bluuebunny/crossref_metadata_2025 huggingface dataset:
Lower Limb Movements and Urologic Function in Fetuses with Neural Tube and Other Central Nervous System Defects
Authors: Warsof Steven L. , Abramowicz Jacques S. , Sayegh Sue K. , Levy Donald L.
Published: November 2009

Lower limb movements and urologic systems were evaluated by prenatal ultrasound in 120 fetuses with either neural tube defects or intracranial anomalies. Despite anticipated major lower extremity and bladder dysfunction, lower limb movements were seen in 100% of the fetuses with anencephaly and encephaloceles, 93% with isolated spina bifïda, 60% with complex spina bifida and 90% with abnormal intracranial findings. In all the cases except those with cloacal exstrophy, fetal bladder and collecting systems appeared normal. Therefore, fetal lower limb movements and urinary tract integrity appear to have no diagnostic or prognostic value in fetuses with neural tube defects or other central nervous system anomalies. These diagnoses can only be made by direct ultrasound observation of the lesion itself.
Diagnosis and Treatment of Feto-Maternal Hemorrhage in a Fetus with Homozygous von Willebrand’s Disease
Authors: Ash K.M. , Mibashan R.S. , Nicolaides K.H.
Published: November 2009

In a fetus with severe type-III von Willebrand’s disease, fetal blood sampling by cordocentesis was associated with feto-maternal hemorrhage, fetal hypovolemia, and persistent bradycardia. The fetal condition improved after intracardiac transfusion of blood.
Effects of Intrauterine Treatment on Nonimmunologic Hydrops fetalis
Authors: Maeda Hirotaka , Shimokawa Hiroshi , Nakano Hitoo
Published: November 2009

In 44 cases with nonimmunologic hydrops fetalis (NIHF), perinatal management was performed based on our protocol. Twenty-one cases were treated by albumin and/or packed red blood cell (PRC) injection into the fetal abdominal cavity, and 8 cases were treated by transplacental digitalization. Among the cases treated by albumin and/or PRC injection, 5 of 7 cases without pleural effusion recovered in utero, and all 5 cases are alive at the time of writing. However, of 14 cases with pleural effusion, none recovered in utero, and only 1 case is alive. Of 8 cases treated by transplacental digitalization, 2 cases recovered in utero, and 1 case is alive. All fetuses with congenital heart anomaly died. This evidence indicates that albumin and/or PRC injection into the fetal abdominal cavity is an effective procedure for in utero treatment of NIHF without pleural effusion, but suggests that in NIHF resulting from either congenital heart anomaly and/or heart failure, the survival rate may not be increased by transplacental digitalization.
Direct Intrauterine Fetal Treatment of Fetal Tachyarrhythmia with Severe Hydrops fetalis by Antiarrhythmic Drugs
Authors: Gembruch U. , Hansmann M. , Bald R.
Published: November 2009

In cases of non-immune hydrops fetalis caused by tachyarrhythmias, the transplacental passage of antiarrhythmic drugs may be hampered. When this is proven by fetal blood sampling in cases of tachyarrhythmia refractory to transplacental treatment, additional administration of antiarrhythmic drugs into the fetus is necessary and seems to improve the results. Although injections of antiarrhythmic agents in fetal ascites are also highly effective, intravascular administration by sonographic guidance is to be preferred. Then, simultaneous measurements of fetal and maternal drug levels are possible for the evaluation of pharmacokinetics and for monitoring the antiarrhythmic therapy.
New Therapeutic Aspects in Nonimmune Hydrops fetalis Based on Four Hundred and Two Prenatally Diagnosed Cases
Authors: Hansmann M. , Gembruch U. , Bald R.
Published: November 2009

In 402 cases with prenatally diagnosed nonimmune hydrops fetalis, cardiovascular diseases were present in 18 %, chromosomal disorders in 11 %, and hematologic disorders of the fetus in 10%. In the last 3 years, fetal blood sampling has become a very important part of the differential diagnosis of nonimmune hydrops (chromosomal, hematologic and metabolic disorders, intrauterine infection). Also, transabdominal placental biopsy has been used for rapid karyotyping. A detailed fetal echocardiogram is absolutely necessary in all cases of nonimmune hydrops, in particular spectral and color Doppler flow mapping. Thus, congenital heart diseases can be accurately diagnosed. Further, in other causes of hydrops regurgitation of atrioventricular valves may be present in advanced stage. New important methods of intrauterine therapy are in particular: intravascular blood substitution in anemia, and the intravascular application of antiarrhythmic drugs in tachyarrhythmia. The overall survival rate was 19.4% (78 of 402); 4.0% (6 of 149) before 24 weeks of gestation, and 28.5% (72 of 253) after this age of gestation. The majority of survivors were in the tachyarrhythmia, hematologic disorder, isolated ascites and hydro-/chylothorax groups (53 of 78 survivors, 68%). In the other groups, the survival rate was generally low.
Conservative Management of Urinary Abnormalities Detected in utero
Authors: Chierici Roberta , Riccipetitoni Giovanna , Tamisari Lalla , Vesce Fortunato , Zanella Bruno , Merlo Luciano , Vigi Vittorio
Published: November 2009

During a 5-year period, we observed 48 fetuses with urinary malformations diagnosed by antenatal sonography. Postnatal investigations confirmed the presence of a urinary tract anomaly in 44 of the 48 fetuses selected by prenatal ultrasound (91 %). Accurate antenatal diagnosis was made in 35 of the 48 cases (73%). In 9 fetuses renal disease was detected, but its specific nature was not in accordance with the prenatal diagnosis. In our series the most common anomaly was hydronephrosis secondary to ureteropelvic junction obstruction. This condition was observed in 31 of the 44 patients (70.4%); 7 of the newborns who showed an obstructive pattern were submitted to early surgical repair, while the remaining 24 cases and 1 renal unit of the group undergoing early surgical repair were relegated to expectant observation, with periodic clinical and laboratory controls. A spontaneous recovery was observed in 12 cases; the dilatation remained unchanged in 10 cases, while 3 patients showed a progressive worsening of the condition which led to a surgical correction. Our findings agree with those in recent reports in providing little support for early, indiscriminate surgical repair. Moreover, our experience confirms the possibility of a spontaneous recovery in newborns with hydronephrosis and draws attention to the benefit of a conservative management in properly selected patients.
Selective Birth in a Dyzygotic Twin Pregnancy with Discordancy for Down’s Syndrome
Authors: Pijpers Leen , Jahoda Milena G.J. , Reuss Annette , Sachs Eva S. , Los Frans J. , Wladimiroff Juriy W.
Published: November 2009

The discovery of a twin pregnancy by ultrasound at the intake procedure for chorionic villus sampling or amniocentesis is not unusual because of the raised incidence of dizygotic twins at increased maternal age. Since the conception of dizygotic twins is genetically a separate and unrelated event, the risk of abnormalities in each twin is independent, but additive. In advanced maternal age, the risk of chromosomal aneuploidy in one of both fetuses varies between 2 and 6% [1]. This case report discusses the early prenatal diagnosis of twins discordant for Down’s syndrome.
Reference Ranges for Fetal Heart Rate Patterns in Normoxaemic Nonanaemic Fetuses
Authors: Sadovsky G. , Nicolaides K.H.
Published: November 2009

Reference ranges for the various components of fetal heart rate (FHR) patterns with gestation were established from the study of 119 fetuses at 20–39 weeks. These fetuses were proved by cordocentesis to be normoxaemic and nonanaemic. The mean baseline FHR decreased, while the baseline variability, both for amplitude and oscillation frequency, increased with gestation. The number and amplitude of accelerations increased, and the frequency and duration of decelerations decreased with gestation. These data indicate that in the interpretation of FHR patterns adjustments according to the gestational age of the fetus should be made.
Arginine Vasopressin and Acute, Intravascular Volume Expansion in the Human Fetus
Authors: Weiner Carl P. , Smith Francine , Robillard Jean E.
Published: November 2009

There is presently no information concerning the ontogeny and control of arginine vasopressin (AVP) in the human fetus. AVP was measured in 22 nonanemic control fetuses and 7 fetuses with hemolytic anemia undergoing 13 intravascular transfusions. Each transfused fetus received pancuronium (0.3 mg/kg) and furosemide (2 mg/kg). Compared to the control group of nonanemic fetuses with hemolytic disease, AVP was significantly lower in the anemic fetus prior to transfusion (2.6 ± 0.4 μU/ml versus 10.4 ± 4.1 μU/ml, p < 0.05). This suggests that hemolytic anemia is associated with a relative increase in fetal intravascular volume. Intravascular transfusion was associated with a significant increase in AVP (p < 0.05). These findings could not be explained by changes in either blood pressure, plasma osmolality, or fetal oxygenation.
Early Third Trimester Selective Feticide of a Compromising Twin
Authors: Still K. , Kolatat T. , Corbett T.C. , Byrne P.B.
Published: November 2009

We report successful selective feticide of an anomalous, comprising twin by using intracardiac potassium chloride injection at 26 weeks gestation. This was associated with later delivery and survival of a very low birth weight infant with normal neurodevelopmental follow-up at 2 years. We suggest that selective feticide in such cases may have an important role to play in management.
Albumin Transfusion in Non-Immune Fetal Hydrops: Doppler Ultrasound Evaluation of the Acute Effects on Blood Circulation in the Fetal Aorta and the Umbilical Arteries
Authors: Lingman Goran , Stangenberg Magnus , Legarth Jesper , Rahman Feryal
Published: November 2009

A case of non-immune fetal hydrops, diagnosed as mucopolysaccharidosis VII with hypoalbuminemia, was treated in utero with albumin transfusions via cordocentesis on five occasions. Blood samples were taken for analysis of full blood count and blood gases before and after the transfusions. Pulsed Doppler ultrasound examinations of the arterial waveform were performed in the umbilical arteries and the descending fetal aorta and analyzed for the pulsatility index (PI). The hemoglobin concentration and the hematocrit decreased from Ill ± 5 g/l and 0.335 ± 0.008 to 95 ± 5 g/l and 0.282 ± 0.023 (mean ± SD), respectively, after the transfusions. The calculated blood volume increased more than the given volume, indicating an autotransfusion causing additional plasma volume expansion. The blood gases were not significantly changed by transfusion. The PI decreased both in the umbilical arteries (p < 0.05) and the descending fetal aorta, indicating peripheral vasodilatation. A positive correlation was found between the umbilical artery PI and the hematocrit before and after the albumin transfusion (r = 0.59; p < 0.05). This relation could be due to covariation with other factors, e.g. peripheral vasodilatation secondary to the increased blood volume and the puncture of the umbilical vein itself. No improvement of the hydrops was seen after the albumin transfusions. The fetus died in utero during spontaneous labor after 30 gestational weeks.
Placenta previa and Congenital Cardiac Anomalies
Authors: Neri Alexander , Manor Yoram , Matityahu Abraham , Blieden Leonard
Published: November 2009

This study was designed to evaluate the association of placenta previa (PP) with cardiac anomalies in the fetus/neonate. The study group (n = 82 babies) was compared to a control group (n = 82) matched for maternal and gestational age. Five babies of the study group expired within 24 h of delivery, and postmortem examination was carried out in 4 of them. The living children of the control and study group (51 of the 77 babies) underwent complete cardiac workup including physical examination, ECG, chest X-ray and echocardiography. The incidence of congenital cardiac anomalies in the study group was significantly higher (Fisher exact test, p = 0.025). The obstetrician should refer the pregnant woman with PP for echocardiographic studies.
Fetal Goitrous Hypothyroidism
Authors: Johnson R.L. , Finberg H.J. , Perelman A.H. , Clewell W.H.
Published: November 2009

We present a first case in whom fetal hypothyroidism with goiter was both successfully diagnosed and treated in utero. An obstetrical sonogram at 33 weeks revealed a bilobed fetal neck mass, compatible with enlarged thyroid gland, associated with neck hyperextension, reduced gastric fluid, and polyhydramnios. Umbilical blood sampling after volume reduction amniocentesis confirmed fetal hypothyroidism with a euthyroid mother. Fetal T4 measured 1.3 μg/dl, free T4 0.3 ng/dl, and thyroidstimulating hormone 186 μU. Intra-amniotic levothyroxine, 500 μg, was given twice with a 14-day interval. The head flexed, gastric fluid increased, and amniotic fluid levels returned to normal. Prenatal (36 weeks) and neonatal blood sampling demonstrated return to euthyroid indices. Ultrasonic estimates of thyroid volume decreased by over 50%. Vaginal delivery at 39 weeks was incomplicated. The newborn appeared normal and is being maintained on thyroid replacement therapy.
Umbilical Cord Blood Rheology in Relation to Maternal Disease and Fetal Hypoxia
Authors: Romanini Carlo , Tranquilli Andrea L. , Garzetti Gioele , Valensise Herbert , Boemi Massimo , de Tommaso Giuseppe , Fumelli Paolo
Published: November 2009

Erythrocyte aggregation was studied in 60 samples of cord blood taken at delivery from neonates whose mothers suffered from hypertension or diabetes in pregnancy or from neonates who showed hypoxia during labor. Eryhtrocyte aggregation significantly increased in the cord blood of neonates who suffered from hypoxia during labor, and in neonates from hypertensive and diabetic mothers. The effects of maternal disease or intrapartum hypoxia may therefore stimulate fetal erythropoiesis and cause major changes in cord blood rheology.
Compensatory Adrenal Hypertrophy following Unilateral Adrenalectomy of Fetuses of Rats Given Alcohol throughout Gestation
Authors: Arishima K. , Lee M. , Yamamoto M. , Eguchi Y.
Published: November 2009

The effect of maternal alcohol consumption on fetal compensatory adrenal hypertrophy following unilateral adrenalectomy was studied in rats. Females were given 20% alcohol in tap water for 4 weeks prior to mating and 30% alcohol in tap water throughout gestation (alcohol), or were pair-fed to the alcohol group (pair-fed) or were fed ad libitum (control). On day 20, fetuses were unilaterally left-adrenalectomized or sham operated. Mothers were sacrificed on day 22 of gestation and right adrenals of adrenalectomized, shamoperated, and unoperated fetuses were removed and weighed. Some adrenals were fixed, sectioned, and stained for histological examination. Adrenalectomized fetuses of all three dietary treatment groups demonstrated compensatory hypertrophy. Adrenals of alcohol exposed fetuses weighed less than those of pair-fed or control fetuses, and the ratio of adrenal weight/body weight was greater, regardless of surgical procedure. Histological sections of right adrenals of left-adrenalectomized fetuses showed larger cells and widened sinusoids, compared to unoperated fetuses in the corresponding dietary treatment groups. These results are consistent with a retardation in adrenal growth and development as a result of alcohol exposure, but show that alcohol consumption throughout gestation does not affect the ability of the adrenals to undergo compensatory hypertrophy following unilateral adrenalectomy.
Premature Separation of Placenta in a Patient with Idiopathic Thrombocytopenic Purpura
Authors: Neri A. , Pardon Y. , Schoenfeld A. , Zaizov R. , Cohen I.J.
Published: November 2009

The most common autoimmune hemolytic disorder encountered during pregnancy is idiopathic thrombocytopenic purpura. Premature separation of the placenta is one of the most serious complications in the second half of pregnancy. Since the association of the two is not known, the aim of the present paper is to present such a case and to draw the attention of the obstetrician to this possibility.
Significance of Velocimetry as a Monitor of Fetal Assessment and Management1
Authors: Echizenya Narihiro , Kagiya Akífumi , Tachizaki Tatsno , Saito Yoshiharu
Published: November 2009

Using pulsed Doppler ultrasound velocimetry, we set out to examine (a) the significance of velocimetry as a monitor of fetal management (including fetal therapy), and (b) the correlation between the occurrence of abnormal blood flow values and perinatal morbidity. We compared the incidence of abnormal values between a control group of normal pregnant women (59 cases) and an ‘abnormal pregnancy’ group (60 cases), composed of patients exhibiting maternal complications, IUGR, and fetal distress. The incidence of abnormal values was 23.7% in the control group and 71.7% in the abnormal group. Our results indicate clearly that velocimetry of the middle cerebral artery is the most reliable way to diagnose fetal distress. Also, when high or multiple abnormal values are detected by velocimetry, the incidence and degree of perinatal morbidity increases.
Ethical Issues in Prenatal Diagnosis and Fetal Therapy
Authors: Sgreccia Elio
Published: November 2009

The author deals with the ethical problems arising from the techniques of prenatal diagnosis and fetal therapy. With regard to the use of prenatal diagnostic response, he underlines the frequent connection between the unfortunate response and the voluntary termination of pregnancy; with regard to this, he reports the various positions which can be found in the literature on ethics. In the light of Catholic ethics, the author affirms that prenatal diagnosis is only acceptable when it respects the life and integrity of the embryo and the human fetus and is directed towards its safeguarding or healing. The moment and form of the communication of the response is also considered. Finally, some guidelines to justify conditions for fetal therapy intervention are pointed out.
Genetic Correction of Hereditary Disease
Authors: Johnson Mark Paul , Drugan Arie , Miller Orlando J. , Evans Mark I.
Published: November 2009

Several hereditary disorders may be potentially correctable by the introduction and incorporation of the normal gene into human tissues using a variety of systems. Although technical issues surrounding integration, stable expression and potential insertional mutagenesis to the treated cells has not yet been fully resolved, enough scientific progress has already been made to consider somatic cell gene therapy acceptable from both the scientific and ethical viewpoints. Tissue-specific stem cell and embryonic stem cell transplantation will allow therapy earlier in the developing embryo. As technical problems are eliminated, these procedures will become morally permissible, as they will allow the correction of devastating hereditary disease.
Prenatal Diagnosis of Congenital Uropathies
Authors: Noia G. , Masini L. , Caruso A.C. , Perrelli L. , Calisti A. , Salvaggio E. , Mancuso S.
Published: November 2009

We discuss data on urinary tract dilatations diagnosed in utero from February 1980 to May 1988. Over 8,900 pregnancies prenatally investigated with ultrasound during second and third trimester in our center. We diagnosed 401 fetal defects (4.5%) with 121 urinary system anomalies (1.35%). In 90 cases (1.01 %) urinary tract dilatation was present, representing the most frequent urinary pathology in utero (74.3% of all urinary anomalies). We describe some diagnostic findings as particularly useful in differential diagnosis of functional and obstructive conditions, stressing the possibility and the difficulty of diagnostic accuracy for urinary tract anomalies. The perinatal outcome of each condition is reported.
Prevention and Treatment of Fetal Lung Immaturity
Authors: Cosmi E.V. , Di Renzo G.C.
Published: November 2009

In the last 10 years the strategy for the prevention of neonatal respiratory distress syndrome (RDS) has been directed towards the acceleration of fetal lung maturity in utero by means of drugs administered to the mother, the most thoroughly investigated being glucocorticoids (GC), and to the development of surfactant substitutes for the treatment of surfactant deficiency at birth or following the development of RDS. GC decreases the incidence of RDS in the neonate delivered between 28 and 32 weeks and weighing less than 1,500 g. The type of GC and the drug delivery interval are critical. Harmful potential side effects of GC have led to the testing of other drugs capable of accelerating fetal lung maturity, among which are ambroxol and aminophylline. Ambroxol has been shown to significantly reduce RDS compared to placebo without causing important adverse effects in either mother or baby. Our experimental studies on aminophylline have shown that the drug exerts only minor beneficial effects on fetal lung maturation and surfactant production. We have evaluated the association of GC with inositol. The sugar alcohol administered to the mother dramatically affected fetal lung mechanics, reducing GC adverse effects such as the decrease of lung protein content. More recently supplementary surfactant instilled into the trachea has been shown to improve oxygenation of premature babies and to reduce the severity of RDS.
Effect of Prednisone and Heparin Treatment in 14 Patients with Poor Reproductive Efficiency Related to Lupus Anticoagulant
Authors: Semprini A.E. , Vucetich A. , Garbo S. , Agostoni G. , Pardi G.
Published: November 2009

In women with a previous intrauterine fetal death related to lupus anticoagulant (LAC), we studied the effect of prednisone and calcieparine treatment to enable longer intrauterine life, increased fetal growth and increased survival rate. LAC was determined by the kaolin clotting time and was associated with elevated levels of antinuclear and anticardiolipin antibody in 42% and 21 % of the cases, respectively. 14 women entered the study; they had a past history of 27 pregnancies, with only 1 small-for-gestational age (SGA) liveborn. The mean gestational age at the time of fetal death was 30 ± 4 weeks. During index pregnancies, we observed 2 miscarriages, 9 liveborns (6 of appropriated gestational weight, 3 SGA) and a mean gestational age of 35 ± 3 weeks. The mean decrease in fetal weight from the 50th percentile in previous pregnancies was 44%, and with treatment this was reduced to 12%. All these differences were statistically significant. We conclude that prednisone and heparin treatment can improve reproductive prognosis in fertile patients with LAC.
Fetal and Neonatal Immunoincompetence
Authors: Vetro Sam W. , Bellanti Joseph A.
Published: November 2009

This paper discusses the development of the immune system from early gestation throughout postnatal development. The major aspects of immunoregulation and immunocompetence are reviewed. The mechanism(s) of immunologic tolerance, graft rejection reactions, mixed lymphocyte reactions, allogeneic bone marrow transplantation and graft versus host disease are described.
Workplace Democracy and the Global Financial Crisis
Authors: Lansbury Russell D.
Published: November 2009

The global financial crisis provides an opportunity for Australia to undertake reforms that will create a more democratic workplace. This will require a new social settlement between government, employers and unions, which not only restores and extends collective bargaining rights but also strengthens workers’ legal rights to participate in decision making at the enterprise level. In the global era, Australia should also play a more active role in supporting efforts by international bodies, such as the ILO, to promote decent jobs which embody core labour standards. This paper examines recent Australian and international experience as well as outlining future challenges for workplace democracy.
The (Continuing) Importance of Industry Studies in Industrial Relations
Authors: Bray Mark , Waring Peter
Published: November 2009

In the context of a recent tendency towards industrial relations studies at the level of either the nation or the enterprise, the aim of this article is to demonstrate the continuing importance of industry studies. Three main arguments are advanced to support this assertion, based respectively on the empirical and public policy relevance of industries and the potential of industry studies to develop theory.
What Helps Organizing Work? The Indicators and the Facilitators of Organizing
Authors: Burchielli Rosaria , Bartram Timothy
Published: November 2009

This article examines the adoption of the organizing model at three Australian union branches. It disentangles key conceptual dimensions of organizing, in particular the indicators and facilitators of organizing. Subsequently, these dimensions are explored through the views of Australian union officials actively engaged in the struggle of organizing. Findings suggest the critical supporting role of four facilitators: use of crisis, visionary and distributed leadership, branch cohesiveness and financial resources. However, in the process of union change, constraining factors such as internal conflict and industry restructure may prevent the adoption of the organizing strategy. Our findings may help to explain unions’ current limited adoption of the organizing model of revitalization.
The Revitalization of Trade Unions and the Re-emergence of Industrial Conflict in Argentina: The Case of the Oil Industry
Authors: Senén González Cecilia , Medwid Bárbara
Published: November 2009

This article examines the revitalization of trade unions and re-emergence of industrial conflict in Argentina, following the neo-liberal reforms of the government of Carlos Menem. The case of two unions in the vegetable oil industry is examined in detail. The research revealed that the key factors which accounted for differences in the effectiveness of the two unions included the following: the capacity of the unions to mobilize the workforce, the origins of the companies’ capital, and the political and economic environment in which both the unions and the employers operated.
Is Social Science Research Useful to State Legislators?
Authors: Hirasuna Donald P. , Hansen Susan B.
Published: November 2009

We examine whether social science research can influence state legislation and elaborate on why social scientists may sometimes fail to have an impact. To begin, we construct a simple model of the policy process in which social scientists supply research to legislators, which they then use to fashion bills into law. Next, we discuss the risks that may prevent achievement of this depiction and how legislators, other policy groups, and social scientists themselves may act to compromise the process. Afterward, we offer actions that may enhance the chances that research will be used by legislators.
Analysis for Public Policy at the State and Regional Levels The Role of Think Tanks
Authors: Teitz Michael B.
Published: November 2009

Think tanks (policy research institutes) in the U.S. have played a role in policy making for almost 100 years, though most date from after WWII. At the state level, however, they have been much less prominent, and their activity in regional research has been limited. Three types of state level think tanks can be identified: first, those associated with state government and universities, the latter often specialized; second, small think tanks that exist in large numbers and are primarily committed to advocacy of particular viewpoints; and third, a small group that are independent and similar to national think tanks, such as Rand, which aspire to objective research and analysis with the aim of improving public policy. The Public Policy Institute of California falls into the third category. Its experience offers some useful insights into the effectiveness of such entities, particularly their relevance to regional policy research.
Interpretive Bias in Acupuncture Research?
Authors: O'Connell Neil E. , Wand Benedict M. , Goldacre Ben
Published: November 2009

Acupuncture is one of the most widely used and broadly researched of the complementary and alternative therapies, but high-quality trials generally show no benefit over sham acupuncture. Many would view this result as evidence of ineffectiveness for this intervention. This discussion article focuses on the report of a large multicenter randomized controlled trial of acupuncture for chronic low-back pain (CLBP) in the lay and academic press, the ensuing discussion, and its impact on both clinical practice and service provision. The authors suggest that interpretive bias has affected reporting, leading to questionable conclusions and advocacy in favor of this form of care that may exceed the evidence. They also suggest that a lack of understanding of research into the placebo effect may have contributed to confusion in the interpretation of these trials.
The combined use of risperidone long-acting injection and clozapine in patients with schizophrenia non-adherent to clozapine: a case series
Authors: Se Hyun Kim  , Dong Chung Jung  , Yong Min Ahn  , Yong Sik Kim
Published: November 2009

Poor adherence to clozapine treatment represents an important problem in clinical practice because additional useful treatment options are unavailable. Although switching to risperidone long-acting injection (RLAI) has been recommended for those with compliance problems, this medication has been found to be less suitable for patients who previously received clozapine. Based on the suggested beneficial effects of RLAI, such as higher rates of treatment continuation and patient satisfaction, and the possible effectiveness of oral risperidone augmentation, it seems worthwhile to try RLAI augmentation for clozapine non-adherence. In this article, we present the cases of four patients with schizophrenia undergoing combined treatment with RLAI and clozapine for more than one year after multiple relapses related to clozapine non-adherence. Durations and frequencies of hospitalizations markedly declined after RLAI augmentation. Indeed, three patients receiving RLAI and clozapine for 1.2—3.5 years were never hospitalized during this period. The lengths of hospitalizations before and after augmenting with RLAI were 54.7 ± 33.1 and 4.2 ± 4.2 days/year, respectively. Participants also showed great improvements in social skills. These findings suggest the possible beneficial effects of RLAI augmentation in cases of clozapine nonadherence. However, controlled clinical trials are necessary to confirm whether RLAI augmentation represents a useful treatment option for patients who have not adhered to clozapine treatment.
A review of residential solid waste management in the occupied Palestinian Territory: a window for improvement?
Authors: Al-Khatib Issam A. , Arafat Hassan A.
Published: November 2009

Solid waste is considered an urgent environmental health issue in the Palestinian Territory. The aim of this paper was to analyse the current status of residential solid waste (RSW) management in the Palestinian Territory, with the objective of identifying windows for improvement. The study is based on a national household sample survey in the Palestinian Territory, which was conducted by the Palestinian Central Bureau of Statistics (PCBS). The results of this study revealed various interesting trends. For example, while about 90% of households in the Palestinian Territory receive solid waste collection service, about 50% of the households receive this service three times per week or less, leaving a chance for waste pile-up and litter generation. Organic waste (including food waste) was found to account for more than 90% of RSW, providing an opportunity for waste utilization through composting or biogas generation. Additional efforts are required, and some were suggested in this paper, in order to improve the current situation of Palestinian residential solid waste management.
Adopted technologies and basis for selection at municipal solid waste landfill facilities constructed in recent years in Japan
Authors: Asakura Hiroshi , Matsuto Toshihiko , Inoue Yuzo
Published: November 2009

In Japan, as the construction of new landfill facilities has become extremely difficult and the number of sites procured for landfill construction has decreased due to the ‘not in my back yard’ (NIMBY) syndrome, it has been assumed that the adoption of new technologies has increased. As the performance of new technologies exceeds that of conventional technologies, it is also assumed that residents would prefer the use of these new technologies and therefore any construction plans should be devised to ensure their use to ensure residents’ satisfaction. In the present study, the technologies adopted for municipal solid waste landfill facilities constructed in recent years (2000 to 2004) in Japan and the bases for their adoption were investigated by means of a questionnaire survey. One of the main bases for the adoption of new technologies was the request by residents for new technology for roofing, rather than the other for new technologies for barrier systems, leachate treatment, and monitoring. In addition, it is possible that the municipalities did not recognize the difference between conventional and new technologies as defined in this study. The roof-type landfill that isolates waste from the surrounding environment was one of the requirements for the construction of new landfill facilities identified in the present investigation, and in this regard waste isolation should be required in all circumstances.
Hybrid life-cycle assessment (LCA) of CO2 emission with management alternatives for household food wastes in Japan
Authors: Inaba Rokuta , Nansai Keisuke , Fujii Minoru , Hashimoto Seiji
Published: November 2009

In this study, we conducted a hybrid life-cycle assessment (LCA) to evaluate reductions in CO2 emissions by food waste biogasification of household food wastes in Japan. Two alternative scenarios were examined. In one alternative (Ref), all combustible municipal solid wastes (MSWs), including food waste, are incinerated. In the other (Bio), food waste is biogasified, while the other combustible wastes are incinerated. An inventory analysis of energy and material flow in the MSW management system was conducted. Subsequently, the inventory data were summarized into an input—output format, and a make-use input—output framework was applied. Furthermore, a production equilibrium model was established using a matrix representing the input— output relationship of energy and materials among the processes and sectors. Several levels of power generation efficiency from incineration were applied as a sensitivity analysis. The hybrid LCA indicated that the difference between the Bio and Ref scenarios, from the perspective of CO 2 emissions, is relatively small. However, a 13—14% reduction of CO2 emissions of the total waste management sector in Japan may be achieved by improving the efficiency of power generation from incineration from 10% to 25%.
Drivers in current and future municipal solid waste management systems: cases in Yokohama and Boston
Authors: Contreras Francisco , Ishii Satoshi , Aramaki Toshiya , Hanaki Keisuke , Connors Stephen
Published: November 2009

Despite some progress, municipal solid waste (MSW) still poses pressure on cities and remains one of the major challenges in environmental management. There is no single solution to the problem since the drivers behind MSW systems may vary significantly from city to city. In this context, the development of a common strategy to attain a sustainable management has been increasingly difficult. This paper presents an issue-driven analytical framework to evaluate the past, present and future MSW management strategy for the cities of Yokohama and Boston considering four driver categories while evaluating if the relevance of these drivers has changed over time. These categories represent: (i) legal drivers ( e.g. laws and regulations); (ii) technology development and institutional drivers ( e.g. available technologies); (iii) regional and international drivers ( e.g. solid waste flow as recyclable resources); and (iv) socio-economic drivers ( e.g. population trends and public awareness). The analysis indicated that solid waste management capacity for both cases was under stress due to different reasons. In the case of Boston, the moratorium for disposal facilities played an important role while increasing population was a key driver for the city of Yokohama. The future management scenario suggests that various waste-to-energy alternatives and strong solid waste reduction policies will play a key role for Boston. In Yokohama, a shift on waste composition and generation triggered by a demographic change may open the path for new technologies while also considering the international demand of solid waste as a recyclable resource.
Use of copper slag in glass-epoxy composites for improved wear resistance
Authors: Biswas Sandhyarani , Satapathy Alok
Published: November 2009

Copper slag is a by-product obtained during matte smelting and refining of copper. The common management options for copper slag are recycling, recovery of metal and production of value-added products. In the present study using copper slag as a filler in glass-epoxy composites, the tensile modulus increased from 8.77 GPa to 9.64 GPa when using up to 10 wt% of copper slag but on further addition of copper slag (up to 20 wt%), the tensile modulus started to decrease down to 7.11 GPa. Similar trends were observed in the case of flexural strength and interlaminar shear strength. With the incorporation of copper slag particles, the impact strength increased about 10—15%. This work includes the processing, characterization and study of the erosion behaviour of a class of such copper slag filled glass-epoxy composites based on Taguchi’s experimental approach to characterise erosion behaviour. The results show that peak erosion takes place at an impingement angle of 60° for the unfilled composites whereas for the copper slag filled glass-epoxy composites it occurs at a 45° impingement angle. This paper considers the possible utilisation of copper slag as filler material for the preparation of composite materials and preparation of added-value products such as abrasive tools, cutting tools and railroad ballast.
Assessment of air pollutant emissions from the Akrotiri landfill site (Chania, Greece)
Authors: Chalvatzaki E. , Lazaridis M.
Published: November 2009

Air pollutants emitted from landfills affect air quality, contribute to the greenhouse effect and may cause serious problems to human health under certain circumstances. The current study was focused on the determination of air emissions from the Akrotiri landfill site which is located in the Akrotiri area (Chania, Greece). The landfill consists of two phases, phase A (first phase) which is currently closed (operational between 2003 and 2007) and phase B (second phase, operation between 2007 and (foreseen) 2013). Three different emission models (the EPA LandGEM model, the triangular model and the stoichiometric model) were used for the quantification of emissions. The LandGEM 3.02 software was further adopted and used in conjunction with the long-term dispersion model ISC3-LT for the evaluation of the dispersion of gaseous chemical components from the landfill. The emission and meteorological conditions under which the models were applied were based on the worst-case emission scenario. Furthermore, the concentration of hydrogen sulfide, vinyl chloride and benzene were determined in and around the landfill site. The concentrations of hydrogen sulfide and benzene were calculated to be far below the limit value proposed by the World Health Organization (WHO) for human health safety. However, the vinyl chloride concentrations were above the WHO reference lifetime exposure health criteria for the phase B area.
A survey of recycling behaviour in households in Dhaka, Bangladesh
Authors: Afroz Rafia , Hanaki Keisuke , Tuddin Rabaah , Ayup Kartinah
Published: November 2009

This paper examines the factors that might influence recycling behaviour of the households in Dhaka city, Bangladesh. Information on recycling activity, socio-economic characteristics, and attitudes of the households towards recycling were obtained from interviews with 456 households in Dhaka. Logistic regression analysis was used to determine the dominant factors that might influence the recycling behaviour of the households. The results showed that environmental consciousness, the availability of storage space, and age (25—35 years) are significant positive predictors of recycling behaviour (at the 1% level). Another variable Income 2 (TK3,000—15,000) is also positively correlated with recycling (at the 5% level). Establishment of a recycling programme could be an effective strategy in implementing sustainable waste management in Bangladesh. For this strategy to succeed, however, active partnership between households and the waste management service department is required. The households’ attitudes toward recycling should, therefore, be taken into consideration as should the results of this study, which are important indicators of households’ positive attitudes toward sustainable waste management in Dhaka.
Testicular toxicity in cannabis extract treated mice: association with oxidative stress and role of antioxidant enzyme systems
Authors: Mandal Tapas K , Das Nildari S
Published: November 2009

Intraperitoneal injection of cannabis extract at low doses (total doses ranging from 40 mg to 60 mg per mouse) induced adverse effect on testes and oxidative stress. At low doses, there was a significant increase in lipid peroxidation and decrease in testicular lipid content, but the effects were significantly less at higher doses and at the withdrawal of cannabis treatment (recovery dose). There was a marked decrease in antioxidant enzyme profiles (superoxide dismutase, catalase and glutathione peroxidase) and glutathione content at low doses, but these effects were higher at higher dose and at withdrawal of the treatment (recovery effect). Histology revealed significant shrinkage of tubular diameter and detrimental changes in seminiferous epithelium of testis with resulting lowered serum testosterone and pituitary gonadotropins (follicular stimulating [FSH] and luteinizing hormones [LH]) levels at low doses. But at higher doses and particularly at withdrawal of the treatment, regression of various germ cell layers of testes through the revival of testosterone hormone and pituitary gonadotropins (FSH and LH) were observed, indicating that recovery effects on testes became operative possibly through the corrective measure of endogenous testicular antioxidant enzymes profiles and pituitary gonadotropins hormones feedback mechanisms.
Changes of cytokine production and cell viability of peripheral blood mononuclear cells from silicosis patients: effect of in vitro treatment with acetylsalicylic acid
Authors: Dobreva Zlatka Georgieva , Prakova Gospodinka Radeva , Slavov Emil Slavov , Stanilova Spaska Angelova
Published: November 2009

In this study, IL-6 and IL-12p40 production and cell viability of peripheral blood mononuclear cells from silicosis patients after in vitro stimulation were investigated. Furthermore, the effects of introducing acetylsalicylic acid to stimulated patients’ peripheral blood mononuclear cells on cytokine production and cell viability were determined. Nine patients with moderate silicosis, 11 with severe silicosis and 14 healthy subjects were recruited for this study. The level of IL-6 produced by patients peripheral blood mononuclear cells decreased depending on the stage of the disease. The addition of acetylsalicylic acid had significantly suppressive effect on the IL-6 production by lipopolysaccharide—stimulated patients’ peripheral blood mononuclear cells. Acetylsalicylic acid treatment of C3 binding glycoprotein—stimulated patients’ peripheral blood mononuclear cells led to significant upregulation of IL-12p40 production. Results showed a stage-dependent decrease of cell viability of peripheral blood mononuclear cells from silicosis patients. Acetylsalicylic acid significantly decreased cell viability entirely in stimulated peripheral blood mononuclear cells from patients with severe silicosis. In conclusion, this study showed that the disease progression affects peripheral blood mononuclear cells in patients with silicosis and causes functional changes that became apparent after stimulation. Our study demonstrated that in severe silicosis the treatment with acetylsalicylic acid, as an anti-inflammatory agent, might not be beneficial for patients.
Synthesis of Processable Conducting Polyaniline Nanocomposite Based on Novel Methodology
Authors: Eisazadeh Hossein , Eghtesadi Maral
Published: November 2009

A series of nanocomposites between aniline and vinyl acetate were synthesized chemically by an oxidative polymerization and inverse emulsion polymerization by using different solutions and oxidants such as ammonium persulfate/potassium iodate and potassium permanganate/benzoyl peroxide in the presence of various surfactants such as sodium dodecylbenzenesulfonate, poly(vinyl alcohol) and hydroxypropylcellulose, respectively. The products were characterized in terms of conductivity, morphology, particle size, conversion of monomers to polymer and molecular structure. The results show that the morphology, particle size and electrical conductivity of products are dependent on the type of surfactant and solution and the arrangement of monomer injection. The molecular structure of the product was studied by Fourier transform infrared spectroscopy.
Transient, unsettling and creative space: Experiences of liminality through the accounts of Chinese students on a UK-based MBA
Authors: Simpson Ruth , Sturges Jane , Weight Pauline
Published: November 2009

This article explores the experiences of liminality through the accounts of Chinese students on a UK-based MBA programme. The transient nature of the MBA experience, as well as the international status of the Chinese student, is resonant with conceptualizations of liminality as ‘in between’ space. Based on semi-structured interviews with 20 MBA graduates who had subsequently returned to China with their qualification, we explored their perceptions of outcomes from the course and their experiences as international students on a programme imbued with western norms and values. Results support the unsettling yet creative implications of liminality, as well as the fragmented insecure nature of identities, as individuals pass through the MBA ‘rite of passage’ in terms of ‘becoming’ a manager and entering a new phase of career. Accounts suggest the creation of hierarchical structures within liminal space whereby Chinese students, through their positioning at the margin, have uncomfortable yet illuminating encounters with alterity. At the same time, they experience levels of ambiguity and uncertainty in the post-liminal phase of China-located employments, as new western-based managerial identities collide with dominant discourses of Chinese organization.