bluuebunny/crossref_metadata_2025 huggingface dataset:
Torsion of normal adnexa in postmenarcheal women: can ultrasound indicate an ischemic process?
Authors: Smorgick N. , Maymon R. , Mendelovic S. , Herman A. , Pansky M.
Published: February 2008

Objective

Torsion of normal adnexa is a rare event involving steadily increasing congestion and ischemia of the ovary. We investigated whether this process can be characterized by sonographic features.

Methods

Twelve menstrually cycling women with 14 separate episodes of laparoscopic‐proven torsion of normal adnexa were identified retrospectively, and the results of their preoperative gray‐scale ultrasound examinations and Doppler flow evaluations were analyzed. The cases were classified into ‘short‐term’ (< 24 h; range, 3–24 h) and ‘prolonged’ (> 24 h; range, 1–10 days) duration of torsion according to the reported period of abdominal pain before admission. Absence of any additional adnexal pathology was confirmed by both intraoperative inspection and postoperative follow‐up ultrasound examinations.

Results

The median age of the cohort was 24.0 (interquartile range (IQR), 20.5–28.7) years, and parity ranged from 0 to 3. All affected ovaries were significantly enlarged compared with non‐affected ones (median cross‐sectional area, 18.1 (IQR, 12.4–26.4) cm2 vs. 4.3 (IQR, 2.9–6.2) cm2, P < 0.01). We could distinguish two distinct sonographic patterns of torted ovaries: there were numerous small peripheral follicles in the ovarian parenchyma in nine cases, and there was a solid‐appearing mass with hypo‐ and hyperechogenic foci in five cases. Comparison of the ultrasound images of patients with short‐term vs. long‐term abdominal pain revealed that the solid‐appearing ovary was more common in the latter group (0/6 vs. 5/8, P = 0.03), while there was no significant difference between groups in the presence of free pelvic fluid or median ovarian cross‐sectional area. Intraovarian blood flow was diminished or absent in five of the eight patients in whom color Doppler imaging was performed.

Conclusions

Ultrasound images of twisted normal adnexa may vary according to the duration of the condition, reflecting the pathological series of events of increased ovarian congestion and necrosis. Recognition of the different sonographic features of twisted normal adnexa may assist in the correct diagnosis of these patients. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.
Cerebral arterial air embolism in a child after intraosseous infusion
Authors: van Rijn R. R. , Knoester H. , Maes A. , van der Wal A. C. , Kubat B.
Published: February 2008

Cerebral arterial air embolism (CAAE) has been reported as a rare complication of medical intervention. There has been one reported case of CAAE after the use of an intraosseous infusion (IO) system. We report on a case of CAAE after tibial IO infusion in a 7-month-old girl during resuscitation.
Avian species richness and abundance at Lake Constance: diverging long-term trends in Passerines and Nonpasserines
Authors: Bauer Hans-Günther , Lemoine Nicole , Peintinger Markus
Published: February 2008

In Central Europe, massive losses in species richness of breeding birds have been documented in the last decades, but the question arises whether species richness is currently still decreasing or again increasing due to conservation efforts. In this study, we investigated regional and local species richness as well as mean number of breeding pairs and mean biomass per tetrad over a period of some 20 years at Lake Constance. Three quantitative censuses of 303 tetrads (2 × 2 km2) repeated at 10-year intervals (1980–1981, 1990–1992, 2000–2002) revealed an increase in regional species richness (total number of breeding species). At the same time, however, a strong decline in local species richness (number of breeding species per tetrad), number of breeding pairs, and estimated biomass were observed. Changes of species richness differed markedly between Nonpasserine and Passerine birds. Whereas species richness of Nonpasserines remained constant from 1980 to 1990, and even increased between 1990 and 2000, that of Passerines decreased in both periods. This indicates that effects of conservation efforts apparently eclipse more general effects of climate and habitat change in Nonpasserines. The massive abundance and biomass losses observed in formerly common Passerine species are not compensated by gains in populations of Nonpasserine species. The results of the three bird censuses at Lake Constance imply that ongoing habitat degradation and human impacts as well as increasing effects of climate change are the main drivers of the observed population changes.
The Importance of Program Evaluation: How Can it be Applied to Diverse Genetics Education Settings?
Authors: Metcalfe Sylvia A. , Aitken MaryAnne , Gaff Clara L.
Published: February 2008

The role of a genetic counselor often entails providing education to patient, community and/or health professional groups. While counseling supervision assists genetic counselors to be reflective about their clinical work and to enhance clinical skills, evaluation is a rather analogous process in the provision of education. Program evaluation of education activities can be applied to provide information about the needs of the target group (needs assessment), the delivery of the program (process evaluation) as well as determining the extent to which the education activity has met its intended aims (summative evaluation). Evaluation assists the educator to assess the impact of their program and provides an evidence base about genetics education. Although program evaluation can be a complex activity, the tools are ones that can be used by individuals to evaluate single or simple education activities. The components of evaluation are discussed with reference to genetic counseling practice and three very different examples of actual evaluations are provided to illustrate the diversity of evaluation strategy and programs to which it can be applied.
Genetics Education for Health Professionals: Strategies and Outcomes from a National Initiative in the United Kingdom
Authors: Farndon Peter A. , Bennett Catherine
Published: February 2008

The National Health Service (NHS) National Genetics Education and Development Centre was established by the Department of Health in 2004 to help drive and co‐ordinate genetics education for health professionals working outside specialist genetic services. This paper reviews the experiences and lessons learned to date. At the outset, it was clear that understanding the learning ethos, preferred delivery methods and attitudes towards genetics of different NHS healthcare groups was vital. We collected evidence by undertaking needs assessments with educators, practitioners and patients. We have determined the genetics knowledge, skills and attitudes which they said were needed and translated these into learning outcomes and workforce competences in a continuum of education. Beginning with core concepts introduced (and examined) pre‐registration, the continuum continues with development of concepts post‐registration as appropriate for role, leading to practical application and assessment of competences in the workplace. These are supported by a portfolio of resources which draw heavily on patient based scenarios to demonstrate to staff that genetics is relevant to their work, and to convince educators and policy makers that genetic education is likely to result in real clinical benefit. A long term educational policy, inclusive of learners, educationalists and their institutions must be evidence based, flexible and responsive to changes in workforce structure, provision of clinical services and conceptual and financial commitments to education. The engagement of national policy, regulatory and professional bodies is vital (www.geneticseducation.nhs.uk).
Styrene Solubilization and Adsolubilization on an Aluminum Oxide Surface Using Linker Molecules and Extended Surfactants
Authors: Charoensaeng Ampira , Sabatini David A. , Khaodhiar Sutha
Published: February 2008

The impact of lipophilic linker and extended surfactant properties on admicelle formation and styrene adsolubilization were evaluated through adsorption and adsolubilization studies on aluminum oxide. While linker‐based systems achieved a higher maximum adsorption than extended surfactants, the extended surfactants reached maximum adsorption at a lower aqueous surfactant concentration. Results of solubilization and adsolubilization studies are summarized by the extent of solute solubilization into micelles and admicelles, as captured through the micellar partition coefficient, Kmic, and the admicellar partition coefficient, Kadm. The extended‐surfactant‐based micelles showed greater solubilization capacity than linker‐based micelles. Relative to the effect of the number of propoxy groups for extended surfactants with the same alkyl chain length, the results show that the solubilization capacity increases when the PO number increases for both C12,13‐ and C14,15‐based surfactant series. Thus, adsolubilization using extended‐surfactant‐based admicelles showed adsolubilization enhancement but required lower amounts of surfactants to form admicelles. These results thus provide insights into external and internal linker‐based and extended‐surfactant‐based admicellar systems and highlight the differences observed between them and admicelles based on conventional surfactant systems.
Possibilities of Fisherman’s Friend Type Lozenges Fortification with Omega‐3 LC PUFA by Addition of Microencapsulated Fish Oil
Authors: Kolanowski Wojciech , Weißbrodt Jenny
Published: February 2008

The aim of this study was to evaluate the influence of fish oil powder addition on sensory quality and oxidative stability of Fisherman’s Friend type lozenges. Microencapsulated fish oil (MFO) was used for lozenge formulation. Sensory quality of the moderate and strong mint flavored lozenges was not significantly affected by fish oil powder addition up to 60 and 80 g kg−1, respectively. Higher MFO addition resulted in significant reduction in the sensory quality and increases in fishy off‐flavor intensity. During 4 months of storage in air permeable packages, a gradual decrease in sensory quality and an increase in fishy off‐flavor were detected in lozenges containing MFO, which were more significant in moderately flavored than in strongly flavored ones. The peroxide value increased significantly during air storage. However, the peroxide value of vacuum stored samples increased slightly whereas sensory scores remained stable. A recommendation to pack and store the MFO lozenges under limited oxygen is suggested due to the low stability of the MFO product. A dose of 5 lozenges fortified with MFO might provide 40 mg of omega‐3 LC PUFA elevating its average level in the diet.
Second-order analysis for optimal control problems with pure state constraints and mixed control-state constraints
Authors: Bonnans J. Frédéric , Hermant Audrey
Published: February 2008

This paper deals with the optimal control problem of an ordinary differential equation with several pure state constraints, of arbitrary orders, as well as mixed control-state constraints. We assume (i) the control to be continuous and the strengthened Legendre–Clebsch condition to hold, and (ii) a linear independence condition of the active constraints at their respective order to hold. We give a complete analysis of the smoothness and junction conditions of the control and of the constraints multipliers. This allows us to obtain, when there are finitely many nontangential junction points, a theory of no-gap second-order optimality conditions and a characterization of the well-posedness of the shooting algorithm. These results generalize those obtained in the case of a scalar-valued state constraint and a scalar-valued control.

Dans cet article on s'intéresse au problème de commande optimale d'une équation différentielle ordinaire avec plusieures contraintes pures sur l'état, d'ordres quelconques, et des contraintes mixtes sur la commande et sur l'état. On suppose que (i) la commande est continue et la condition forte de Legendre–Clebsch satisfaite, et (ii) une condition d'indépendance linéaire des contraintes actives est satisfaite. Des résultats de régularité des solutions et multiplicateurs et des conditions de jonction sont donnés. Lorsqu'il y a un nombre fini de points de jonction, on obtient des conditions d'optimalité du second-ordre nécessaires ou suffisantes, ainsi qu'une caractérisation du caractère bien posé de l'algorithme de tir. Ces résultats généralisent les résultats obtenus dans le cas d'une contrainte sur l'état et d'une commande scalaires.
Non‐enzymatic fast repair of DNA oxidative damage might also exist in cells
Authors: Zhang Qi , Pan Jing , Zhao Chenyang , Wang Yuan , Jia Zhongjian , Zheng Rongliang
Published: February 2008

Many studies have shown that in a chemical system natural polyphenols can rapidly repair DNA oxidative damage. In this paper we report that in a cellular system the non‐enzymatic fast repair activities of two natural polyphenols might also exist. The viability of a Chinese hamster ovary cell line (AA8) highly expressing the XRCC1 gene (a DNA repairing protein) treated with H2O2 is significantly higher than that of a normal Chinese hamster ovary cell line (CHO). Following inhibition of the enzymatic repair system by different inhibitors—methoxyamine (MX), 3‐aminobenzamide (3AB) or nicotinamide (NIC)—DNA oxidative damage by H2O2 increased 2–5‐fold in both cell lines. However, when natural polyphenols—rosmarinic acid (RA) or verbascoside (VER)—were added, DNA oxidative damage was significantly reduced. This decrease of DNA oxidative damage by RA or VER is not due to their scavenging activity for reactive oxygen species (ROS) because cells suffered from heavy ROS throughout the whole experimental process. Therefore, the decrease of DNA damage might be due to their non‐enzymatic fast repair mechanisms. Further investigation showed that H2O2 induced a drop in the mitochondrial membrane potential (MMP), and that RA and VER were able to attenuate the drop. Previous studies have shown that H2O2 initiates a chain of events in cells, involving mtDNA damage, a drop in MMP and loss of repair activity. These results, taken together with our present results, suggest that the non‐enzymatic fast repair mechanism exists not only in chemical systems but also might exist in cells.
In vitro odontoblast‐like cell differentiation of cranial neural crest cells induced by fibroblast growth factor 8 and dentin non‐collagen proteins
Authors: Jiang Hong‐Bing , Tian Wei‐Dong , Liu Lai‐Kui , Xu Yan
Published: February 2008

During tooth development, cranial neural crest (CNC) cells represent a population of pluripotent stem cells that give rise to various dental tissues. This study aimed to investigate whether CNC cells could differentiate into odontoblast‐like cells by in vitro induction. CNC cells were isolated from explants of cranial neural tubes and cultured in serum‐free Dulbecco's modified Eagle's medium (DMEM)/F12 medium which contained fibroblast growth factor 8 (FGF8) and dentin non‐collagen proteins (DNCP). The initiation of controlled differentiation was determined using histological assays, and the expression of specific gene phenotypes was detected using immunocytochemical staining and reverse transcription—polymerase chain reaction (RT—PCR). The first branchial arch phenotype of the CNC cells demonstrated negative Hoxa2 expression and positive vimentin expression in the presence of 100 ng/ml FGF8. Following DNCP induction, the CNC cells became bipolar, demonstrated high alkaline phosphatase (ALP) activity, and formed mineralized nodules. In addition, the expression of DSPP, DMP1, and collagen type I confirmed the odontoblast phenotype. The results indicate that the tissue‐specific cellular differentiation (odontoblast‐like cells) of early‐stage embryonic‐derived cells (such as CNC cells) can be induced by adult extracellular matrix proteins (such as DNCP). CNC cells may be used as a valuable cell model for research on dental tissue differentiation and regeneration.
HALL'S CONDITION AND IDEMPOTENT RANK OF IDEALS OF ENDOMORPHISM MONOIDS
Authors: Gray R.
Published: February 2008

In 1990, Howie and McFadden showed that every proper two-sided ideal of the full transformation monoid $T_n$, the set of all maps from an $n$-set to itself under composition, has a generating set, consisting of idempotents, that is no larger than any other generating set. This fact is a direct consequence of the same property holding in an associated finite $0$-simple semigroup. We show a correspondence between finite $0$-simple semigroups that have this property and bipartite graphs that satisfy a condition that is similar to, but slightly stronger than, Hall's condition. The results are applied in order to recover the above result for the full transformation monoid and to prove the analogous result for the proper two-sided ideals of the monoid of endomorphisms of a finite vector space.
THE OPERATOR SHIFT SPACE
Authors: Oikhberg Timur
Published: February 2008

We construct and examine an operator space $X$, isometric to $\ell_2$, such that every completely bounded map from its subspace $Y$ into $X$ is a compact perturbation of a linear combination of multiples of a shift of given multiplicity and their adjoints. Moreover, every completely bounded map on $X$ is a Hilbert–Schmidt perturbation of such a linear combination.
SOME INEQUALITIES FOR THE GENERALIZED GRÖTZSCH FUNCTION
Authors: Zhang Xiaohui , Wang Gendi , Chu Yuming
Published: February 2008

For $a\in(0,\tfrac12]$ and $r\in(0,1)$, let $\mu_a(r)$ be the so-called generalized Grötzsch function which appears in Ramanujan's generalized modular equations. In this paper, several sharp inequalities for $\mu_a(r)$ are obtained and a conjecture on $\mu_a(r)$, which was presented by Qiu and Vuorinen in 1999, is proved.
ON THE ASPHERICITY OF LENGTH-6 RELATIVE PRESENTATIONS WITH TORSION-FREE COEFFICIENTS
Authors: Kim Seong Kun
Published: February 2008

An interesting result of Ivanov implies that a non-aspherical relative presentation that defines a torsion-free group would provide a potential counterexample to the Kaplansky zero-divisor conjecture. In this point of view, we prove the asphericity of the length-6 relative presentation $\langle H,x: xh_1xh_2xh_3xh_4xh_5xh_6\rangle$, provided that each coefficient is torsion free.
INEQUALITIES OF THE HILBERT TYPE IN $\mathbb{R}^{n}$ WITH NON-CONJUGATE EXPONENTS
Authors: Čižmešija Aleksandra , Perić Ivan , Vuković Predrag
Published: February 2008

In this paper we state and prove a new general Hilbert-type inequality in $\mathbb{R}^{n}$ with $k\geq2$ non-conjugate exponents. Using Selberg's integral formula, this result is then applied to obtain explicit upper bounds for the doubly weighted Hardy–Littlewood–Sobolev inequality and some further Hilbert-type inequalities for $k$ non-negative functions and non-conjugate exponents.
AN ANALYTICAL APPROACH TO HEAT KERNEL ESTIMATES ON STRONGLY RECURRENT METRIC SPACES
Authors: Hu Jiaxin
Published: February 2008

In this paper we prove that sub-Gaussian estimates of heat kernels of regular Dirichlet forms are equivalent to the regularity of measures, two-sided bounds of effective resistances and the locality of semigroups, on strongly recurrent compact metric spaces. Upper bounds of effective resistances imply the compact embedding theorem for domains of Dirichlet forms, and give rise to the existence of Green functions with zero Dirichlet boundary conditions. Green functions play an important role in our analysis. Our emphasis in this paper is on the analytic aspects of deriving two-sided sub-Gaussian bounds of heat kernels. We also give the probabilistic interpretation for each of the main analytic steps.
ON $m$-ACCRETIVE SCHRÖDINGER OPERATORS IN $L^1$-SPACES ON MANIFOLDS OF BOUNDED GEOMETRY
Authors: Milatovic Ognjen
Published: February 2008

Let $(M,g)$ be a manifold of bounded geometry with metric $g$. We consider a Schrödinger-type differential expression $H=\Delta_M+V$, where $\Delta_M$ is the scalar Laplacian on $M$ and $V$ is a non-negative locally integrable function on $M$. We give a sufficient condition for $H$ to have an $m$-accretive realization in the space $L^1(M)$.špace{-4pt}
SOME NEW IMMERSION RESULTS FOR COMPLEX PROJECTIVE SPACE
Authors: Davis Donald M.
Published: February 2008

We prove the following two new optimal immersion results for complex projective space. First, if $n\equiv3\,\Mod 8$ but $n\not\equiv3\,\Mod 64$, and $\alpha(n)=7$, then $CP^{n}$ can be immersed in $\mathbb{R}^{4n-14}$. Second, if $n$ is even and $\alpha(n)=3$, then $CP^n$ can be immersed in $\mathbb{R}^{4n-4}$. Here $\alpha(n)$ denotes the number of 1s in the binary expansion of $n$. The first contradicts a result of Crabb, which said that such an immersion does not exist, apparently due to an arithmetical mistake. We combine Crabb's method with that developed by the author and Mahowald.
DEMOGRAPHIC DECOMPOSITION OF THE MARRIAGE MARKET IN ENGLAND AND WALES 1911–1991
Authors: BHROLCHÁIN MÁIRE NÍ
Published: February 2008

A method for decomposing partner availability into its demographic components (preferences, previous birth trends, migration and mortality, and structure by marital status) is presented and applied to marriage market estimates for selected census years 1911–91 in England and Wales. Preferences are a key component at the youngest ages. The role of other factors varies by age and time period. Contrary to widespread assumption, variation in cohort sizes resulting from past fertility trends is not the dominant contributor to partner availability during this period. Mortality and migration effects tend to be larger than the effect of birth trends and the two marital status components are generally the largest in size. Determinants of intercensal change are similar to the cross-sectional picture. Reasons for the modest contribution of trends in annual births are discussed. Cohort effects on partner supply are not necessarily absent but could arise through a number of mechanisms.
RURAL, SUBURBAN AND URBAN DIFFERENCES IN THE SELF-DIAGNOSIS OF CORONARY HEART DISEASE IN THE UNITED STATES
Authors: JONES ANTWAN , GOZA FRANKLIN
Published: February 2008

This study explores rural, suburban and urban differences in coronary heart disease (CHD) using the 2005 Behavior Risk Factor Surveillance Survey conducted in the United States. Although areal context is not often considered in morbidity studies, this study evaluates the importance of place of residence given that areas offer differential access to health infrastructures and different contextual factors that could affect health. Also examined is the role of geographic heterogeneity on the recent racial divergence in CHD in the United States. Results indicate that area of residence is associated with CHD diagnosis, net of health and demographic variables. The area-stratified analysis documents that rural residents are most impacted by exercise and smoking, while being male or above age 50 are most detrimental for suburban residents. In addition, the racial divergence in CHD is driven by differences in rural locales. These findings indicate a disparate impact of geography on CHD and highlight the need for health research to take into account areal context.
A multi-modular approach to gradual change in grammaticalization
Authors: FRANCIS ELAINE J. , YUASA ETSUYO
Published: February 2008

Examining four constructions in three languages (English quantificational nouns, Japanese subordinating conjunctions, Cantonese coverbs, Japanese deverbal postpositions), this paper shows that semantic properties can change faster than syntactic properties in gradual processes of grammaticalization. In each of these cases, the syntactic properties of one category become associated with the semantic properties of a different category when an item undergoes semantic change, leading to the appearance of mixed categorial properties. We propose that this sort of change is best captured using a multi-modular framework (Sadock 1991, Yuasa 2005), which allows changes to affect semantics independently of syntax, and which shows clearly that the relevant items and constructions still conform to the separate structural constraints of syntax and semantics, despite the unusual combination of properties. These findings are important for theories of grammaticalization because they suggest that the cover term ‘decategorialization’ (the loss of grammatical properties associated with the source category) must be understood in terms of at least two separate processes: (1) the effects of semantic change on an item's distribution; and (2) the effects of frequency (Bybee & Hopper 2001) and Pressure for Structure–Concept Iconicity (Newmeyer 1998) on an item's syntactic categorization. Our case studies show that the first kind of decategorialization effects can occur even in the absence of the second kind. Implications of these findings, including possible reasons for both the instability and the long-term retention of mismatch constructions, are also considered.
Palatal nasal decomposition in Slovene, Upper Sorbian and Polish
Authors: RUBACH JERZY
Published: February 2008

This article investigates the types of palatal nasal decomposition from the perspective of three Slavic languages: Slovene, Upper Sorbian and Polish. The prepalatal nasal exhibits three different patterns of behaviour: retention, decomposition and depalatalization. Decomposition results in a cluster of the glide [j] and a nasal consonant. The details of this process are different in each of the three phonological systems considered, for instance, the process can yield either [jn] or [nj], and it can occur either in the onset or in the coda. Also the drivers for decomposition are different and include constraints defining permissible inventories as well as constraints governing assimilation. From the theoretical perspective, nasal decomposition raises the question of whetheridentconstraints should be bidirectional or unidirectional. It is concluded that the latter are indispensable.
Jamaat-i-Islami in Bangladesh: Women, Democracy and the Transformation of Islamist Politics
Authors: SHEHABUDDIN ELORA
Published: February 2008

This article argues that leaders of the Jamaat-i-Islami in Bangladesh regularly invoke women's privileged status as mothers to counter the claims of the largely secularist non-governmental organizations operating in the country today that Islam has been harmful to women and that the only route to progress is to discard the shackles of religion and tradition. The current Jamaat rhetoric marks a significant change from the original Jamaat position—elaborated by the party's founder Abul Ala Maududi—that women's divinely ordained place is in the home. Now, several decades later, Jamaat leaders in Bangladesh still enjoin women to fulfil domestic obligations; however, they also go to great lengths to highlight Islam's recognition of women as ‘individuals’ with ‘individual’ responsibilities to God and Islam as well as Islam's support for women's right to study, work and vote. I contend that the Jamaat in Bangladesh has been prompted to undertake these recent modifications by specific developments in local social and political contexts, specifically the twin pressures on the Jamaat of operating in a functioning, if often imperfect, democratic polity; and of competing with more secular organizations for the hearts, minds and votes of impoverished women.
Phylogenetic relationships amongEimeriaspp. (Apicomplexa, Eimeriidae) infecting rabbits: evolutionary significance of biological and morphological features
Authors: KVIČEROVÁ J. , PAKANDL M. , HYPŠA V.
Published: February 2008

Monophyly of all 11 validEimeriaspecies from rabbits (Oryctolagus cuniculusLinnaeus, 1758) was revealed based on nuclear 18S rDNA sequence data. This finding implies that these species, which vary considerably in terms of their morphology and biology, diversified on a single host or several closely related species. Phylogenetic analysis divided rabbitEimeriaspecies into 2 sister lineages, corresponding to the presence/absence of the oocyst residuum. Other morphological or biological traits (oocyst shape and size, presence/absence of oocyst inner structures, pathogenicity, infection site, pre-patent and patent periods, sporulation time, and number of asexual generations) do not explicitly correlate with the phylogeny of rabbit coccidia.
Finite-rank Bratteli–Vershik diagrams are expansive
Authors: DOWNAROWICZ TOMASZ , MAASS ALEJANDRO
Published: February 2008

The representation of Cantor minimal systems by Bratteli–Vershik diagrams has been extensively used to study particular aspects of their dynamics. A main role has been played by the symbolic factors induced by the way vertices of a fixed level of the diagram are visited by the dynamics. The main result of this paper states that Cantor minimal systems that can be represented by Bratteli–Vershik diagrams with a uniformly bounded number of vertices at each level (called finite-rank systems) are either expansive or topologically conjugate to an odometer. More precisely, when expansive, they are topologically conjugate to one of their symbolic factors.
Searching for and use of conference abstracts in health technology assessments: Policy and practice
Authors: Dundar Yenal , Dodd Susanna , Williamson Paula , Walley Tom , Dickson Rumona
Published: February 2008

Objectives:Current policy and practice regarding identification of and extent of use of data from conference abstracts in health technology assessment reviews (TARs) are examined.

Methods:The methods used were (i) survey of TAR groups to identify general policy and experience related to use of abstract data, and (ii) audit of TARs commissioned by the National Institute for Health and Clinical Excellence (NICE) and published between January 2000 and October 2004.

Results:Five of seven TAR groups reported a general policy that included searching for and including studies available as conference abstracts and presentations. A total of sixty-three published HTA reports for NICE were identified. Of these reports, thirty-eight identified at least one randomized controlled trial available as an abstract/presentation. Twenty-six (68 percent) of these thirty-eight TARs included studies available as abstracts.

Conclusions:There are variations in policy and practice across TAR groups regarding the searching for and inclusion of studies available as conference abstracts. There is a need for clarity and transparency for review teams regarding how abstract data are managed. If conference abstracts are to be included, reviewers need to allocate additional time for searching and managing data from these sources. Review teams should also be encouraged to state explicitly their search strategies for identifying conference abstracts, their methods for assessing these abstracts for inclusion and, where appropriate, how the data were used and their effect on the results.
Technology assessment and knowledge brokering: The case of assisted reproduction in The Netherlands
Authors: van Kammen Jessika , Jansen Carin W. , Bonsel Gouke J. , Kremer Jan A. M. , Evers Johannes L. H. , Wladimiroff Juriy W.
Published: February 2008

Objectives:Even when policy makers show interest and evidence-informed and convincing HTA studies are available, use of assessment products is not guaranteed. In this article, we report our experience with knowledge brokering to foster evidence-informed policy making on cost-effective treatment and reimbursement of assisted reproduction in The Netherlands.

Methods:From earlier work in the field of knowledge brokering, we foresaw the need for a deliberative strategy to manage the inherent tension between scientific rigor demanded by researchers and responsiveness to real-time needs demanded by policy makers. Therefore, we structured the process in three distinct steps: (i) agreement about the main messages from the research, (ii) analysis of the policy context and of the meaning of the main messages for the actors involved, and (iii) an invitational meeting to make recommendations for action.

Results:One of the recommendations that would require changes in ministerial policy was followed up instantly, whereas the other recommendation is still under debate. The Dutch Society of Obstetrics and Gynecology activated the revision of two guidelines. The patient organization uses the new scientific insights in informing members and the public. Closing the loop, The Netherlands Organisation for Health Research and Development (ZonMw) funded research to close knowledge gaps that became apparent in the process.

Conclusions:Knowledge brokering is a promising approach to bring HTA into practice. We conclude that the methodologies to feed research results into the policy process are still in an incipient stage and need further development.
Economics of tandem mass spectrometry screening of neonatal inherited disorders
Authors: Pandor Abdullah , Eastham Joe , Chilcott James , Paisley Suzy , Beverley Catherine
Published: February 2008

Objectives:The aim of this study was to evaluate the cost-effectiveness of neonatal screening for phenylketonuria (PKU) and medium-chain acyl-coA dehydrogenase (MCAD) deficiency using tandem mass spectrometry (tandem MS).

Methods:A systematic review of clinical efficacy evidence and cost-effectiveness modeling of screening in newborn infants within a UK National Health Service perspective was performed. Marginal costs, life-years gained, and cost-effectiveness acceptability curves are presented.

Results:Substituting the use of tandem MS for existing technologies for the screening of PKU increases costs with no increase in health outcomes. However, the addition of screening for MCAD deficiency as part of a neonatal screening program for PKU using tandem MS, with an operational range of 50,000 to 60,000 specimens per system per year, would result in a mean incremental cost of −£17,298 (−£129,174, £66,434) for each cohort of 100,000 neonates screened. This cost saving is associated with a mean incremental gain of 57.3 (28.0, 91.4) life-years.

Conclusions:Cost-effectiveness analysis using economic modeling indicates that substituting the use of tandem MS for existing technologies for the screening of PKU alone is not economically justified. However, the addition of screening for MCAD deficiency as part of a neonatal screening program for PKU using tandem MS would be economically attractive.
Genetic screening by DNA technology: A systematic review of health economic evidence
Authors: Rogowski Wolf
Published: February 2008

Objectives:The Human Genome Project has led to a multitude of new potential screening targets on the level of human DNA. The aim of this systematic review is to critically summarize the evidence from health economic evaluations of genetic screening in the literature.

Methods:Based on an extensive explorative search, an appropriate algorithm for a systematic database search was developed. Twenty-one health economic evaluations were identified and appraised using published quality criteria.

Results:Genetic screening for eight conditions has been found to be investigated by health economic evaluation: hereditary breast and ovarian cancer, familial adenomatous polyposis (FAP) colorectal cancer, hereditary nonpolyposis colorectal carcinoma (HNPCC), retinoblastoma, familial hypercholesterolemia, hereditary hemochromatosis, insulin-dependent diabetes mellitus, and cystic fibrosis. Results range from dominated to cost-saving. Population-wide genetic screening may be considered cost-effective with limited quality of evidence only for three conditions. The methodology of the studies was of varying quality. Cost-effectiveness was primarily influenced by mutation prevalence, genetic test costs, mortality risk, effectiveness of treatment, age at screening, and discount rate.

Conclusions:Health economic evidence on genetic screening is limited: Only few conditions have properly been evaluated. Based on the existing evidence, healthcare decision makers should consider the introduction of selective genetic screening for FAP and HNPCC. As genetic test costs are declining, the existing evaluations may warrant updating. Especially in the case of hereditary hemochromatosis, genetic population screening may be about to turn from a dominated to a cost-effective or even cost-saving intervention.
Economic evaluation of empirical antisecretory therapy versusHelicobacter pylorifor management of dyspepsia: A randomized trial in primary care
Authors: Jarbol Dorte Ejg , Bech Mickael , Kragstrup Jakob , Havelund Troels , de Muckadell Ove B. Schaffalitzky
Published: February 2008

Objectives:An economic evaluation was performed of empirical antisecretory therapy versus test forHelicobacter pyloriin the management of dyspepsia patients presenting in primary care.

Methods:A randomized trial in 106 general practices in the County of Funen, Denmark, was designed to include prospective collection of clinical outcome measures and resource utilization data. Dyspepsia patients (n=722) presenting in general practice with more than 2 weeks of epigastric pain or discomfort were managed according to one of three initial management strategies: (i) empirical antisecretory therapy, (ii) testing forHelicobacter pylori, or (iii) empirical antisecretory therapy, followed byHelicobacter pyloritesting if symptoms improved. Cost-effectiveness and incremental cost-effectiveness ratios of the strategies were determined.

Results:The mean proportion of days without dyspeptic symptoms during the 1-year follow-up was 0.59 in the group treated with empirical antisecretory therapy, 0.57 in theH. pyloritest-and-eradicate group, and 0.53 in the combination group. After 1 year, 23 percent, 26 percent, and 22 percent, respectively, were symptom-free. Applying the proportion of days without dyspeptic symptoms, the cost-effectiveness for empirical treatment,H. pyloritest and the combination were 12,131 Danish kroner (DKK), 9,576 DKK, and 7,301 DKK, respectively. The incremental cost-effectiveness going from the combination strategy to empirical antisecretory treatment orH. pyloritest alone was 54,783 DKK and 39,700 DKK per additional proportion of days without dyspeptic symptoms.

Conclusions:Empirical antisecretory therapy confers a small insignificant benefit but costs more than strategies based on test forH. pyloriand is probably not a cost-effective strategy for the management of dyspepsia in primary care.
Health economic evaluation in Greece
Authors: Rovithis Dimitrios
Published: February 2008

Objectives: There is a growing volume of literature on health economic evaluation, with this form of analysis becoming increasingly influential at the decision-making level worldwide. The purpose of this study was to review the current state of health economic evaluation in Greece, with a view to uncovering reasons why its use in this country is limited.

Methods: A search of the NHS Economic Evaluation Database was undertaken. The search included cost, cost-of-illness, cost-minimization, cost-effectiveness, cost-consequences, cost-utility, and cost-benefit analyses and was narrowed only to Greek authors undertaking solo or joint health economic evaluation in Greece.

Results: The search revealed that, in Greece, very little health economic evaluation has been undertaken. The main reason for the lack of interest is that the current chaotic healthcare system structure and financing does not provide the appropriate incentives to stimulate a powerful interest in this type of research. This condition is a result of the lack of a long-term national health policy and the hesitation of the present and past Greek governments to date to proceed to large-scale reforms because of political considerations. The Greek governments have also been content with the good health indicators being achieved.

Conclusions: Even if it is accepted that good health prevails in Greece, slower economic growth rates, an ageing population, and the continuous immigration will place increasing pressure on healthcare resources and will necessitate a more rational use of these resources. Health economic evaluation, by weighing benefits against costs, therefore, has an important role to play.
Cost-effectiveness analysis of strategies for HER2 testing of breast cancer patients in France
Authors: Morelle Magali , Haslé Elodie , Treilleux Isabelle , Michot Jean-Philippe , Bachelot Thomas , Penault-Llorca Frédérique , Carrère Marie-Odile
Published: February 2008

Objectives: A cost-effectiveness analysis was conducted comparing diagnostic strategies for determining the HER2 status of invasive breast carcinomas, as an indication for trastuzumab at metastatic relapse.

Methods: A decision tree compared five strategies distinguished by (i) the use of immunohistochemical (IHC) and/or fluorescent in situ hybridization (FISH) techniques, and (ii) the test schedule (at initial diagnosis or metastatic relapse). Most cost and effectiveness data came from a French multicentric study of 2,045 patients from eight hospitals. We were not able to select final criteria for trastuzumab effectiveness, because published data rely on IHC techniques not used in France (i.e., HercepTest). We, therefore, selected two intermediate criteria for inappropriate treatment at relapse, that is, patients with HER2-amplified tumors not receiving trastuzumab (Criterion 1) and HER2-nonamplified tumors improperly treated with trastuzumab (Criterion 2). Sensitivity analyses were then performed to assess the robustness of the results to (i) discount rate, (ii) cost of FISH, and (iii) tissue fixation technique.

Results: The strategy using IHC at diagnosis was dominated by the four other strategies. Among these approaches, the only efficient strategy for both criteria was IHC used alone at metastatic relapse; strategies using FISH, or IHC followed by FISH on IHC2+ cases were efficient for Criterion 1, whereas IHC followed by FISH on IHC2+ and 3+ cases was efficient for Criterion 2.

Conclusions: Determining HER2 status at diagnosis, as an indication for trastuzumab at metastatic relapse, incurs substantial incremental costs, which do not appear to be justified. No other strategy can be excluded at first.
Short Note: An ibis-like bird from the Upper La Meseta Formation (Late Eocene) of Seymour Island, Antarctica
Authors: Jadwiszczak Piotr , GaŹdzicki Andrzej , Tatur Andrzej
Published: February 2008

Ibises are a group of medium- to large-sized, mainly wading birds in the family Threskiornithidae (Aves: Ciconiiformes; see also discussion in Mayr 2002). They are known from all the continents except Antarctica, though one species breeds as far south as Tierra del Fuego (del Hoyoet al.1992, p. 499). The oldest fossil bones (including skull elements) attributed to ibises are those ofRhynchaeites messelensisWittich, 1898 from the Middle Eocene of Messel, Germany (Peters 1983, Mayr 2002). Another supposed member of this group is the Pondaung bird from the late Middle Eocene of Myanmar (formerly Burma) represented solely by an incomplete tibiotarsus (Stidhamet al.2005, fig. 2). The taxonomic position ofMinggangia changgouensisHou, 1982 from the Late Eocene of China (Hou 1982) was recently questioned by Stidhamet al.(2005, p. 183). Here, we present a partial bill from the Eocene La Meseta Formation (Seymour Island, Antarctica) which most closely resembles that of ibises.
Growth form and population genetic structure ofAzorella selagoon sub-Antarctic Marion Island
Authors: Mortimer Elizabeth , McGeoch Melodie A. , Daniels Savel R. , Vuuren Bettine Jansen van
Published: February 2008

Seven community complexes have been described across sub-Antarctic Marion Island, amongst these fellfield that comprise low plant cover dominated byAzorella selagoHook. f.Azorellais considered a keystone species since it forms nutrient rich environments for microarthropod communities and epiphytic plants. Two distinct growth forms typifyAzorella, namely discrete cushions and continuous mats. Whether these continuous mats normally consist of a single large cushion individual, or whether several individual plants merge, interdigitating to form a continuous area, remains unclear. As such, it is important to obtain some measure ofAzorellagrowth dynamics before embarking on phylogeographic studies. Previous genetic studies indicated that several microarthropod species are significantly substructured across Marion Island, but it remains unclear whether similar subdivisions characterizeAzorella. We used chloroplast sequence data (trnH-psbA) and amplified fragment length polymorphism (AFLP) to investigate these questions. No sequence variation characterized thetrnH-psbA region inAzorellaacross Marion Island. In contrast, the AFLP results indicated that anA. selagomat comprises multiple individuals. We argue that mats can be formed through at least two processes namely fragmentation, where parts of the cushion plant die off creating open areas for the establishment of different individuals and/or high density of interdigitating individuals merging to form the mat. Fragment data further indicated significant substructure forAzorellaacross Marion Island (FST = 0.101,P = 0.01) and we attribute this to past vicariance.
Mammalian target of rapamycin (mTOR) pathway signalling in lymphomas
Authors: Drakos Elias , Rassidakis George Z. , Medeiros L. Jeffrey
Published: February 2008

The mammalian target of rapamycin mTOR is a central element in an evolutionary conserved signalling pathway that regulates cell growth, survival and proliferation, orchestrating signals originating from growth factors, nutrients or particular stress stimuli. Two important modulators of mTOR activity are the AKT and ERK/MAPK signalling pathways. Many studies have shown that mTOR plays an important role in the biology of malignant cells, including deregulation of the cell cycle, inactivation of apoptotic machinery and resistance to chemotherapeutic agents. The development of several mTOR inhibitors, in addition to rapamycin, has facilitated studies of the role of mTOR in cancer, and verified the antitumour effect of mTOR inhibition in many types of neoplasms, including lymphomas. Clinical trials of rapamycin derivatives in lymphoma patients are already in development and there are encouraging preliminary results, such as the substantial response of a subset of mantle cell lymphoma patients to the rapamycin analogue temsirolimus. Based on results obtained from in vitro and in vivo studies of the mTOR pathway in lymphomas, it seems that better understanding of mTOR regulation will reveal aspects of lymphomagenesis and contribute to the development of more powerful, targeted therapies for lymphoma patients.
Indications for the sentinel node: multicentric, size of tumor, prior surgery
Authors: Hanker L. C. , Rody A. , Ruckhaeberle E. , Kaufmann M.
Published: February 2008

Sentinel lymph node biopsy (SLNB) has been adopted as an applicable alternative to the standard axillary lymph node dissection (ALND) level I and II. It makes possible a less extensive axillary surgery in patients with early breast cancer with negative lymph node, who would not benefit from further dissection, in order to prevent unnecessary morbidity. On the other hand, SLNB is not appropriate in every clinical circumstance. In some clinical situations like tumor size T1 and T2, SLNB is, meanwhile, regarded as a standard procedure. In other settings like increased age and body mass index, pregnancy, ductal carcinoma in situ (DCIS), neoadjuvant chemotherapy, advanced disease (T3 and T4), prior surgery and multifocal/multicentric disease, there is a controversial debate about the importance of SLNB. This article reviews the absolute and relative contraindications of this procedure in respect to the latter three clinical situations.

For the advanced breast cancers T3 and T4, there seems to be an increasing evidence of an acceptable accuracy, although it should be further evaluated in randomized clinical trials (RCT). The indication of SLNB in previously operated patients depends on the type of prior surgery. A diagnostic biopsy does not represent a contraindication, whereas the sentinel node biopsy should not be used after an extensive breast surgery neither in the context of oncologic nor non-oncologic purposes. In the context of multicentric disease, there is growing evidence that SLNB is suitable, but actually it should be restricted to RCT. However, the multifocal disease is only a relative contraindication, that is it could be applied in well-selected patients.