bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative (stereological) study of the effects of vasectomy on spermatogenesis in rabbits
Authors: Kong Ling‐Shu , Huang An‐Pei , Deng Xian‐Zhong , Yang Zheng‐Wei
Published: August 2004

Using stereological methods, especially the optical disector for unbiased estimation of nuclear number, our recent study demonstrated that long‐term (6 or 12 months) vasectomy in the rhesus monkey had no significant effects on spermatogenesis (Peng et al. Reproduction 2002, 124, 847–856). This study aimed to determine the scenario in the rabbit using the same morphometric methodology. Three groups of normal male Japanese white rabbits (aged 4–5 months) were subjected to unilateral vasectomy; 10 days, 6 months and 12 months later both testes and epididymides were removed. Testicular and epididymal methacrylate‐embedded sections were obtained for stereology. Vasectomy‐induced damage to spermatogenesis was observed, primarily sloughing of spermatogenic cells with a greater reduction in the number of advanced (adluminal) cells. The damage was most severe at 10 days, occurring in all the testes on the vasectomized side and involving sloughing of even type A spermatogonia, the number of which returned to normal at 6 and 12 months. Damage was less severe at 6 and 12 months, being found in half of the testes of the vasectomy side, in which the total numbers of later germ cell types were 24.0–59.1% (spermatocytes) and 0.3–11.6% (spermatids) of control at 6 months, and 20.1–22.1% (spermatocytes) and 0.4–12.0% (spermatids) of control at 12 months. By contrast, Sertoli cell number per testis was unchanged following vasectomy in any group. Epididymis on the vasectomy side, especially at 10 days and 6 months, appeared larger than on the contralateral side, but this difference was not statistically significant, and no sperm granuloma was seen in the epididymis.
Immediate contact reactions to fragrance mix constituents and Myroxylon pereirae resin
Authors: Tanaka S. , Matsumoto Y. , Dlova N. , Ostlere L. S. , Goldsmith P. C. , Rycroft R. J. G. , Basketter D. A. , White I. R. , Banerjee P. , Mcfadden J. P.
Published: August 2004

We have studied patients who have positive‐patch test reactions to fragrance‐allergic screening substances fragrance mix (FM) or Myroxylon pereirae resin (balsam of Peru) for immediate contact reactions to the standard FM, the constituents of the FM and Myroxylon pereirae resin. In the fragrance‐positive subjects (n = 60), there were positive immediate contact reactions to Myroxylon pereirae resin in 56.6% and to FM in 11.6%. In a control group (n = 50) of eczematous, patch test‐negative patients there were positive immediate reactions to Myroxylon pereirae resin in 58.0% subjects and to FM in 12.0%. The absence of a significant difference between the fragrance‐allergic group and control group is in keeping with a non‐immunological basis for the majority of the immediate reactions seen.
Determination of skin irritation potential in the human 4‐h patch test
Authors: Basketter David A. , York Michael , McFadden John P. , Robinson Michael K.
Published: August 2004

Recently adopted legislation in Europe has increased the focus that must be placed on the development of in vitro alternatives to the traditional toxicology tests employed to identify the human health hazards associated with chemicals. Included in these is the rabbit skin‐irritation test which is used to discriminate those substances which possess significant acute skin irritation potential from those which are of more limited irritation potential. So far, the considerable efforts to replace this assay with in vitro alternatives have not been successful, which may in part be due to the relatively poor quality of the existing in vivo dataset. To help address this problem, we have elected to present our complete database of information on the skin irritation potential of some 65 substances, all of which have been tested in a standard human 4‐h patch test. These provide a high quality dataset, generated in man (the goal of toxicologists' health protection‐related activities). The data are presented in the context of results with a concurrent positive skin irritation control to ensure that results from individual experiments can be correlated. Consequently, in vitro or in silico alternatives which can identify the significant acute human skin irritants in this group may well represent suitable alternatives to the rabbit.
After the euphoria: HIV medical technologies from the perspective of their prescribers
Authors: Rosengarten Marsha , Imrie John , Flowers Paul , Davis Mark D. , Hart Graham
Published: July 2004

Abstract  This paper focuses on the relationship of HIV medical technologies to current styles of medical practice and highlights issues posed by the technologies for those working and/or living with HIV. The paper examines HIV anti‐retroviral combination therapies and associated tests from the perspective of their prescribers. The prescribers were interviewed during the later part of 2002 at three London HIV clinics. Their comments, considered in light of other recent studies in the field, suggest that current therapies are part of a transitional phase in the epidemic which informs the identification and negotiation of known risks and uncertainty. An undetermined but extended life expectancy, afforded by anti‐retroviral therapies, is understood against risk of iatrogenic diseases and/or viral drug resistance. The tension arising in this situation of unwanted and even uncertain phenomena poses ethical dilemmas and affects doctor/patient relations. Indeed, it also contributes to a reconfiguring of the lived experience of managing HIV. While the new technologies have offered considerable advances in the medical management of HIV, they are altering the nature of HIV medicine both materially and socially. The scenario is further complicated by the uneven allocation of resources and different patient health and disease states. The heterogeneity of resources, disease states and technological effects points to the need for ongoing and extended evaluation as the relationship between these and the everyday practice of medicine continues to change.
Genres across cultures: types of acceptability variation
Authors: Shaw Philip , Gillaerts Paul , Jacobs Everett , Palermo Ofelia , Shinohara Midori , Verckens J. Piet
Published: August 2004

Abstract:  One can ask four questions about genre validity across cultures. Does a certain form or configuration occur in the culture in question? Is it acceptable? If acceptable, is it in practice preferred? Is it recommended by prescriptive authorities? This paper reports the results of an attempt to answer these questions empirically by testing the responses to four different customer‐complaint dialogues in English of 100 students in each of six countries: Sweden, Denmark, Belgium, England, Italy, and Japan. The result is that most versions are seen by respondents as occurring in most cultures, that a ‘clear, brief, sincere’ version seems most acceptable worldwide, that this version is also preferred in the four north‐western European countries, but not necessarily in Italy or Japan, and that of the various prescribed versions some are never preferred and others are only preferred in one or two countries.
The officialization of English and ELT in Japan: 2000
Authors: Matsuura Hiroko , Fujieda Miho , Mahoney Sean
Published: August 2004

Abstract:  This study reports on Japanese university‐level EFL teacher (N = 50) and student (N = 660) reactions to the notion of making English an official language, as proposed by an advisory board to Prime Minister Obuchi in 2000. The study also reports on beliefs about English language learning and teaching in general in terms of goals, proficiencies of Japanese people, and appropriate instructional styles for Japanese. Students appeared to believe that it would be beneficial to be proficient in English, although a number of them did not welcome English‐only EFL classes. Students tended to link beliefs about English proficiency to legislating English as an official language, while their reactions to the officialization of the language varied widely. Teachers’ beliefs, on the other hand, appeared to be drawn from their own experiences in current English‐using contexts in Japan. The majority of teachers indicated that English should not be given official language status, and that people would not use English in their daily life even if it were to become official.
Expression of angiogenic factors in chronic myeloid leukaemia: role of the bcr/abl oncogene, biochemical mechanisms, and potential clinical implications
Authors: Sillaber C. , Mayerhofer M. , Aichberger K. J. , Krauth M.‐T. , Valent P.
Published: August 2004

Chronic myeloid leukaemia (CML) is a stem cell disease characterized by an increased production and accumulation of clonal BCR/ABL–positive cells in haematopoietic tissues. The chronic phase of CML is inevitably followed by an accelerated phase of the disease, with consecutive blast crisis. However, depending on genetic stability, epigenetic events, and several other factors, the clinical course and survival appear to vary among patients. Recent data suggest that angiogenic cytokines such as vascular endothelial growth factor (VEGF), are up‐regulated in CML, and play a role in the pathogenesis of the disease. These factors appear to be produced and released in leukaemic cells in patients with CML. In line with this notion, increased serum‐levels of angiogenic growth factors are measurable in CML patients. In this study we provide an overview of angiogenic growth factors expressed in CML cells, discuss the possible pathogenetic role of these cytokines, the biochemical basis of their production in leukaemic cells, and their potential clinical implications.
The biological and clinical significance of MLL abnormalities in haematological malignancies
Authors: Mitterbauer‐Hohendanner G. , Mannhalter C.
Published: August 2004

The MLL (Mixed Lineage Leukaemia or Myeloid/Lymphoid Leukaemia) gene on chromosome 11q23 is frequently involved in chromosomal translocations associated with human acute leukaemias. These translocations lead to fusion genes generally resulting in novel chimeric proteins containing the amino terminus of MLL fused in‐frame to one of about 30 distinct partner proteins. Abnormalities involving the MLL gene are observed in leukaemias of either lymphoid or myeloid lineage derivation, as well as in poorly differentiated or biphenotypic leukaemias. They are frequently seen in infant patients, and patients with therapy‐related secondary AML following treatment with inhibitors of topoisomerase II (epipodophyllotoxins). In the majority of cases, abnormalities involving the MLL gene are associated with a very poor prognostic outcome. In this review, we will discuss some of the recent advances in MLL research resulting from biological as well as clinical studies.
Novel molecular diagnostic and therapeutic targets in chronic lymphocytic leukaemia
Authors: Gaiger A. , Heintel D. , Jäger U.
Published: August 2004

B‐cell lymphocytic leukaemia (B‐CLL) is an indolent non‐Hodgkin's lymphoma and the most frequent leukaemia. However, after many years, the incurable disease CLL has again become an exciting subject for research. Recently, both serum and molecular markers have been identified which could be used to predict the outcome of patients in early stages. With the advent of microarray analysis, novel diagnostic and therapeutic targets have been discovered. Here we describe the molecular strategies for target identification and validation. An evaluation of some established, and the most promising novel factors, with their diagnostic and prognostic applications is given. Potential therapeutic target molecules and their inhibitors are reviewed.
What Makes Circuit Breakers Attractive to Financial Markets? A Survey
Authors: Kim Yong H. , Yang J. Jimmy
Published: July 2004

After the stock market crash of October 1987, theBrady Report (1988)and several academic researchers suggested the imposition of “circuit breakers” to prevent the market from fluctuating excessively. Most financial markets in the world have imposed circuit breaker systems, in the form of price limits and trading halts, in an attempt to reduce excessive market volatility. Similar to any other regulations, circuit breakers have proponents and opponents. In this survey, we analyze the benefits and costs of each type of circuit breaker, provide existing theoretical models and predictions related to each type of circuit breaker, and present findings from empirical studies to justify or disqualify the existence of circuit breakers. In addition, we synthesize existing studies and offer directions for further research in this area.
An Empirical Study of Audit ‘Expectation Gap’ in The People's Republic of China
Authors: Lin Z. Jun , Chen Feng
Published: August 2004

The audit ‘expectation gap’ is a crucial issue associated with the independent auditing function and has significant implications on the development of auditing standards and practices. Through a questionnaire survey, this study investigated the rise of ‘expectation gap’ and related auditing issues under business and auditing environment in the People's Republic of China. The results reveal that the role and benefits of public accounting (independent auditing) had been positively recognized by Chinese audit beneficiaries and auditors, and there were increasing demands for expanding the applicability of public accounting. This study obtained substantial evidence on the emergence of audit ‘expectation gap’ in China, with respect to audit objectives, auditor's obligation to detect and report fraud, auditor independence, and third party liability of auditors. The causes and practical implications of the ‘expectation gap’ are therefore analyzed contextual to the present practices of public accounting in changing Chinese social and economic conditions. This study should cast light on understanding of the institutional setting and recent development of independent audits in China.
Role of early EEG and neuroimaging in determination of prognosis in children with complex febrile seizure
Authors: Yücel Oya , Aka Sibel , Yazicioglu Levent , Ceran Omer
Published: August 2004

Abstract
Background
: The present study investigates the role of early use of EEG in children with no known neuropathology prior to the first CFS, and the contribution made by computed tomography (CT) and magnetic resonance imaging (MRI) to treatment and prognosis.

Methods
: Over a period of 7 years, the authors evaluated 159 children (age range: 2 months−5 years) who were being treated for CFS at Haydarpasa Numune Training and Research Hospital, Pediatrics Clinic, Istanbul, Turkey, and who had no previously known neurological disorder. Patients who presented with febrile seizure were determined to have CFS if they fulfilled the following criteria: <3 months of age when seizure occured, duration of seizure ≥15 min, more than one seizure occurred during a single episode of illness, or focal seizures and postictal neurological deficit was found. EEG was performed on all patients. CT was performed on the patients who had postictal neurologic deficit or focal seizures. Cranial MRI was performed on patients who had focal findings in their EEGs.

Results
: Electroencephalogram abnormality was found in 71 cases; 51 of these were diagnosed with epilepsy during follow up. Six of the 16 cases whose EEGs were abnormal between days 2 and 6 were diagnosed with epilepsy. Twenty of the 30 cases whose EEGs were abnormal between days 7 and 10 were diagnosed with epilepsy. All 25 cases who had abnormal EEGs after day 11 were diagnosed with epilepsy. CT was performed for 36 patients, of which five were found to have pathological changes. Pathological changes were detected in two of the nine patients who had cranial MRI. Patients who received CT or MRI were all diagnosed with epilepsy during follow up.

Conclusion
: The results suggest that if neurological examination of CFS patients are normal after their clinical status has stabilised, EEG should be performed after 7 days at the earliest, however for the most accurate diagnosis EEG should be performed 10 days after CFS. The most important predictor for neuroimaging was found to be detection of postictal neurologic deficit. MRI had no advantages over CT in first treating CFS in the emergency unit.
Oesophageal adenocarcinoma or gastric cancer with or without eradication of Helicobacter pylori infection in chronic atrophic gastritis patients: a hypothetical opinion from a systematic review
Authors: Nakajima S. , Hattori T.
Published: August 2004

Background : As chronic atrophic gastritis is a precancerous condition for gastric cancer and the eradication of Helicobacter pylori infection halts chronic gastritis, eradication of infection may prevent gastric cancer. However, as chronic atrophic gastritis is a risk factor for reflux oesophagitis after eradication of infection, the risk of oesophageal adenocarcinoma may also increase.

Methods : We systematically reviewed papers and estimated the expected annual incidence of oesophageal or gastric cancer with and without eradication of H. pylori infection in patients with chronic atrophic gastritis.

Results : The expected annual incidence of gastric cancer in patients with corpus atrophy with persistent infection was at least 5.8‐fold higher than that for oesophageal adenocarcinoma after the eradication of infection at all ages. Even for patients with accompanying reflux oesophagitis or Barrett's oesophagus, the expected incidence of either gastric or oesophageal adenocarcinoma with persistent infection was higher than that of oesophageal adenocarcinoma after eradication of infection.

Conclusion : If eradication of infection lowers the incidence of gastric cancer, it should be recommended for patients with corpus atrophy at all ages irrespective of the presence of reflux oesophagitis or Barrett's oesophagus, especially in populations having a high prevalence of gastric cancer.
Effect of dietary anti‐Helicobacter pylori‐urease immunoglobulin Y on Helicobacter pylori infection
Authors: Suzuki H. , Nomura S. , Masaoka T. , Goshima H. , Kamata N. , Kodama Y. , Ishii H. , Kitajima M. , Nomoto K. , Hibi T.
Published: August 2004

Recently, chicken egg yolk was recognized as an inexpensive antibody source, and the therapeutic usefulness of egg yolk immunoglobulin Y (IgY) in oral passive immunization has been investigated. Although multiple antibiotic treatments eradicate most Helicobacter pylori (H. pylori) infections, therapy fails in 10–15% of cases due to the development of drug resistance. Consequently, it is important that new, more broadly based therapies for the treatment of H. pylori infection should be identified. The present study evaluated the effect, on H. pylori infection, of IgY prepared from egg yolk of hens immunized with H. pylori urease (anti‐HpU IgY). Seventeen asymptomatic volunteers diagnosed as H. pylori‐positive by the 13C‐urea breath test (UBT) were orally administered anti‐HpU IgY for 4 weeks. Four weeks later, UBT values were significantly decreased although no case showed H. pylori eradication. An H. pylori‐positive 53‐year‐old female gastritis patient administered anti‐HpU IgY plus lansoprazole for 8 weeks showed a decrease in serum pepsinogen (PG) I and UBT values as well as an increase in the PG I/II ratio. In conclusion, anti‐HpU IgY may mitigate H. pylori‐associated gastritis and partially attenuate gastric urease activity. Furthermore, anti‐HpU IgY combined with antacids appears to ameliorate gastric inflammation. These encouraging results may represent a novel approach to the management of H. pylori‐associated gastroduodenal disease.
Polymorphisms in ADAM33 are associated with allergic rhinitis due to Japanese cedar pollen
Authors: Cheng L. , Enomoto T. , Hirota T. , Shimizu M. , Takahashi N. , Akahoshi M. , Matsuda A. , Dake Y. , Doi S. , Enomoto K. , Yamasaki A. , Fukuda S. , Mao X.‐Q. , Hopkin J. M. , Tamari M. , Shirakawa T.
Published: August 2004

Background
A recent report provided evidence that a disintegrin and metalloprotease domain 33 (ADAM33), a member of the ADAM family, is a novel susceptibility gene in asthma linked to bronchial hyper‐responsiveness. However, there has been no investigation of the genetic role of ADAM33 variants in nasal allergy.

Objective
The purpose of this study was to test the association between ADAM33 polymorphisms and Japanese cedar pollinosis (JCPsis), a most common seasonal allergic rhinitis in Japan.

Methods
We conducted a case–control association study among a Japanese population, involving 95 adult individuals with JCPsis and 95 normal healthy controls. A total of 22 single‐nucleotide polymorphisms (SNPs) in ADAM33 were genotyped using PCR‐based molecular methods.

Results
Six SNPs of ADAM33 gene, three in introns (7575G/A, 9073G/A and 12540C/T) and three in the coding region (10918G/C, 12433T/C and 12462C/T), were strongly associated with JCPsis (P=0.0002−0.022 for absolute allele frequencies) and most of the SNPs were in linkage disequilibrium with each other. A higher frequency of the common alleles of these SNPs was noted for the subjects with JCPsis in comparison with healthy controls. We also identified a haplotype associated with the disease susceptibility. In addition, associations were found between ADAM33 polymorphisms and various cedar pollinosis phenotypes including clinical severity, eosinophil counts in nasal secretion and allergen‐specific IgE levels in sera, but not total serum IgE levels.

Conclusion
These results indicate that polymorphisms in the ADAM33 gene are associated with susceptibility to allergic rhinitis due to Japanese cedar pollen, but the functional relationship still needs clarification.
Allergic airway inflammation is exacerbated during acute influenza infection and correlates with increased allergen presentation and recruitment of allergen‐specific T‐helper type 2 cells
Authors: Marsland B. J. , Scanga C. B. , Kopf M. , Le Gros G.
Published: August 2004

Background
Respiratory viral infections are a leading cause of the hospitalization of asthmatics, however, the cellular immunological interactions which underlie these two diseases remain elusive.

Objective
We sought to characterize the effect influenza viral infection has on allergic airway inflammation and to identify the cellular pathways involved.

Methods
We have used an ovalbumin (OVA) model of allergic airway inflammation, which involves sensitization of animals with OVA adsorbed in alum adjuvant followed by an intranasal challenge with OVA in phosphate‐buffered saline. To study T cell recruitment into the lung, we adoptively transferred in vitro activated T cell receptor‐transgenic T cells, which were subsequently identified by fluorescence‐activated cell sorting (FACS) analysis. In addition, to study in vivo dendritic cell (DC) migration, we administered fluorescently labelled dextran and identified DCs that had phagocytosed it by FACS analysis.

Results
We found that different stages of influenza infection had contrasting effects upon the outcome of OVA‐induced allergic airway inflammation. The allergic response against OVA was exacerbated during the acute stage of influenza infection; however, mice were protected against the development of airway eosinophilia at late time‐points following infection. We investigated the mechanisms responsible for the virus‐induced exacerbation and found that the response was partially independent of IL‐4 and that there was increased delivery of inhaled allergens to the draining lymph node during the acute stage of the infection. In addition, virus‐induced inflammation in the lung and draining lymph node resulted in the non‐specific recruitment of circulating allergen‐specific effector/memory cells.

Conclusion
In addition to virus‐mediated damage to the lung and airways, influenza viral infection can also enhance unrelated local allergic responses.
Immunoglobulin G4 antibodies to rat urinary allergens, sensitization and symptomatic allergy in laboratory animal workers
Authors: Portengen L. , De Meer G. , Doekes G. , Heederik D.
Published: August 2004

Background and objectives
We have previously reported that high rat urinary allergen (RUA) exposure was not associated with increased risk of rat allergy in long‐term‐exposed laboratory animal (LA) workers. We aimed to assess whether strong allergen‐specific IgG4 responses could explain the absence of a dose response in these subjects. We investigated whether IgG4 was associated with allergen exposure and prevalence of sensitization or respiratory symptoms to rats. The longitudinal relation between IgG4 and rat allergy was studied using data obtained during 2 years of follow‐up.

Methods
Five hundred and twenty‐nine LA workers answered a questionnaire on respiratory symptoms and occupational history and participated in skin prick testing. Blood samples were analysed for specific IgG4 and IgE to RUA. Exposure to RUA was estimated based on personal air samples. The relation between IgG4 and newly occurring sensitization or rat allergy was studied in workers who were not sensitized or did not report respiratory symptoms to rats.

Results
IgG4 titres were higher in atopic than in non‐atopic subjects, and increased with higher allergen exposure. Titres were highest in subjects who were sensitized and reported respiratory symptoms to rats when compared with those who were not (geometric mean [geometric standard deviation]=202 [5.7] vs. 8.4 [18.3] AU). The association between IgG4 and sensitization or symptomatic rat allergy was independent of estimated allergen exposure. IgG4 was a strong predictor of newly occurring sensitization and symptomatic rat allergy during follow‐up in atopic and rat‐sensitized subjects.

Conclusion
High exposure to RUA is associated with a strong allergen‐specific IgG4 antibody response. High anti‐RUA IgG4 is a strong predictor of prevalent and incident sensitization and symptomatic rat allergy in atopic and rat‐sensitized subjects. IgG4 can therefore not explain the absence of a dose response between allergen exposure and allergy in long‐term‐exposed workers. We consider anti‐RUA IgG4 to be a marker that combines aspects of exposure and susceptibility.
Effects of primary and secondary low‐grade respiratory syncytial virus infections in a murine model of asthma
Authors: Kondo Y. , Matsuse H. , Machida I. , Kawano T. , Saeki S. , Tomari S. , Obase Y. , Fukushima C. , Kohno S.
Published: August 2004

Background
Respiratory syncytial virus (RSV) infection is known to develop and exacerbate asthma in young children. In adult, RSV causes recurrent but asymptomatic infections. However, the impact of asymptomatic RSV infection on adult asthma is yet to be determined. The present study is designed to determine the effects of primary and secondary low‐grade RSV infections on allergic airway inflammation in a murine model of allergic asthma.

Methods
A low‐grade RSV (2 × 103 plaque‐forming units/mouse) was inoculated, and this caused neither pulmonary inflammation nor symptoms but induced significant IFN‐γ production in thoracic lymph nodes. To investigate interaction between low‐grade virus and Dermatophagoides farinae (Df), airway hyper‐responsiveness, lung inflammation and cytokine production from thoracic lymph nodes were compared after primary and secondary low‐grade RSV infections in four groups of mice; control, Df allergen‐sensitized, RSV‐infected and Df‐sensitized RSV‐infected mice. A direct comparison between low‐ and high‐grade RSV infections was also performed in primary infection. To investigate the role of IL‐5 during secondary RSV infection, anti‐IL‐5 monoclonal antibody (anti‐IL‐5 mAb) was injected in mice and similar parameters were compared in four groups of mice.

Results
Primary high‐grade RSV infection increased allergen‐induced airway inflammation, while primary low‐grade RSV infection attenuated allergen‐induced airway inflammation concomitant with significant IFN‐γ production in lung‐draining lymph nodes. In marked contrast, secondary low‐grade RSV infection increased both IFN‐γ and IL‐5 production, resulting in exacerbation of allergen‐induced airway inflammation. Anti‐IL‐5 mAb treatment in secondary low‐grade RSV infection and Df allergen‐sensitized mice attenuated virus and allergen‐induced airway inflammation.

Conclusions
Low‐grade RSV infection per se does not cause pulmonary inflammation, whereas it induces a significant immunological response in the allergen‐sensitized host. These results indicate that subclinical and recurrent RSV infection may play an important role in exacerbation and maintenance of asthma in adults, wherein IL‐5 is critically involved.
The influence of moisture content on the rheological properties of processed cheese spreads
Authors: Lee Siew Kim , Anema Skelte , Klostermeyer Henning
Published: July 2004

Model processed cheese spreads were prepared from rennet casein, sunflower oil, water and a trisodium citrate/citric acid chelating salt system. The samples were cooked using a laboratory‐scale processed cheese cooker. The moisture content of the samples varied from 49.1 to 55.6%. The samples were characterized by dynamic rheology, rotational viscometry and fat particle size analysis. With increasing moisture content, the rheological behaviour of the samples changed from solid‐like (concentrated solution) to liquid‐like (dilute solution). The moduli decreased and the frequencies at which G′‐G′′ crossed over increased with increasing moisture content. Increasing moisture content resulted in an increase in pH and increase in the volume‐to‐surface diameter of the fat droplets. Rotational viscometry indicated that all the samples were shear thinning. The flow curves fitted a power law relationship (r2 = 0.993). Thixotropic behaviour was displayed by all samples except those above 54% moisture. The shear stress at any particular shear rate increased with decreasing moisture content, indicating a stronger network structure in the low moisture samples.
The effect of whitening agents on the gel‐forming ability and whiteness of surimi
Authors: Benjakul Soottawat , Visessanguan Wonnop , Kwalumtharn Yuwathida
Published: July 2004

The effect of different concentrations of the whitening agents, calcium carbonate, titanium dioxide and soybean oil, on the gel‐forming ability and whiteness of a mixture of bigeye snapper and mackerel surimi was investigated. The whiteness of the surimi gels increased as the concentration of all whitening agents increased (P < 0.05). Titanium dioxide was a good whitening agent and it had no detrimental effects on gel‐forming ability, while oil reduced the gel breaking force and deformation. The addition of calcium carbonate did not result in a marked increase in whiteness, but it did increase the breaking force and deformation to some extent. The different whitening agents showed different influences on the whiteness and gelling characteristics of surimi gel.
Introducing the Learning Practice – I. The characteristics of Learning Organizations in Primary Care
Authors: Rushmer Rosemary , Kelly Diane , Lough Murray , Wilkinson Joyce E. , Davies Huw T. O.
Published: August 2004

Rationale, aims and objectives  This paper is the first of three related papers exploring the ways in which the principles of Learning Organizations (LOs) could be applied in Primary Care settings at the point of service delivery. Here we introduce the notion of the Learning Practice (LP) and outline the characteristics and nature of an LP, exploring cultural and structural factors in detail.

Methods  Drawing upon both theoretical concepts and empirical research into LOs in health care settings, the format, focus and feasibility of an LP is explored.

Results and conclusions  Characteristics of LPs include flatter team‐based structures that prioritize learning and empowered change, involve staff and are open to suggestions and innovation. Potential benefits include: timely changes in service provision that are realistic, acceptable, sustainable, and owned at practitioner level; smoother interprofessional working; and fast flowing informal communication backed up by records of key decisions to facilitate permanent learning. Critical comment on potential pitfalls and practical difficulties highlights features of the present system that hinder development: tightly defined roles; political behaviours and individual‐oriented support systems; plus the ongoing difficulties involved in tolerating errors (whilst people learn). This paper contributes to the wider quality improvement debate in the area in three main ways. First, by locating Government's desires to create health systems capable of learning within the theoretical and empirical evidence on LOs. Second, it suggests what an LP could be like and how its culture and structures might benefit both staff and patients in addition to meeting externally driven reforms and health priorities. Third, it extends the application of LO concepts to the health care sector locating the principles in bottom‐up change.
Introducing the Learning Practice – III. Leadership, empowerment, protected time and reflective practice as core contextual conditions
Authors: Rushmer Rosemary , Kelly Diane , Lough Murray , Wilkinson Joyce E. , Davies Huw T. O.
Published: August 2004

Rationale, aims and objectives This paper is the third of three related papers exploring the ways in which the principles of Learning Organizations (LOs) could be applied in Primary Care settings at the point of service delivery.

Methods Here we provide a systematic literature review of contextual factors that either play a key role in providing a facilitative context for a Learning Practice or manifest themselves as barriers to any Practice's attempts to develop a learning culture.

Results and conclusion Core contextual conditions are identified as, first, the requirement for strong and visionary leadership. Leaders who support and develop others, ask challenging questions, are willing to be learners themselves, see possibilities and make things happen, facilitate learning environments. The second core condition is the involvement and empowerment of staff where changes grow from the willing participation of all concerned. The third prerequisite is the setting‐aside of times and places for learning and reflection. This paper contributes to the wider quality improvement debate in three main ways. First, by highlighting the local contextual issues that are most likely to impact on the success or failure of a Practice's attempts to work towards a learning culture. Second, by demonstrating that the very same factors can either help or hinder depending on how they are manifest and played out in context. Third, it adds to the evidence available to support the case for LOs in health care settings.
Involving patients in decision making and communicating risk: a longitudinal evaluation of doctors’ attitudes and confidence during a randomized trial
Authors: Edwards Adrian , Elwyn Glyn
Published: August 2004

Background Important barriers to the wider implementation of shared decision making (SDM) and risk communication in practice remain. The attitudes of professionals undergoing training in these approaches may inform how to overcome these barriers, but there are few such data yet available.

Aim To identify the attitudes of professionals during participation in a large practice‐based intervention study with substantial individual exposure to SDM and risk communication, and to assess their confidence with these approaches and reported frequency of implementing them.

Setting and participants Twenty general practitioners (GPs) who had been in practice between 1 and 10 years, and participated in an explanatory trial lasting 6 months. The trial interventions comprised training in SDM skills and the use of risk communication materials. The doctors consulted with up to 48 patients each (mean = 40, half of them audio‐taped) for the study.

Methods Questionnaire assessments before and after each training stage.

Results The GPs indicated positive attitudes towards involving patients and towards the training interventions. They indicated that the risk information packs were applicable but had used them only occasionally with patients outside the trial. No statistically significant changes were associated with the specific interventions in terms of doctors’ confidence in discussing risk information after the risk communication intervention, or attitudes to patient involvement after the SDM intervention. Most attitudes and confidence ratings showed positive changes during the course of the trial as a cohort effect. Such positive changes were associated with female doctors more than male doctors, but not with MRCGP (postgraduate vocational) qualification. Time constraints remained important throughout the study in not implementing the approach more frequently.

Conclusions Professionals appear receptive to patient involvement, and willing to acquire the relevant skills. SDM and risk communication training did not appear to contribute differentially to this. Practical barriers such as time constraints should probably be addressed with greater priority than the precise content of training or continuing professional development initiatives if ‘involvement’ is to become a commoner experience for patients in primary care.
Resource effects of training general practitioners in risk communication skills and shared decision making competences
Authors: Cohen David , Longo M. F. , Hood Kerenza , Edwards Adrian , Elwyn Glyn
Published: August 2004

Rationale, aims and objectives  Involving patients more in decisions about their own care requires doctors to be trained in effective ways of communicating information and in developing competences to negotiate levels of patient involvement which are most appropriate for each case. The aim of this study was to determine the cost of such training and identify which service resource variables are subsequently affected.

Methods  An explanatory cluster randomized crossover trial was carried out which involved training general practitioners (GPs) in the use of risk communication (RC) tools, shared decision making (SDM) competences or both. Continuing care by GPs of patients with one of four chronic conditions (menopausal symptoms, menorrhagia, atrial fibrillation, prostatism) was reviewed before and after training. Cost of training was assessed by prospective monitoring of resources used. Data on prescribing, referrals and investigations were collected via questionnaires to participating practitioners. Data on follow‐up GP consultations were extracted from medical records. Three two‐level logistic models were performed to investigate the probability of training having an effect on prescribing, referrals and investigations ordered at the review consultation.

Results  Training cost £1218 per practitioner which increased the cost of a consultation by £2.89. Training in SDM or combined with RC significantly affected the probability of a prescription being issued to women with menopausal symptoms and menorrhagia (although RC on its own had no effect) but did not significantly affect prescribing for patients with prostatism or atrial fibrillation. It did not significantly affect the probability of investigations, referrals or follow‐up GP visits for any of the conditions.

Conclusion  Unless training has a major influence on consultation length, it is unlikely to have any major impacts on cost.
Quality circles to improve prescribing patterns in primary medical care: what is their actual impact?
Authors: Wensing Michel , Broge Björn , Kaufmann‐Kolle Petra , Andres Edith , Szecsenyi Joachim
Published: August 2004

Rationale, aims and objectives  Quality circles comprise small group sessions of doctors and written feedback on their individual practice patterns. Although 50% of German primary care doctors participate in quality circles, their effectiveness has hardly been evaluated in Germany. This study determined the impact of a large‐scale programme of quality circles on quality and costs of prescribing.

Method  A controlled before–after study was performed, in which primary care doctors were allocated to a quality circles group or a control group. Subjects were 100 000 patients in 1996 and in 1998, who had visited one of 177 doctors in the 3 month registration periods in one region in Germany. The intervention comprised a quality circles programme, comprising 11 sessions and repeated feedback on prescribing. Main outcome measures were proportion of patients who received a prescription, mean prescription costs per patient and proportion of generic prescriptions.

Results  The absolute numbers of prescriptions decreased in both groups, but the mean prescription costs per patient increased. The quality circles reduced the proportion of patients who received a prescription (OR = 0.86) and the mean prescription costs per patient (B =−3.99 euro), while it increased the proportion of generic drugs (OR = 1.10). The intervention had intended effects on four of the 15 secondary indicators.

Conclusions  Large‐scale application of quality circles had intended effects on prescribing decisions in primary care in Germany. The effects found in this study may reflect better what improvements can be achieved than randomized trials of similar interventions.
Humoral response and susceptibility of five full‐sib families of Atlantic salmon, Salmo salar L., to the haemoflagellate, Cryptobia salmositica
Authors: Chin A , Glebe B D , Woo P T K
Published: August 2004

Susceptibility and antibody production against pathogenic and vaccine strains of the haemoflagellate, Cryptobia salmositica were investigated in five full‐sib families (A–E) of Atlantic salmon, Salmo salar. Humoral response and susceptibility of families were compared within three treatments: infection, vaccination and vaccination followed by challenge. Parasitaemias caused by the vaccine strain of C. salmositica were considerably lower than those caused by the pathogenic strain. All vaccinated families were protected when challenged with the pathogenic strain. Family B had significantly lower parasitaemias (with both strains) than the other families. When naïve fish were infected with the pathogenic strain, this family had a significantly lower and earlier peak parasitaemia (4.3 ±1.3 × 106 parasites mL−1 blood at 3 weeks post‐infection; w.p.i.) than the other families. Family C had the highest peak (11.1 ± 1.2 × 106 parasites mL−1 blood), which occurred at 4 w.p.i. Antibodies against C. salmositica were detected earlier in Family B (3 w.p.i.) than in Family C (5 w.p.i.). This demonstrates an association of increased susceptibility with a delayed antibody response. Western immunoblot identified antibodies against 112, 181 and 200 kDa antigens earlier in more resistant fish (Family B). Antigenic stimulation leading to a stronger antibody response was shown with the vaccine strain and in the later stages of infection.
Salmonid gill bacteria and their relationship to amoebic gill disease
Authors: Bowman J P , Nowak B
Published: August 2004

16S ribosomal RNA gene analysis was used to assess the bacterial community associated with Atlantic salmon, Salmo salar L., gills which were either affected by amoebic gill disease (AGD) or were AGD‐negative, in order to determine the role that bacteria may play in the development of AGD. AGD‐positive specimens were either infected in the laboratory with Neoparamoeba pemaquidensis, the causative agent of AGD, or were obtained from commercial salmon cages. Samples from laboratory fish maintained in sea water possessed a marine‐type community while field samples which had been treated by a series of freshwater baths possessed a more diverse community which included variable proportions of different bacterial ecotypes, including groups typically associated with soil, skin surfaces and faeces. Samples from fish infected with AGD in the laboratory and a sample from one of two salmon cage fish specimens were dominated by a phylotype belonging to the strictly marine bacterial genus Psychroserpens (family Flavobacteriaceae, phylum Bacteroidetes). The phylotype was not detected in any of the AGD‐negative samples or in one of two AGD‐positive samples obtained from fish subjected to temporary freshwater immersion. The possibility of certain Psychroserpens species as potential opportunistic pathogens associated with salmonid AGD is proposed.
A double‐blind randomized trial of 5% ascorbic acid vs. 4% hydroquinone in melasma
Authors: Espinal‐Perez Liliana Elizabeth , Moncada Benjamin , Castanedo‐Cazares Juan Pablo
Published: August 2004

Background  Melasma is an acquired treatment‐resistant hyperpigmentation of the skin.

Methods  Sixteen women with idiopathic melasma were included in our trial. After randomization by another clinician, they were instructed to use, at night, 5% ascorbic acid cream on one side of the face and 4% hydroquinone cream on the other side, for 16 weeks. Sunscreen was applied daily throughout the period of observation. They were evaluated every month by colorimetry, digital photography, and regular color slides. Subjective evaluation by each patient was also taken into account.

Results  The best subjective improvement was observed on the hydroquinone side with 93% good and excellent results, compared with 62.5% on the ascorbic acid side (P < 0.05); however, colorimetric measures showed no statistical differences. Side‐effects were present in 68.7% (11/16) with hydroquinone vs. 6.2% (1/16) with ascorbic acid.

Conclusion  Although hydroquinone showed a better response, ascorbic acid may play a role in the therapy of melasma as it is almost devoid of side‐effects; it could be used alone or in combination therapy.
Foot dermatitis from the shoes
Authors: Onder Meltem , Atahan Asena Cigdem , Bassoy Banu
Published: August 2004

Background  Foot dermatitis from the shoes is a common disorder.

Methods  Patients with foot complaints seen at the Contact Dermatitis Unit, Department of Dermatology, Gazi University Faculty of Medicine between May 2001 and May 2002 were evaluated.

Results  Four patients with foot dermatitis from shoe allergens were found. Their clinical and patch test results of shoe contact dermatitis were reviewed. We also summarized the standard test allergens for shoe dermatitis. All four patients were treated with topical corticosteroid creams and were informed about patch test‐positive materials.

Conclusions  Patients with foot dermatitis from shoes should undergo patch testing to exclude other causes of foot dermatosis. Contact dermatitis from shoes can be managed by the recognition and avoidance of the allergens responsible. The control of hyperhidrosis and the use of topical and systemic corticosteroid therapies may also be beneficial.
Spectrum of skin diseases in Yemen (Hajjah and adjacent region)
Authors: Lal Khatri Mishri
Published: August 2004

Background  Epidemiological study of skin diseases from Yemen is not available, although some data has been published from nearby Arab countries.

Objective  To determine the pattern of skin diseases in Yemen and particularly in Hajjah and nearby regions.

Methods  This is a prospective study and analysis of the consecutive new patients attending the Dermatology Clinic of Saudi Hospital at Hajjah, Yemen, from January 1997 to December 1999. The majority of the patients were from Hajjah and nearby regions but a substantial number of patients came from different distant regions of Yemen. The diagnosis was mainly based on clinical features but supported by laboratory investigations, diagnostic procedures and histopathology when needed.

Results  The total number of new patients was 13,840 with 14,259 diseases, with a male to female ratio of 1 : 0.81. Ninety‐nine percent of the patients were Yemeni nationals. The leading group of diseases was dermatitis and eczematous disorders, followed by infections and infestations (including cutaneous leishmaniasis and mycetoma), followed by acne and acneiform disorders.

Conclusion  The spectrum of skin diseases in this analysis revealed that more than 50% of the diseases belonged to dermatitis and eczematous disorders and infectious diseases groups. Socioeconomic and environmental factors of the region are responsible for this. Implementation of public health programs, a proper health education, and inclusion of a suitable training program of dermatology in the undergraduate medical studies of this country may help to prevent and manage these problems rationally.