bluuebunny/crossref_metadata_2025 huggingface dataset:
Relative androgen deficiency in relation to obesity and metabolic status in older men
Authors: Chen R. Y. T. , Wittert G. A. , Andrews G. R.
Published: August 2005

Background:  Although androgen deficiency in men has been linked with obesity and the metabolic syndrome, whether it predisposes to, or is a consequence of, type 2 diabetes mellitus (T2DM) is still unclear.

Objective:  To determine the relationship between plasma androgen levels, obesity, metabolic status and T2DM in men of 70 years or older.

Design and methods:  A sample of 195 men from the Australian Longitudinal Study of Ageing with a mean age of 76.2 ± 0.3 years were followed up for 8 years. Total testosterone (TT), fasting plasma glucose (FPG), urate, serum creatinine, total cholesterol (TC), HDL cholesterol (HDL‐C), LDL cholesterol (LDL‐C), triglycerides (TG), blood pressure (BP), body mass index (BMI), waist circumference (WC) and diabetic status were assessed at baseline. Self‐reported diabetic status was obtained after 8 years. Metabolic syndrome was diagnosed based on the Third National Cholesterol Education Program Adult Treatment Panel clinical criteria.

Results:  TT levels were lower in diabetic men compared with non‐diabetic men (12.1 ± 0.7 vs. 14.2 ± 0.4 nmol/l, p = 0.026). TT levels in healthy, non‐diabetic men over 80 years of age were lower (11.9 ± 0.8 vs. 15.0 ± 0.5 nmol/l, p = 0.002) than TT levels in those aged 70–79 years, inversely related to BMI (r = −0.26, p = 0.001), WC (r = −0.30, p < 0.001) and TG (r = −0.22, p = 0.005) and positively related to LDL‐C (r = 0.25, p = 0.002). Men with the metabolic syndrome had significantly lower levels of TT and HDL‐C, and higher values of BP, FPG, TG, BMI and WC, compared with those without. However, no significant difference in plasma TT levels was noted between men with incident T2Dm and healthy men. Stepwise linear regression analysis revealed that only LDL‐C and WC related significantly to the variance of TT. Multiple logistic regression revealed FPG to be the only independent predictor of incident diabetes (odds ratio = 60.2, p = 0.003).

Conclusions:  Testosterone levels continue to decline even in healthy men over the age of 80 years. Although TT levels were inversely related to visceral obesity and several components of the metabolic syndrome, our data do not support a predictive or causative role for decreasing TT levels in the development of incident T2Dm. Androgen deficiency is consequent upon, rather than a cause of, poor metabolic status.
Elevated C‐reactive protein in Native Canadian children: an ominous early complication of childhood obesity
Authors: Retnakaran R. , Hanley A. J. G. , Connelly P. W. , Harris S. B. , Zinman B.
Published: August 2005

Aim:  Subclinical inflammation has been proposed as a pathophysiologic mechanism linking obesity with vascular and metabolic disease. Native North American populations are experiencing high prevalence rates of both (i) childhood obesity and (ii) adult cardiovascular disease (CVD) and type 2 diabetes. Thus, we sought to determine whether subclinical inflammation is an early complication of obesity in Native children.

Methods:  Serum concentrations of the inflammatory biomarker C‐reactive protein (CRP) were assessed in a population‐based, cross‐sectional study of the Sandy Lake Oji‐Cree community of Northern Ontario, Canada, involving 228 children aged 10–19 years (mean age 14.8).

Results:  Median CRP in this population was 0.5 mg/l (interquartile range 0.18–1.79 mg/l). CRP levels were higher than age‐matched reference data from the Third National Health and Nutrition Examination Survey (NHANES III). Importantly, fully 15.8% of the children of this community had CRP concentrations between 3 and 10 mg/l, a range that identifies adults at high risk of CVD. Moreover, increasing CRP concentration in this paediatric population was associated with an enhanced CV risk profile, consisting of increased adiposity, higher insulin resistance, worsening lipid profile (higher total cholesterol, triglycerides, low‐density lipoprotein cholesterol, apolipoprotein B and total cholesterol : high‐density‐lipoprotein cholesterol ratio), increased leptin and decreased adiponectin. On multivariate analysis, waist circumference and interleukin‐6 (IL‐6) emerged as independent determinants of CRP concentration.

Conclusion:  Subclinical inflammation is an early complication of childhood obesity in Native children and may foreshadow an increased burden of CVD and type 2 diabetes in the future.
A comparison of glycaemic and metabolic control over time among South Asian and European patients with Type 2 diabetes: results from follow‐up in a routine diabetes clinic
Authors: Mukhopadhyay B. , Forouhi N. G. , Fisher B. M. , Kesson C. M. , Sattar N.
Published: August 2005

Aims  Although South Asians have a higher prevalence of diabetes which develops at a younger age, data on change in metabolic parameters post‐diagnosis are relatively sparse. We therefore wished to determine whether South Asians with diabetes had similar or greater year‐on‐year deterioration in metabolic parameters compared with Europeans.

Methods  We analysed longitudinal change in metabolic parameters [glycated haemoglobin (HbA1c), blood pressure, body mass index (BMI), lipids] among South Asian (n = 210) and European (n = 1557) patients consecutively attending the same diabetes clinic over a mean period of 5.3 years.

Results  South Asians were younger than Europeans at first recorded diagnosis of diabetes (mean age 45.9 vs. 57.3 years, P < 0.001) and had significantly lower (∼1.2 units) BMI and blood pressure. Mean HbA1c was not different across ethnic groups at first visit, but with time glycaemic control was worse in South Asians than Europeans, with average deterioration 1.31% (= 0.23%/year) in Asians vs. 0.82% (0.16%/year) in Europeans, P = 0.003. This ethnic difference in mean change in HbA1c persisted after adjustment for age, sex, baseline HbA1c, and weight change in linear regression analysis (beta = 0.46, 95% CI 0.24–0.69, P < 0.001), and with additional adjustment for time to referral and duration of diabetes (P = 0.01). Moreover, South Asians had significantly smaller improvements in blood pressure (P < 0.001) and cholesterol (P = 0.044) over the follow‐up period in keeping with fewer prescriptions of anti‐hypertensive agents and lipid‐lowering agents.

Conclusions  These data suggest the need to be more aggressive in the management of diabetes and related risk factors in South Asians.
The effect of obesity on glycaemic response to metformin or sulphonylureas in Type 2 diabetes
Authors: Donnelly L. A. , Doney A. S. F. , Hattersley A. T. , Morris A. D. , Pearson E. R.
Published: August 2005

Aims  In treating Type 2 diabetes (T2DM), UK guidelines recommend metformin in obese and overweight patients, and either sulphonylureas or metformin in normal weight patients. Although other factors influence prescribing choice, a key objective in treating T2DM is to lower plasma glucose. There is little data on how glycaemic response to oral agents varies with body mass index (BMI). Therefore, we assessed current prescribing practice and effect of BMI on glycaemic response to sulphonylureas and metformin in a large population T2DM cohort.

Methods  BMI was determined in 3856 T2DM patients on sulphonylurea or metformin monotherapy in 2001–2002. Patients were identified from the Diabetes Audit and Research in Tayside, Scotland (DARTS) database. In a linear regression, the effect of BMI and other confounders on drug response was assessed in 2064 treatment‐naïve patients commencing sulphonylureas or metformin between 1994 and 2002.

Results  In 2001–2002, metformin was more likely to be used in obese than non‐obese patients: 13% normal weight, 33.6% overweight and 62.1% obese patients were treated with metformin. Glycaemic response to sulphonylureas was not influenced by BMI (P = 0.81). Metformin was more effective in lowering glucose in those with a lower BMI (r = –0.02, P = 0.02), although the clinical impact of this was small. The HbA1c reduction in non‐obese patients was similar to that in obese patients (1.46% vs. 1.34%, P = 0.11).

Conclusions  Glycaemic response to metformin in non‐obese and obese patients is similar, suggesting that an individual's BMI should not influence the choice of oral agent. Given the non‐glycaemia‐related benefits of metformin, it should be used in more non‐obese patients than is current practice in Tayside, Scotland.
No evidence of diabetes‐specific CD38 (ADP ribosil cyclase/cyclic ADP‐ribose hydrolase) autoantibodies by liquid‐phase immunoprecipitation
Authors: Sordi V. , Lampasona V. , Cainarca S. , Bonifacio E.
Published: August 2005

Aims/hypothesis  Autoantibodies to the ADP ribosyl cyclase/cyclic ADP‐ribose hydrolase CD38 have been suggested to be markers of autoimmunity in Type 1 and Type 2 diabetes. The aim of this study was to develop a fluid phase assay for population screening.

Methods  Human recombinant CD38 was cloned and expressed by in vitro transcription and translation for fluid phase radio‐binding assay, as a fusion protein in COS7 cells for fluid phase immunoprecipitation, and as a fusion protein for western blot assays. Antibody binding to each recombinant protein was measured in sera from patients with Type 1 diabetes, Type 2 diabetes and control subjects.

Results  Immunoprecipitation of radio‐labelled in vitro transcribed and translated CD38 was low in all sera, including monoclonal anti‐CD38 antibodies, with no difference between patients and control subjects. Monoclonal antibodies to CD38, but not patient or control sera immunoprecipitated recombinant CD38 fusion protein expressed in COS7 cells. Antibody binding to recombinant CD38 in solid‐phase western blot assay was detected in sera from 2% of patients with Type 1 diabetes, 6% of patients with Type 2 diabetes, and 8% of control subjects.

Conclusions  This study failed to detect diabetes relevant binding of antibodies to recombinant CD38 using liquid‐phase methods. Formal comparison of anti‐CD38 antibody detection between laboratories is suggested.
Lifelong Learning in the European Union: whither the Lisbon Strategy?
Authors: JONES HYWEL CERI
Published: August 2005

This article traces the Lisbon strategy back to the White Paper issued by President Jacques Delors in 1993 on Growth, Competitiveness, and Jobs as the launching point for the structural reform agenda needed to turn around the massive unemployment crisis and proposing a combination of policies for the structural reform of the labour market and stability‐oriented macroeconomic policies designed to stimulate economic growth. The centrality of education and training in the Lisbon strategy is seen as key to the lifelong chances of every citizen linked to the need for Europe to compete on the basis of a knowledge‐based economy if it is to maintain its high social standards. Describing the first years of the Lisbon strategy as ‘a stuttering start’, the mid‐term stock‐taking which offered European leaders the opportunity to fine‐tune or radically modify the strategy is analysed. The article highlights the paradox that, although human capital is claimed to be Europe's most precious resource, there is inadequate focus on the weakest aspects of current systems. It also focuses on policy and financial levers which need to be mobilised within Member States as well as the implications for national budgets. It suggests the prioritisation of a small number of areas on which to concentrate efforts and echoes the Council calling for a ‘quantum leap’ in the ambition of the EU to ensure that the necessary follow‐up is given to meet the challenges. Finally, a strong argument is put forward to take steps to move towards a unified set of proposals for lifelong learning.
The Lisbon Strategy Challenges to the Czech Republic Human Resources
Authors: KADERABKOVA ANNA
Published: August 2005

When achieving long‐term sustainable growth, the key role is assigned to ­knowledge‐based competitiveness. The new EU Member States therefore face a double challenge on the Lisbon road. On the one hand, higher expenditure is required to improve the quality of research and education input and infrastructure, and on the other, innovation system changes are necessary to increase the efficiency of expended resources. At the same time, both supply and demand sides must be adequately balanced in policy supporting knowledge‐based competitiveness. On the supply side, the position of the new Member States in EU‐25 has been defined in the competitiveness matrix; on the demand side, specific attention is given to the quality of human resources as a prerequisite of competitiveness in the EU as assessed by Czech companies. Finally, recommendations are formulated for the competitiveness support both in the form of a comprehensive innovation policy and a more specific support to human resource supply for innovation.
The Withdrawal of Current Cost Accounting in the United Kingdom: A Study of the Accounting Standards Committee
Authors: PONG CHRISTOPHER K. M. , WHITTINGTON GEOFFREY
Published: August 2005

Evidence from the archives of the U.K. Accounting Standards Committee (ASC) is used to trace the events leading to the withdrawal of the current cost accounting standard, SSAP 16, from 1980 to 1988. Three central issues are addressed. First, the ASC's role as a regulatory body is considered in the light of the failure to obtain compliance with SSAP 16 and to find an acceptable replacement. Second, the decline in support for SSAP 16 is explained in terms of changes in the economic environment. Third, the roles of different interest groups in the process are analysed.
Asymmetry in Stock Returns Following Block Trades on the Australian Stock Exchange: A Note
Authors: AITKEN MICHAEL , FRINO ALEX
Published: August 2005

A number of recent US. studies have examined the price impact of large (block) trades using intraday data. A major finding is that the price movement following block trades continues upwards following purchases but reverses following sales. This asymmetry in price behaviour, which suggests that block sellers pay a liquidity premium while block buyers do not, has been described as ‘intriguing’ and a ‘key puzzle’. The purpose of this note is to determine whether the phenomenon exists on the Australian Stock Exchange. Evidence consistent with the ‘puzzling’ asymmetry is shown to exist when returns are measured from the block trade until the close of trade. Contrary to US. findings, which have shown that prices appear to reverse following both block purchases and sales in transaction time analysis, the asymmetry in price behaviour is also demonstrated to exist in transaction returns for the ASX. All results are found to be robust to a number of research design innovations and data partitions.
Ends, Ways, Means and Conceptual Frameworks
Authors: CHAMBERS R. J.
Published: August 2005

Frameworks for thinking about experiences and occurrences have long been the basis of organized knowledge and technology. They consist of sets of descriptive statements of what commonly occurs, and what is therefore possible. The term ‘conceptual framework’ has been given an entirely different interpretation in accounting ‐a ‘constitution’ prescribing the nature of accounting and its products. In spite of the conceptual framework projects of recent years. the diversity of rules and practices which have prompted attempts to reform accounting persists. These projects have failed through disregard of the role of systematic knowledge in the design of serviceable practical devices.
The Equity Accounting Saga in Australia: Cyclical Standard Setting
Authors: GORDON ISABEL , MORRIS RICHARD D.
Published: August 2005

Equity accounting in Australia has had a long, chequered history. This article examines that history by reference to a succession of six Exposure Drafts, one Statement of Accounting Practice and two Standards issued between 1968 and 1995. We adapt Nobes' (1991, 1992a. 1992b) cycle model of regulation to explain variation in ‘standardization’ across these documents. Nobes defined ‘standardization’ to mean the restriction of choice in accounting methods but we modify the concept to allow for measurement rule ‘improvements’ and changes in required disclosure levels. Nobes' cycle model has four stages: a starting point of varied practice: energy inputs, often crises, drawing attention to the issue at hand: forces opposing and forces in favour of standardization. A cycle‐ like pattern of variation in standardization emerges in the present context. Potential shortcomings of the cycle model are addressed, including Skerratt and Whittington's (1992) criticisms of Nobes' cycle model. The article extends the literature with respect to a cyclical explanation of the standard setting process. The cycle pattern evident here reflects a slow and incomplete resolution of various conceptual and legal difficulties in regulating equity accounting in Australia.
Optimal Transfer Pricing Method and Fixed Cost Allocation
Authors: SHIH MICHAEL S. H.
Published: August 2005

Prior empirical research on transfer pricing only reported what firms do but seldom explained why. This study moves the research forward by introducing hypothesis testing.

Atkinson (1987) shows that pricing transfers at variable cost when capacity is in excess. as prescribed by economic theory. would induce the buying unit to overstate expected demand at the capacity planning stage and cause a waste of resources. To test whether the strategic issue affects transfer pricing decisions, the study compares pricing methods for long‐ term transfer situations. which were provided for at the capacity planning stage, and ad hoc transfers.

As well. while the two‐step method of charging full cost ‐charging variable cost for each unit transferred and separately charging a flat fee each period for capacity on reserve ‐has many good control qualities, it remained just an academic curiosity: there was no evidence of its wide use among firms. This study finds that the two‐step method is as widely in use as the one‐step method ‐charging variable cost plus unit fixed costs for each unit transferred.
Positron emission tomography and magnetic resonance imaging in spinocerebellar ataxia type 2: a study of symptomatic and asymptomatic individuals
Authors: Inagaki A. , Iida A. , Matsubara M. , Inagaki H.
Published: August 2005

Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant neurodegenerative disorder characterized as an expanded CAG trinucleotide repeats in SCA2 gene resulting in abnormal polyglutamine sequence. We used positron emission tomography (PET) and magnetic resonance imaging (MRI) to clarify metabolic and atrophic changes of the brain in two symptomatic and three asymptomatic individuals who were genetically confirmed for SCA2. PET revealed decreased glucose metabolism in both patients and two of the three asymptomatic carriers in the cerebellum, pons, or both. No PET abnormality was found in the remaining one carrier who had only a very mildly expanded CAG repeat. MRI showed cerebellar and/or pontine atrophic changes in both patients and one of three carriers. The present study suggest that hypometabolism and atrophy of the cerebellum and pons may occur years before the clinical onset of SCA2. PET and MRI may be useful in the early detection of subclinical brain changes associated with SCA2.
First‐line nitrosourea‐based chemotherapy in symptomatic non‐resectable supratentorial pure low‐grade astrocytomas
Authors: Frenay M. P. , Fontaine D. , Vandenbos F. , Lebrun C.
Published: August 2005

At the present time, there are no proven beneficial effects of chemotherapy (CT) for the treatment of pure low‐grade astrocytomas. Brain radiotherapy (RT) still remains the standard treatment in order to reduce or delay tumor progression or symptoms, despite possible long‐term neurologic complications. We report 10 patients, with histologically proven pure low‐grade fibrillary astrocytomas, to which we administered a first‐line nitrosourea‐based CT. All patients were symptomatic with pharmaco‐resistant epilepsy or neurologic symptoms, and had been rejected for neurosurgical resection. All patients with epilepsy had a clinical improvement with reduction in seizure frequency and 60% became seizure‐free. CT was well tolerated; all patients developed myelosuppression with 40% of grade III/IV hematotoxicity. Seven were alive at the time of writing with a mean follow‐up of 6.5 years (3.5–12) from first recorded symptoms. The three deceased patients died 7.5, 7.5, and 8.5 years from first symptoms. These results demonstrate that some patients with symptomatic non‐resectable fibrillary low‐grade astrocytomas can be treated with up‐front CT to improve their neurologic status. This report suggests that benefits of CT on symptoms, survival, and quality of life should be prospectively compared with RT.
Electromyographic evaluation of the sound and involved side during gait of spastic hemiplegic children with cerebral palsy
Authors: Patikas D. , Wolf S. , Döderlein L.
Published: August 2005

The purpose of this study was to investigate the surface electromyogram (EMG) of the lower limbs of hemiplegic children with spastic cerebral palsy during gait. The EMG of seven muscles was analyzed for 17 children (5–12 years old). The EMG of the involved side was decreased for the examined shank muscles and increased for the hamstrings, during certain phases of the gait cycle, compared with the sound side. The rectus femoris of the involved side showed prolonged activation during the swing phase. The enhanced activation of the hamstrings may be beneficial/compensatory, preventing knee hyperextension. The presence of equinus foot obstructs the foot clearance and hence the prolonged rectus femoris EMG activity during the swing phase may contribute to shorten the lower limb by flexing the hip. Possible compensatory mechanisms of the proximal muscles of the involved lower limb that can be measured with instrumented gait analysis should be taken into account before the decision for a specific treatment.
Presenilin immunoreactivity in Alzheimer's disease
Authors: Panegyres P. K. , Toufexis K.
Published: August 2005

The role of presenilin (PS) mutations in familial Alzheimer's disease (AD) may be as a toxic gain of function, but in sporadic disease their contribution is more difficult to understand. In this study, we investigated PS proteins in sporadic AD by comparing the immunocytochemical profiles in sporadic AD with control brains using a quantitative immunocytochemical approach to both the N‐ and C‐terminals of PS1 and PS2. Ten patients with pathologically proven AD (using modified Consortium to Establish a Registry for Alzheimer's Disease [CERAD] criteria) and 10 controls were age‐ and sex‐matched. The immunocytochemical primary antibodies were affinity‐purified goat polyclonal antibodies and the secondary antibodies were biotinylated donkey anti‐goat to the N‐ and C‐terminal of both PS1 and PS2. The number of PS‐containing neurones was quantified manually and without the knowledge of the diagnosis. We found no significant differences in the number of PS1‐ and PS2‐containing neurones in three anatomical regions for both N‐ and C‐terminals between AD and controls. Our findings argue in favour of functional changes in PS molecules contributing to the pathogenesis of AD and are consistent with the hypothesis of dysfunction of the entire γ‐secretase complex, of which PS proteins are a constituent.
Enteroviruses and the risk of MS in the Finnish Twin Cohort
Authors: Kuusisto H. , Hyöty H. , Kares S. , Kinnunen E. , Saarelainen M. , Elovaara I.
Published: August 2005

To investigate the possible association of enterovirus (EV) infection with the development of multiple sclerosis (MS). The role of various genetic and environmental factors has been intensively studied in the etiopathogenesis of MS but the cause of the disease has remained unknown. Enteroviruses are possible candidates because they are neurotropic and able to cause chronic infections. Serum and cerebrospinal fluid (CSF) were tested with reverse transcription‐polymerase chain reaction specific for enteroviruses in 17 MS twin pairs. No enteroviral RNA was found in any serum (n = 34) or CSF (n = 12) sample. We found no evidence of enterovirus infection in twins with MS or their healthy siblings. To our knowledge this is a first study to assess the role of enterovirus infections in the risk of developing MS in twins.
Neurological presentation of intravascular lymphoma: report of two cases and discussion of diagnostic challenges
Authors: Lozsadi D. A. , Wieshmann U. , Enevoldson T. P.
Published: August 2005

About a third of patients with intravascular lymphoma (IVL) present to the neurologist with symptoms mimicking thromboembolic events. Diagnosis is difficult, and often made postmortem. As remission may be induced in almost half of patients with combination chemotherapy, early diagnosis of this rare disease is essential. We report two cases of IVL. A 62‐year‐old male presented with hyperacute myelopathy followed by cortical ischaemic events. The diagnosis was reached with frontal cortical and meningeal biopsy. A 56‐year‐old female had symptoms of transient ischaemic events, subacute dementia, weight loss and fever. As the disease progressed, she developed nephrotic syndrome and thrombocytopenia. Diagnosis was made postmortem. Our cases illustrate that IVL should be considered in the differential diagnosis of cerebral and systemic vasculitis and subacute bacterial endocarditis. Literature suggests IVL can also mimic Creutzfeld–Jakob disease and paraneoplastic encephalomyelitis.
A Theory of Currency Board with Irrevocable Commitments*
Authors: Chan Alex W. H. , Chen Nai‐fu
Published: August 2005

Currency boards are subject to runs if the foreign currency reserve is insufficient to back the convertible money supply. We construct a simple model and show how pre‐specified optimal reserve commitments can avert currency board runs. If there exists asymmetric information on the government's resolve, the government can also use commitments as a costly signal to induce a separating equilibrium. The model can be adapted to analyze other hard‐fixed exchange rate systems such as dollarizations and monetary unions. We illustrate the implications of our model in terms of the recent success in Hong Kong and possible remedies for Argentina.
The Behavior and Performance of Foreign Investors in Emerging Equity Markets: Evidence from Taiwan
Authors: Lin Anchor Y. , Swanson Peggy E.
Published: August 2005

This study investigates trading behavior and investment performance of foreign investors in 60 large‐size firms listed on the Taiwan Stock Exchange. Strong evidence is found that foreign investors employ momentum strategies of buying past winners and selling past losers and favor large‐size, high book‐to‐market, and high‐tech stocks, while no evidence is found that foreign investors herd on market consensus. Findings show that foreign investors are short‐term superior performers but long‐term inferior performers. The short‐term superior performance appears to be driven partially by price momentum of winners portfolios rather than by risk taking. After controlling for firm size, share turnover, and industry, foreigners' short‐term performance in large‐size, high‐turnover, and high‐tech stocks is better than it is in small‐size, low‐turnover, and non‐high‐tech stocks.
Looking for Spot in the Presence of Futures*
Authors: Ramaswamy Krishna , Waldron Patrick
Published: August 2005

This paper deals with a novel problem of price search in a world where futures markets play an important role. In the absence of the futures market, customers are unable to tell whether a high spot quote reflects a fundamental change in market conditions or whether they have run into a high‐pricing dealer. The optimal strategy of a customer carrying out a costly search among dealers for the best spot price (while also participating in a futures market) is shown to have a reservation price property, where the reservation price is a function of the current futures price. In equilibrium, dealers randomize their price quotes in a way that is consistent with searchers' expectations, yielding a self‐fulfilling expectations equilibrium. This solution is consistent with optimal dealer behavior.
Finding genes in child psychology and psychiatry: When are we going to be there?
Authors: Plomin Robert
Published: August 2005

Background:  The seven papers in this special section chart where we are in the quest for quantitative trait loci (QTLs) in key areas of child psychology and psychiatry such as reading and hyperactivity. But we are not there yet.

Methods:  This commentary considers some new developments that are likely to accelerate the journey towards the identification of QTLs.

Results:  The single most important factor is the need for very large samples to attain adequate power to detect and replicate QTLs of very small effect size. Another important development is the microarray, which makes it possible to genotype hundreds of thousands of SNPs simultaneously. Using microarrays in association studies allows SNPs across the whole genome to be genotyped. Microarrays will boost power even more when they contain all functional polymorphisms in the genome, including functional non‐coding DNA.

Conclusions:  Once replicable QTLs are identified in areas such as reading and hyperactivity, the real journey will begin. Future studies will use sets of QTLs as genetic risk indicators in top‐down behavioural genomic research, leading to gene‐based diagnoses, gene‐based treatments tailored to the individual, and early warning systems and interventions. These discoveries will eventually help to prevent or at least ameliorate childhood disorders before they cast their long shadow over development.
Institutional care: associations between inattention and early reading performance
Authors: Roy Penny , Rutter Michael
Published: August 2005

Background:  Recent government papers have expressed concern about the poor educational attainment of ‘looked after’ children. Early reading development has been found to be significant in their subsequent academic achievement. The possibility that biosocial factors extraneous to their experiences in public care may underpin their low attainment has not been investigated to date.

Methods:  The reading ability of 19 primary school children, who had been raised in institutional care from an early age, were compared with 19 children, matched for age and sex, who were comparable in biological background and who had experienced uninterrupted family foster care. Both groups were compared with classroom controls using teacher questionnaires, interviews, systematic observations and cognitive testing.

Results:  Reading delay was more prevalent in the institutional group and as a group they had lower reading scores than the children reared in family foster care. Variation in IQ accounted for the lower reading scores of the family foster care group compared with their matched classroom controls. Inattention, found in a previous study to be much more evident in the institutional group, partially accounted for the group difference in reading scores, and was situationally specific to formal teacher‐directed tasks. Differential effects of caregivers’ interest in terms of help with homework were also found.

Conclusions:  Early reading performance was associated with the experience of being raised ‘in care’ but was not an inevitable outcome. It was concluded that the type of substitute caregiving experienced affected reading performance. Institutional upbringing affected reading performance both directly and indirectly through the heightened levels of inattention associated with institutional care.
Suicide attempts and severe psychiatric morbidity among former child welfare clients – a national cohort study
Authors: Vinnerljung Bo , Hjern Anders , Lindblad Frank
Published: August 2005

Background: Few large sample studies have examined psychiatric morbidity among former child welfare/protection clients. In this study, risks for suicide attempts and severe psychiatric morbidity in younger years were assessed for former child welfare clients in ten national birth cohorts, comparing them with general population peers and inter‐country adoptees.

Methods: We used national register data for almost one million people: 22,305 former child welfare clients who had experienced interventions before their teens, 955,326 general population cohort peers and 12,240 inter‐country adoptees. Multivariate Cox regression models were used to estimate risks of hospitalisation for suicide attempts and psychiatric disorders from age 13 to age 18–27.

Results: Former child welfare clients were in year of birth and sex standardised risk ratios (RRs) four to five times more likely than peers in the general population to have been hospitalised for suicide attempts. They were five to eight times more likely to have been hospitalised for serious psychiatric disorders in their teens, four to six times in young adulthood. High excess risks were also found for psychoses and depression. Individuals who had been in long‐term foster care tended to have the most dismal outcome. Adjusting for birth parents’ hospitalisations with a psychiatric diagnosis or for substance abuse, and for birth‐home‐related socio‐economic factors, reduced excess risks to around twofold.

Conclusions: Irrespective of issues of causality, findings suggest that former child welfare/protection clients should be considered a high‐risk group for suicide attempts and severe psychiatric morbidity. Results have substantial practice implications for mental health and social agencies serving this group in adolescence and/or young adulthood.
Airways, respiration, and respiratory sinus arrhythmia during picture viewing
Authors: Ritz Thomas , Thöns Miriam , Fahrenkrug Saskia , Dahme Bernhard
Published: August 2005

Emotional stimuli can cause airway constriction; however, it is uncertain whether a dimensional or categorical model of emotion can better describe airway changes. Also, little is known about the affective modulation of respiration and vagal activity, which can influence airway tone. We studied changes in oscillatory resistance (Ros), respiration, and respiratory sinus arrhythmia (RSA) in asthmatics and controls during viewing of affective pictures eliciting anxiety, depression, disgust, happiness, contentment, erotic tension, or neutral affect. Ros, respiration, cardiac activity, and self‐report were measured during picture presentations. Ros increased monotonically with picture unpleasantness mainly due to disgust pictures. RSA and respiratory timing parameters were particularly sensitive to erotic pictures. Differences between asthmatics and controls were minimal, suggesting that airway responses to unpleasant pictures are not specific to asthma.
Affective modulation of nociception at spinal and supraspinal levels
Authors: Rhudy Jamie L. , Williams Amy E. , McCabe Klanci M. , Nguyê˜n Mary Anh Thù V. , Rambo Philip
Published: August 2005

This study was designed to examine the effect of emotion on the nociceptive flexion reflex and pain ratings. To do so, 28 participants viewed pictures varying in emotional valence (unpleasant, neutral, pleasant) and electric stimulations were delivered during and in between pictures. Biceps femoris EMG resulting from the stimulations was used to quantify the nociceptive flexion reflex (spinal nociception), and pain ratings to the stimulations were used as an evaluative measure of supraspinal nociception. Manipulation checks suggested that pictures effectively manipulated emotion. Moreover, nociceptive flexion reflex magnitudes and pain ratings were modulated in a parallel manner. Specifically, viewing unpleasant pictures enhanced the nociceptive flexion reflex and pain, whereas viewing pleasant pictures inhibited the reflex and pain. Analyses suggested that emotional valence, but not arousal, mediated the effects of pictures.
Characteristic changes in the physiological components of cybersickness
Authors: Kim Young Youn , Kim Hyun Ju , Kim Eun Nam , Ko Hee Dong , Kim Hyun Taek
Published: August 2005

We investigated the characteristic changes in the physiology of cybersickness when subjects were exposed to virtual reality. Sixty‐one participants experienced a virtual navigation for a total of 9.5 min, and were required to detect specific virtual objects. Three questionnaires for sickness susceptibility and immersive tendency were obtained before the navigation. Sixteen electrophysiological signals were recorded before, during, and after the navigation. The severity of cybersickness experienced by participants was reported from a simulator sickness questionnaire after the navigation. The total severity of cybersickness had a significant positive correlation with gastric tachyarrhythmia, eyeblink rate, heart period, and EEG delta wave and a negative correlation with EEG beta wave. These results suggest that cybersickness accompanies the pattern changes in the activities of the central and the autonomic nervous systems.
Electrophysiological correlates of anticipatory task‐switching processes
Authors: Nicholson Rebecca , Karayanidis Frini , Poboka Dane , Heathcote Andrew , Michie Patricia T.
Published: August 2005

Recent studies show a differential switch‐related positivity emerging before a switch trial and reflecting anticipatory task‐set reconfiguration processes. In this study, the switch‐related positivity was examined in a cued task‐switching paradigm. Cue‐stimulus and response‐stimulus intervals were independently manipulated to dissociate between the effects of anticipatory preparation and passive dissipation of task‐set interference. Reaction time switch cost declined with increasing cue‐stimulus and response‐stimulus intervals, suggesting a contribution from both active preparation and passive interference processes. In cue‐related difference waveforms, a switch positivity peaked around 350–400 ms and is interpreted as reflecting differential activation of task‐set reconfiguration. In stimulus‐related difference waveforms, a switch‐related negativity is believed to indicate the role of S‐R priming and response interference in task‐switching.
Obstetric and gynaecological presentations of hydatid disease
Authors: RAHMAN M. S. , RAHMAN J. , LYSIKIEWICZ A.
Published: August 2005

Summary. Hydatid disease of the female pelvis is rare in gynaecological practice. In Libya, where the disease is endemic, 14 women with pelvic hydatid disease were encountered in one hospital department between 1971 and 1979. Five of these women were pregnant, a hospital prevalence of 1 in 20000. The other nine women accounted for 0.3% of all gynaecological laparotomies in the same hospital. The clinical features, diagnosis and management of this rare condition are described.
Uterine geometry and IUCD design
Authors: HASSON HARRITH M.
Published: August 2005

Summary. The endometrial cavity is an isosceles trapezoid that changes in shape with the phase of the cycle. The distance from the fundus to where the cavity narrows to 12 mm is the effective length. This and the total length of the uterine cavity can be measured with the Wing Sound. IUCD complications are more frequent if the length of a device exceeds the effective length or the width of the uterine cavity. Devices must be designed to fit the uterine cavity and to conform to physiological changes in the shape of the organ.
The IUCD in nulliparous women: with special reference to the Multiload copper 250 ‘mini’ and ‘short’ IUCDs
Authors: GOLDSTUCK N. D.
Published: August 2005

Summary. The problems relating to the fitting of intrauterine contraceptive devices (IUCDs) in nulliparae are (i) when to fit, (ii) how to fit and (iii) what type of IUCD to fit. IUCDs are best fitted around the time of ovulation as the uterine cavity is most relaxed and accommodating towards the IUCD. The device should be placed to abut the uterine fundus to ensure that it does not encroach on the cervical isthmus. This may be a problem in this group as the endometrial cavity may sometimes be less than 3 cm. The functional endometrial cavity width in nulliparae is probably much smaller than was previously assumed. IUCDs with a horizontal width of about 18 mm and vertical length of less than 30 mm appear best suited to the nulliparous endometrial cavity. Two studies on the ML Cu250 short and ML Cu250 mini indicate that the ML Cu250 short is well suited to the nulliparous endometrial cavity and that the ML Cu250 mini will be useful in patients with extreme narrowing of the endometrial cavity. Both these devices are often acceptable to patients who are intolerant of other types of IUCD. Insertion of these devices may be accompanied by some pain which is usually of limited duration.
12. Maternal mortality
Authors: ROSSITER C. E.
Published: August 2005

Summary. There were 238 maternal deaths. Five deaths occurred after delivery among booked women who had no antenatal complications (0.4 deaths per 1000 deliveries); 14 deaths were among booked women who developed complications during pregnancy (3.7 per 1000); and 219 deaths were in the emergency admissions (28.6 per 1000). Bacterial infections, eclampsia, anaemia, haemorrhage and disproportion together with its consequences, were the leading causes. The principal high‐risk factors were lack of antenatal care, early teenage pregnancy, high parity and high child mortality rate from previous births. In the emergency admissions the operative delivery rate was 25% in the women who survived and 49% in those who died. In severe eclampsia and in neglected obstructed labour, a high haematocrit (≥0.45) and, to a lesser extent, a low haematocrit (≥0.14) were of ominous significance, mortality rate being 25–60% in such cases compared with <10% in most other obstetric complications. Measures to reduce maternal mortality should aim to lower the proportion of high‐risk women (40% at present) and also make it possible for operative deliveries, especially caesarean section, to be performed as soon as the need arises.
Prostaglandin D2 release by endometrium and myometrium
Authors: REES MARGARET C.P. , KELLY R. W.
Published: August 2005

Summary. Prostaglandin D2 (PGD2) release was studied using a super‐fusion technique in endometrium and myometrium obtained at hysterectomy from 36 women with measured menstrual blood loss (range 4–840 ml). PGD2 was produced by both tissues with greater rates from endometrium. Cyclical changes in release were found only in the endometrium with increased rates during menstruation and the midluteal phase. In the myometrium the highest release rates were present during menstruation at the start of the superfusion. No significant correlation was found between menstrual blood loss and endometrial or myometrial PGD2 release.
Comparisons of data from regional perinatal mortality surveys
Authors: MACFARLANE ALISON , COLE SUSAN , HEY EDMUND
Published: August 2005

Summary. The standard format in which NHS regions are invited to submit data from their perinatal mortality surveys for comparative analysis in the British Journal of Obstetrics and Gynaecology is described. Some examples of the way these data can and will be used to compare regional differences in mortality patterns are given and possible future developments are discussed. Although the term perinatal mortality is used in the title, it is hoped that surveys will cover stillbirths and neonatal deaths and also, where possible, late fetal deaths of less than 28 weeks gestation.
The effects of norethisterone in postmenopausal women on oestrogen replacement therapy: a model for the premenstrual syndrome
Authors: MAGOS A. L. , BREWSTER E. , SINGH R. , O'DOWD T. , BRINCAT M. , STUDD J. W. W.
Published: August 2005

Summary. The influence of norethisterone on mood and behaviour was investigated in prospective placebo‐controlled study in 58 postmenopausal hysterectomized women who were being treated with subcutaneous oestradiol and testosterone implants. Norethisterone, 2·5 or 5 mg daily, was given for 7 days and a placebo for two periods of 7 days. Psychological, behavioural and physical variables were assessed using the Menstrual Distress Questionnaire. There were widespread adverse effects which were dose‐related. Significant changes in five of the eight symptom complexes studied (pain, concentration, behavioural change, water retention and negative affect) were found with 5 mg/day of the progestogen. The symptoms were similar to the typical complaints of the premenstrual syndrome, such that a combination of oestradiol and testosterone implants with cyclical oral norethisterone appears to be a model for this condition. The dose of this progestogen should therefore be the minimum to achieve the desired therapeutic effect.
Amniotic fluid concentrations of secreted pregnancy‐associated endometrial α1 and α2‐globulins (α1‐ and α2‐PEG)
Authors: BELL S. C. , HALES M. W. , PATEL S. R. , KIRWAN P. H. , DRIFE J. O. , MILFORD‐WARD A.
Published: August 2005

Summary. The levels of pregnancy‐associated endometrial α1‐ and α2‐globulins (α1‐ and α2‐PEG), the two major proteins synthesized and secreted by the endometrium in vitro have been assayed in 210 amniotic fluid specimens obtained at termination of pregnancy or by amniocentesis, or at delivery. α1‐PEG was undetectable until week 10 and thereafter rose to peak levels between weeks 20 and 24. Levels fell 15‐fold by week 35 but substantial amounts were still present at parturition. α2‐PEG was present at highest levels during early pregnancy, at weeks 6–15, but thereafter levels rapidly fell until during weeks 31–42 α2‐PEG was detectable in only 3 of 25 specimens. During weeks 15–20, when α2‐PEG levels fell and α1‐PEG levels rose, a high correlation was observed between the week of gestation and the log of the ratios of the concentration of these proteins. These observations provide the opportunity to assess the role of endometrial and decidual dysfunction in the aetiology of pregnancy disorders.
Comparison of different antibody preparations against pregnancy‐associated plasma protein‐A (PAPP‐A) for use in localization and immunoassay studies
Authors: CHEMNITZ J. , FOLKERSEN J. , TEISNER B. , SINOSICH M. J. , TORNEHAVE D. , WESTERGAARD J. G. , BOLTON A. E. , GRUDZINSKAS J. G.
Published: August 2005

Summary. Four antibody preparations against pregnancy‐associated plasma protein (PAPP‐A) were compared in order to find an explanation for the contradictory results published on tissue localization, clinical usefulness and biological function of PAPP‐A. One of the preparations studied was a rabbit anti‐PAPP‐A antiserum which has been offered for general scientific use (Bischof et al. 1979). Only the IgG fraction of anti‐PAPP‐A antisera which appeared to be monospecific and had been further absorbed with fetal connective tissue gave specific uniform staining of the cytoplasm of the syncytiotrophoblast exclusively. Circulating PAPP‐A could not be detected by RIA employing this IgG preparation in the non‐pregnant state, or before 18 days after conception. Circulating PAPP‐A could be detected in all seven pregnant women studied within 4 weeks after conception. Identical results were obtained with a commercially available IgG fraction against PAPP‐A.
The relation between aldosterone concentrations in plasma and saliva during pregnancy
Authors: FEW J. D. , PAINTIN D. B. , James V. H. T.
Published: August 2005

Summary. The concentrations of aldosterone and glucocorticoids (cortisol+cortisone) were measured in saliva and plasma samples obtained from healthy women during early (11–19 weeks), mid (24–29 weeks) and late (32–37 weeks) pregnancy. There was a progressive increase in mean aldosterone levels in both saliva and plasma throughout pregnancy, though at each stage of pregnancy the range was very wide. Glucocorticoid levels increased up to mid‐pregnancy and then remained constant. At no stage were aldosterone and glucocorticoid levels significantly correlated. The proportion of free (non‐protein bound) aldosterone in plasma, and the sa1iva: plasma ratio of aldosterone did not differ from the non‐pregnant range at any stage of pregnancy. We conclude that measurement of aldosterone concentration in saliva is a convenient and valid method for the estimation of plasma free aldosterone in pregnancy and so provide a non‐invasive technique for assessing aldosterone status throughout pregnancy.