whole landscape. Explanatory variables were composed of three data sets derived from GIS habitat mapping: (1) spatial variables (polynomial terms of geographical coordinates of samples), (2) landscape composition as the percentage cover of the six main habitats, and (3) landscape structure metrics including indices of fragmentation and spatial heterogeneity. We used canonical correspondence analysis with variance partitioning to evaluate the joint and independent effects of the three sets of variables on the ordination of species assemblages. Moran'sIcorrelograms and Mantel tests were used to assess for spatial structure in species distribution and relationships with separate landscape attributes.

Results Landscape composition was the main factor explaining the distribution patterns of birds and carabids at the mesoscale of 400 × 400 m. Independent effects of spatial variables and landscape structure were still significant for bird assemblages once landscape composition was controlled for, but not for carabid assemblages. Spatial distributions of birds and carabids were primarily influenced by the amount of heathlands, young pine plantations, herbaceous firebreaks and deciduous woodlands. Deciduous woodland species had positive responses to edge density, while open habitat species were positively associated with mean patch area.

Main conclusions Forest birds were favoured by an increase in deciduous woodland cover and landscape heterogeneity, but there was no evidence for a similar effect on carabid beetles. Fragmentation of open habitats negatively affected both early‐successional birds and carabids, specialist species being restricted to large heathlands and young plantations. Several birds of conservation concern were associated with mosaics of woodlands and grasslands, especially meadows and firebreaks. Conserving biodiversity in mosaic plantation landscapes could be achieved by the maintenance of a significant amount of early‐successional habitats and deciduous woodland patches within a conifer plantation matrix.
Management of gestational diabetes from the patient's perspective – a comparison of Swedish and Middle‐Eastern born women
Authors: Hjelm Katarina , Bard Karin , Nyberg Per , Apelqvist Jan
Published: December 2006

Aim.  To explore patients’ evaluation of a specialized diabetes clinic for management of women with gestational diabetes born in Sweden and the Middle East and its contribution to a decreased level of stress and improved coping capability to promote health in patients receiving care.

Background.  No studies comparing patients’ perceptions of healthcare in women of different origin with gestational diabetes have been found. A perceived clinical problem in specialized diabetes care is of lower activity level in self‐care in foreign‐ than Swedish‐born women and the question is whether the healthcare organization is optimal in meeting different individuals’ needs.

Design.  Explorative study.

Method.  Semi‐structured individual interviews by external evaluators.

Participants.  Consecutive sample. Females with gestational diabetes, 13 born in Sweden and 14 born in the Middle East.

Results.  The healthcare model was perceived as functioning well. Swedish women were problem focused and information seeking. Frustration and stress were increased due to perceived delay in information concerning gestational diabetes, limited access to telephone service and lack of confidence in staff because they lacked the expected competence. Control of gestational diabetes and pregnancy by different persons led to perceived lack of holistic care. Women from the Middle East felt cared, had been given the necessary information and claimed to follow advice. Adequate information reduced respondents’ anxiety and increased their control over the situation.

Conclusions.  The clinic needs to be further improved by adapting programmes to persons to become problem focused by giving adequate information immediately.

Relevance to clinical practice.  Cultural differences in coping strategies and attitudes to gestational diabetes need to be considered. Training of staff working with gestational diabetes patients is urgently needed.
The effect of different body positions on blood pressure
Authors: Eşer İsmet , Khorshid Leyla , Yapucu Güneş Ülkü , Demir Yurdanur
Published: December 2006

Aim.  The aim of the present study was to test the effects of different body on BP readings in a Turkish healthy young adults.

Background.  It is known that many factors influence an individual's blood pressure measurement. However, guideliness for accurately measuring blood pressure inconsistently specify that patient's position and they should keep feet flat on the floor. Although there are more information on arm position in blood pressure measurement, surprisingly little information can be found in the literature with respect to the influence of body position on the blood pressure readings in healthy young people.

Methods.  A total of 157 healthy young students who had accepted to participate in the study were randomly selected. In all subjects the blood pressure was measured subsequently in four positions: Sitting blood pressure was taken from the left arm, which was flexed at the elbow and supported at the heart level on the chair. After at least one minute of standing, the blood pressure was then taken standing, with the arm supported at the elbow and the cuff at the heart level. After one minute of rest, the blood pressure was subsequently taken supine position. Finally, after one minute the blood pressure was again taken in this last position with supine position with crossed legs.

Results.  The blood pressure tended to drop in the standing position compared with the sitting, supine and supine with crossed legs. Systolic and diastolic blood pressure was the highest in supine position when compared the other positions. There was a difference between systolic blood pressures and this was statistically significant (P < 0·001) but the difference between diastolic blood pressure was not statistically significant (P > 0·05). All changes in systolic blood pressure were statistically significant except those from supine to supine position with crossed legs.

Relevance to clinical practice.  When assessing blood pressure it is important to take the position of the patient into consideration. Also, blood pressure measurement must be taken in sitting position with the arms supported at the right a trial level.
Organizational and individual factors associated with breakdown of residential placements for people with intellectual disabilities
Authors: Broadhurst S. , Mansell J.
Published: December 2006

Background  People with intellectual disabilities (IDs) whose behaviour challenges services are at increased risk of placement breakdown. Most previous research has tended to focus on the role of individual characteristics in predicting breakdown. A small number of studies have suggested that service variables may impact on intervention effectiveness and hence placement breakdown.

Method  This study used a non‐experimental group comparison design to investigate potential differences between two groups of residential homes, one of which had experienced placement breakdown, and one of which had successfully maintained placements in the community.

Results  More residents in the breakdown group had inappropriate sexual behaviours but there were no other differences. Services in the breakdown group had more limited procedural guidance for staff, weaker training, supervision and team meetings and less external professional support.

Conclusion  Placement characteristics may be an important determinant of community placement success for people with IDs and challenging behaviour. Those selecting and funding residential placements for such people should attend to the technical competence of the placement (in terms of its use of procedural guidance, training and professional advice) and to the extent of support for staff (in terms of training, supervision and team meetings).
Natural history of thyroid function in adults with Down syndrome – 10‐year follow‐up study
Authors: Prasher V. , Gomez G.
Published: December 2006

Background  The natural history of thyroid function in adults with Down syndrome (DS) is unknown.

Method  This study investigated annual thyroid function tests in 200 adults with DS over a 10‐year period.

Results  Transient and persistent thyroid dysfunction was common. The 5‐ and 10‐year incidence of definite hypothyroidism was 0.9%−1.64% and 13.6%, respectively. Subclinical hypothyroidism was not found to be an early sign for definite hypothyroidism.

Conclusions  Routine screening for adults with DS who are euthyroid can be reduced to every 5 years rather than the present policy of every 1–2 years.
Deletions of VCX‐A and NLGN4: a variable phenotype including normal intellect
Authors: Macarov M. , Zeigler M. , Newman J. P. , Strich D. , Sury V. , Tennenbaum A. , Meiner V.
Published: December 2006

Background  Patients with Xp22.3 interstitial and terminal deletions have been shown to be affected by intellectual disability (ID) or autism. Previously, VCX‐A (variably charged protein X‐A), located at Xp22.3, was introduced as a gene for ID and its presence was suggested to be sufficient to maintain normal mental development. Recent reports suggest that mutations in NLGN4 (neuroligin 4), located at that same region, are involved in autistic disorders and ID.

Methods  In the current case study, we clinically and molecularly describe a pedigree of three generations affected by contiguous gene syndrome that includes features of X‐linked ichthyosis and Kallmann syndrome.

Results  Molecular analysis revealed the presence of an interstitial deletion spanning approximately 4.5Mb at Xp22.3. The centromeric breakpoint was localized between markers DXS1467 and DXS8051, proximal to KAL‐1. The telomeric breakpoint was localized between markers DXS89 and DXS1060, distal to NLGN4. The deletion of VCX‐A and NLGN4 in this family prompted us to examine the cognitive functions of our two adult patients using comprehensive intellectual and neurocognitive assessment. Normal intellectual function was found in one patient and mild ID was revealed in the other. Neither patient met any Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition criteria for a pervasive developmental disorder such as autism.

Conclusions  These findings suggest that deletion of VCX‐A and NLGN4 can result in variable phenotypic features and that normal mental development can be achieved despite this deletion, emphasizing the importance of environmental factors and possible modifier genes.
Quality of written communication and master impressions for fabrication of removable partial prostheses in the Kingdom of Bahrain
Authors: RADHI A. , LYNCH C. D. , HANNIGAN A.
Published: December 2006

summary   The aim of this study was to examine the quality of written instructions and choice of impression trays and materials for removable partial dentures (RPDs) in the Kingdom of Bahrain. All six private dental laboratories in Bahrain were contacted and invited to participate in the study. Five laboratories participated, and submitted written instructions received by them for fabrication of both acrylic (A‐RPDs) and cobalt‐chromium (CC‐RPDs) RPDs. These were examined for evidence of selected design variables. Types of impression trays and materials used were also recorded. One hundred and thirty‐one written instructions were examined. Eleven percent (n = 14) were for CC‐RPDs, 89% (n = 117) for A‐RPDs. All treatments were provided on a private basis. Fifty‐seven percent (n =1 8) of CC‐RPD instructions requested the technician to design the prosthesis, 43% (n = 6) contained a diagram and 43% (n = 6) mentioned all design variables. Seventy‐nine percent (n = 92) of A‐RPDs requested the technician to design the denture, and only 1% (n = 1) mentioned all design variables. Alginate impression material was most commonly used for master impressions (83% of impressions (n = 109); 85% (n = 99) of A‐RPDs, and 71% (n = 10) of CC‐RPDs). Master casts were poured after a minimum of 24 h. Acrylic custom trays were used in 14% (n = 19) of cases (43% (n = 6) of CC‐RPDs; 13% (n = 15) of A‐RPDs). The quality of written instructions to dental laboratories for the fabrication of RPDs was found to be inadequate in Kingdom of Bahrain. There was widespread use of inappropriate impression trays and materials.
Comparison of increased overjet cases and controls: normative data for condylar positions
Authors: TURASI B. , ARI‐DEMIRKAYA A. , BIREN S.
Published: December 2006

summary  The aim was to compare normal overjet versus large overjet cases with clinically healthy temporomandibular joints (TMJ); to establish normative data regarding the difference between condylar positions in centric occlusion (CO) and maximum intercuspation (MI) and deflective CO contacts. Two study groups of normal overjet and large overjet cases consisted each of 33 subjects with no detectable clinical signs of temporomandibular disorder (TMD). CO‐MI differences were recorded using the SAM® Mandibular Position Indicator. Deflective contacts were examined on models mounted in CO. There was a significant difference between groups in the vertical (P = 0·030) and transverse (P = 0·008) range of movement from CO to MI, but not in the antero‐posterior direction. There were no differences in the location of deflective contacts. Results of this study showed that patients with increased overjet show some differences compared with normal overjet patients, even in the non‐patients. Further research on TMD patients is needed to find out about the role these features play in the aetiology and treatment of temporomandibular disorder (TMD). This study indicates that the clinician should be paying special attention to the TMJ status of patients with a large overjet.
Individuals’ perception of oral health and its impact on the health‐related quality of life
Authors: LEE I.‐C. , SHIEH T.‐Y. , YANG Y.‐H. , TSAI C.‐C. , WANG K.‐H.
Published: December 2006

summary  This research divides oral health status into two parts: clinical disease and patients’ subjective perceptions, and then discusses what impact these two items have on the health‐related quality of life. A total of 1600 elderly persons, over 65 years old, were sampled as the research target. The overall response rate was 71·62%. SF‐36 was used to measure the health‐related quality of life, Oral Health Impact Profile (OHIP) was used to measure individuals’ subjective perception of their oral health status, and the number of natural teeth was considered as the clinical issue. There are 12 items which affect quality of life in the physical aspect, namely: OHIP score; age; gender; weekly frequency of social activities and interactions; financial status; physician visits per month on a regular basis; hospitalization during the last 6 months; arthritis, rheumatism, cardiovascular disease or diabetes; abnormal IADL patients; and the satisfaction level of current lifestyle. Factors affecting quality of life (i.e. mental aspects), are few, including: OHIP score, gender, education level, weekly frequency of social activities and interactions and satisfaction level of current lifestyle. The results indicate that individuals’ subjective perceptions of their oral health status had a greater impact, than did the clinical issue, on their health‐related quality of life. The outcomes and findings derived from this research may provide alternative perspectives for professionals, so that they may be more careful concerning individuals’ subjective perceptions.
Induction doses of interferon‐α‐2a in combination with ribavirin and/or amantadine for the treatment of chronic hepatitis C in non‐responders to interferon monotherapy: a randomized trial
Authors: Salmerón J. , Diago M. , Andrade R. , Pérez R. , Solá R. , Romero M. , De La Mata M. , Granados R. , Ruiz‐Extremera A. , Mu¯oz de Rueda P.
Published: December 2006

Summary.  The benefit of the triple therapy (interferon + amantadine + ribavirim) is still unknown. The efficacy of induction doses of interferon‐α‐2a monotherapy or in combination with ribavirin and/or amantadine was evaluated in interferon non‐responders with chronic hepatitis C. A total of 378 patients were randomized. All the groups received the same doses and duration of interferon‐α‐2a: (i) interferon 9 MUI/day for 4 weeks and then 3 MUI/3 t.i.w. for 44 weeks (n = 53); (ii) interferon in combination with amantadine 100 mg twice daily for 48 weeks (n = 111); (iii) interferon in combination with ribavirin 1000–1200 mg (n = 106); (iv) interferon in combination with amantadine and ribavirin (n = 108). Baseline parameters were similar in the four groups. Sustained virological and biochemical responses were 13%, 6%, 18% and 22% respectively. No significant differences were found between double ribavirin arm vs triple therapy, but the difference was significant between interferon–amantadine (P = 0.008) and triple therapy (P = 0.0005). Hence, the induction doses of interferon in combination with ribavirin or ribavirin plus amantadine showed encouraging results in patients with chronic hepatitis C who were resistant to interferon. However, triple therapy is not superior to double.
Short‐duration therapy for hepatitis C: suitable for all?
Authors: Mangia A.
Published: December 2006

Summary.  Peginterferon α (PegIFN α) plus ribavirin achieves sustained virological response (SVR) in more than 50% of patients with chronic hepatitis C virus (HCV) infection. Although in the trials which led to the registration of this combination therapy, only a 48‐week period of treatment had been evaluated, current international guidelines state that 48 or 24 weeks of treatment should be recommended in accordance with genotype; i.e. 48 weeks for genotypes 1 and 4, and 24 weeks for 2 and 3. However, side effects and the high cost of antiviral therapy forced investigators to evaluate further reductions in the treatment duration. Based on the new evidence that fast and persistent viral clearance is highly predictive of SVR, a week 4 negative HCV RNA by a sensitive molecular assay was recently utilized as a criterion for halving the duration of treatment to 12–16 weeks for genotypes 2 and 3, and 24 weeks for genotype 1 patients. However, some issues on this topic, are still open. In this review, existing evidence is discussed, and both the relevance and limitations of published studies are considered.
Staphylococcus aureus bacteremia in patients receiving pegylated interferon‐alpha and ribavirin for chronic hepatitis C virus infection
Authors: Webster D. , Ahmed R. , Tandon P. , Chui L. , McDonald R. R. , Obarianyk A. , Antonishyn N. , Doucette K.
Published: December 2006

Summary.  Bacteremia has rarely been reported in patients receiving treatment for hepatitis C virus (HCV) infection. We describe the features and investigation of four cases of Staphylococcus aureus bacteremia occurring between 3 November 2004 and 10 January 2005 in patients on therapy for chronic HCV infection. The unusual occurrence of S. aureus bacteremia in a series of patients led to an epidemiologic investigation and molecular typing methods were employed to assess the relatedness of cases. The mean time of bacteremia onset was week 10 of HCV treatment. No patient had neutropenia previously. The average duration of bacteremia was 2.6 days and complications included acute renal failure (2/4), disseminated intravascular coagulopathy (DIC) with sepsis syndrome (1/4), septic arthritis (1/4), spinal epidural abscess (1/4) and endocarditis (1/4). Two patients were in the same weight class for dosing, but no other epidemiologic links were found. One patient admitted to intravenous drug use (IVDU) and a second was suspected of IVDU. The two other patients were cirrhotic, but had no further identifiable risk factors. All bacterial isolates were methicillin‐susceptible. By pulsed‐field gel electrophoresis, two cases were found to have identical bacterial strains. However, fluorescent‐based amplified fragment‐length polymorphism analysis demonstrated distinct band patterns in all four cases. The epidemiologic data and molecular analysis of this cluster of S. aureus bacteremia cases among patients receiving combination therapy for treatment of chronic HCV infection suggest that these cases were not related. Additionally, IVDU and cirrhosis, but not neutropenia, are identified as potential risk factors for this uncommon complication of HCV therapy.