bluuebunny/crossref_metadata_2025 huggingface dataset:
Horizontal transfer of virulence genes encoded on the Enterococcus faecalis pathogenicity island
Authors: Coburn Phillip S. , Baghdayan Arto S. , Dolan GT , Shankar Nathan
Published: December 2006

Enterococcus faecalis, a leading cause of nosocomial antibiotic resistant infections, frequently possesses a 150 kb pathogenicity island (PAI) that carries virulence determinants. The presence of excisionase and integrase genes, conjugative functions and multiple insertion sequence elements suggests that the PAI, or segments thereof, might be capable of horizontal transfer. In this report, the transfer of the E. faecalis PAI is demonstrated and a mechanism for transfer elucidated. In filter matings, chloramphenicol resistance was observed to transfer from strain MMH594b, a clinical isolate possessing the PAI tagged with a cat marker, to OG1RF (pCGC) with a frequency of 3.2 × 10−10 per donor. Secondary transfer from primary transconjugant TCRFB1 to strain JH2SS in filter and broth matings occurred with a frequency of 1 and 2 × 10−1 per donor respectively. Analysis of the transconjugants demonstrated that a 27 744 bp internal PAI segment was capable of excision and circularization in the donor, and is mobilized as a cointegrate with a pTEF1‐like plasmid. High‐frequency transfer also occurred from TCRFB1 to JH2SS during transient colonization of the mouse gastrointestinal tract. This is the first demonstration of the horizontal transfer of PAI‐encoded virulence determinants in E. faecalis and has implications for genome evolution and diversity.
Percutaneous implantation of gastric electrodes – a novel technique applied in animals and in patients
Authors: Elfvin A. , Andersson S. , Abrahamsson H. , Edebo A. , Simrén M. , Lönroth H.
Published: December 2006

Abstract  Temporary electrodes implanted under general anaesthesia, or via an oral or percutaneous endoscopic gastrostomy route have been used for testing of gastric electrical stimulation (GES). We have developed a principle for percutaneous electrode implantation. Leads were constructed so that the tip could be anchored to the gastric submucosa under gastroscopic control. Acute experiments were performed in anaesthetized pigs. Three patients referred for nausea and/or vomiting and non‐established indications for GES (chronic intestinal pseudo‐obstruction, functional dyspepsia without gastroparesis) were evaluated. Electrode function was tested by recording and stimulation techniques. In the pigs, a slow‐wave (SW) rhythm (3 min−1) was recorded with decrease in frequency at the end of the experiments. In the patients, implantation time from start of gastroscopy to end of electrode placement was 12–20 min. Electrode distance varied from 12 to 45 mm. Gastric electromyography showed a regular SW rhythm of about 3 min−1. Antral pressure waves had intervals being multiples of the SW‐to‐SW time. With temporary GES for 7–9 days, weekly frequency of the referral symptoms decreased >80% in two patients and 33% in one patient. Temporary percutaneous gastric leads can easily be implanted and may be used for testing of GES and study of gastric electrophysiology.
Why are some species more commonly afflicted by arthritis than others? A comparative study of spondyloarthropathy in primates and carnivores
Authors: NUNN C. L. , ROTHSCHILD B. , GITTLEMAN J. L.
Published: December 2006

Spondyloarthropathy is a painful arthritic affliction of humans that also occurs in wild mammals. Important questions remain concerning the underlying causes of spondyloarthropathy in mammals, particularly regarding whether it is infectious in origin or driven by genetic predisposition and environmental stressors. Moreover, spondyloarthropathy has negative effects on host fitness, leading to potential conservation concerns if it impacts threatened species. Using a comparative data set on the prevalence of joint disease in 34 primate species and 100 carnivore species, we tested predictions involving the epidemiological correlates of spondyloarthropathy in wild mammals. Analyses revealed that 5.6% of primates and 3.6% of carnivores exhibited signs of spondyloarthropathy, with maximum incidence as high as 22% in great apes and 27% in bears. We tested whether prevalence of spondyloarthropathy increases with population density and group size, greater contact with soil, a slower host life history, increased ranging, dietary factors and body mass. We found general support for an effect of body mass, with larger bodied primates and carnivores exhibiting a higher prevalence of spondyloarthropathy. In addition, more threatened species experienced higher rates of spondyloarthropathy, with this association influenced by body mass and phylogeny. The effect of body mass could reflect that larger animals are exposed to more pathogens through greater consumption of resources, or that joints of larger bodied mammals experience greater biomechanical stresses, resulting in inflammation and activation of local joint infections.
When does diversity fit null model predictions? Scale and range size mediate the mid‐domain effect
Authors: Dunn Robert R. , McCain Christy M. , Sanders Nathan J.
Published: December 2006

Aim  Recently, a flurry of studies have focused on the extent to which geographical patterns of diversity fit mid‐domain effect (MDE) null models. While some studies find strong support for MDE null models, others find little. We test two hypotheses that might explain this variation among studies: small‐ranged groups of species are less likely than large‐ranged species to show mid‐domain peaks in species richness, and mid‐domain null model predictions are less robust for smaller spatial extents than for larger spatial extents.

Location  We analyse data sets from elevational, riverine, continental and other domains from around the world.

Methods  We use a combination of Spearman rank correlations and binomial tests to examine whether differences within and among studies and domains in the predictive power of MDE null models vary with spatial scale and range size.

Results  Small‐ranged groups of species are less likely to fit mid‐domain predictions than large‐ranged groups of species. At large spatial extents, diversity patterns of taxonomic groups with large mean range sizes fit MDE null model predictions better than did diversity patterns of groups with small mean range sizes. MDE predictions were more explanatory at larger spatial extents than at smaller extents. Diversity patterns at smaller spatial extents fit MDE predictions poorly across all range sizes. Thus, MDE predictions should be expected to explain patterns of species richness when ranges and the scale of analysis are both large.

Main conclusions  Taken together, the support for these hypotheses offers a more sophisticated model of when MDE predictions should be expected to explain patterns of species richness, namely when ranges and the scale of analysis are both large. Thus the circumstances in which the MDE is important are finite and apparently predictable.
Rights of Non‐humans? Electronic Agents and Animals as New Actors in Politics and Law
Authors: Teubner Gunther
Published: December 2006

Personification of non‐humans is best understood as a strategy of dealing with the uncertainty about the identity of the other, which moves the attribution scheme from causation to double contingency and opens the space for presupposing the others' self‐referentiality. But there is no compelling reason to restrict the attribution of action exclusively to humans and to social systems, as Luhmann argues. Personifying other non‐humans is a social reality today and a political necessity for the future. The admission of actors does not take place, as Latour suggests, into one and only one collective. Rather, the properties of new actors differ extremely according to the multiplicity of different sites of the political ecology.
District Judges and Possession Proceedings
Authors: Cowan Dave , Blandy Sarah , Hitchings Emma , Hunter Caroline , Nixon Judy
Published: December 2006

In this article, we draw on data obtained in interviews with District Judges about the factors which they say influence the exercise of their discretion in possession proceedings. Analysing the data set enabled us to create three ideal types of judicial decision—making which we have labelled ‘liberal’, ‘patrician’, and formalist'. We discuss the differences between each ideal type across five different variables: the District Judge role; approach; view of occupiers; the problem; behaviour of occupiers. Our data demonstrate a set of reasons to explain different approaches and outcomes between different District Judges (as well as the perhaps unlikely identification of a ‘maverick’ or ‘idiosyncratic’ style of judging). We conclude by suggesting on the basis of our data that, despite calls to structure or remove the discretion from District Judges, any such changes are unlikely to have much effect.
English Law's Epistemology of Expert Testimony
Authors: Ward Tony
Published: December 2006

The decision whether to believe an expert witness raises difficult epistemological and ethical questions for a lay juror or judge. This article examines the English courts' approach to these questions in the light of a series of cases which endorse the test of admissibility formulated in the Australian case o/R v. Bonython. It argues that, if interpreted more rigorously than it generally has been to date, Bonython could provide the framework for an approach which avoids the pitfalls of either a ‘scientistic’ or a ‘constructivist’ epistemology of expert testimony. Such an approach needs to distinguish between different types of expertise and the differing degrees of deference that they call for on the part of a lay fact‐finder.
From Universal Values to Millennium Development Goals: Lost in Translation
Authors: Saith Ashwani
Published: December 2006

Are the Millennium Development Goals just a string of global wish lists? Are they simply a distraction or gimmick? This contribution argues that there is more to the enveloping global exercise of the MDGs than meets the eye. Despite its alarming and terminal weaknesses with regard to theory, method and scope, and notwithstanding its multitude of errors of commission and omission, the MDG phenomenon carries the potential for distorting meaningful intellectual and research agendas, and could function as the catalyst and vehicle for a fundamental realignment of the political economy of development at the global level. The question is whether this realignment will be of a benign character that reflects the emancipatory aspirations so readily evoked in the Millennium Declaration.
Cosmopolitan Presumptions? On Martha Nussbaum and her Commentators
Authors: Gasper Des
Published: December 2006

This article presents a framework for analysis of discourses on ethical cosmopolitanism, and applies it to Martha Nussbaum's Frontiers of Justice (2006), with comparisons to the views of other authors. After outlining the book's form of ethical cosmopolitanism, the article considers the psychological, philosophical and sociological presumptions, the methodology of abstraction, the implicit audiences, and the programmatic targets and implied strategy of social change. It links and comments on sister papers by Giri, McCloskey, Murphy, Nederveen Pieterse and Truong.
One Humanity, Many Consciousnesses: Unresolved Issues in Nussbaum's New Frontiers of Justice
Authors: Truong Thanh‐Dam
Published: December 2006

Taking the work of Martha Nussbaum as one point of departure, this contribution addresses three questions related to capabilities theory: how it can reconcile its pursuit of universal ethical principles with a world of diversity; whether it can liberate itself from neoliberal discourse; and whether it can deal with compassion and care. The challenge for global justice is to gain universal acceptance through dialogue and mutual transformation between paradigms. This requires a modification of Eurocentric orientations in moral reasoning to overcome differences of epistemic practices.
Cosmopolitanism and Beyond: Towards a Multiverse of Transformations
Authors: Giri Ananta Kumar
Published: December 2006

A revival of cosmopolitanism seems to be underway in both discourse and practice. However, much of this revival draws from only one trajectory of cosmopolitanism, and fails to build upon different traditions of cosmopolitan thinking and experimentation. Cosmopolitanization is an ongoing process of critique, creativity and border‐crossing which involves transformations in self, culture, society, economy and polity. It requires multi‐dimensional processes of self‐development, inclusion of the other, and planetary realizations. Against this background, this contribution explores the multiverse of transformations that confront contemporary discourses of cosmopolitanism. It also discusses the issue of cosmopolitan responsibility, noting three major challenges: global justice; cross‐species dignity; and dialogue among civilizations, cultures, religions and traditions.
AUCTIONS, EX POST COMPETITION AND PRICES: THE EFFICIENCY OF PUBLIC‐PRIVATE PARTNERSHIPS*
Authors: Chong Eshien , Huet Freddy , Saussier Stéphane
Published: December 2006

ABSTRACT**:  Using an original database concerning 1102 French local public authorities in 2001, we explore the relationships between prices charged by private operators in water contracts and ex post competition. We show that prices charged in contracts in which operators are in a monopoly situation throughout the duration of the contract, are not affected by a ‘competition effect’ between private operators. However, a competition effect between private operators and public management appears to be crucial in explaining prices combined with a ‘termination effect’, reflecting the fact that the contract is close to being renewed, and hence re‐auctioned.
GLOBALISATION, FIRM UPGRADING AND IMPACTS ON LABOUR
Authors: KNORRINGA PETER , PEGLER LEE
Published: December 2006

The question that drives this paper is: When can we expect firm upgrading by developing‐country suppliers in global value chains will lead to improvements in labour conditions? To deal with this question we, (a) position firm upgrading in the global value chain approach, (b) investigate existing evidence and conceptualisations on how economic globalisation impacts on labour, and (c) develop some hypotheses on when we can expect firm upgrading and improvements in labour conditions to go together. We conclude that firm upgrading in developing‐country suppliers in global value chains as a rule does not lead to improvements in labour conditions. Instead, the much broader and more forceful process of immiserising growth makes it very unlikely that workers in such relatively low‐skilled production activities will enjoy improvements in labour conditions. Ethical sourcing may lead to improvements in labour conditions of core workers in final product manufacturers and key supplier firms, but it is as yet unclear to what extent such a business model can and will be disseminated. More generally, even though economic globalisation does selectively create new jobs, even labour conditions of core workers may be under pressure while the overall proportion of core workers appears to be declining.
LA LAGUNA: OF EXPORTING JEANS AND CHANGING LABOUR RELATIONS
Authors: DOOREN ROBINE VAN
Published: December 2006

This paper analyses the development of a garment cluster in La Laguna, North Mexico, since the coming into effect of the North American Free Trade Agreement. Employment in the local garment industry increased rapidly and working conditions improved, due to increasingly stringent buyer standards. However, both buyer‐supplier and employee‐worker relations became strained, causing some entrepreneurs to relocate operations to cheaper sites and others to adopt a modular production strategy to save on labour costs – and shift co‐ordination and management risk onto workers. La Laguna's specialisation of jeans production for export is a form of hyper specialisation that may well be required in global markets, for the sake of cost efficiency, but it also enhances the vulnerability of a cluster in the face of fluctuating world demand and changing international trade policies. As the cluster is an important part of the regional economy, the problems of the cluster have a great impact on the region.
GLOBALISATION AND GOOD WORK: IMPIVA, A SPANISH PROJECT TO REGENERATE INDUSTRIAL DISTRICTS
Authors: HOLMSTRÖM MARK
Published: December 2006

How can clusters of small and medium enterprises meet global competition? The point is not just to create jobs, but good work (decent conditions, autonomy, and opportunities to improve skills and build a career). Impiva, a Valencian regional government agency, has set up technological institutes for established industries, and local business innovation centres to back new projects, following the examples of Emilia Romagna (Italy), Baden‐Württemberg (Germany) and Denmark, though Spain lacks the levels of trust between entrepreneurs found in those regions. The Institute for toys (AIJU) is in Ibi, a town which makes most Spanish toys but must diversify because of Chinese competition; so AIJU has become an all‐purpose local development agency, like Baden‐Württemberg's technology transfer centres. The Baden‐Württemberg model – catering for established industries and diversification – can be adapted to local conditions. Places like Ibi can provide good work, if local firms keep some control over design, innovation and problem‐solving.
Measuring Conditional Persistence in Nonlinear Time Series*
Authors: Kapetanios George
Published: December 2006

The persistence properties of economic time series have been a primary object of investigation in a variety of guises since the early days of econometrics. Recently, work on nonlinear modelling for time series has introduced the idea that persistence of a shock at a point in time may vary depending on the state of the process at that point in time. This article suggests investigating the persistence of processes conditioning on their history as a tool that may aid parametric nonlinear modelling. In particular, we suggest that examining the nonparametrically estimated derivatives of the conditional expectation of a variable with respect to its lag(s) may be a useful indicator of the variation in persistence with respect to its past history. We discuss in detail the implementation of the measure and present a Monte Carlo investigation. We further apply the persistence analysis to real exchange rates.
Housing Allowances and Economic Efficiency
Authors: HAFFNER MARIETTA E.A. , BOELHOUWER PETER J.
Published: December 2006

Housing allowances aim to make rental housing affordable for the recipients. Whether affordability for tenants is achieved in an economically efficient way is the question that is discussed in this essay. Three aspects of efficiency are focused on: disincentives to work, over‐consumption of housing and horizontal inefficiency. These topics are tackled through a discussion that focuses mainly on the principles, but also on some of the outcomes, of the means‐tested housing allowance systems in six Western countries: Belgium, Germany, the Netherlands, the United Kingdom, the United States and Sweden. Conclusions concern the apparent unimportance of the poverty trap or the unemployment trap specifically for rental housing, the concept of notional rent used to tackle over‐consumption, and the frequent existence of some form of horizontal inefficiency.
Security or Safety in Cities? The Threat of Terrorism after 9/11
Authors: MARCUSE PETER
Published: December 2006

A great deal is at issue in the handling of the threat of terrorism in the United States today. Restrictions on the use of public space are a direct consequence, at the urban level, of what is happening. But beyond that, and beyond the various abuses of civil liberties and common sense that have been involved in the governmental misuse of the threat after 9/11, the most serious misuse may be the sale of the threat as a threat to existential security instead of as one danger among others to public safety. It has been manipulated for purposes having nothing to do with terrorism. The intended result has been to reinforce the positions of those in power, to displace the insecurity inherent in a capitalist free market system, and to limit further the freedom that is at the heart of the right to the city. The current treatment of public space illustrates the process.
Tenancy Databases, Professional Practices and Housing Access among Low‐Income Tenants in the Private Rental Sector in Australia
Authors: SHORT PATRICIA , MINNERY JOHN , MEAD ELSPETH , O’FLAHERTY MARTIN , PEAKE ANDREW
Published: December 2006

This essay addresses the impacts of electronic tenancy databases upon social relations in the field of private rental tenancy in Australia. Insights arise from research carried out, in 2002–3, in the eastern, mainland states of Australia that included interviews with tenants and property managers in the private rental sector. Property managers viewed tenancy databases as a tool for efficient, effective and professional risk management, and ‘professional’ practice was held to render misconduct or improper listings extremely unlikely. In this context, tenants were individualized and expected to actively work to construct, maintain and document their reputation as a ‘good tenant’. For tenants, tenancy databases could have a particular, definitive effect. ‘Not being listed’ (along with getting a full rental bond refund, references from previous landlords, and so on) is an indicator that helps build a satisfactory, personal rental history. On the other hand, being ‘listed’ is read as a prime indicator of risk and effectively overriding other aspects of a tenant’s application for tenancy. ‘Listed’ tenants find themselves being forced to shift further and further away from the formal rental market and ultimately into insecure and inappropriate housing arrangements at the periphery.
Psychological Factors Associated with Obtaining Employment
Authors: Hensel Elizabeth , Kroese Biza Stenfert , Rose John
Published: December 2006

Background  Less than 10% of people with intellectual disabilities are employed. The aim of the present study was to investigate what psychological factors might predict employment outcome for people with intellectual disability who had received a placement in a supported employment service.

Method  Sixty people were interviewed whilst they were in the supported employment preparation agency and where possible 3 and 9 months after leaving. The structured interview included a number of psychological measures. Those who subsequently gained employment were compared with those who did not.

Results  Those who gained employment were significantly more motivated by status aspiration, and judged themselves significantly less happy than those who did not gain employment, at the first interview.

Conclusions  It is possible that people who are more dissatisfied with their life might be more motivated to change their circumstances. Supported employment agencies might consider using a measure of motivation as an entry criterion or as a way of identifying who needs help with developing motivation.
A randomised trial of carbetocin versus syntometrine in the management of the third stage of labour
Authors: Leung SW , Ng PS , Wong WY , Cheung TH
Published: December 2006

Objective  Syntometrine is an effective uterotonic agent used in preventing primary postpartum haemorrhage but has adverse effects including nausea, vomiting, hypertension and coronary artery spasm. Carbetocin is a newly developed long‐acting oxytocin analogue that might be used as an uterotonic agent. We compare the efficacy and safety of intramuscular (IM) carbetocin with IM syntometrine in preventing primary postpartum haemorrhage.

Design  Prospective, double‐blinded, randomised controlled trial.

Setting  Delivery suite of a university‐based obstetrics unit.

Population  Women with singleton pregnancy achieving vaginal delivery after and throughout 34 weeks.

Methods  Three hundred and twenty‐nine eligible women were randomised to receive either a single dose of 100 microgram IM carbetocin or 1 ml IM syntometrine (a mixture of 5 iu oxytocin and 0.5 mg ergometrine) at the end of second stage of labour.

Main outcome measures  Difference in haemoglobin drop measured 2 days after delivery between the two groups.

Results  There was no difference in the drop of haemoglobin concentration within the first 48 hours between the two groups. The incidence of additional oxytocic injections, postpartum haemorrhage (blood loss ≥ 500 ml) and retained placenta were also similar. The use of carbetocin was associated with significant lower incidence of nausea (relative risk [RR] 0.18, 95% confidence interval [CI] 0.04–0.78), vomiting (RR 0.1, 95% CI 0.01–0.74), hypertension 30 minutes (0 versus 8 cases, P < 0.01) and 60 minutes (0 versus 6 cases, P < 0.05) after delivery but a higher incidence of maternal tachycardia (RR 1.68, 95% CI 1.03–3.57).

Conclusions  IM carbetocin is as effective as IM syntometrine in preventing primary postpartum haemorrhage after vaginal delivery. It is less likely to induce hypertension and has a low incidence of adverse effect. It should be considered as a good alternative to conventional uterotonic agents used in managing the third stage of labour.
Short communication: The relationship between pre‐pregnancy care and early pregnancy loss, major congenital anomaly or perinatal death in type I diabetes mellitus
Authors: Pearson DWM , Kernaghan D , Lee R , Penney GC ,   Scottish Diabetes in Pregnancy Study Group
Published: December 2006

The relationships between markers of pregnancy planning and pre‐pregnancy care and adverse outcomes (early pregnancy loss, major congenital anomaly and perinatal death) were examined in 423 singleton pregnancies in women with pre‐gestational type I diabetes mellitus. Pregnancy planning and markers of pre‐pregnancy care were associated with reduced risks of adverse pregnancy outcomes. ‘Documentation of achievement of an optimal haemoglobin A1c prior to discontinuation of contraception’ was the marker associated with the lowest rate of adverse outcome (OR 0.2; 95% CI 0.06–0.67) and might serve as an appropriate definition of pre‐pregnancy care for research and audit purposes.
Stress symptoms and burnout in obstetric and gynaecology residents
Authors: Castelo‐Branco C , Figueras F , Eixarch E , Quereda F , Cancelo MJ , González S , Balasch J
Published: December 2006

Objective  This study was designed to examine the burnout syndrome among residents in obstetrics and gynaecology in Spain, and to analyse the predisposing factors for this condition.

Setting  Eight Spanish University hospitals.

Sample  A total of 162 residents representative of all active residents in obstetrics and gynaecology in Spain with regards to age, sex and year of residency were asked to take part in this survey.

Methods  The Maslach Burnout Inventory was mailed to each resident of eight Spanish hospitals representative of all active residents in obstetrics and gynaecology in Spain with regards to age, sex and year of residency. Burnout was defined as a high score on the emotional exhaustion or depersonalisation subscores, according to validated standard cutoff values. The demographic and predisposing work factors were noted for each participant using a self‐reported questionnaire. A binary logistic regression model was constructed from all predisposing factors as covariates for the prediction of the burnout syndrome.

Results  Sixty‐seven percent of the 162 eligible residents returned their questionnaires within a 3‐month period. Of those, 58% fulfilled the criteria for the burnout syndrome. In the multivariate analysis, marital status and workload in office practice were found to be significant predisposing factors. Single marital status increased the odds ratio for burnout by 5.2 (95% CI 1.3–21). For every extra ten patients attended in the office per week, the odds ratio for burnout increased by 1.25 (95% CI 1.0–1.5). A stratified multivariate subanalysis showed that this risk remained significant only in the group of residents without staff supervision with an odds ratio of 2.1 (95% CI 1.3–2.9).

Conclusion  The prevalence of the burnout syndrome during obstetrics and gynaecology residency is high. Single marital status and workload in office practice without staff supervision are significant predisposing factors.
Trends in maternal obesity incidence rates, demographic predictors, and health inequalities in 36 821 women over a 15‐year period
Authors: Heslehurst N , Ells LJ , Simpson H , Batterham A , Wilkinson J , Summerbell CD
Published: December 2006

Objective  The aim of this study was to identify trends in maternal obesity incidence over time and to identify those women most at risk and potential‐associated health inequalities.

Design  Longitudinal database study.

Setting  James Cook University Hospital maternity unit, Middlesbrough, UK.

Sample  A total of 36 821 women from 1 January 1990 to 31 December 2004.

Methods  Trends in maternal obesity incidence over time were analysed using chi‐square test for trend. Demographic predictor variables were analysed using multivariate logistic regression, adjusting for confounding factors after testing for multicollinearity. National census data were used to place the regional data into the context of the general population.

Main outcome measure  Trends in maternal obesity incidence. Demographic predictor variables included ethnic group, age, parity, marital status, employment and socio‐economic disadvantage.

Results  The proportion of obese women at the start of pregnancy has increased significantly over time from 9.9 to 16.0% (P < 0.01). This is best described by a quadratic model (P < 0.01) showing that the rate is accelerating; by 2010, the rate will have increased to 22% of this population if the trend continues. There is also a significant relationship with maternal obesity and mothers’ residing in areas of most deprivation (odds ratio [OR] = 2.44, 95% CI = 1.98, 3.02, P < 0.01), with increasing age (OR = 1.04, 95% CI = 1.04, 1.05, P < 0.01), and parity (OR = 1.17, 95% CI = 1.12, 1.21, P < 0.01).

Conclusions  The incidence of maternal obesity at the start of pregnancy is increasing and accelerating. Predictors of maternal obesity are associated with health inequalities, particularly socio‐economic disadvantage.
Adenomyosis and risk of preterm delivery
Authors: Juang C‐M , Chou P , Yen M‐S , Twu N‐F , Horng H‐C , Hsu W‐L
Published: December 2006

Objective  To evaluate the risk of preterm delivery in patients with adenomyosis.

Design  A 1:2 nested case–control study.

Setting  Tertiary‐care institution.

Population  A base cohort population of 2138 pregnant women who attended routine prenatal check‐up between July 1999 and June 2005.

Methods  From this base cohort population, gravid women with singleton pregnancy who delivered prior to the completion of 37 weeks of gestation were identified and formed the study group. Singleton gravid women who had term delivery and who matched with age, body mass index, smoking, and status of previous preterm delivery were recruited concurrently and served as control group. Preterm delivery cases were further divided into spontaneous preterm delivery and preterm premature rupture of membranes (PPROM) cases.

Main outcome measures  Risk analysis of preterm delivery between gravid women with and without adenomyosis.

Results  One‐hundred and four preterm delivery case subjects and 208 control subjects were assessed. Overall, gravid women with adenomyosis were associated with significantly increased risk of preterm delivery (adjusted odds ratio 1.96, 95% CI 1.23–4.47, P = 0.022). For subgroup analysis, gravid women with adenomyosis had an adjusted 1.84‐fold risk of spontaneous preterm delivery (95% CI 1.32–4.31, P = 0.012) and an adjusted 1.98‐fold risk of PPROM (95% CI 1.39–3.15, P = 0.017).

Conclusions  Gravid women with adenomyosis were associated with increased risk of both spontaneous preterm delivery and PPROM. A common pathophysiological pathway may exist in these two disorders. Further in‐depth biochemical and molecular studies are necessary to explore this phenomenon.
Factors associated with fall in neonatal intubation rates in the United Kingdom – prospective study
Authors: Little MP , Järvelin M‐R , Neasham DE , Lissauer T , Steer PJ
Published: December 2006

Objective  To investigate the trend of neonatal resuscitation by intubation or mask ventilation over time and to assess its association with changes in prevalence of caesarean section and use of general anaesthesia in labour.

Methods  All women booking pregnancy at any of 15 maternity units, analysed using logistic regression.

Design  Prospective study.

Setting  UK hospital‐based maternity units (15 centres).

Population  A total of 221 322 first singleton births of babies weighing 200 g or more in the St Mary’s Maternity Information System cohort, 1988–2000, covering the North West Thames area of London.

Main outcome measures  Prevalence of intermittent positive‐pressure ventilation (IPPV) (by intubation or mask) by calendar year.

Results  Overall use of IPPV decreased markedly (two‐sided P < 0.01) over the course of the study, and this decrease was evident by all modes of delivery. Adjusted mean prevalence of intubated IPPV decreased from 0.51% (95% CI 0.44–0.58) in 1988 to 0.07% (95% CI 0.06–0.09) in 2000. There was a similar decrease in the prevalence of IPPV by mask. However, despite substantial increases in prevalence of caesarean sections and reductions in the use of general anaesthesia over the course of the study, adjusting for these variables made little difference to the temporal trends in intubation or use of mask ventilation.

Conclusions  There has been a marked reduction in the prevalence of infants given resuscitation by positive‐pressure ventilation that cannot be explained by changes in the prevalence of caesarean section or use of general anaesthesia in labour.
Novel modulators of amyloid‐β precursor protein processing
Authors: Tang Bor Luen , Liou Yih Cherng
Published: December 2006

Proteolytic processing of the amyloid precursor protein (APP) is modulated by the action of enzymes α‐, β‐ and γ‐secretases, with the latter two mediating the amyloidogenic production of amyloid‐β (Aβ). Cellular modulators of APP processing are well known from studies of genetic mutations (such as those found in APP and presenilins) or polymorphisms (such as the apolipoprotein E4 ɛ‐allele) that predisposes an individual to early or late‐onset Alzheimer's disease. In recent years, several classes of molecule with modulating functions in APP processing and Aβ secretion have emerged. These include the neuronal Munc‐18 interacting proteins (Mints)/X11s, members of the reticulon family (RTN‐3 and RTN‐4/Nogo‐B), the Nogo‐66 receptor (NgR), the peptidyl‐prolyl isomerase Pin1 and the Rho family GTPases and their effectors. Mints and NgR bind to APP directly, while RTN3 and Nogo‐B interact with the β‐secretase BACE1. Phosphorylated APP is a Pin1 substrate, which binds to its phosphor‐Thr668‐Pro motif. These interactions by and large resulted in a reduction of Aβ generation both in vitro and in vivo. Inhibition of Rho and Rho‐kinase (ROCK) activity may underlie the ability of non‐steroidal anti‐inflammatory drugs and statins to reduce Aβ production, a feat which could also be achieved by Rac1 inhibition. Detailed understanding of the underlying mechanisms of action of these novel modulators of APP processing, as well as insights into the molecular neurological basis of how Aβ impairs leaning and memory, will open up multiple avenues for the therapeutic intervention of Alzheimer's disease.
Isolation and characterization of polymorphic microsatellite markers in Anthyllis vulneraria
Authors: VAN GLABEKE S. , COART E. , HONNAY O. , ROLDÁN‐RUIZ I.
Published: December 2006

To study the reproductive system of the putative autogamous species Anthyllis vulneraria in Belgian calcareous grasslands, eight polymorphic microsatellite loci were developed using the sequence‐tagged microsatellite profiling technique and 35 plants were typed for all loci. No linkage disequilibrium was found between any pair of loci. Over the loci, the number of alleles ranged from two to five. Observed and expected heterozygosities ranged from 0.053 to 0.688 and from 0.053 to 0.631, respectively. The estimated FIS values (FIS = 0.031 and 0.122) are not in accordance with a predominantly selfing reproductive system.
Characterization of 12 polymorphic microsatellite loci for eastern chipmunks (Tamias striatus)
Authors: ANDERSON SARA J. , FIKE JENNIFER A. , DHARMARAJAN GUHA , RHODES OLIN E.
Published: December 2006

Eastern chipmunks are small forest rodents for which ecological data at multiple spatial scales exist, but no molecular markers have been developed that provide adequate resolution to examine genetic structure at fine scales in this species. Thus, we developed 12 variable microsatellite loci, which amplified in three multiplexed reactions, and screened them in 27 individuals from northern Indiana, USA. Observed heterozygosities across loci ranged from 0.26 to 0.91 and number of alleles per locus ranged from three to 10. We will use these markers along with ecological data to understand population dynamics of eastern chipmunks at small spatial scales.
Microsatellite loci for Australian agamid lizards
Authors: SCHWARTZ TONIA S. , WARNER DANIEL A. , BEHEREGARAY LUCIANO B. , OLSSON MATS
Published: December 2006

We characterize 15 microsatellite loci from two microsatellite libraries developed from the Australian agamid lizards Amphibolurus muricatus and Ctenophorus pictus. All loci were tested for amplification in four other agamids: Ctenophorus fordi, Ctenophorus decresii, Chlamydosaurus kingii, and Physignathus lesueurii. These loci were highly polymorphic within and across species, with nine to 12 loci amplifying for each species tested.
Skin‐derived fibroblasts from long‐lived species are resistant to some, but not all, lethal stresses and to the mitochondrial inhibitor rotenone
Authors: Harper James M. , Salmon Adam B. , Leiser Scott F. , Galecki Andrzej T. , Miller Richard A.
Published: December 2006

Fibroblast cell lines were developed from skin biopsies of eight species of wild‐trapped rodents, one species of bat, and a group of genetically heterogeneous laboratory mice. Each cell line was tested in vitro for their resistance to six varieties of lethal stress, as well as for resistance to the nonlethal metabolic effects of the mitochondrial inhibitor rotenone and of culture at very low glucose levels. Standard linear regression of species‐specific lifespan against each species mean stress resistance showed that longevity was associated with resistance to death induced by cadmium and hydrogen peroxide, as well as with resistance to rotenone inhibition. A multilevel regression method supported these associations, and suggested a similar association for resistance to heat stress. Regressions for resistance to cadmium, peroxide, heat, and rotenone remained significant after various statistical adjustments for body weight. In contrast, cells from longer‐lived species did not show significantly greater resistance to ultraviolet light, paraquat, or the DNA alkylating agent methylmethanesulfonate. There was a strong correlation between species longevity and resistance to the metabolic effects of low‐glucose medium among the rodent cell lines, but this test did not distinguish mice and rats from the much longer‐lived little brown bat. These results are consistent with the idea that evolution of long‐lived species may require development of cellular resistance to several forms of lethal injury, and provide justification for evaluation of similar properties in a much wider range of mammals and bird species.
N−3 polyunsaturated fatty acids impair lifespan but have no role for metabolism
Authors: Valencak Teresa G. , Ruf Thomas
Published: December 2006

Although generally considered as beneficial components of dietary fats, polyunsaturated fatty acids (PUFA) have been suspected to compromise maximum lifespan (MLSP) in mammals. Specifically, high amounts of phospholipid PUFAs are thought to impair lifespan due to an increase in the susceptibility of membranes to lipid peroxidation and its damaging effect on cellular molecules. Also, there is evidence from in vitro studies suggesting that highly unsaturated PUFAs elevate basal metabolic rate (BMR). Previous comparative studies in this context were based on small sample sizes, however, and, except for one study, failed to address possible confounding influences of body weight and taxonomic relations between species. Therefore, we determined phospholipid membrane composition in skeletal muscle from 42 mammalian species to test for a relation with published data on MLSP, and with literature data on BMR (30 species). Using statistical models that adjust for the effects of body weight and phylogeny, we found that among mammals, MLSP indeed decreases as the ratio of n−3 to n−6 PUFAs increases. In contrast to previous studies, we found, however, no relation between MLSP and either membrane unsaturation (i.e. PUFA content or number of double bonds) or to the very long‐chain, highly unsaturated docosahexaenoic acid (DHA). Similarly, our data set gave no evidence for any notable relation between muscle phospholipid fatty acid composition and BMR, or MLSP and BMR in mammals. These results contradict the ‘membrane pacemaker theory of aging’, that is, the concept of a direct link between high amounts of membrane PUFAs, elevated BMR, and thus, impaired longevity.
The Impact of Welfare Reform on Insurance Coverage before Pregnancy and the Timing of Prenatal Care Initiation
Authors: Gavin Norma I. , Adams E. Kathleen , Manning Willard G. , Raskind‐Hood Cheryl , Urato Matthew
Published: December 2006

Objective. This study investigates the impact of welfare reform on insurance coverage before pregnancy and on first‐trimester initiation of prenatal care (PNC) among pregnant women eligible for Medicaid under welfare‐related eligibility criteria.

Data Sources. We used pooled data from the Pregnancy Risk Assessment Monitoring System for eight states (AL, FL, ME, NY, OK, SC, WA, and WV) from 1996 through 1999.

Study Design. We estimated a two‐part logistic model of insurance coverage before pregnancy and first‐trimester PNC initiation. The impact of welfare reform on insurance coverage before pregnancy was measured by marginal effects computed from coefficients of an interaction term for the postreform period and welfare‐related eligibility and on PNC initiation by the same interaction term and the coefficients of insurance coverage adjusted for potential simultaneous equation bias. We compared the estimates from this model with results from simple logistic, ordinary least squares, and two‐stage least squares models.

Principal Findings. Welfare reform had a significant negative impact on Medicaid coverage before pregnancy among welfare‐related Medicaid eligibles. This drop resulted in a small decline in their first‐trimester PNC initiation. Enrollment in Medicaid before pregnancy was independent of the decision to initiate PNC, and estimates of the effect of a reduction in Medicaid coverage before pregnancy on PNC initiation were consistent over the single‐ and two‐stage models. Effects of private coverage were mixed. Welfare reform had no impact on first‐trimester PNC beyond that from reduced Medicaid coverage in the pooled regression but separate state‐specific regressions suggest additional effects from time and income constraints induced by welfare reform may have occurred in some states.

Conclusions. Welfare reform had significant adverse effects on insurance coverage and first‐trimester PNC initiation among our nation's poorest women of childbearing age. Improved outreach and insurance options for these women are needed to meet national health goals.
Do Increases in Patient Activation Result in Improved Self‐Management Behaviors?
Authors: Hibbard Judith H. , Mahoney Eldon R. , Stock Ronald , Tusler Martin
Published: December 2006

Objective. The purpose of this study is to determine whether patient activation is a changing or changeable characteristic and to assess whether changes in activation also are accompanied by changes in health behavior.

Study Methods. To obtain variability in activation and self‐management behavior, a controlled trial with chronic disease patients randomized into either intervention or control conditions was employed. In addition, changes in activation that occurred in the total sample were also examined for the study period. Using Mplus growth models, activation latent growth classes were identified and used in the analysis to predict changes in health behaviors and health outcomes.

Data Sources. Survey data from the 479 participants were collected at baseline, 6 weeks, and 6 months.

Principal Findings. Positive change in activation is related to positive change in a variety of self‐management behaviors. This is true even when the behavior in question is not being performed at baseline. When the behavior is already being performed at baseline, an increase in activation is related to maintaining a relatively high level of the behavior over time. The impact of the intervention, however, was less clear, as the increase in activation in the intervention group was matched by nearly equal increases in the control group.

Conclusions. Results suggest that if activation is increased, a variety of improved behaviors will follow. The question still remains, however, as to what interventions will improve activation.
Trauma: physiology, pathophysiology, and clinical implications
Authors: Muir William
Published: December 2006

Objective: To review the physiology, pathophysiology, and consequences of trauma. The therapeutic implications of hypovolemia, hypotension, hypothermia, tissue blood flow, oxygen delivery, and pain will be discussed.

Data Sources: Human and veterinary clinical and research studies.

Human and veterinary data synthesis: Trauma is defined as tissue injury that occurs more or less suddenly as a result of violence or accident and is responsible for initiating hyothalamic–pituitary–adrenal axis, immunologic and metabolic responses that are designed to restore homeostasis. Tissue injury, hemorrhage, pain, and fear are key components of any traumatic event. Trauma and blood loss result in centrally integrated autonomic‐mediated cardiovascular responses that are designed to increase heart rate, systemic vascular resistance, and maintain arterial blood pressure (ABP) to vital organs at the expense of blood flow to the gut and skeletal muscle. Severe trauma elicits exuberant physiologic, immunologic, and metabolic changes predisposing the animal to organ malfunction, a systemic inflammatory response, infection, and multiple organ dysfunctions. The combination of both central and local influences produces regional redistribution of blood flow among and within tissue beds which, when combined with impaired vascular reactivity, leads to maldistribution of blood flow to tissues predisposing to tissue hypoperfusion and impaired oxygen delivery and extraction. Gut blood flow and viability may serve as a sentinel of patient survival. These consequences are magnified in animals suffering from pain or that become hypothermic. Successful treatment of traumatized animals goes beyond the restoration of blood pressure and urine output, is dependent on a fundamental understanding of the pathophysiologic processes responsible for the animals current physical status, and incorporates the reduction of pain, stress, and the systemic inflammatory response and methods that restore microcirculatory blood flow and tissue oxygenation.

Conclusions: Severe trauma is a multifaceted event and is exacerbated by hypothermia, pain, and stress. Therapeutic approaches must go beyond the simple restoration of vascular volume and ABP by maintaining tissue blood flow, restoring tissue oxygenation, and preventing systemic inflammation.