bluuebunny/crossref_metadata_2025 huggingface dataset:
The NIDA Methamphetamine Clinical Trials Group: a strategy to increase clinical trials research capacity
Authors: Elkashef Ahmed , Rawson Richard A. , Smith Edwina , Pearce Valerie , Flammino Frank , Campbell Jan , Donovick Roger , Gorodetzky Charles , Haning William , Mawhinney Joseph , McCann Michael , Weis Dennis , Williams Lorie , Ling Walter , Vocci Frank
Published: February 2007

Aims  In order to increase the number of investigative teams and sites conducting research on pharmacological treatments for methamphetamine use disorders, the National Institute on Drug Abuse (NIDA) established an infrastructure of clinical sites in areas where methamphetamine addiction is prevalent. This multi‐site infrastructure would serve to run multiple Phases II and III protocols effectively and expeditiously.

Methods  NIDA collaborated with investigators from the University of California at Los Angeles (UCLA) to set up the Methamphetamine Clinical Trials Group (MCTG). This paper describes the development process, as well as data from a test trial to assess the capability of research‐naive sites to recruit research participants and conduct study procedures according to research protocol. Subsequent trials are also described.

Results  A total of 151 candidates signed consent; 65 individuals were enrolled and 35 (53.8%) completed the 12 weeks' behavioral trial. Self‐reported substance use report (SUR) showed comparable use of methamphetamine across sites with the individual site means ranging from 59% (site 5) to 80% (site 3). Drug use as measured by urinalysis was greatly reduced at week 13 compared to the baseline measure; the average rate of methamphetamine‐free urine samples across all participants in sites at week 13 was 53%. The highest percentage of methamphetamine‐free samples was 85% at site 5; the lowest was at site 1 (40%). Addiction severity index (ASI) composite scores at baseline and protocol completion for all participants demonstrated improvement in all categories over time, except for the medical composite score. The largest composite score reduction in baseline‐protocol completion was in the drug domain (0.23 versus 0.15). The changes in the ASI scores from baseline to week 13 were consistent across all five sites.

Conclusions  Outcomes of the behavioral trial indicated that the MCTG recruited well; collected study data accurately and reliably; and created a vehicle that can assess promising pharmacotherapies for methamphetamine addiction treatment medications. The MCTG strategy appears to be a feasible approach to increase NIDA's capacity to conduct clinical trials to evaluate potential pharmacotherapies for methamphetamine addiction.
Spatial dynamics of an invasive bird species assessed using robust design occupancy analysis: the case of the Eurasian collared dove (Streptopelia decaocto) in France
Authors: Eraud Cyril , Boutin Jean‐Marie , Roux Denis , Faivre Bruno
Published: February 2007

Aim The study of the spatial dynamics of invasive species is a key issue in invasion ecology. While mathematical models are useful for predicting the extent of population expansions, they are not suitable for measuring and characterizing spatial patterns of invasion unless the probability of detection is homogeneous across the distribution range. Here, we apply recently developed statistical approaches incorporating detection uncertainty to characterize the spatial dynamics of an invasive bird species, the Eurasian collared dove (Streptopelia decaocto).

Location France.

Methods Data on presence/absence of doves were recorded from 1996 to 2004 over 1045 grid cells (28 × 20 km) covering the entire country. Each grid cell included five point counts spaced along a route, which was visited twice a year, allowing for an estimation of detection probability. Each route was assigned to one of six geographical regions. We used robust design occupancy analysis to assess spatial and temporal variation in parameters related to the spatial dynamics of the species. These parameters included occupancy rate, colonization and local extinction probabilities. Our inference approach was based on the selection of the most parsimonious model among competitive models parametrized with conditional probabilities.

Results The probability of detecting the presence of doves on a given route was high. However, we found evidence to incorporate detection uncertainty in inference processes about spatial dynamics, since detection probability was neither perfect (i.e. it was < 1), nor constant over space and time. Results showed a clear positive trend in occupancy rate over the study period, increasing from 55% in 1996 to 76% in 2004. In addition, occupancy rate differed among regions (range: 37–79%) and further analysis showed that colonization probability by region was positively related to occupancy rate. Finally, local extinction probability was lower than colonization probability and showed a tendency to decrease over the study period.

Main conclusions Our results emphasize the importance of estimating detection probabilities in order to draw proper inferences about the spatial and temporal dynamics of the invasion pattern of the collared dove. In contrast to the perceived spatial dynamics from national atlas surveys, we provide evidence that the range of this species is currently increasing in France. Other results, such as regional specificity in colonization probabilities and time variation in local extinction are consistent with expectations from invasion and metapopulation theory.
Identifying the most efficient items from the Mini‐Mental State Examination for cognitive function assessment in older Taiwanese patients
Authors: Lou Meei‐Fang , Dai Yu‐Tzu , Huang Guey‐Shiun , Yu Po‐Jui
Published: February 2007

Aims.  The purpose of the study was to identify the most efficient items from the Mini‐Mental State Examination for assessment of cognitive function.

Background.  The Mini‐Mental State Examination is the most frequently used cognitive screening instrument. However, the Mini‐Mental State Examination has been criticized for insensitivity to mild cognitive dysfunction, limited memory assessment and variability in level of difficulty of the individual items.

Method.  This study used secondary data analysis. Item response theory two‐parameter model was used to analyse the data from the admission assessment of mental status by the Mini‐Mental State Examination for 801 patients.

Results.  By using item response analysis, 16 items were selected from the original 30‐item Mini‐Mental State Examination. The 16 items included mainly the measures of orientation, recall and attention and calculation. The internal consistency of the 16‐item Mini‐Mental State Examination was 0·84. The proposed new cut‐off point for the 16‐item Mini‐Mental State Examination was 11. The correct classification rate was 0·94, the sensitivity was 100% and the specificity was 97·4%, when compared with the original 30‐item Mini‐Mental State Examination from the cut‐off point of 24. This new cut‐off point was determined for the purpose of over‐identifying patients at risk so as to ensure early detection of and prevention from the onset of cognitive disturbance.

Conclusion.  Only a few items are needed to describe the subject's cognitive status. Using item response theory analysis, the study found that the Mini‐Mental State Examination could be simplified.

Relevance to clinical practice.  Deleting the items with less variation makes this assessment tool not only shorter, easier to administer and less strenuous for respondents, but also enables one to maintain validity as a cognitive function test for clinical setting.
Design and construction of a new temperature‐controlled chamber for light and confocal microscopy under monitored conditions: biological application for plant samples
Authors: BUCHNER O. , LÜTZ C. , HOLZINGER A.
Published: February 2007

A new light microscope–temperature‐controlled chamber (LM–TCC) has been constructed. The special feature of the light microscope–temperature‐controlled chamber is the Peltier‐element temperature control of a specimen holder for biological samples, with a volume capacity of 1 mL. This system has marked advantages when compared to other approaches for temperature‐controlled microscopy. It works in a temperature range of −10°C to +95°C with an accuracy of ±0.1°C in the stationary phase. The light microscope–temperature‐controlled chamber allows rapid temperature shift rates. A maximum heating rate of 12.9°C min−1 and a maximum cooling rate of 6.0°C min−1 are achieved with minimized overshoots (≤1.9°C). This machinery operates at low cost and external coolants are not required. Especially with samples absorbing irradiation strongly, temperature control during microscopy is necessary to avoid overheating of samples. For example, leaf segments of Ficaria verna exposed to 4500 μmol photons m−2 s−1 in a standard microscopic preparation show a temperature increase (δT) of 18.0°C, whereas in the light microscope–temperature‐controlled chamber this is reduced to 4°C. The kinetics of microscope‐light induced δT are described and infrared thermography demonstrates the dissipation of the temperature. Chloroplasts of the cold adapted plant Ranunculus glacialis show the tendency to form stroma‐filled protrusions in relation to the exposure temperature. The relative number of chloroplasts with protrusions is reduced at 5°C when compared to 25°C. This effect is reversible. The new light microscope–temperature‐controlled chamber will be useful in a wide range of biological applications where a rapid change of temperature during microscopic observations is necessary or has to be avoided allowing a simulation of ecologically relevant temperature scenarios.
PRECLINICAL STUDY: Evidence for the role of dopamine D3receptors in oral operant alcohol self‐administration and reinstatement of alcohol‐seeking behavior in mice
Authors: Heidbreder Christian A. , Andreoli Michela , Marcon Cristina , Hutcheson Daniel M. , Gardner Eliot L. , Ashby Charles R.
Published: February 2007

The present study examined the effects of the acute intraperitoneal (i.p.) administration of the selective dopamine (DA) D3receptor antagonist SB‐277011A (10, 20 or 30 mg/kg i.p.) on the oral operant self‐administration of alcohol in male C57BL/6N mice. These effects were compared with those of naltrexone (0.5, 1 and 2 mg/kg i.p.) and acamprosate (100, 200 and 400 mg/kg i.p.). Compared with vehicle, the acute administration of SB‐277011A (10 or 20 mg/kg) did not significantly alter the operant self‐administration of alcohol, whereas the 30 mg/kg dose significantly reduced alcohol intake (g/kg), the number of reinforcers, and the number of active lever presses. The oral self‐administration of alcohol was not significantly altered by the acute administration of either naltrexone or acamprosate, compared with vehicle‐treated mice. SB‐277011A, naltrexone and acamprosate were also tested in a model of drug/cue‐triggered reinstatement of alcohol‐seeking behavior. In this model, neither naltrexone (2 mg/kg) nor acamprosate (400 mg/kg) prevented relapse to alcohol‐seeking behavior. In contrast, SB‐277011A significantly reduced reinstatement of alcohol seeking in a dose‐dependent manner. Provided these results can be extrapolated to humans, they suggest that selective DA D3receptor antagonists may be useful in the pharmacotherapeutic management of alcohol intake and prevention of relapse to alcohol‐seeking behavior.
Head‐to‐head comparison of retropubic, perineal and laparoscopic radical prostatectomy
Authors: Schmeller Nikolaus , Keller Hansjörg , Janetschek Günter
Published: February 2007

Objective:  As more patients are diagnosed with prostate cancer at an early stage, it is becoming increasingly important to refine the technique of surgical excision. For this purpose we have generated objective data comparing three different surgical approaches used by three experienced surgeons.

Methods:  We prospectively compared three contemporary personal series of 50 consecutive radical prostatectomy (RP) patients. The health‐related quality of life was evaluated preoperatively and in months 1, 3, 6, 12 and 24.

Results:  Considering in turn the patients undergoing retropubic, perineal and laparoscopic RP, the median procedure time was 2 h and 27 min, 1 h and 50 min and 4 h, with a transfusion rate of 2, 0 and 8%, respectively. In the perineal group there were more wound infections. Median catheter drainage was 7, 10 and 7 days and zero, 13 and one patients needed reinsertion of a catheter. Early continence varied considerably, with 57.4, 11.4 and 6.3% of patients pad‐free after 1 month, but there were no differences in social continence (zero or one pad) with 97.8, 97.8 and 91.9% after 2 years. The Litwin score for incontinence (preoperative minus postoperative) was −24, −41 and −63% after 1 month and −13, +3 and −29% after 2 years. Twenty‐nine, five and 15 patients had a preoperative five‐item version of International Index of Erectile Function (IIEF‐5) score of ≥17 points and a nerve‐sparing procedure. After 2 years, 48.1, 0 and 0% had an IIEF‐5 score of ≥17 points without the use of phosphodiesterase type 5 (PDE‐5) inhibitors, but when including patients using inhibitors there were no significant differences.

Conclusions:  A comparison of morbidity, short‐term convalescence and long‐term side‐effects of different surgical techniques is strongly biased by both the preoperative status of patients and the skill of the surgeons. Overall, we found some differences in the short‐term results (e.g. early continence) and comparable long‐term results.
ENDOLUMINAL GASTROPLICATION FOR GASTROESOPHAGEAL REFLUX APPEARING AFTER GASTRIC SURGERY
Authors: Idani Hitoshi , Ishikawa Takashi , Iwamoto Takayuki , Watanabe Shinichiro , Ukida Minoru
Published: February 2007

Endoluminal gastroplication (ELGP) is a new endoscopic treatment for gastroesophageal reflux disease (GERD). However, its efficacy has been reported only for primary GERD but not for postoperative GERD. Here we report the first two cases of GERD that appeared after gastric surgery and were successfully treated by ELGP. Both patients developed GERD after gastric surgery. Esophagogastrofiberscopy showed esophagitis and small hiatal hernia. The symptoms failed to disappear after medical therapy and ELGP was performed. ELGP involved the use of the BARD (EndoCinchTM) endoscopic suturing system, where two to three plications were placed at the esophagogastric junction. Procedure time, start of soft diet and hospital stay were 55 min, the first postoperative day (POD), 5 days and 60 min, 1 POD and 5 days, for patients 1 and 2, respectively. No adverse events were noted apart from mild and transient epigastric pain. The GERD‐related symptoms markedly improved after ELGP. Improvements were also noted in acid exposure time and bile reflux time after the procedure. ELGP is safe and effective for GERD that develops after surgery although this needs to be confirmed in long‐term follow‐up studies. ELGP is potentially suitable for GERD after Billroth‐I distal gastrectomy with lymph node dissection for gastric cancer.
Tumour budding at invasive margins and outcome in colorectal cancer
Authors: Kanazawa H. , Mitomi H. , Nishiyama Y. , Kishimoto I. , Fukui N. , Nakamura T. , Watanabe M.
Published: February 2007

Objective  Tumour budding, defined as small clusters of undifferentiated cancer cells at invasive margins, has been shown to reflect biologic aggressiveness of colorectal cancers. We therefore examined the prognostic significance of tumour budding in patients with colorectal carcinoma, particularly focusing on comparisons with other clinicopathological findings.

Method  Tumour budding was investigated in surgically resected specimens from 159 patients with colorectal carcinoma. With haematoxylin and eosin stained slides containing the entire invasive margin, the degree of tumour budding was classified into three grades: mild, <1/3 of the entire invasive margin; moderate, 1/3–2/3; marked, >2/3.

Results  Mild tumour budding was found in 54 (34%) cases, moderate in 59 (37%) cases and marked in 46 (29%) cases. The degree of budding was linked with poor tumour differentiation, lymph node metastasis and advanced TNM stage (P < 0.001). In univariate analysis, patients with marked tumour budding [5‐year cancer‐related survival (CRS)/recurrence‐free survival (RFS), 39%/53%] had significantly worse survival [CRS, hazard ratio (HR), 4.561; 95% confidence interval (CI), 2.265–9.184; P < 0.001; RFS, HR, 3.240; 95% CI, 1.430–7.342; P = 0.005] than those with mild (5‐year CRS/RFS, 80%/82%) or moderate (63%/66%) budding. In the Cox regression model, marked tumour budding (HR, 3.137; 95% CI, 1.517–6.487; P = 0.002) and advanced tumour stage (stage III, HR, 3.226; 95% CI, 1.475–7.053; P = 0.003; stage IV, HR, 24.443; 95% CI, 10.843–55.100; P < 0.001) proved to be an independent predictor of short CRS.

Conclusion  Tumour budding is a practical and significant histological index for identification of high malignant potential and poor outcome in patients with colorectal carcinoma.
Workaholism, Burnout, and Work Engagement: Three of a Kind or Three Different Kinds of Employee Well‐being?
Authors: Schaufeli Wilmar B. , Taris Toon W. , Van Rhenen Willem
Published: February 2007

The present study investigated in a sample of 587 telecom managers whether workaholism, burnout, and work engagement—the supposed antipode of burnout—can be distinguished empirically. These three concepts were measured with existing, validated multi‐dimensional questionnaires. Structural equation modeling revealed that a slightly modified version of the hypothesised model that assumed three distinct yet correlated constructs—burnout, engagement, and workaholism—fitted the data best. Multiple regression analyses revealed that these three concepts retained unique hypothesised patterns of relationships with variables from five clusters representing (1) long working hours, (2) job characteristics, (3) work outcomes, (4) quality of social relationships, and (5) perceived health, respectively. In sum, our analyses provided converging evidence that workaholism, burnout, and engagement are three different kinds of employee well‐being rather than three of a kind.

La présente étude examine auprès d’un échantillon de 587 cadres des télécommunications la question de savoir si l’addiction au travail, le burnout et l’engagement au travail—supposé l’inverse du burnout—peuvent être distingués empiriquement. Ces trois concepts sont mesurés à partir de questionnaires multi‐dimensionnels existants et validés. La modélisation d’équation structurale indique qu’une version légèrement modifiée du modèle testé selon lequel le burnout, l’engagement au travail et l’addiction au travail sont trois formes distinctes bien que corrélées du bien‐être, rend mieux compte des résultats. Des analyses de régression multiples montrent que ces trois concepts renvoient à des modèles de relations supposés uniques entre les variables des cinq groupes suivants: 1) le nombre d’heures travaillées, 2) les caractéristiques du travail, 3) les résultats du travail, 4) la qualité des relations sociales et 5) la santé perçue. En conclusion, les analyses montrent de façon convergente que l’addiction au travail, le burnout et l’engagement au travail sont trois formes différentes de bien‐être des employés plutôt que trois facettes du bien‐être.
Fluctuating prostate‐specific antigen levels in patients with initial negative biopsy: should we be reassured?
Authors: Celhay Olivier , De La Taille Alexandre , Salomon Laurent , Doré Bertrand , Irani Jacques
Published: February 2007

OBJECTIVE

To evaluate whether the risk of having a positive repeat prostate biopsy is lower in patients with fluctuating prostate‐specific antigen (PSA) levels than in patients with a steady or steadily increasing PSA level.

PATIENTS AND METHODS

Files were extracted from the 2000–2003 databases of two teaching hospitals; 191 patients who had a first negative biopsy followed by one or more sets of biopsies and at least two PSA measurements were included. A ‘fluctuating PSA level’ in a patient was defined as a PSA series including at least one PSA value lower than the one immediately preceding it.

RESULTS

The median PSA level at the first biopsy was 7 ng/mL, while that for the second, third and fourth biopsies were 8.0, 8.0 and 8.7 ng/mL, respectively. The median time between the first and second, and the second and third PSA tests was 290 and 317 days, respectively. Prostate cancer was eventually detected in 53 men (27.7%) in whom 39 it was at the first repeat biopsy. Among the 79 patients with a fluctuating PSA level, 17 (22%) had prostate cancer, vs 36 (32%) among the 112 with a ‘steady’ PSA level; the difference was not significant (P = 0.14). When considering the 53 patients diagnosed with prostate cancer, the 17 with a fluctuating PSA level and the 36 others had no significant difference in age, T stage, first PSA level and Gleason score.

CONCLUSION

In the present study, by contrast with the common and unfounded view, the risk of having a positive repeat prostate biopsy was no lower in men with a fluctuating PSA level than in those with a steady or steadily increasing PSA level. The practical and economical implications warrant further studies to confirm these findings.
Nurturing and growing innovative start‐ups: the role of policy as integrator
Authors: Clarysse Bart , Bruneel Johan
Published: February 2007

Nurturing and growing innovative start‐ups have become an important point on the political agenda. After the dotcom bubble, however, many financial schemes and incubation initiatives initiated, in the mid‐nineties, were cancelled or down scaled. There was a consensus that innovative start‐ups need more than just money. Networking and coaching were identified as additional needs. Besides this, there is a change in the intensity and nature of these needs during the different stages of the early life cycle. In this paper we make an in‐depth study of three approaches to nurture and grow innovative start‐ups. Each of these initiatives embeds in a very different national innovation system: Chalmers Innovation in Sweden and Anvar/Banque de Développement des PMEs in France, and Sitra's PreSeed Service in Finland. Each approach is compared in terms of its financing, networking, and coaching support, along the different stages of the start‐up's life cycle.
THE ILLIBERALITY OF ‘LIBERAL EUGENICS’
Authors: Fox Dov
Published: February 2007

This essay evaluates the moral logic of ‘liberal eugenics’: the ideal of genetic control which leaves decisions about what sort of people to produce in the hands of individual parents, absent government intervention. I argue that liberal eugenics cannot be justified on the basis of the underlying liberal theory which inspires it. I introduce an alternative to Rawls's social primary goods that might be called natural primary goods: hereditable mental and physical capacities and dispositions that are valued across a range of projects and pursuits. I suggest that reproductive genetic biotechnologies like embryo selection, cellular surgery, and genetic engineering, which aim to enhance ‘general purpose’ traits in offspring are less like childrearing practices a liberal government leaves to the discretion of parents than like practices the state makes compulsory. I argue that if the liberal commitment to autonomy is important enough for the state to mandate childrearing practices such as health care and basic education, that very same interest is important enough for the state to mandate safe, effective, and functionally integrated genetic practices that act on analogous all‐purpose traits such as resistance to disease and general cognitive functioning. I conclude that the liberal case for compulsory eugenics is a reductio against liberal theory.
WHY NO COMPROMISE IS POSSIBLE
Authors: TÄNNSJÖ TORBJÖRN
Published: February 2007

Abstract: Adherents of different moral views hold conflicting views on the permissibility of embryonic stem cell research. Pace Ronald Dworkin, no liberal compromise is possible. Whichever way the decision goes, some people will be deeply hurt and feel that basic moral principles are being flouted. And yet, when a majority exists in defence of such research, it should not hesitate to allow it.
Solidarity towards immigrants in European welfare states
Authors: van Oorschot Wim
Published: February 2007

The concern that immigration could threaten the sustainability of the European Social Model is a reason to have a closer look at popular images of immigrants in the context of European welfare states. The focus is on Europeans’ informal solidarity towards immigrants relative to other vulnerable groups in society. Using data from the European Values Survey 1999/2000 we find that in all European countries the public is least solidaristic towards migrants, in comparison with elderly people, sick and disabled people and unemployed people. Contrary to expectation, there is little relation between welfare state characteristics and people's solidarity, while the relative solidarity towards immigrants is higher in culturally more diverse countries. As expected, the relative solidarity towards immigrants is lower in countries with a more negative opinion climate towards immigrants and in poorer countries of Europe.
Labelling genetically modified food products: consumers’ concern in the United Kingdom
Authors: Rimal Arbindra , Moon Wanki , Balasubramanian Siva
Published: February 2007

An online survey method was used to collect data regarding the concern and attitude of UK consumers towards genetically modified (GM) food labelling. Questionnaires were sent to 9000 participants of the online panel via emails, and 2568 consumers completed the online survey. The response rate was 29%. This study found that more than 75% of the consumers questioned were concerned about the labelling of food products with GM ingredients. Eight perceived risks and benefits of agro‐biotechnology were identified to be associated with consumers’ attitude towards GM food labelling. Among them, three were perceived benefits, such as reduced use of chemicals in crop production, improved nutritional content, and increased yields. The five perceived risks were health risks, environmental risks, moral considerations, image of multinational corporations as the primary beneficiaries of biotechnology, and growing control of multinational corporations over farming. While all five perceived risks from GM food played a statistically significant role in shaping the overall attitude towards GM labelling, improved nutritional content due to application of biotechnology was the only benefit that was statistically significant. Age of the respondents was the only demographic variable playing a statistically significant role in shaping the attitude of respondents towards GM food labelling. Older respondents were more likely to be concerned about the existing GM labelling practices than younger respondents.
Calcium and neurodegeneration
Authors: Mattson Mark P.
Published: February 2007

When properly controlled, Ca2+ fluxes across the plasma membrane and between intracellular compartments play critical roles in fundamental functions of neurons, including the regulation of neurite outgrowth and synaptogenesis, synaptic transmission and plasticity, and cell survival. During aging, and particularly in neurodegenerative disorders, cellular Ca2+‐regulating systems are compromised resulting in synaptic dysfunction, impaired plasticity and neuronal degeneration. Oxidative stress, perturbed energy metabolism and aggregation of disease‐related proteins (amyloid β‐peptide, α‐synuclein, huntingtin, etc.) adversely affect Ca2+ homeostasis by mechanisms that have been elucidated recently. Alterations of Ca2+‐regulating proteins in the plasma membrane (ligand‐ and voltage‐gated Ca2+ channels, ion‐motive ATPases, and glucose and glutamate transporters), endoplasmic reticulum (presenilin‐1, Herp, and ryanodine and inositol triphosphate receptors), and mitochondria (electron transport chain proteins, Bcl‐2 family members, and uncoupling proteins) are implicated in age‐related neuronal dysfunction and disease. The adverse effects of aging on neuronal Ca2+ regulation are subject to modification by genetic (mutations in presenilins, α‐synuclein, huntingtin, or Cu/Zn‐superoxide dismutase; apolipoprotein E isotype, etc.) and environmental (dietary energy intake, exercise, exposure to toxins, etc.) factors that may cause or affect the risk of neurodegenerative disease. A better understanding of the cellular and molecular mechanisms that promote or prevent disturbances in cellular Ca2+ homeostasis during aging may lead to novel approaches for therapeutic intervention in neurological disorders such as Alzheimer's and Parkinson's diseases and stroke.
Measuring clinical practice
Authors: Shah Rakhee , Edgar David , Evans Bruce J. W.
Published: February 2007

The goals of this paper are to review techniques for measuring clinical practice within healthcare professions and to discuss possible applications of these techniques to primary care optometry. A review of the literature suggests a lack of systematic research investigating standards of clinical practice within optometry. It is argued that evidence‐based research to determine the content of typical optometric eye examinations would be valuable for several reasons: to evaluate the service provided to the public by the profession; setting priorities and assessing the outcomes of continuous education and training; to influence governmental and professional policy decisions; National Health Service General Ophthalmic Services issues; the equitable management of clinicolegal matters and consumer complaints; setting appropriate professional guidelines and developing undergraduate training. Evidence‐based studies within other healthcare professions have evaluated the content of clinical consultations. The literature reviewed reveals three main approaches: (1) abstraction of medical records, (2) use of clinical vignettes and (3) use of standardized patients (SPs) who present unannounced to clinics. In this review, we compare and contrast the use of these different methods in assessing the content of clinical consultations. It is clear from the literature reviewed that the use of SPs is the ‘gold standard’ methodology. Clinical vignettes can also provide useful data, especially if computerized.
Prevention of Childhood Emotional Disorders: Reducing the Burden of Suffering Associated with Anxiety and Depression
Authors: Farrell Lara J. , Barrett Paula M.
Published: February 2007

Anxiety and depression are the most common mental health problems affecting young people today. This review presents a description of the prevalence and impact of these emotional disorders in children and youth. While treatment offers one approach to intervening, research indicates that most sufferers will not actually receive clinical intervention, and of the minority who do, many will terminate prematurely, fail to respond, or experience recurrent difficulties despite treatment. Prevention approaches offer an alternative and adjunct to treatment, and have become a priority for governments, offering a cost effective and efficient means of providing services to children and youth prior to the onset of psychopathology. This review describes current practises in prevention research and provides an overview of an Australian developed cognitive‐behavioural programme that has acquired a solid evidence‐base as well as popularity in schools as one approach to building emotional resilience in children and youth, whilst effectively reducing the burden associated with emotional disturbances of anxiety and depression. Future directions for prevention practice and research are highlighted.
Critiquing environmental management in indigenous Australia: two case studies
Authors: Carter Jennifer L , Hill Greg J E
Published: February 2007

The notion of community participation in sustainable environmental management is well documented, but applications between environmental scientists and indigenous Australians are less known. Many indigenous Australians are socially and culturally marginalized, and agencies debate over appropriate designs for collaborative, cross‐cultural environmental programmes that will alleviate marginalization. This paper presents two case studies from northern Australia, where indigenous people participated in an environmental project exploring the commercial potential of the local sea cucumber resource. A framework with principles of participation and knowledge exchange guided project implementation at both localities. Participant observation data that related to these principles suggests that abuse of power imbalances and exploitation (institutional racism) may be more easily disguised within formalized governance structures than in the informal networks and structures that can be supported through less formalized representation. Linking informal and formal governance structures and canvassing a range of governance modalities will ultimately connect the human behaviours and governance structures needed to progress indigenous environmental management in Australia.
Eliciting emotions in HIV/AIDS research: a diary‐based approach
Authors: Thomas Felicity
Published: February 2007

Little attention has been given to understanding the emotional well‐being of people living with HIV/AIDS in developing countries, despite the fact that emotions may impact on people's sense of purpose and value, and ultimately their ability and resolve to hold livelihood and familial responsibilities together. Drawing upon research undertaken in the Caprivi Region of Namibia, this paper examines the use of solicited text and photo diaries in enabling insight into the emotional impacts of HIV/AIDS. The advantages and constraints of diary methods are examined, focusing on informant‐directed research and the ethical considerations surrounding their use.
Genetic Rescue in an Isolated Metapopulation of a Naturally Fragmented Plant Species, Parnassia palustris
Authors: BOSSUYT BEATRIJS
Published: February 2007

Abstract:  The loss of habitat of naturally fragmented species may result in isolated metapopulations: small groups of populations that are still connected by gene flow but have become isolated from other metapopulations. Genetic isolation may result in genetic differentiation between metapopulations and lowered genetic diversity within the metapopulation. Gene input from outside the metapopulation can hence be expected to enhance crosscompatibility and seed viability. Simultaneously, due to genetic drift, inbreeding, and pollen limitation in the small populations, fitness is likely to increase with population size within a metapopulation. I tested these hypotheses in three isolated metapopulations of the endangered plant species Parnassia palustris L. in a study area of 15 × 0.5 km along the coast of western Belgium and northwestern France. Seed and fruit weight, measured in the 27 populations distributed over the three metapopulations, significantly differed among the metapopulations, which suggests genetic differentiation. These fitness variables also increased with population size within two metapopulations. With a pollination experiment, I investigated whether genetic rescue with pollen from another metapopulation enhanced seed set. Outside‐metapopulation crosses led to a significantly higher seed set than within‐metapopulation crosses, and this effect was more pronounced in small populations. This means pollen from outside the metapopulation was more compatible than pollen from within the metapopulation, due to a lowered genetic diversity within the metapopulation. The seed set of naturally pollinated flowers was at least equal to that of hand‐pollinated flowers, which can be explained by a compensation effect of pollen quantity and donor diversity for pollen quality. One can assume that the loss of genetic diversity at the level of the metapopulation affected loci not just related to cross compatibility. Reconnection of metapopulations by stepping stones may be necessary to prevent further genetic erosion and assure the viability of the Parnassia populations in the study area over the long term.
Evidence‐Based Strategies for Reducing Cesarean Section Rates: A Meta‐Analysis
Authors: Chaillet Nils , Dumont Alexandre
Published: February 2007

ABSTRACT:  Background:
Canada’s cesarean section rate reached an all‐time high of 22.5 percent of in‐hospital deliveries in 2002 and was associated with potential maternal and neonatal complications. Clinical practice guidelines represent an appropriate mean for reducing cesarean section rates. The challenge now lies in implementing these guidelines. Objectives of this meta‐analysis were to assess the effectiveness of interventions for reducing the cesarean section rate and to assess the impact of this reduction on maternal and perinatal mortality and morbidity.
Methods:
The Cochrane Library, EMBASE, and MEDLINE were consulted from January 1990 to June 2005. Additional studies were identified by screening reference lists from identified studies and expert suggestions. Studies involving rigorous evaluation of a strategy for reducing overall cesarean section rates were identified. Randomized controlled trials, controlled before‐and‐after studies, and interrupted time series studies were evaluated according to Effective Practice and Organisation of Care Group criteria.
Results:
Among the 10 included studies, a significant reduction of cesarean section rate was found by random meta‐analysis (pooled RR = 0.81 [0.75, 0.87]). No evidence of publication bias was identified. Audit and feedback (pooled RR = 0.87 [0.81, 0.93]), quality improvement (pooled RR = 0.74 [0.70, 0.77]), and multifaceted strategies (pooled RR=0.73 [0.68, 0.79]) were effective for reducing the cesarean section rate. However, quality improvement based on active management of labor showed mixed effects. Design of studies showed a higher effect for noncontrolled studies than for controlled studies (pooled RR = 0.76 [0.72, 0.81] vs 0.92 [0.88, 0.96]). Studies including an identification of barriers to change were more effective than other interventions for reducing the cesarean section rate (pooled RR = 0.74 [0.71, 0.78] vs 0.88 [0.82, 0.94]). Among included studies, no significant differences were found for perinatal and neonatal mortality and perinatal and maternal morbidity with respect to the mode of delivery. Only 1 study showed a significant reduction of neonatal and perinatal mortality (p < 0.001). Conclusions: The cesarean section rate can be safely reduced by interventions that involve health workers in analyzing and modifying their practice. Our results suggest that multifaceted strategies, based on audit and detailed feedback, are advised to improve clinical practice and effectively reduce cesarean section rates. Moreover, these findings support the assumption that identification of barriers to change is a major key to success. (BIRTH 34:1 March 2007)
Distribution of Auditory and Visual Naming Sites in Nonlesional Temporal Lobe Epilepsy Patients and Patients with Space‐Occupying Temporal Lobe Lesions
Authors: Hamberger Marla J. , McClelland Shearwood , McKhann Guy M. , Williams Alicia C. , Goodman Robert R.
Published: February 2007

Summary:  Purpose: Current knowledge regarding the topography of essential language cortex is based primarily on stimulation mapping studies of nonlesional epilepsy patients. We sought to determine whether space‐occupying temporal lobe lesions are associated with a similar topography of language sites, as this information would be useful in surgical planning.

Methods: We retrospectively compared the topography of auditory and visual naming sites in 25 nonlesional temporal lobe epilepsy patients (“nonlesional”) and 18 patients with space‐occupying lesions (“lesional”) who underwent cortical language mapping before left temporal resection.

Results: Both groups exhibited a similar pattern of auditory naming sites anterior to visual and dual (auditory–visual) naming sites; no group differences were specific to auditory or visual naming sites. However, significantly fewer lesional (10 of 20) compared with nonlesional patients (21 of 25) exhibited any naming sites in the temporal region (p = 0.04). Although the proportion of naming sites on the superior temporal gyrus was similar between groups, naming sites were found on the middle temporal gyrus in 13 of 25 nonlesional patients, yet in only one of 18 lesional patients (p = 0.002). Across groups, patients with visual naming sites were older than patients without visual naming sites identified (p = 0.02).

Conclusions: The precise location of essential language cortex cannot be reliably inferred from anatomic landmarks or patient‐related variables. As time constraints are a common quandary in stimulation mapping, the different patterns reported here for patients with and without space‐occupying lesions can be used to guide mapping strategies, thereby increasing the efficiency by which positive naming sites are identified.
Lamotrigine Therapy of Epilepsy with Angelman's Syndrome
Authors: Dion Marie‐Hélène , Novotny Edward J. , Carmant Lionel , Cossette Patrick , Nguyen Dang Khoa
Published: February 2007

Summary:  Purpose: Angelman syndrome (AS) is a neurogenetic disorder characterized by developmental delay and a frequently refractory epileptic condition. Valproate, clonazepam and/or phenytoin are said to be the most effective antiepileptic drugs (AEDs) against the seizures in AS. Experience with the newer AEDs is very limited despite their better safety profile and tolerability. Considering its favorable side effect profile and its effectiveness against both partial and generalized seizures, we hypothesized that lamotrigine (LTG) might be more efficacious and better tolerated.

Methods: Potential patients for this retrospective study were identified from the epilepsy clinics at Notre‐Dame, Sainte‐Justine, and Yale New Haven hospitals. Patients were included in the study if they had AS along with refractory seizures. The medical record of each patient was reviewed with interest on seizure types, previous AEDs and response to LTG.

Results: Five patients (2M, 3F) were included in this study. Age at LTG ranged from 10 to 33 years old. All had ≥2 seizure types, mainly generalized tonic–clonic, myoclonic seizures, and atypical absences. Previously tried AEDs included valproic acid (5), benzodiazepines (5), phenytoin (4), carbamazepine (3), and topiramate (1). One patient had pancreatitis on phenytoin, one had worsened seizures on carbamazepine, and one developed hepatic encephalopathy on valproic acid. Three patients became seizure‐free with LTG (9, 20, and 36 months FU), one was seizure‐free for 1 year with subsequent loss of efficacy, and one showed >50% reduction in myoclonic seizures (20 months FU). No side effects were reported.

Conclusion: LTG can be efficacious and well tolerated in patients with AS.
Prevalence and Pattern of Epilepsy Treatment in Different Socioeconomic Classes in Brazil
Authors: Noronha Ana L. A. , Borges Moacir A. , Marques Lucia H. N. , Zanetta Dirce M. T. , Fernandes Paula T. , De Boer Hanneke , Espíndola Javier , Miranda Claudio T. , Prilipko Leonid , Bell Gail S. , Sander Josemir W. , Li Li M.
Published: February 2007

Summary: Purpose:The worldwide prevalence of epilepsy is variable,estimated at 10//1,000 people, and access to treatment is also variable. Many people go untreated, particularly in resource‐poor countries.

 Objective:To estimate the prevalence of epilepsy and the proportion of people not receiving adequate treatment in different socioeconomic classes in Brazil, a resource‐poor country.

Methods:A door‐to‐door survey was conducted to assess the prevalence and treatment gap of epilepsy in three areas of two towns in Southeast Brazil with a total population of 96,300 people. A validated screening questionnaire for epilepsy (sensitivity 95.8%, specificity 97.8%) was used. A neurologist further ascertained positive cases. A validated instrument for socioeconomic classification was used.

Results:Lifetime prevalence was 9.2/1,000 people [95% CI 8.4–10.0] and the prevalence of active epilepsy was 5.4/1,000 people. This was higher in the more deprived social classes (7.5/1,000 compared with 1.6/1,000 in the less deprived). Prevalence was also higher in elderly people (8.5/1,000). Thirty‐eight percent of patients with active epilepsy had inadequate treatment (19% on no medication); the figures were similar in the different socioeconomic groups.

Conclusion:The prevalence of epilepsy in Brazil is similar to other resource‐poor countries, and the treatment gap is high. Epilepsy is more prevalent among less wealthy people and in elderly people. There is an urgent need for education in Brazil to inform people that epilepsy is a treatable, as well as preventable, condition.
Structural Determination of Two Active Compounds That Bind to the Muscarinic M3 Receptor in Beer
Authors: Yamaji Nahoko , Yokoo Yoshiaki , Iwashita Takashi , Nemoto Asuka , Koike Minako , Suwa Yoshihide , Wakimoto Toshiyuki , Tsuji Kuniro , Nukaya Haruo
Published: February 2007

Background: It is known that beer accelerates gastrointestinal motility in humans. Our previous studies showed that beer congener stimulates gastrointestinal motility by directly stimulating the muscarinic M3 receptor. Further, we isolated 2 active compounds (compounds A and B) from beer by liquid chromatography. The objective of the present study was to identify the 2 active compounds that bind to the muscarinic M3 receptor in beer.

Methods: Structural analyses of the active compounds were performed by fast atom bombardment mass spectra, 1H‐nuclear magnetic resonance (NMR), and 13C‐NMR spectroscopy. Active compounds were chemically synthesized from p‐coumaric acid and agmatine as starting materials. Binding activity to the muscarinic M3 receptor was used to confirm the activity of the synthetic compounds.

Results: It was identified that 2 active compounds had the same structural characteristics: stereoisomers (cis‐isomer and trans‐isomer), molecular weight=550 and molecular formula=C28H38N8O4. Trans‐isomer (compound B) was identified as the known substance hordatine A, a kind of phytoalexin in barley, and cis‐isomer (compound A) was found to be a novel compound (tentatively referred to as aperidine). Both naturally present and chemically synthesized aperidine (compound A) and hordatine A (compound B) were demonstrated to have potent binding activities to the muscarinic M3 receptor.

Conclusions: The 2 active compounds isolated from beer, namely aperidine (compound A) and hordatine A (compound B), have structurally and functionally been identified as active entities of binding to the muscarinic M3 receptor.
Effect of Chronic Dietary Ethanol Consumption on Colonic Cancer in Rats Induced by 1,1‐Dimethylhydrazine
Authors: Hayashi Nobuhiko , Tsutsumi Mikihiro , Fukura Masayuki , Yano Hirokazu , Tsuchishima Mutsumi , Takase Shujiro
Published: February 2007

Background:The pathogenetic correlation between chronic alcohol consumption and development of colon cancer is not clear. The role of alcohol abuse in the carcinogenic action of 1,1‐dimethylhydrazine (DMH), which induces tumors in the colon, was evaluated.

Methods:Twenty male rats were fed liquid diets containing ethanol or carbohydrates for 39 weeks. DMH (20 mg/kg body weight, once a week) was injected subcutaneously from the 5th to the 20th week. Pair feeding was stopped at 10:00amand DMH was administered at 02:00pm. Ethanol was not detected in the blood at the time of injection. Liquid diets were provided again at 05:00pmuntil 10:00amnext day. The animals were killed at the end of the 39th week, and the colons were removed for examination for the number of aberrant crypt foci (ACF) by methylene blue staining. Tissue sections were stained for histology and cytochrome P4502E1 (CYP2E1) expression.

Results:The number of ACF in colons obtained from ethanol‐fed rats with DMH was 24 (n=5, 4.4±2.5/rat), which was significantly (p<0.001) more than that of the other treated rats: only 3 (n=5, 0.6±0.5/rat) in the pair‐fed control rats with DMH, and none in the ethanol‐fed or control‐fed rats without DMH. Cytochrome P4502E1 staining demonstrated marked expression in the colon mucosa from ethanol‐fed rats, but not in the pair‐fed control rats.

Conclusions:The increased expression of CYP2E1 induced by chronic ethanol consumption promotes the development of DMH‐induced colon cancer.