bluuebunny/crossref_metadata_2025 huggingface dataset:
Severe Acute Respiratory Syndrome Coronavirus as an Agent of Emerging and Reemerging Infection
Authors: Cheng Vincent C. C. , Lau Susanna K. P. , Woo Patrick C. Y. , Yuen Kwok Yung
Published: October 2007

Before the emergence of severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV) in 2003, only 12 other animal or human coronaviruses were known. The discovery of this virus was soon followed by the discovery of the civet and bat SARS-CoV and the human coronaviruses NL63 and HKU1. Surveillance of coronaviruses in many animal species has increased the number on the list of coronaviruses to at least 36. The explosive nature of the first SARS epidemic, the high mortality, its transient reemergence a year later, and economic disruptions led to a rush on research of the epidemiological, clinical, pathological, immunological, virological, and other basic scientific aspects of the virus and the disease. This research resulted in over 4,000 publications, only some of the most representative works of which could be reviewed in this article. The marked increase in the understanding of the virus and the disease within such a short time has allowed the development of diagnostic tests, animal models, antivirals, vaccines, and epidemiological and infection control measures, which could prove to be useful in randomized control trials if SARS should return. The findings that horseshoe bats are the natural reservoir for SARS-CoV-like virus and that civets are the amplification host highlight the importance of wildlife and biosecurity in farms and wet markets, which can serve as the source and amplification centers for emerging infections.
Plasmodium malariae
: Parasite and Disease
Authors: Collins William E. , Jeffery Geoffrey M.
Published: October 2007

A review of the life history of Plasmodium malariae, the quartan malaria parasite of humans, is presented. Much of the information is based on data obtained from induced infections in humans who were given malaria therapy for the treatment of neurosyphilis between 1940 and 1963. Prepatent periods (i.e., the time until the first day of parasite detection) fever episodes, and maximum parasitemias as a result of infection with P. malariae were obtained and are presented. Experimental and known vectors of the parasite are also discussed. Splenectomized chimpanzees and New World monkeys are readily infected and serve as sources of parasites and antigens for diagnostic and molecular studies. South American monkeys are naturally infected with a parasite known as Plasmodium brasilianum. This parasite appears to be P. malariae that has adapted from humans to grow in monkeys, probably within the last 500 years. Infection with P. malariae is associated with the production of immune complexes in the kidneys and the associated nephrotic syndrome. The essential lesions are a thickening of the glomerular basement membrane and endocapillary cell proliferation. Studies of monkeys infected with P. malariae indicate the same pathology as that demonstrated in humans.
Do you get value for money when you buy an expensive pair of running shoes?
Authors: Clinghan R , Arnold G P , Drew T S , Cochrane L A , Abboud R J
Published: October 2007

Objective:

This investigation aims to determine if more expensive running shoes provide better cushioning of plantar pressure and are more comfortable than low-cost alternatives from the same brand.

Methods:

Three pairs of running shoes were purchased from three different manufacturers at three different price ranges: low (£40–45), medium (£60–65) and high (£70–75). Plantar pressure was recorded with the Pedar® in-shoe pressure measurement system. Comfort was assessed with a 100 mm visual analogue scale. A follow-on study was conducted to ascertain if shoe cushioning and comfort were comparable to walking while running on a treadmill. Forty-three and 9 male subjects participated in the main and follow-on studies, respectively. The main outcome measure was the evaluation of plantar pressure and comfort.

Results:

Plantar pressure measurements were recorded from under the heel, across the forefoot and under the great toe. Differences in plantar pressure were recorded between models and between brands in relation to cost. Shoe performance was comparable between walking and running trials on a treadmill. No significant difference was observed between shoes and test occasions in terms of comfort.

Conclusions:

Low- and medium-cost running shoes in each of the three brands tested provided the same (if not better) cushioning of plantar pressure as high-cost running shoes. Cushioning was comparable when walking and running on a treadmill. Comfort is a subjective sensation based on individual preferences and was not related to either the distribution of plantar pressure or cost.
Investigating the over-representation of older persons in do-it-yourself home maintenance injury and barriers to prevention
Authors: Ashby K , Ozanne-Smith J , Fox B
Published: October 2007

Objective:

To examine why older persons undertake high-risk do-it-yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low-risk alternatives to DIY, and to assess if alternatives are feasible in the current context.

Design:

Exploratory qualitative study using focus-group methodology.

Setting and subjects:

Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities.

Results:

Older persons’ involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost-effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review.

Conclusions:

This research is an important first step in understanding issues facing community-dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs.
Obesity and workplace traumatic injury: does the science support the link?: Table 1
Authors: Pollack Keshia M , Cheskin Lawrence J
Published: October 2007

Objective:

To explore whether obesity is associated with non-fatal traumatic occupational injury.

Design:

Systematic literature review.

Methods:

The peer-reviewed literature was searched from 1 January 1980 to 31 December 2005 for studies on the risk of overweight and obesity on non-fatal traumatic occupational injuries among non-office employees. The search was conducted using Medline, eLCOSH, NIOSHTIC-2, CINAHL, PsycLit, and OSH-ROM. Studies were excluded that focused on military populations, chronic/repetitive workplace injuries, back pain, only height as a risk factor, or were not written in English.

Results:

The search identified only 12 studies. The risk of injury for obese versus non-obese employees overall was slightly increased, although many of the estimates were not statistically significant. In studies in which increased risk estimates were shown, there was limited exploration of the mechanism of obesity-related injury, but the influence of chronic disease, fatigue or sleepiness, ergonomics, and physical limitations were most often hypothesized.

Discussion:

With the current growing prevalence of obesity worldwide, more research is needed to better establish its impact on workplace injuries and lost work time. Studies are needed that use large diverse samples, advanced statistical methods, and control for potential confounders, and explore issues related to temporality. Gaining a better understanding of how obesity influences workplace injury may foster the development of interventions that address weight, while still emphasizing the important environmental and sociocultural risk factors for injury.
Providing car seat checks with well-child visits at an urban health center: a pilot study
Authors: Quinlan Kyran P , Holden Janet , Kresnow Marcie-jo
Published: October 2007

Objective:

To evaluate a pilot program of providing child restraint system (CRS) checks by certified technicians with well-child care in an urban health center serving a low-income community.

Methods:

During well-child care, nationally certified child passenger safety technicians assessed CRS use, educated care givers, corrected misuse, and provided a new CRS if necessary. The program’s effect was assessed at a subsequent medical visit.

Results:

A total of 3650 CRS checks were performed. CRS non-use was found for 307 (17%) infants, 604 (50%) toddlers, and 593 (88%) booster seat-sized children. Exposure to the program was associated with a significant positive effect on CRS use (p<0.001) and significant improvements in the major components of misuse (p<0.05) months later.

Conclusions:

This urban health center has high rates of CRS non-use and near-universal misuse. Providing CRS checks by certified technicians during well-child care is a promising means of promoting sustained and improved CRS use.
Behavioral assessment of child-directed canine aggression
Authors: Reisner Ilana R , Shofer Frances S , Nance Michael L
Published: October 2007

Objective:

To characterize behavioral circumstances of bites to children by dogs presented to a veterinary behavior clinic.

Methods:

Retrospective case series examining medical records of dogs presenting by referral to a university veterinary hospital for aggression and which had bitten a child <18 years old. Behavioral data included age of victim, familiarity with dog, and circumstances of bites.

Results:

Records of bites to 111 children were examined. Children <6 years old were most commonly bitten in association with resource guarding (44%), whereas older children were most commonly bitten in association with territory guarding (23%). Similarly, food guarding was the most common circumstance for bites to familiar children (42%) and territory guarding for bites to unfamiliar children (53%). Behavioral screening of the 103 dogs examined revealed resource guarding (61%) and discipline measures (59%) as the most common stimuli for aggression. Anxiety screens revealed abnormalities in 77% of dogs. Potential contributory medical conditions were identified/suspected in 50% of dogs. When history before presentation was known, 66% of dogs had never previously bitten a child, and 19% had never bitten any human. Most dogs (93%) were neutered, and 66% of owners had taken their dogs to obedience training classes.

Conclusions:

Most children were bitten by dogs with no history of biting children. There is a high rate of behavioral abnormalities (aggression and anxiety) in this canine population. Common calming measures (neutering, training) were not routinely effective deterrents.
Effects of the Occupational Safety and Health Administration’s control of hazardous energy (lockout/tagout) standard on rates of machinery-related fatal occupational injury
Authors: Bulzacchelli Maria T , Vernick Jon S , Webster Daniel W , Lees Peter S J
Published: October 2007

Objective:

To evaluate the impact of the United States’ federal Occupational Safety and Health Administration’s control of hazardous energy (lockout/tagout) standard on rates of machinery-related fatal occupational injury. The standard, which took effect in 1990, requires employers in certain industries to establish an energy control program and sets minimum criteria for energy control procedures, training, inspections, and hardware.

Design:

An interrupted time-series design was used to determine the standard’s effect on fatality rates. Machinery-related fatalities, obtained from the National Traumatic Occupational Fatalities surveillance system for 1980 through 2001, were used as a proxy for lockout/tagout-related fatalities. Linear regression was used to control for changes in demographic and economic factors.

Results:

The average annual crude rate of machinery-related fatalities in manufacturing changed little from 1980 to 1989, but declined by 4.59% per year from 1990 to 2001. However, when controlling for demographic and economic factors, the regression model estimate of the standard’s effect is a small, non-significant increase of 0.05 deaths per 100 000 production worker full-time equivalents (95% CI −0.14 to 0.25). When fatality rates in comparison groups that should not have been affected by the standard are incorporated into the analysis, there is still no significant change in the rate of machinery-related fatalities in manufacturing.

Conclusions:

There is no evidence that the lockout/tagout standard decreased fatality rates relative to other trends in occupational safety over the study period. A possible explanation is voluntary use of lockout/tagout by some employers before introduction of the standard and low compliance by other employers after.
Area socioeconomic status and childhood injury morbidity in New South Wales, Australia
Authors: Poulos Roslyn , Hayen Andrew , Finch Caroline , Zwi Anthony
Published: October 2007

Objective:

To explore the relationship between child injury morbidity and socioeconomic status.

Design:

A cross-sectional analysis of routinely collected hospital separation data for unintentional injury for the period 1999/2000–2004/2005.

Setting:

All statistical local areas of New South Wales (NSW), Australia

Subjects:

110 549 unintentional injury-related hospital separations for NSW children aged 0–14 years.

Main outcome measure:

Adjusted incidence rate ratios (IRRs) for hospital separations for unintentional injury (for all injury and by individual injury mechanisms) by quintile of socioeconomic disadvantage for children aged 0–14 years.

Results:

There was no clear relationship between socioeconomic status and injury when all injury mechanisms were combined. However, children in the more disadvantaged quintiles were more likely to be hospitalized than children in the least disadvantaged quintile for the following injury mechanisms: motor cycle (point estimates for IRRs across the socioeconomic status quintiles ranged from 2.95 to 4.02 relative to the least disadvantaged quintile), motor-vehicle occupant (IRR range 1.33–2.27), pedestrian (IRR range 1.43–2.54 for ages 0–4 years), pedal cyclist (IRR range 1.30–1.50), fire and burns (IRR range 1.37–2.00), and poisoning (IRR range 1.32–1.91). Similarly, hospital separation rates for foreign body, other transport, and pedestrian (aged 5–9 years) injuries were also greater, but the differences were not statistically significant across all quintiles. These injury mechanisms accounted for about 25% of the hospital separations.

Conclusions:

The relationship between relative socioeconomic disadvantage and injury risk in NSW children is strongest for transport-related injuries, fires and burns, and poisoning. Interventions that address these specific injury mechanisms may help to reduce the disparity between high and lower socioeconomic groups.
Pediatric hospitalizations for bicycle-related injuries
Authors: Shah Summit , Sinclair Sara A , Smith Gary A , Xiang Huiyun
Published: October 2007

Objectives:

To determine the incidence of bicycle-related injury hospitalizations among children and adolescents 20 years of age and younger and to examine the associated use of healthcare resources.

Design:

Nationally representative data from the 2003 Healthcare Cost and Utilization Project’s Kids’ Inpatient Database (KID).

Outcome measures:

National estimates of hospitalization for bicycle-related injuries according to patient demographics, type of injury, total hospital charges, and length of hospital stay.

Results:

In 2003, an estimated 10 700 children were hospitalized for a bicycle-related injury in the USA. Inpatient charges totaled nearly $200 million with a mean charge of $18 654 per hospitalization. The national rate was 12.7 hospitalizations per 100 000 children. Young adolescents aged 10–13 years accounted for the highest percentage of cases (36.6%) followed by children aged 6–9 years (25.1%). Most patients were male (76.7%) and resided in an urban area (94.4%). A head injury was diagnosed in one out of three hospitalized bicyclists; 30% were due to a motor vehicle collision.

Conclusions:

Pediatric bicycle-related hospitalizations are a significant public health problem. The morbidity and mortality among children and the economic costs to society are large. The patient characteristics and injury types identified by this study should be used to develop targeted prevention strategies.
Smooth handling: The lack of safety-related consumer information in car advertisements: Table 1
Authors: Wilson Nick , Maher Anthony , Thomson George , Keall Michael
Published: October 2007

Objective:

To examine the content and trends of safety-related consumer information in magazine vehicle advertisements, as a case study within the worldwide marketing of vehicles.

Methods:

Content analysis of popular current affairs magazines in New Zealand for the 5-year period 2001–2005 was undertaken (n =  514 advertisements), supplemented with vehicle data from official websites.

Results:

Safety information in advertisements for light passenger vehicles was relatively uncommon with only 27% mentioning one or more of nine key safety features examined (average: 1.7 out of nine features in this 27%). Also included were potentially hazardous features of: speed imagery (in 29% of advertisements), power references (14%), and acceleration data (4%). The speed and power aspects became relatively more common over the 5-year period (p < 0.05 for trend).

Conclusions:

To enhance informed consumer choice and improve injury prevention, governments should consider regulating the content of vehicle advertisements and vehicle marketing – as already occurs with many other consumer products.
Genotypes and serum concentrations of human alpha-1-antitrypsin “P” protein variants in a clinical population
Authors: Bornhorst Joshua A , Calderon Fernanda R O , Procter Melinda , Tang Wei , Ashwood Edward R , Mao Rong
Published: October 2007

Background:

Alpha-1-antitrypsin (AAT) deficiency is a relatively common genetic disorder that can lead to the development of pulmonary disorders. Diagnosis of AAT deficiency is typically performed by isoelectric focusing (IEF) protein phenotyping in concert with determination of AAT serum concentration levels. The “P” phenotypic variant is associated with several known genetic variants that are found at unknown relative frequencies.

Aims:

To investigate the genetic variation of “P” alleles in patient samples.

Methods:

A DNA sequencing protocol for the full AAT coding region from serum was developed. Additionally, a retrospective evaluation of AAT concentrations in serum samples containing “P” allele IEF phenotype variants was undertaken.

Results:

“P” phenotypic variants are observed in ∼1 of every 900 samples received in the reference laboratory. Heterozygous “MP” allele samples exhibited a wide range of serum protein concentrations. Genotyping revealed the presence of the deleterious Plowellvariant in six heterozygous MP samples, two heterozygous PZ samples, and one homozygous PP sample. A non-deleterious Pst albansvariant was observed in a single MP sample. A novel heterozygous AAT M“P” variant, Psalt lakewas identified, that did not exhibit a reduced AAT serum concentration.

Conclusions:

Genetic heterogeneity is present in clinical “P” phenotype variants identified by IEF, and the deleterious Plowellvariant appears to be relatively common. Sequencing of “P” phenotype variants can provide useful clinical information, especially when the “P” phenotype variant is paired with a deficiency phenotype allele.
Mucosal endocrine cell micronests and single endocrine cells following neo-adjuvant therapy for adenocarcinoma of the distal oesophagus and oesophagogastric junction
Authors: Stewart Colin J R , Hillery Simon
Published: October 2007

Aims:

To determine the frequency of endocrine cell micronests (ECM) and single endocrine cells (SEC) within the glandular mucosa of the distal oesophagus and oesophagogastric junction (OGJ) following neo-adjuvant therapy for adenocarcinoma.

Methods:

The resection specimens from 11 patients with adenocarcinoma of the distal oesophagus or OGJ who had undergone preoperative chemotherapy or chemoradiotherapy (CRT) were reviewed and stained immunohistochemically for cytokeratin and chromogranin. The presence of ECM and/or SEC within the mucosa adjacent to the tumour was noted, and the results correlated with the extent of tumour regression. The corresponding pretreatment endoscopic biopsy specimens were reviewed in 6 cases, and the results were also compared to 10 tumour resections from patients with no history of neo-adjuvant treatment.

Results:

ECM and/or SEC were identified in 8/11 resection specimens after chemotherapy or CRT. The endocrine cells were typically located within the deep lamina propria or muscularis mucosae and were associated with varying degrees of glandular atrophy and inflammation. The appearances were most consistent with endocrine cell preservation (pseudo-hyperplasia) following treatment. Isolated endocrine elements were not seen in the pretreatment biopsy specimens, while rare SEC without ECM were identified in only 2/10 control resection specimens.

Conclusions:

Endocrine cell pseudo-hyperplasia may be seen within atrophic glandular mucosa following neo-adjuvant therapy of distal oesophageal/OGJ adenocarcinomas. The changes are analogous to those seen in chronic atrophic gastritis and should not be misinterpreted as those of residual tumour.
E2F-1 overexpression correlates with decreased proliferation and better prognosis in adenocarcinomas of Barrett oesophagus
Authors: Evangelou K , Kotsinas A , Mariolis-Sapsakos T , Giannopoulos A , Tsantoulis P K , Constantinides C , Troupis T G , Salmas M , Kyroudis A , Kittas C , Gorgoulis V G
Published: October 2007

Background:

E2F-1 expression is positively associated with tumour growth in oesophageal squamous-cell carcinomas (OSCC), while it exhibits oncosuppressive features in colonic adenocarcinomas (AC). To date there are no data regarding E2F-1 expression and its relationship with tumour kinetics (proliferation, apoptosis) in adenocarcinomas that develop on Barrett oesophagus.

Aim:

As oesophageal adenocarcinomas occur almost exclusively in the metaplastic Barrett epithelium and the opposing E2F-1 behaviour seems to be cell and tissue-type dependent, we examined the manner in which E2F-1 acts in ACs of Barrett oesophagus.

Methods:

We estimated the immunohistochemical expression of E2F-1, Ki-67, caspase-3 and p53 immunohistochemical status in 35 Barrett oesophagus ACs.

Results:

E2F-1 immunopositivity correlated inversely with Ki-67, by semi-serial section and statistical analysis (p = 0.023, Spearman correlation). Semi-serial section analysis revealed a direct association between E2F-1 and caspase-3 staining. No correlation was found with p53 status. Cases with higher E2F-1 immunoexpression exhibited longer survival (p = 0.047, Cox-regression).

Conclusions:

E2F-1 expression was negatively related to tumour proliferation in ACs of Barrett oesophagus. Additionally, E2F-1 immunohistochemical status correlated positively with patient survival. These findings are opposite from those seen in OSCCs, suggesting that the tumour-suppressing E2F-1 behaviour in oesophageal adenocarcinomas is possibly due to the intestinal-type nature of the metaplastic Barrett mucosa.
Squamous cell carcinoma antigen in human liver carcinogenesis
Authors: Guido M , Roskams T , Pontisso P , Fassan M , Thung S N , Giacomelli L , Sergio A , Farinati F , Cillo U , Rugge M
Published: October 2007

Background:

Squamous cell carcinoma antigen (SCCA) is a serine protease inhibitor that can be overexpressed in hepatocellular carcinoma (HCC) at both molecular and protein level, but no data are available on its expression in pre-malignant stages.

Aim:

To assess SCCA expression by immunohistochemistry in HCC and its nodular precursors in cirrhotic livers.

Methods:

55 nodules from 42 explanted livers were evaluated: 7 large regenerative nodules (LRNs), 7 low-grade dysplastic nodules (LG-DNs), 10 high-grade DNs (HG-DNs), and 31 HCC. SCCA expression was semiquantitatively scored on a four-tiered scale.

Results:

SCCA hepatocyte immunostaining was always restricted to the cytoplasm, mainly exhibiting a granular pattern. Stain intensity varied, ranging from weak to very strong. Within the nodules, positive cells were unevenly distributed, either scattered or in irregular clusters. The prevalence of SCCA expression was 29% in LRNs, 100% in DNs and 93% in HCC. A significant difference emerged in both prevalence and score for LRNs versus LG-DNs (p<0.039), HG-DNs (p = 0.001), and HCC (p = 0.000). A barely significant difference (p = 0.49) was observed between LG-DNs and HG-DNs, while no difference in SCCA expression was detected between HG-DNs and HCC. Cirrhotic tissue adjacent to the nodules was positive in 96% of cases, with a significant difference in the score (p = 0.000) between hepatocytes adjacent to HCC and those surrounding LRNs.

Discussion:

This study provides the first evidence that aberrant SCCA expression is an early event in liver cell carcinomatous transformation.
Detection of epidermal growth factor receptor gene mutations in cytology specimens from patients with non-small cell lung cancer utilising high-resolution melting amplicon analysis
Authors: Smith G D , Chadwick B E , Willmore-Payne C , Bentz J S
Published: October 2007

Background:

Activating epidermal growth factor receptor (EGFR) mutations have been implicated in non-small cell lung cancer (NSCLC), and have also been clinically correlated with patient sensitivity to targeted EGFR inhibitors.

Aim:

To describe a technique for determining EGFR mutation status on archival fine needle aspirate (FNA) specimens from advanced NSCLC patients.

Methods:

Eleven archival FNA slides from patients with advanced NSCLC were examined for diagnostic material to identify tumour cell-enriched regions. EGFR mutation status was determined using a slide-scrape DNA extraction protocol of selected tumour cell regions on the smear slides, followed by real time PCR and high resolution melt analysis (HRMAA) of EGFR exons 18, 19, 20, and 21, followed by sequence analysis.

Results:

All DNA samples were successfully amplified by PCR. Three adenocarcinoma patient samples contained EGFR mutations in exon 19 (L747-P753insS). One of the three had an additional exon 19 mutation (A755D).

Conclusions:

Archival cytology slides from patients with NSCLC can be used to determine EGFR mutation status by PCR, HRMAA, and sequencing. The ability to use archival cytology slides greatly increases the potential material available for molecular analysis in diagnosis and selection of patients for targeted therapeutic agents.
A review of recorded information given to patients starting to take clozapine and the development of guidelines on disclosure, a key component of informed consent: Table 1
Authors: Parsons Brian , Kennedy Miriam
Published: October 2007

Clozapine is a very effective drug with both significant benefits and significant risks in treatment-resistant schizophrenia. Informed consent is generally accepted as both desirable and necessary in order to ensure that the patient’s human rights and dignity are respected. Disclosure is a key element of informed consent. It is unclear if the adequate documentation of disclosure is standard practice before initiation of clozapine. The aim of this study was to assess the adequacy of the documentation of disclosure in consent to clozapine treatment in an adult mental health service and to develop guidelines on disclosure. The method was a retrospective analysis of charts of patients given clozapine who received the drug through the pharmacy of a single North Dublin psychiatric hospital. Results show that current practice has evident gaps. The professional, ethical and legal issues are discussed.
Spanish public awareness regarding DNA profile databases in forensic genetics: what type of DNA profiles should be included?: Figure 1
Authors: Gamero Joaquín J , Romero Jose-Luis , Peralta Juan-Luis , Carvalho Mónica , Corte-Real Francisco
Published: October 2007

The importance of non-codifying DNA polymorphism for the administration of justice is now well known. In Spain, however, this type of test has given rise to questions in recent years: (a) Should consent be obtained before biological samples are taken from an individual for DNA analysis? (b) Does society perceive these techniques and methods of analysis as being reliable? (c) There appears to be lack of knowledge concerning the basic norms that regulate databases containing private or personal information and the protection that information of this type must be given. This opinion survey and the subsequent analysis of the results in ethical terms may serve to reveal the criteria and the degree of information that society has with regard to DNA databases. In the study, 73.20% (SE 1.12%) of the population surveyed was in favour of specific legislation for computer files in which DNA analysis results for forensic purposes are stored.
Compassion as a basis for ethics in medical education
Authors: Leget Carlo , Olthuis Gert
Published: October 2007

The idea that ethics is a matter of personal feeling is a dogma widespread among medical students. Because emotivism is firmly rooted in contemporary culture, the authors think that focusing on personal feeling can be an important point of departure for moral education. In this contribution, they clarify how personal feelings can be a solid basis for moral education by focusing on the analysis of compassion by the French phenomenologist Emmanuel Housset. This leads to three important issues regarding ethics education: (1) the necessity of a continuous attention for and interpretation of the meaning of language, (2) the importance of examining what aspect of “the other” touches one and what it is that evokes the urge to act morally and (3) the need to relate oneself to the community, both to the medical community and to collectively formulated rules and laws. These issues can have a place in medical education by means of an ethical portfolio that supports students in their moral development. First, keeping a portfolio will improve their expression of the moral dimension of medical practice. Second, the effects of self-knowledge and language mastery will limit the pitfalls of emotivism and ethical subjectivism and will stimulate the inclination to really encounter the other. Third, it will show medical students from the start that their moral responsibility is more than following rules and that they are involved personally.
Who wants to live forever? Three arguments against extending the human lifespan
Authors: Pijnenburg Martien A M , Leget Carlo
Published: October 2007

The wish to extend the human lifespan has a long tradition in many cultures. Optimistic views of the possibility of achieving this goal through the latest developments in medicine feature increasingly in serious scientific and philosophical discussion. The authors of this paper argue that research with the explicit aim of extending the human lifespan is both undesirable and morally unacceptable. They present three serious objections, relating to justice, the community and the meaning of life.
Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in “vulnerable” groups
Authors: Battin Margaret P , van der Heide Agnes , Ganzini Linda , van der Wal Gerrit , Onwuteaka-Philipsen Bregje D
Published: October 2007

Background:

Debates over legalisation of physician-assisted suicide (PAS) or euthanasia often warn of a “slippery slope”, predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period.

Methods:

The data from Oregon (where PAS, now called death under the Oregon Death with Dignity Act, is legal) comprised all annual and cumulative Department of Human Services reports 1998–2006 and three independent studies; the data from the Netherlands (where both PAS and euthanasia are now legal) comprised all four government-commissioned nationwide studies of end-of-life decision making (1990, 1995, 2001 and 2005) and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought.

Results:

Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured (inapplicable in the Netherlands, where all are insured), people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups.

Conclusions:

Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges.
Occupational lung cancer risk among men in the Netherlands
Authors: Preller L , Balder H F , Tielemans E , van den Brandt P A , Goldbohm R A
Published: October 2007

Objectives:

To assess male lung cancer risks for industrial sectors in the Netherlands and to estimate the proportion of lung cancer attributed to working in specific industrial sectors.

Methods:

Associations were studied among men aged 55–69 years (n = 58 279) from the prospective Netherlands Cohort Study. 1920 incident lung cancer cases were available after 11.3 years of follow-up. Based on a case-cohort design, and using Cox proportional hazards models, risks were estimated for blue collar workers in 26 industrial sectors.

Results:

Adjustment for individual smoking habits affected risk estimates for some sectors, but adjustment for fruit/vegetables and alcohol intake did not. Adjusted for confounders, an increased risk of lung cancer was observed for employment for ⩾15 years in blue collar jobs in the “electronics and optical instruments” industry (rate ratio (RR) 1.99; 95% CI 1.18 to 3.35), “construction and homebuilding business” (RR 1.64; 95% CI 1.21 to 2.22) and “railway company” (RR 2.40; 95% CI 1.00 to 5.73). The attributable fraction for working for ⩾15 years in these three industries was 5%. In three other sectors there was a statistically non-significant elevated RR of >1.5.

Conclusions:

Male lung cancer risk is increased in several industrial sectors. Approximately 2000 lung cancer cases between 1986 and 1997 in the 55–69-year-old age group in the Netherlands may be attributable to working for ⩾15 years in the three sectors with increased risk. In addition, estimates for occupational lung cancer risks for sectors may be biased if no individual information is available on smoking habits.
A meta-analysis for neurobehavioural effects due to electromagnetic field exposure emitted by GSM mobile phones
Authors: Barth A , Winker R , Ponocny-Seliger E , Mayrhofer W , Ponocny I , Sauter C , Vana N
Published: October 2007

Background and objective:

Numerous studies have investigated the potential effects of electromagnetic fields (EMFs) emitted by GSM mobile phones (∼900 MHz to ∼1800 MHz) on cognitive functioning, but results have been equivocal. In order to try and clarify this issue, the current study carried out a meta-analysis on 19 experimental studies.

Design:

Meta-analysis.

Methods:

Nineteen studies were taken into consideration. Ten of them were included in the meta-analysis as they fulfilled several minimum requirements; for example, single-blind or double-blind experimental study design and documentation of means and standard deviation of the dependent variables. The meta-analysis compared exposed with non-exposed subjects assuming that there is a common population effect so that one single effect size could be calculated. When homogeneity for single effect sizes was not given, an own population effect for each study and a distribution of population effects was assumed.

Results:

Attention measured by the subtraction task seems to be affected in regard to decreased reaction time. Working memory measured by the N-back test seems to be affected too: under condition 0-back target response time is lower under exposure, while under condition 2-back target response time increases. The number of errors under condition 2-back non-targets appears to be higher under exposure.

Conclusion:

Results of the meta-analysis suggest that EMFs may have a small impact on human attention and working memory.
A case crossover study of triggers for hand injuries in commercial fishing
Authors: Kucera K L , Loomis D , Marshall S W
Published: October 2007

Objectives:

Previous studies estimate hand and wrist injuries are common in commercial fishing. Risk factors including working with catch, handling gear and slips or falls, have been identified from activity and injury contact reports, but no studies have examined the influence of transient risk factors, or triggers. This case crossover study design was conducted to investigate triggers for acute hand trauma in commercial fishing.

Methods:

A case crossover study was nested within a previously established prospective cohort of 217 southeastern United States commercial fishermen followed from April 1999 through October 2001. Hand injury cases and controls were matched using three control selection strategies. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated to determine if transient risk factors such as glove use, engaging in more than one type of fishing, maintenance activities and other covariates of interest increased the risk of occupational traumatic hand/wrist/digit injuries.

Results:

21% (46/217) of fishermen reported one or more hand/wrist/digit injuries, yielding 65 eligible cases. Performing maintenance work (any vs none) (OR 3.1, 95% CI 1.8 to 5.5) and using multiple types of fishing equipment in comparison to using only one type (OR 1.9, 95% CI 0.9 to 3.8) were associated with increased risk of hand/wrist/digit injury. There was no evidence glove use was protective (any vs none) for hand/wrist/digit injury (OR 0.9, 95% CI 0.5 to 1.7).

Conclusions:

The case crossover design is a useful method to determine triggers of commercial fishing-related hand/wrist/digit injuries. Maintenance work was strongly associated with hand/wrist/digit injury for these fishermen.
Incidence of surgically treated osteoarthritis in the hip and knee in male construction workers
Authors: Järvholm B , From C , Lewold S , Malchau H , Vingård E
Published: October 2007

Objective:

Occupational workload has been associated with an increased risk of osteoarthritis. The objective was to further examine the association between workload and occurrence of osteoarthritis and in particular to study whether heavy workload has similar importance as a causative factor for osteoarthritis of the hip and knee.

Methods:

In a cohort study, the authors investigated the incidence of surgically treated osteoarthritis in the hip and knee among men employed in the Swedish construction industry (n = 204 741). Incident cases were found by linkage with the Swedish hospital discharge register between 1987 and 1998. Incidence rates adjusted for age and BMI were compared between different occupational groups.

Results:

The incidence rates for osteoarthritis in hip and knee were positively correlated (r = 0.62; p = 0.01). There was a significantly increased risk of surgically treated osteoarthritis in the knee among floor layers, asphalt workers, sheet-metal workers, rock workers, plumbers, brick layers, wood workers and concrete workers. Even if there was a trend towards increased relative risks for osteoarthritis in the hip in floor layers, asphalt workers, wood workers and concrete workers they were not statistically significant. The relative risk for surgically treated osteoarthritis of the knee was 4.7 (95% CI 1.8 to 12.3) among floor layers, indicating an attributable fraction for work factors of 79%.

Conclusions:

This study shows that some work-related factors seem to be risk factors for osteoarthritis both in the knee and hip. However, the risk factors seem to be of greater importance for osteoarthritis in the knee compared with the hip. This study indicates that at least 50% of the cases of severe osteoarthritis of the knee can be prevented through decreasing occupational risk factors in some occupational groups.
Ozone modifies associations between temperature and cardiovascular mortality: analysis of the NMMAPS data
Authors: Ren C , Williams G M , Morawska L , Mengersen K , Tong S
Published: October 2007

Objectives:

Both ambient ozone and temperature are associated with human health. However, few data are available on whether ozone modifies temperature effects. This study aims to explore whether ozone modified associations between maximum temperature and cardiovascular mortality in the USA.

Methods:

The authors obtained data from the US National Morbidity, Mortality, and Air Pollution Study (NMMAPS) website. They used two time-series Poisson regression models (a response surface model and a stratification model) to examine whether ozone modified associations between maximum temperature and cardiovascular mortality (CVM) in 95 large US communities during 1987–2000 in summer (June to September). Bayesian meta-analysis was used to pool estimates in each community.

Results:

The response surface model was used to examine the joint effects of temperature and ozone on CVM in summer. Results indicate that ozone positively modified the temperature-CVM associations across the different regions. The stratification model quantified the temperature-CVM associations across different levels of ozone. Results show that in general the higher the ozone concentration, the stronger the temperature-CVM associations across the communities. A 10°C increase in temperature on the same day was associated with an increase in CVM by 1.17% and 8.31% for the lowest and highest level of ozone concentrations in all communities, respectively.

Conclusion:

Ozone modified temperature effects in different regions in the USA. It is important to evaluate the modifying role of ozone when estimating temperature-related health impacts and to further investigate the reasons behind the regional variability and mechanism for the interaction between temperature and ozone.
Exposure to inhalable dust and its cyclohexane soluble fraction since the 1970s in the rubber manufacturing industry in the European Union
Authors: de Vocht F , Vermeulen R , Burstyn I , Sobala W , Dost A , Taeger D , Bergendorf U , Straif K , Swuste P , Kromhout H
Published: October 2007

Objectives:

As exposures to airborne particulates in the European rubber industry might still be causing genotoxic risks, it is important to assess trends in levels of inhalable dust and its cyclohexane soluble fraction (CSF) between the 1970s and 2003.

Methods:

13 380 inhalable and 816 respirable dust and 5657 CSF measurements, collected within the framework of the European Union Concerted Action EXASRUB, were analysed. Hierarchical mixed effects models were applied to assess exposure trends, taking into account between-factory, between-worker/location and day-to-day variances.

Results:

Geometric mean levels of inhalable dust and CSF exposure changed by −4 (range −5.8 to +2.9) and −3 (range −8.6 to 0) per year, respectively. Significant reductions in inhalable dust concentrations were found in all countries for handling of crude materials and mixing and milling (−7 to −4 per year), as well as for miscellaneous workers (−11 to −5 per year), while significant CSF exposure reductions were found in curing (−8.6 per year) and maintenance and engineering departments (−5.4 per year).

Conclusion:

These analyses suggest that on average exposure levels of inhalable dust and its CSF in the European rubber manufacturing industry have steadily declined. Most likely genotoxic risks have also lessened over time since exposure levels have decreased and the most toxic chemicals have been replaced. In addition to differences in exposure reductions and levels among various stages of the production process, large differences across countries were noted. These patterns should be taken into account in retrospective assessment of exposure for epidemiological studies assessing cancer risk in the rubber industry.
Mesothelioma mortality in men: trends during 1977–2001 and projections for 2002–2016 in Spain
Authors: Pitarque S , Clèries R , Martínez J M , López-Abente G , Kogevinas M , Benavides F G
Published: October 2007

Objectives:

To evaluate mesothelioma death trends in Spain and to predict the number of future cases of mesothelioma.

Methods:

After descriptive analysis of mesothelioma mortality data, an age-period-cohort model was applied to estimate future mesothelioma deaths.

Results:

From 1977 to 2001, 1928 men over 35 years of age died of mesothelioma in Spain. Projections indicate that 1321 men are expected to die from mesothelioma between 2007 and 2016.

Conclusion:

It is expected that mesothelioma deaths will increase at least until 2016. Available data do not allow prediction of the year when mortality will start to decrease.