bluuebunny/crossref_metadata_2025 huggingface dataset:
Impaired transient elevation of blood hemoglobin in response to acute hypoxia in neonates with asplenia
Authors: OKA TATSUJIRO , ITOI TOSHIYUKI , HAMAOKA KENJI
Published: November 2007

Background: It has been shown that acute hypoxia induces the transient elevation of blood hemoglobin concentration ([Hb]) as a consequence of sympathetic‐mediated splenic contraction to maintain the supply of oxygen, and splenectomy abolishes this phenomenon. The purpose of the present paper was to determine, retrospectively, whether the ability of transient elevation of [Hb] against acute hypoxia would be impaired in neonates with asplenia.

Method: Eleven neonates who underwent surgery from 1998 to 2003 were enrolled in this retrospective study. They were divided into two groups: (i) five patients with asplenia syndrome with cyanotic congenital heart disease (asplenia group); and (ii) six patients with hypoplastic left heart syndrome who needed nitrogen gas inhalation therapy (HLHS group). In the asplenia group simultaneous data of arterial oxygen saturation (Sao2) and [Hb] were obtained before and after the temporary unexpected decrease of percutaneous arterial oxygen saturation. In the HLHS group they were obtained before and after nitrogen gas administration therapy. The arterial oxygen content (Cao2) changes and the ratio of Cao2 change (Cao2 after hypoxia divided by Cao2 before hypoxia) were also calculated.

Results: In the asplenia group [Hb] was unchanged (12.9 ± 1.6 g/dL to 12.8 ± 1.4, n.s.) and Cao2 was decreased (14.5 ± 1.6 mL/dL to 11.9 ± 1.1, P = 0.018). In the HLHS group [Hb] was increased (14.6 ± 1.3 g/dL to 15.4 ± 1.5, P = 0.028), but Cao2 was changed (18.2 ± 2.2 mL/dL to 16.7 ± 3.0, P = 0.043). The ratio of Cao2 change for the HLHS group was significantly different from that of the asplenia group (0.92 ± 0.10, 0.83 ± 0.10, respectively, P = 0.02).

Conclusions: Patients with asplenia syndrome have some disadvantage regarding this protective mechanism against acute hypoxia.
Neonatal subgaleal hemorrhage: Clinical presentation, treatment, and predictors of poor prognosis
Authors: CHANG HUNG‐YANG , PENG CHUN‐CHIH , KAO HSIN‐AN , HSU CHYONG‐HSIN , HUNG HAN‐YANG , CHANG JUI‐HSING
Published: November 2007

Background: Neonatal subgaleal hemorrhage (SGH) is a rare but potentially lethal medical emergency. The objective of the present retrospective study was to clarify the clinical presentation, management, and factors associated with morbidity and mortality.

Methods: The records of all newborns from January 1995 to December 2004 were reviewed for evidence of SGH, based on the presence of a fluctuating hemorrhagic mass that crossed suture lines and extended toward the neck. Characteristics were compared between those with a poor or a good outcome.

Results: Forty‐two newborns with SGH were identified, 77% having had an instrumental delivery. The incidence was 0.6/1000 deliveries and 4.6/1000 vacuum‐assisted deliveries. Thirteen patients (31%) had a poor outcome (five died, four had epilepsy, three with severe auditory dysfunction, two with cerebral palsy, and one with renal vein thrombosis). The group with the poor outcome had significantly more patients who had been transferred from other hospitals (P < 0.001). Those with a poor outcome had significantly more hypotension (P < 0.001) and seizures (P < 0.05). Laboratory findings associated with a poor outcome included anemia, coagulopathy, metabolic acidosis, and renal impairment. Other predictors of a poor prognosis included skull bone fracture, the need for pressors, blood transfusion, ventilator support, intensive care unit admission, and a longer hospital stay.

Conclusions: SGH may be associated with serious complications and death. The condition must be recognized promptly and monitored closely. Those with poor prognostic factors should be referred for intensive care, treated aggressively, and followed in the long term.
Prevalence and clinical findings of migraine and tension‐type headache in adolescents
Authors: UNALP AYCAN , DIRIK ERAY , KURUL SEMRA
Published: November 2007

Background: The majority of previous studies on headache in children and adolescents have focused mainly on migraine. There is a paucity of population‐based studies investigating the prevalence of tension‐type headache (TTH). The objectives of the present study were to estimate the prevalence of migraine and TTH in adolescents using the 2004 International Headache Society (IHS) criteria and to determine the sociodemographic and clinical differences between the migraine and TTH.

Methods: Stratified group sampling was used in the present analytic, school‐based, cross‐sectional study. From the city of Izmir, 2384 students aged 14–18 years were invited to complete a questionnaire.

Results: Migraine was found to be more common than TTH (21.3% vs 5.1%). The prevalence increased considerably to 29.9 and 15%, respectively, when the criteria defining the number and duration of headaches were excluded. All types of headaches were more frequent in female subjects but no significant difference was found in gender between the headache groups (P= 0.073). Headache in temples, number of siblings (more than one sibling), mother’s and father’s education (at least high school graduation) were more commonly seen in students with TTH. Absenteeism rate due to the headache was found to be higher in the migraine group than in the TTH group (P= 0.000).

Conclusions: Migraine and TTH were found to be common types of headaches in adolescents. It was thought that, with the use of modified IHS criteria, the number of undiagnosed patients with headache will decrease.
Tissue Doppler echocardiographic assessment of cardiac function in children with bronchial asthma
Authors: ZEYBEK CENAP , YALCIN YALIM , ERDEM ABDULLAH , POLAT TUGCIN BORA , CIGDEM AKTUGLU‐ZEYBEK A , BAYOGLU VEYSEL , AKDENIZ CELAL , CELEBI AHMET
Published: November 2007

Background: The aim of the present study was to evaluate the role of tissue Doppler echocardiography in assessment of ventricular function in pediatric patients with bronchial asthma (BA).

Patients and methods: Fifty‐one pediatric patients with BA and 30 age‐ and sex‐matched healthy subjects were studied. BA patients were divided into two groups: mild BA (n = 33) and moderate to severe BA (n = 18). All subjects were examined on conventional and tissue Doppler echocardiography, and 44 patients had pulmonary function tests on spirometry within 1 week of echocardiographic examination.

Results: Conventional echocardiographic parameters were all similar in mild asthmatic patients and control subjects. Tricuspid E velocity, E/A ratio and isovolumetric relaxation time (IVRT) in moderate and severe cases differed significantly from mild cases and control subjects. E′, A′, E′/A′ ratio and IVRT of the lateral tricuspid annulus, and IVRT of the medial and lateral mitral annuli were different between mild cases and control subjects. E′ velocity and IVRT of the lateral tricuspid annulus and IVRT of the medial and lateral mitral annuli were also different between mild cases and moderate to severe cases. Pulmonary function tests correlated well with E′, E′/A′ and IVRT of lateral tricuspid annulus.

Conclusion: Patients with BA have subclinical right ventricular diastolic dysfunction even in the early stages. The severity of the functional impairment is parallel with the severity of the disease. Tissue Doppler echocardiography has a greater predictive value than conventional imaging, and is useful for evaluating ventricular function in patients with BA.
Menstrual pattern and common menstrual disorders among university students in Turkey
Authors: CAKIR MURAT , MUNGAN ILKE , KARAKAS TANER , GIRISKEN İLKNUR , OKTEN AYSENUR
Published: November 2007

Background: Menstrual disorders may affect the life of adolescents and young adult women, and may sometimes cause serious problems. The patterns of menstrual cycles were analyzed for association with age of menarche, prevalence of menstrual irregularity, dysmenorrhea, prolonged menstrual bleeding, and effect of menstrual disorders, especially dysmenorrhea, on social activities and school attendance among the female students.

Methods: A total of 480 students were randomly selected and asked to complete an the anonymous questionnaire of 25 items.

Results: The mean age of the subjects at menarche was 12.8 ± 1.3 years with a range of 9–17 years. The duration between two periods and the menstrual flow were 27.7 ± 2.5 days and 5.8 ± 1.4 days, respectively. The prevalence of menstrual irregularity, prolonged menstrual bleeding and dysmenorrhea were 31.2%, 5.3% and 89.5%, respectively. Approximately 10% of dysmenorrheic subjects had severe dysmenorrhea; and school absenteeism and need to consult a physician were more common in those subjects. The first source of their knowledge about menarche and menstruation was their mothers in 211 subjects (54%); only 18 subjects (4.6%) were given a lecture about menstruation and menarche at school.

Conclusion: The prevalence of dysmenorrhea and menstrual irregularity was high, and most adolescents have inappropriate and insufficient information about menstrual problems. Hence, an education program is needed at the end of primary school about menarche and menstrual problems.
Randomized controlled trial of short‐term withdrawal of i.v. immunoglobulin therapy for selected children with human immunodeficiency virus infection
Authors: GRISARU‐SOEN GALIA , LAU WENDY , ARNESON CHERYL , LOUCH DEBORAH , BITNUN ARI , STEPHENS DEREK , READ STANLEY E. , KING SUSAN M.
Published: November 2007

Background: The aim of the present paper was to determine whether monthly i.v. immunoglobulin (IVIG) could be safely discontinued in antiretroviral‐treated human immunodeficiency virus (HIV)‐infected children.

Methods: In a double‐blind cross‐over trial, children ≤18  years with HIV infection, well controlled on antiretroviral therapy, were randomized to alternating courses of 3  consecutive months of IVIG (400  mg/kg once a month) and 3  consecutive months of placebo for 1  year. The primary outcome was days of fever per month. Secondary outcomes were frequency of serious infections, changes in HIV viral load (VL), CD4+ counts and IgG levels.

Results: Fifteen children were enrolled. Using the revised pediatric HIV clinical classification system of the Centers for Disease Control and Prevention, eight were severely symptomatic (C), four were moderately symptomatic (B) and three were mildly symptomatic (A). There were no statistically significant outcome measures. The mean number of days of fever per month with IVIG versus placebo was 0.55  days versus 1.48  days (P =  0.11). The difference was 0.9  days (95% confidence interval: +2.05 to −0.25). There were no serious infections in either period. For the IVIG versus placebo periods, mean CD4 counts were 970  cells/μL versus 906  cells/μL (P =  0.12), VL 2.90  log10 copies/mL versus 2.82  log10 copies/mL (P =  0.70) and IgG levels were 17.41  g/L versus 16.6  g/L (P =  0.13).

Conclusion: In antiretroviral‐treated HIV‐infected children short‐term withdrawal of monthly IVIG was not associated with a significant increase in incidence of infections or a decline in immunologic function (CD4 count, viral load and IgG levels). These results suggest that monthly IVIG can be safely discontinued in HIV‐infected children who are clinically stable and receiving combination antiretroviral therapy.
Risk factors for small for gestational age
Authors: TSUKAMOTO HIROKO , FUKUOKA HIDEOKI , KOYASU MIEKO , NAGAI YASUSHI , TAKIMOTO HIDEMI
Published: November 2007

Background: The purpose of the paper was to determine the risk factors for small‐for‐gestational‐age (SGA) infants at full term, in Japan.

Methods: The study was conducted at four hospitals and clinics in the Tokyo metropolitan area. A retrospective review of 2972 mothers and their infants born from singleton pregnancies at any time during the years 2002 and 2003 was conducted.

Results: Of these women, 8.4% gave birth to SGA infants. The proportion of SGA infants was significantly higher among heavy smokers (>10 cigarettes/day; 13.7%, P < 0.01). The odds ratio (OR) for SGA decreased significantly in proportion to the pregnancy body mass index (OR, 0.89; 95% confidence interval [CI]: 0.84–0.94, P < 0.001). The OR of SGA for stratified maternal weight gain was 1.79 (95%CI: 1.24–2.58, P ≤ 0.01) for weight gain < 8.0 kg; 1.16 (95%CI: 0.79–1.71, P = 0.45) for weight gain 8.0–10.0 kg; and 0.49 (95%CI: 0.3–0.78, P < 0.01) for weight gain >12 kg.

Conclusion: The present study clearly confirms the detrimental effect of a low prepregnancy body mass index, low maternal weight gain and maternal smoking during pregnancy on the incidence of SGA infants.
Suppression of plasma matrix metalloproteinase‐9 following montelukast treatment in childhood asthma
Authors: CHUANG SHIH‐SUNG , HUNG CHIH‐HSING , HUA YI‐MING , TIEN CHIUNG‐HSI , YANG KUENDER D , JONG YUH‐JYH , HSU SHIH‐HSIEN , LIN CHANG‐SHEN
Published: November 2007

Background:Montelukast and ketotifen are commonly prescribed anti‐inflammatory medications used in the treatment of childhood asthma.

Methods:To investigate the modulation effect of montelukast and ketotifen, the levels of exhaled nitric oxide (eNO) and plasma matrix metalloproteinase‐9 (MMP‐9) were analyzed in a group of 30 children with mild persistent asthma.

Results:Patients on montelukast therapy for 8 weeks had significantly decreased levels of eNO and plasma MMP‐9, which were associated with improved symptoms and enhanced peak expiratory flow but not significantly associated with increased level of tissue inhibitor metalloproteinase‐1 (TIMP‐1). In contrast, treatment with ketotifen produced no significant changes in these parameters until 4–6 weeks into the therapy and no effect on plasma MMP‐9.

Conclusion:Leukotriene antagonists, such as montelukast, may be better non‐steroidal anti‐inflammatory drugs for preventing airway inflammation in mild childhood asthma.
Preliminary early intervention study using Nursing Child Assessment Teaching Scale in Japan
Authors: HIROSE TAIKO , TERAMOTO TAEKO , SAITOH SAKAE , TAKAHASHI IZUMI , HIRAMATSU MAYUMI , OKAMITSU MOTOKO , SONOBE MAMI , MIKUNI KUMI , OMORI TAKAHIDE , SHIRAKAWA SONOKO
Published: November 2007

Background: Mother–infant interactions have been acknowledged as one of the most important elements in measuring outcomes of parent support and infant mental health interventions. The present study was conducted to measure early intervention outcomes using the Nursing Child Assessment Teaching Scale (NCATS), and to identify factors that affected Japanese mother–infant interactions.

Methods: Healthy Japanese mother–infant dyads who had lower scores on the NCATS, indicating potential problems, were assigned to an intervention group, and compared with a control group who had higher scores on NCATS. Health‐care professionals visited the intervention group dyads in their homes, and gave them positive feedback on their interactions, consultations on parenting, and health advice. The control group dyads had home visitation once every 6 months for assessment only.

Results: The home visitations started at 3 months of age and continued until 18 months. NCATS scores in both groups were significantly different at baseline but differences faded by the end, which suggests that the intervention promoted improved interactions in the intervention group. Two of five factors were identified as influencing mother–infant interactions: maternal age; and personal networks, and together they significantly explained 27–30% of NCATS variance.

Conclusion: The results appear to support the validity of measuring Japanese mother–infant interactions with NCATS. This study is the first to measure the outcomes of early intervention on Japanese dyads’ interactions using NCATS. Additional replication studies should be conducted elsewhere in Japan, and clinical practices for promoting mother–infant interactions should begin to assess their effectiveness with NCATS as an outcome measure.
Roles of specific cytokines in bone remodeling and hematopoiesis in Gaucher disease
Authors: YOSHINO MAKOTO , WATANABE YORIKO , TOKUNAGA YASUYUKI , HARADA EIMIEI , FUJII CHIEKO , NUMATA SANAE , HARADA MASARU , TAJIMA ASAKO , IDA HIROYUKI
Published: November 2007

Background: Gaucher disease type 1 and type 3 are characterized by bone disease and hematological symptoms. It is known that monocyte/macrophage lineage is activated in Gaucher disease, and accordingly certain cytokines are elevated in blood. The aim of the present study was to explore the possible relationships between cytokines and bone remodeling and hematological abnormalities in this disease.

Methods: The concentrations of seven cytokines and two related proteins were measured in patients with Gaucher disease type 1 and type 3 (n= 8; age range, 2–50 years) who had received enzyme replacement therapy.

Results: Concentrations of interleukin‐18 and transforming growth factor‐β1 were elevated in patients of all clinical types. Elevation of these cytokines in Gaucher disease has not been previously reported. Analysis of correlation among cytokines and bone‐turnover markers showed that interleukin‐18 concentration was correlated with each of two bone formation markers of bone‐specific alkaline phosphatase activity and osteocalcin concentration, whereas macrophage colony‐stimulating factor concentration correlated with the bone absorption marker of N‐telopeptide to helix in urine. Concentrations of macrophage colony‐stimulating factor and tumor necrosis factor‐α were inversely correlated with hemoglobin concentration.

Conclusions: Interleukin‐18 and monocyte macrophage colony‐stimulating factor are cytokines mainly involved in the mechanism of bone disease, while macrophage colony‐stimulating factor and tumor necrosis factor‐α may play a role in the development of hematological abnormalities in Gaucher disease.
Suppression of excitatory cholinergic synaptic transmission by Drosophila dopamine D1‐like receptors
Authors: Yuan Ning , Lee Daewoo
Published: November 2007

The physiological function of dopamine is mediated through its G‐protein‐coupled receptor family. In Drosophila, four dopamine receptors have been molecularly characterized so far. However, due largely to the absence of a suitable preparation, the role of Drosophila dopamine receptors in modulating central synaptic transmission has not been examined. The present study investigated mechanisms by which dopamine modulates excitatory cholinergic synaptic transmission in Drosophila using primary neuronal cultures. Whole‐cell recordings demonstrated that cholinergic excitatory postsynaptic currents (EPSCs) were down‐regulated by focally applied dopamine (10–500 µm). The vertebrate D1 specific agonists SKF38393 and 6‐chloro‐APB (10 µm) mimicked dopamine‐mediated suppression of cholinergic synaptic transmission with higher potency. In contrast, the D2 agonists quinpirole and bromocriptine did not alter cholinergic EPSCs, demonstrating that dopamine‐mediated suppression of cholinergic synaptic transmission is specifically through activation of Drosophila D1‐like receptors. Biophysical analysis of miniature EPSCs indicated that cholinergic suppression by activation of D1‐like receptors is presynaptic in origin. Dopamine modulation of cholinergic transmission is not mediated through the cAMP/protein kinase A signaling pathway as cholinergic suppression by dopamine occurred in the presence of the protein kinase A inhibitor H‐89. In addition, an adenylate cyclase activator, forskolin, led to an increase, not a decrease, of cholinergic EPSC frequency. Finally, we showed that activation of D1‐like receptors decreased the frequency of action potentials in cultured Drosophila neurons by inhibiting excitatory cholinergic transmission. All our data demonstrated that activation of D1‐like receptors in Drosophila neurons negatively modulates excitatory cholinergic synaptic transmission and thus inhibits neuronal excitability.
Rectus sheath block: successful use in the chronic pain management of pediatric abdominal wall pain
Authors: SKINNER ADAM V. , LAUDER GILLIAN R.
Published: November 2007

Seven pediatric patients (aged 11–16 years) with chronic abdominal wall pain are presented who gained significant relief from a rectus sheath block (RSB). We describe the case histories and review the relevant literature for this technique. The etiology of the abdominal wall pain was considered to be abdominal cutaneous nerve entrapment, iatrogenic peripheral nerve injury, myofascial pain syndrome or was unknown. All patients showed significant initial improvement in pain and quality of life. Three patients required only the RSB to enable them to be pain‐free and return to normal schooling and physical activities. Two children received complete relief for more than 1 year. In the majority of cases, the procedure was carried out under general anesthesia as a daycase procedure. Local anesthetic and steroids were used. This is the first report of the successful use of this technique in the chronic pain management setting in children.
A historical review of research on the weaver ant Oecophylla in biological control
Authors: Van Mele Paul
Published: November 2007

1 Although the weaver ant Oecophylla is the first written record of biological control, dating from 304 ad, there have been fewer than 70 scientific publications on this predator as a biological control agent in Asia, from the early 1970s onwards, and fewer than 25 in Africa.

2 Apart from crop‐specific ecological and perceptual factors, a historical review shows that political and market forces have also determined the extent to which Oecophylla was incorporated into research and development programmes.

3 In Africa, research on weaver ants in biological control concentrated on export crops, such as coconut and cocoa, whereas, in Asia and Australia, research focused on fruit and nut crops, primarily destined for domestic markets.

4 Increased evidence of pesticide inefficiency under tropical smallholder conditions, changing paradigm shifts in participatory research and a growing scientific interest in local knowledge in the early 1990s opened up new avenues for research on conservation biological control.

5 Lobbying and advocacy have been needed to ensure that Oecophylla was recognized as an effective biological control agent.

6 With an increased market demand for organic produce, holistic approaches such as conservation biological control, particularly the use of Oecophylla, are increasing in importance.

7 Multi‐stakeholder strategies for collaborative learning are proposed for a better control of major fruit, nut and timber tree pests in Africa, Asia and Australia.
Glycaemic responsiveness to long‐term insulin plus sulphonylurea therapy as assessed by sulphonylurea withdrawal
Authors: Nybäck‐Nakell Å. , Adamson U. , Lins P. E. , Landstedt‐Hallin L.
Published: November 2007

Aims  To assess the effect of sulphonylurea (SU) in patients with Type 2 diabetes undergoing long‐term combination therapy with insulin, by withdrawal of SU, and to identify clinically useful markers of long‐term response.

Methods  We studied 25 patients, aged 59–83 years, mean glycated haemoglobin (HbA1c) 7.0 ± 0.6%, who had been treated with SU for 16 years (7–24 years) in combination with insulin for 10 years (6–15 years). After basal measurements, SU was withdrawn. Fasting plasma glucose (FPG) and C‐peptide were then monitored every 2–3 days during the following 2 weeks. If FPG increased > 40% or P‐glucose exceeded 20 mmol/l, SU was restarted. If neither criterion was met, a clinical follow‐up visit with measurement of HbA1c was scheduled within 8 weeks.

Results  Twenty patients were restarted on SU because of worsening glycaemic control, eight within the first 4 weeks and the remaining 12 at the follow‐up visit as their HbA1c had increased by 1.1% (range 0.4–2.0%). All these patients were defined as ‘SU responders’. The increase in FPG during the initial 2 weeks correlated positively with duration of diabetes (P < 0.01) and duration of SU treatment (P < 0.001). The ‘SU responders’ had higher levels of basal fasting C‐peptide (0.84 ± 0.44 vs. 0.41 ± 0.15 nmol/l, P < 0.05), but the variation was wide and none of the measured variables identified ‘SU responders’.

Conclusions  In 80% of this group of patients, glycaemic control deteriorated after SU withdrawal despite long duration of SU treatment.
Risk factors for coronary disease and stroke in previously hospitalized African‐Americans with Type 1 diabetes: a 6‐year follow‐up
Authors: Roy M. S. , Peng B. , Roy A.
Published: November 2007

Aims  To report the 6‐year incidence of, and risk factors for, cardiovascular disease (CVD), either coronary disease or stroke, in previously hospitalized African‐Americans with Type 1 diabetes mellitus.

Methods  African‐Americans (n = 483) with Type 1 diabetes were re‐examined as part of a 6‐year follow‐up. At both visits, patients underwent a structured clinical interview, which included history of either coronary disease or stroke, ocular examination and masked grading of seven stereoscopic fundus photographs, blood pressure measurements, and administration of the Beck Depression Inventory. Biological measurements included blood and urine assays.

Results  Of the 483 patients who had a 6‐year follow‐up, 449 had no evidence of CVD at the baseline examination. Of these 449 patients, 51 (11.4%) developed any CVD—42 (9.3%) coronary disease and 14 (3.1%) a stroke. Six‐year incidence of any CVD was significantly associated with older age (P < 0.0001) and longer duration of diabetes (P < 0.0001) at baseline. Multiple logistic regression showed that baseline older age, higher body mass index, higher diastolic blood pressure, proteinuria, retinopathy severity and being depressed were significant and independent risk factors for incidence of any CVD.

Conclusion  Six‐year incidence of CVD is high in previously hospitalized African‐Americans with Type 1 diabetes. Risk factors appear to include older age, higher body mass index, higher diastolic blood pressure, proteinuria, retinopathy severity and depression.
Serum uric acid, mortality and glucose control in patients with Type 2 diabetes mellitus: a PreCIS database study
Authors: Ioachimescu A. G. , Brennan D. M. , Hoar B. M. , Kashyap S. R. , Hoogwerf B. J.
Published: November 2007

Aims  To determine the association of serum uric acid with all‐cause mortality and hyperglycaemia in patients with Type 2 diabetes.

Methods  Retrospective cohort analysis of 535 consecutive patients who had uric acid determinations between 1998 and 2004 and whose subsequent vital status was determined at a median of 4.5 years. The association with mortality was analysed with Cox proportional hazards models. The incremental predictive value of uric acid was examined with concordance indexes. The proportional risk of mortality was represented with the Kaplan–Meier survival curves by uric acid quartiles.

Results  We studied 370 men and 165 women aged 59.3 ± 11.5 years. Mean uric acid was 371.7 ± 106.2 µmol/l. Patients with glycated haemoglobin (HbA1c) ≥ 9% had lower uric acid vs. the rest (342.2 ± 112.1 vs. 383.5 ± 106.2, P = 0.002). Overall mortality was 10.8%. For each 59 µmol/l increase in uric acid there was a 41% increase in risk of death (unadjusted analysis). The association of uric acid with mortality remained after adjustment for covariates (hazard ratio = 1.21, 95% confidence interval 1.07–1.45) and after gender subanalyses. Uric acid increased the accuracy of prediction when added to a model including Framingham risk factors, components of metabolic syndrome and fibrinogen (P = 0.03). Mortality was higher in patients taking diuretics vs. the rest (15.9 vs. 7.3%), but uric acid predicted mortality in both subgroups.

Conclusions  Serum uric acid predicts mortality in Type 2 diabetic patients regardless of gender, HbA1c, renal function and diuretic use. Intervention studies should determine whether uric acid is a potential therapeutic target or only a marker of mortality risk.
Oestradiol replacement treatment and glucose homeostasis in two men with congenital aromatase deficiency: evidence for a role of oestradiol and sex steroids imbalance on insulin sensitivity in men
Authors: Rochira V. , Madeo B. , Zirilli L. , Caffagni G. , Maffei L. , Carani C.
Published: November 2007

Aims  The role of sex steroids in glucose and insulin metabolism in men remains unclear. To investigate the effects of sex steroids and oestrogen on insulin sensitivity in men, we studied two male adults with aromatase deficiency (subject 1 and subject 2).

Methods  The effects of transdermal oestradiol (tE2) treatment at different dosages on insulin sensitivity were studied before tE2 treatment (phase 1), and after 6 months (phase 2) and 12 months of tE2 treatment (phase 3) by means of homeostasis model assessment—insulin resistance (HOMA‐IR) and Quantitative Insulin Sensitivity Check Index (QUICKI), insulin tolerance test (ITT), and oral glucose tolerance test (OGTT). The latter was performed only in subject 1, as subject 2 suffered from Type 2 diabetes.

Results  The restoration of normal serum oestradiol led to improved insulin sensitivity, as shown by changes in HOMA‐IR and QUICKI. The ITT provided evidence of improved insulin sensitivity during tE2 treatment. Insulin secretion after OGTT was reduced during tE2 treatment in subject 1. After 12 months of tE2 treatment, insulin sensitivity was improved compared with in phases 1 and 2.

Conclusions  The study suggests a direct involvement of oestrogens in insulin sensitivity, and supports a possible role of oestradiol : testosterone ratio, which may be as influencial as the separate actions of each sex steroid on glucose homeostasis.
Recombinant antibody 2G12 produced in maize endosperm efficiently neutralizes HIV‐1 and contains predominantly single‐GlcNAc N‐glycans
Authors: Rademacher Thomas , Sack Markus , Arcalis Elsa , Stadlmann Johannes , Balzer Simone , Altmann Friedrich , Quendler Heribert , Stiegler Gabriela , Kunert Renate , Fischer Rainer , Stoger Eva
Published: November 2007

Antibody 2G12 is one of a small number of human immunoglobulin G (IgG) monoclonal antibodies exhibiting potent and broad human immunodeficiency virus‐1 (HIV‐1)‐neutralizing activity in vitro, and the ability to prevent HIV‐1 infection in animal models. It could be used to treat or prevent HIV‐1 infection in humans, although to be effective it would need to be produced on a very large scale. We have therefore expressed this antibody in maize, which could facilitate inexpensive, large‐scale production. The antibody was expressed in the endosperm, together with the fluorescent marker protein Discosoma red fluorescent protein (DsRed), which helps to identify antibody‐expressing lines and trace transgenic offspring when bred into elite maize germplasm. To achieve accumulation in storage organelles derived from the endomembrane system, a KDEL signal was added to both antibody chains. Immunofluorescence and electron microscopy confirmed the accumulation of the antibody in zein bodies that bud from the endoplasmic reticulum. In agreement with this localization, N‐glycans attached to the heavy chain were mostly devoid of Golgi‐specific modifications, such as fucose and xylose. Surprisingly, most of the glycans were trimmed extensively, indicating that a significant endoglycanase activity was present in maize endosperm. The specific antigen‐binding function of the purified antibody was verified by surface plasmon resonance analysis, and in vitro cell assays demonstrated that the HIV‐neutralizing properties of the maize‐produced antibody were equivalent to or better than those of its Chinese hamster ovary cell‐derived counterpart.
Regulatory Focus Strategies Scale: A measure of individual differences in the endorsement of regulatory strategies
Authors: Ouschan Lucette , Boldero Jennifer M. , Kashima Yoshihisa , Wakimoto Ryuutaro , Kashima Emiko S.
Published: November 2007

Regulatory focus theory proposes that people can have a promotion or a prevention focus when pursuing goals and choosing strategies. The Regulatory Focus Strategies Scale (RFSS), a scale that assesses the endorsement of promotion and prevention strategies for goal pursuit, is developed and validated in three studies. Exploratory and confirmatory factor analyses in Australia and Japan showed that promotion‐ and prevention‐focused strategic endorsement formed two largely uncorrelated factors. The RFSS exhibits adequate reliability, and discriminant and convergent validity. A cross‐cultural comparison showed that Australians were more promotion‐ but less prevention‐focused than Japanese students. The RFSS provides an additional measure that is useful in future research on self‐regulatory strategies.
On helping lower status out‐groups: The nature of the help and the stability of the intergroup status hierarchy
Authors: Cunningham Emily , Platow Michael J.
Published: November 2007

The current research expanded upon previous theoretical and empirical arguments regarding the nature of intergroup helping. In doing so, we considered the role of relative in‐group status, the stability of this status, and the type of help provided. In a scenario study, we observed that members of a relatively high status group more strongly supported the provision of assistance to in‐group members than members of a lower status out‐group when the assistance was empowering in nature and when the high in‐group status was unstable. When the intergroup status differences were stable, however, support for empowerment help to members of a lower status out‐group was not significantly lower than support for such help to in‐group members. We discuss these data with reference to realistic intergroup conflict theory and social identity theory.
The Power of Assemblages and the Fragility of Things
Authors: Connolly William E.
Published: November 2007

In responding to these thoughtful essays by Mark Wenman, James Williams, Gulshan Khan, David Howarth, Saul Newman and David Owen on my work, I seek to place each into conversation with the others as well as with me.
English language ownership among Singaporean Malays: going beyond the NS/NNS dichotomy
Authors: BOKHORST‐HENG WENDY D. , ALSAGOFF LUBNA , MCKAY SANDRA , RUBDY RANI
Published: November 2007

ABSTRACT:  Singapore represents what Kachru calls an Outer Circle country. English is an official language, the de facto working language of the nation, and is the medium of instruction in all schools. Yet, with three dominant races and their affiliated languages, there is no single pattern of English language acquisition among Singaporeans. While some do indeed learn English as a second language, others acquire it in the process of its use and interaction, much like first language speakers in Inner Circle countries. Among other things, this makes these speakers native users of their variety of English. While much research has been done on the different varieties of English and their legitimacy, we explore speakers' orientations towards and degree of ownership of their English norms in one language community, Singaporean Malays, taking into account race, age, and socioeconomic class. The Malay community is interesting because, while most still use Malay as their predominant home language, English is making rapid inroads. By looking at English speakers across age and socioeconomic categories, we are able to capture a snapshot of their language ownership in transition, taking us beyond the NS/NNS dichotomy and nuancing the meanings of English in Singaporean society.
Can/could and may/might in British, American and Australian English: a corpus‐based account
Authors: COLLINS PETER
Published: November 2007

ABSTRACT:  This paper provides a comprehensive description of the semantics of can, may, could and might in three parallel corpora of contemporary British, American and Australian English. Even though the modals investigated can express the same meanings, paradoxically there is little semantic overlap between them in the data. For example, the meanings of can and may appear to merge in a sentence such as It can/may be cold in Stockholm, but a distinction is discernible between the theoretical dynamic sense of can and the general present epistemic sense of may. The domain of dynamic possibility is dominated by can and could, that of epistemic possibility by may and might. In the latter case the traditional supremacy of may is being threatened by might, especially in American and Australian usage; could is emerging as an exponent of the same meaning; and instances of can that are not restricted to non‐affirmative contexts are beginning to appear.
Real exchange rate and exchange rate policy in Hungary
Authors: Halpern László
Published: November 2007

Five real exchange rate indicators are computed to assess the international competitiveness of Hungarian industry. These indicators are explained in econometric equations by employment, unemployment, productivity, interest spread and real producer wage. Causality tests reveal that external performance has an impact on real exchange rates, and contributes to explaining real exchange rates. There is very limited scope for policy intervention to constrain the negative effects of capital inflows without incurring other costs.
Bank‐led restructuring in Poland: the conciliation process in action1
Authors: Gray Cheryl W. , Holle Arnold
Published: November 2007

Poland's 1993 Enterprise and Bank Restructuring Programme (EBRP) tried to force state‐owned commercial banks to build institutional capacity and resolve their problem loans. The outcome of its innovative bank‐led workout (‘conciliation’) process, documented in this study of 62 firms, is decidedly mixed. The EBRP forced banks to confront their problems, helped them to build instituional capacity in their workout units, and furthered the difficult task of weeding out and closing clearly unviable firms. Yet it had limited power to promote needed restructuring or privatization in firms. The conciliation agreements were relatively unsophisticated and include few tangible requirements for operational or management change. The first two years of implementation saw a slowdown (over earlier years) in the rate of layoffs, a decline in average operating profitablility, and very little real privatization. The main impact of conciliation appears to have been to reduce debt service and thereby give firms ‘breathing room’.
Bank‐led restructuring in Poland (II): bankruptcy and its alternatives
Authors: Gray Cheryl W. , Holle Arnold
Published: November 2007

Poland's 1993 Enterprise and Bank Restructuring Programme (EBRP) provided for the resolution of problem loans through bank‐led or court‐led workouts, liquidation, or loan sales. This paper examines the workings of three traditional exit processes ‐ court‐led conciliation, bankruptcy, and state enterprise liquidation. Neither bankruptcy nor court conciliation as currently designed gives creditors in Poland enough control over firsm in financial distress. Suggested improvements in design need to be complemented by strong economic policies that give banks and other creditors powerful incentives to use these debt collection mechanisms. The most problematic of the three exit routes is state enterprise liquidation, and although on paper designed for solvent firms, it is often used to get around bankruptcy and keep debtor management in control of assets for as long as possible. Now that the special bank conciliation process has expired as an option, Poland should shift its energies to improving traditional, broadly applicable exit and workout processes.
Industrial restructuring in Russia: early reactions fo firms to the shock of liberalization1
Authors: Duflo Esther , Senik‐Leygonie Claudia
Published: November 2007

This paper looks at the reaction of Russian firsm to the shock of liberalization. Firms are exposed to two kinds of shocks. A supply affects their profitability. A demand shock reflects the new expression of consumers and the opening of the country to foreign competition. Econometric tests show that firms adapt to these changes. They react by adjusting their output. They are not able to change their production techniques for lack of fresh capital. Employment is more stable that output: it is preserved by the adjustment of real wages. Therefore, firms with a low share of material inputs are relatively better off.
A portfolio approach to a cross‐sectoral and cross‐national investment strategy in transition economies
Authors: Buiter Willem H. , Lago Ricardo , Rey Hélène
Published: November 2007

This paper takes a systematic look at the portfolio choice problem faced by Investment Banks or Funds investing in transition economies. We relate the performance of projects in the transition economies to the broader macroeconomic and international environments, which affect the project through their input‐output structures and financial balance sheets. Among the macroeconomic determinanst of enterprise behaviour are productivity growth, real wage growth, movements in the international terms of trade, shocks to the relative price of traded and non‐traded goods, domestic and foreign interest rates, currency depreciation and the rate of inflaction. We evaluate the attractiveness of alternative investment strategies and provisioning rules from the perspective of portfoio theory.
Industrialization and spatial income inequality in rural China, 1986‐921
Authors: Yao Shujie
Published: November 2007

Rural industrialization has been a dominant factor responsible for China's rapid economic growth over the last 18 years, but it has been accompanied by increased inter‐regional income inequality. Using the most recent rural income data and two alternative Gini coefficient decomposition methods, this study finds that income inequality, especially inter‐regional income inequality increased significantly in the period 1986‐92. More than half of national income inequality was due to its inter‐provincial component, and three quarters of inter‐provincial inequality was due to its inter‐zonal component. Uneven development of township and village enterprises has been a major cause of increased regional income inequality.
Employment and wage behaviour of industrial enterprises in transition economies: The cases of Poland and Czechoslovakia1
Authors: Basu Swati , Estrin Saul , Svejnar Jan
Published: November 2007

In this paper we use two very large panel datasets from Poland, 1988‐90 and Czechoslovakia, 1990‐1992 to explore the dynamics of employment and wage determination at the enterprise level in the early years of transition. The study is intended to assist in building a coherent picture of microeconomic adjustment in transition, a field which was not sufficiently explored in the early years of reform. We find that Polish firms were already to some extent responsive to market conditions pre‐reform, notably to demand in determining employment. Czechoslovak firms, however, were largely unresponsive to such pressures in 1989‐90. The elasticities rose significantly in both countries in the early years of reform, especially in Czechoslovakia which quickly attained initial Polish patterns of adjustment. Firms became much more responsive to sales and cost pressures in adjusting employment and to their own productivity in setting pay. Ownership effects in these early years were, however, much more modest, with state‐owned firms adjusting employment more than their private counterparts, perhaps because over‐manning was more serious in that sector.
State enterprise performance and soft budget constraints: The case of Bulgaria
Authors: Claessens Stijn , Peters R. Kyle
Published: November 2007

This paper analyses the performance of state enterprises in Bulgaria during 1992‐94. Consistent with the literature on other transitional economies, this paper finds that one key factor underlying (the lack of) enterprise adjustment in Bulgaria during this period was the availability of financing. Empirically, the (lack of) past adjustment and the softness of finance are the best predictors of current adjustment. Many state enterprises, mostly smaller ones, appear to have adjusted to the new economic structure, partly in response to tighter budget constraints. However, a number of large, hard‐core lossmaking state enterprises did not adjust, due primarily to the soft budget constraints that they faced. These enterprises crowded out profitable enterprises, both public and private, through their large financing requirements, adversely affecting economic growth. Moreover, continued bank financing of these large loss‐makers decapitalized the banking system, and budgetary financing of their losses, largely through tax arrears, has undermined fiscal policy. This lack of enterprise adjustment and the resulting financial indiscipline lies at the core of the macroeconomic difficulties that Bulgaria has recently faced.
Restructuring financial systems in transition and developing economies: an approach based on the French financial system
Authors: Bertero Elisabetta
Published: November 2007

The aim of this paper is to contribute to the debate on the redesigning of financial systems in Central and Eastern European and developing countries by focusing attention on specific financial institutions appropriate to easing the transition and fostering the creation of markets. The paper argues that the immediate emulation of the better‐known institutions of the most developed, market‐based financial systems, i.e. the US and the UK, should not be taken for granted. It underlines, instead, the importance of drawing inspiration from the experiences of a variety of institutions and financial systems. Particularly relevant are those systems that have experienced forms of transition and a mix, over time, of market and state intervention.

The approach of this paper is one of institutional financial economics (Neave, 1991 and Williamson, 1986), in which structural details of financial institutions and contracts, in our case French financial institutions, are analysed. We argue that the principles on which some French financial institutions are based and aspects of their functioning are of value to reformers. We discuss the lessons that can be learnt from the Crédit National, the Commissariat Général du Plan, the CODEVI and the SOFARIS.
A net impact analysis of active labour programmes in Hungary
Authors: O'Leary Christopher J.
Published: November 2007

This paper presents estimates of the impact on re‐employment and earnings of the two most popular active labour programmes used during the economic transition in Hungary: retraining and public service employment (PSE). To adjust for non‐random assignment of programme participants, net impacts were computed using matched pair samples and regression models. The evidence suggests retraining may improve the chance for reemployment, is unlikely to improve re‐employment earnings, but may improve job durability. Net societal benefits could be improved by retraining relatively more males, older persons, and those with less education. PSE does not appear to provide a reliable path to a regular non‐subsidized job, and may even lower re‐employment earnings. PSE might best be viewed as an income transfer programme having the collateral benefit of maintaining basic work habits. The net societal impact of PSE could increase if it involved relatively more females and older persons.
Poverty dynamics in Hungary during the transformation1
Authors: Spéder Zsolt
Published: November 2007

At the time of transoformation in Hungary, poverty was one of the most discussed public questions. This paper focuses mainly on the longitudinal aspect of poverty. It describes the development of the poverty figures by the application of different poverty concepts. The dual nature of poverty is both poverty. We aim to dispel some of the doubts about poverty, and portray, the portray the different social groups experiencing permanent and transitory poverty.