bluuebunny/crossref_metadata_2025 huggingface dataset:
An interagency service delivery model for autistic spectrum disorders and attention deficit hyperactivity disorder
Authors: Rowlandson P. H. , Smith C.
Published: March 2009

Background  A multiplicity of government initiatives advocate increasing shared working between services to ensure that holistic and co‐ordinated assessment of need and related shared intervention is available to children and families. Concurrently, there is an increasing demand upon services to provide a wide range of support for children with complex difficulties.

Methods  On the Isle of Wight, joint services have been developing shared practice. The inter‐agency service was initiated in 2001 through a 3‐year project funded jointly between all services on the Island and the government through the ‘Invest to Save’ initiative. The project initially focused upon developing a combined process of diagnosis of autistic spectrum disorders (ASD) and the co‐ordination of intervention at schools, within families and in the child's community. Gradually, the service extended to include children with a much wider range of difficulties, including those of attention deficit hyperactivity disorder (ADHD), developmental co‐ordination disorder and co‐morbid diagnoses.

Results  There are 19 000 school‐aged children on the Isle of Wight. A total of 1101 referrals have been accepted between June 2001 and May 2007. In total, 201 children have been given a diagnosis of ASD. Overall, 392 children have been given a diagnosis of ADHD or ADHD/Co‐morbid. Seventy were co‐morbid for ASD and ADHD. The current service is rated as 85% satisfactory by its users, in contrast to the high level of complaint which resulted in the bid for the project initially.

Conclusion  Following the successful conclusion of the 3‐year government‐funded project Education Services, Social Care and The Health Authority shared the ongoing funding of the current service. This has been operating effectively for over 6 years and has highlighted a wide variety of issues around this style of service delivery.
Community structure in temporary freshwater pools: disentangling the effects of habitat size and hydroregime
Authors: VANSCHOENWINKEL BRAM , HULSMANS ANN , DE ROECK ELS , DE VRIES CHRIS , SEAMAN MAITLAND , BRENDONCK LUC
Published: March 2009

1. Hydroregime (duration, frequency and predictability of the aquatic phase) is a key feature of temporary aquatic habitats that not only moulds community structure and diversity (species sorting) but also life history characteristics of the inhabitants (natural selection). However, since hydroregime is a complex multidimensional entity that cannot be estimated from short term observations, morphometric variables are commonly used as proxies for hydroregime, making it impossible to separate effects of habitat size and hydroregime on biota.

2. We have used a simple hydrological model, validated with recent (average r2 = 96%) and historic water level observations (average r2 = 81%), to accurately reconstruct hydroregime based on historical rainfall and evaporation data in a cluster of 36 temporary rock pools in central South Africa.

3. Using the model output, we demonstrated that both hydroregime and habitat size had unique and shared effects on temporary pool biota and that these effects depended on the dispersal modes of the taxa. Model‐generated hydrological data explained more variation in community patterns than short‐term observations of hydroperiod. Hydroregime was more important for passive dispersers than for active dispersers that can migrate when pools dry up. Basin morphometry was a relatively poor predictor of pool hydroregime. We concluded that simple modelling may greatly improve the resolution of studies linking hydroregime to biological variables.

4. An accurate account of hydrological variation provides a firm foundation to understand community and population structure and dynamics in temporary aquatic habitats. Since many of these habitats have been destroyed or degraded in recent decades, our findings and tools may contribute to the development of reliable conservation guidelines.
Assessing and conserving groundwater biodiversity: an introduction
Authors: GIBERT JANINE , CULVER DAVID C.
Published: March 2009

1. This paper is an introduction to and overview of a special issue on groundwater ecology with a focus on biodiversity assessment and conservation. The subterranean environment harbours unique biological communities of remarkable diversity, comprising both microorganisms and micro‐, meio‐ and macrofauna. This biodiversity of ground waters remains poorly known compared to that of freshwater surface habitats.

2. The papers in this special issue summarise the outcome of a large‐scale European survey, the PASCALIS project (Protocol for theASsessment andConservation ofAquaticLifeIn theSubsurface), complemented by results from a few other comprehensive studies on groundwater diversity. The papers fall into five broad groups. The first group reviews the biology and ecology of poorly investigated but important subterranean taxa such as Bacteria and Archaea, Oligochaeta and Copepoda. Five papers deal with groundwater biodiversity patterns in the six selected PASCALIS regions. Issues addressed range from broad‐scale diversity patterns to partitioning of species richness, cryptic diversity, sampling methodology, and the use of surrogate taxonomic groups for assessing overall diversity. Four papers analyse biodiversity patterns in single European regions, the French Jura, the Walloon region of Belgium, the Lessinian Mountains of Italy and south‐western Germany. Two additional papers address the issue of site selection for the conservation and protection of groundwater species, and the fifth group of three papers expands two central PASCALIS themes – sampling adequacy and the role of dispersal. Finally, a concluding synthesis paper summarises advances in understanding groundwater biodiversity patters and conservation and points out important challenges for future research.

3. Collectively, the information presented in this special issue represents the first broad‐scale examination of aquatic subterranean diversity based on a rigorously standardised sampling protocol, the first examination of stygofauna patterns in both karstic and non‐karstic aquifers, a first step toward integrating traditional and molecular taxonomic studies of groundwater biodiversity, and a start toward elaborating strategies for groundwater reserve selection.
Immunogenetics of factor VIII inhibitor development
Authors: LOZIER JAY , MENASHE IDAN , KRONER BARBARA , GOEDERT JAMES , ROSENBERG PHILIP
Published: March 2009

Objective:  The purpose of our study is to investigate the hypothesis that polymorphisms in immunoregulatory genes and/or the factor VIII gene are partly responsible for recognition of therapeutic factor VIII as ‘foreign’, thereby provoking inhibitor antibodies. As a critical first step in our study we have set out to determine the minimal number of single nucleotide polymorphisms (SNPs) in immunoregulatory genes and the factor VIII gene that define the relevant DNA haplotypes seen in the Caucasian population (CEU) as shown in the HapMap project.

Methods:  We searched the CEU dataset in the HapMap genetic database (release 23a, March 8, 2008) as a source for SNPs with potential to define haplotypes ‘tag SNPs’ in the genes for IL1‐beta, IL4, IL10, IL13, interferon gamma, TNF‐alpha, TGF‐beta, zinc alpha‐2 glycoprotein I, and the coagulation factor VIII gene. These genes were selected based on their central role in regulation of the immune response, previously published correlations with factor VIII inhibitor risk, or results of studies of factor VIII immunogenicity in animals. Using the Haploview programme we surveyed SNPs in each gene, plus approximately 20 kb of DNA 5′ and 3′ to each gene to assess potential regulatory elements that might influence gene expression. Tag SNPs were picked for each gene at various levels of coverage, based on correlation coefficients (r2) of >0.8, >0.9, and =1.0.

Summary:  Our analysis indicates that the total number of tag SNPs required to study the nine genes of interest, with r2 values of > 0.8, > 0.9, or = 1.0, is on the order of 96, 138 and 146, respectively. Thus, a study of these proposed candidate genes is feasible with currently available SNP ascertainment based on multiplex PCR amplification/extension and MALDI‐TOF analysis.

Conclusions:  With approximately 150 SNPs (at r2 = 1.0) we will be able to determine association between factor VIII inhibitor development and any of seven immunoregulatory genes and two plasma proteins, including the coagulation factor VIII gene. We have extracted genomic DNA from peripheral blood leukocytes obtained from >900 caucasian haemophilia A patients who participated in the Multicenter Haemophilia Cohort Studies I & II, and are beginning to ascertain these SNPs for their association with risk for development of inhibitors to factor VIII in haemophilia A patients.
Regulation of triggering receptor expressed on myeloid cells 1 expression on mouse inflammatory monocytes
Authors: Zanzinger Kai , Schellack Carola , Nausch Norman , Cerwenka Adelheid
Published: March 2009

Triggering receptor expressed on myeloid cells 1 (TREM‐1) is an activating receptor involved in inflammatory diseases and septic shock. The TREM‐1 ligand(s) (TREM‐1L) have not yet been identified. In this study, we performed a detailed analysis of the expression of mouse TREM‐1 and its ligand(s). Our results demonstrate that TREM‐1 is expressed on bone‐marrow‐derived dendritic cells (BMDC). On bone‐marrow‐derived macrophages (BMM) its expression is induced in vitro after stimulation by granulocyte–macrophage colony‐stimulating factor, interleukin‐3 or by myeloid differentiation primary response gene 88 (MyD88)‐dependent Toll‐like receptor (TLR) ligands. Under steady‐state conditions mouse TREM‐1 is detectable on a Gr‐1− F4/80+ monocyte subpopulation bearing markers of resident monocytes, but not on Gr‐1+ F4/80+ inflammatory monocytes. During lipopolysaccharide (LPS)‐induced endotoxaemia TREM‐1 was also up‐regulated on inflammatory Gr‐1+ F4/80+ cells in vivo. In tumour‐bearing mice, TREM‐1 was up‐regulated on Gr‐1+ F4/80+ monocytes, which phenotypically and functionally resembled mononuclear myeloid‐derived suppressor cells. Using a soluble TREM‐1 fusion protein, we demonstrate that after intravenous injection of LPS TREM‐1L was induced on Gr‐1+ granulocytes and monocytes but not on other cell populations in peripheral blood. This up‐regulation on granulocytes was directly mediated by TLR ligands and required the adapter protein MyD88. In contrast to human, mouse platelets expressed TREM‐1L neither under steady‐state conditions nor after LPS injection in vivo. Our study reveals differential regulation of TREM‐1 expression on mouse monocyte subpopulations and improves our understanding of the biological role of TREM‐1 during disease.
School‐based education to improve oral cleanliness and gingival health in adolescents in Tehran, Iran
Authors: YAZDANI REZA , VEHKALAHTI MIIRA M. , NOURI MAHTAB , MURTOMAA HEIKKI
Published: March 2009

Background. Schools can be an important setting for health education programmes, controlling the growing burden of oral diseases and promoting oral health.

Aim. The aim of this study was to evaluate the short‐term effect of school‐based educational intervention on oral cleanliness and gingival health of 15‐year‐olds in Tehran, Iran.

Design. The present cluster randomized trial was based on exposing students (n = 287; control,n = 130) at public schools to oral health knowledge through a leaflet or a videotape. The outcome was evaluated after 12 weeks. A positive outcome was defined as at minimum a 50% reduction in numbers of teeth with dental plaque or gingival bleeding compared to baseline. Evaluation included percentage changes, number needed to treat (NNT), and students’ self‐assessment.

Results. At baseline, all students had dental plaque, and 93% had gingival bleeding on at least one index tooth. Positive outcome for oral cleanliness was 58% (P < 0.001) of the students in the leaflet group, 37% (P < 0.001) in the videotape group, and 10% of controls. Corresponding figures for gingival health were 72% (P < 0.001), 64% (P < 0.001), and 30%. For oral cleanliness, NNT was 2 in the leaflet and 3 in the videotape group; for gingival bleeding, NNT in both groups was 3. More than two‐thirds of the students assessed their oral health behaviours as having improved moderately.

Conclusion. An easy‐to‐organize and inexpensive school‐based intervention can in the short term be effective in improving oral cleanliness and gingival health among adolescents; in particular, in countries with a developing oral health system.
Recovery from bark harvesting of 12 medicinal tree species in Benin, West Africa
Authors: Delvaux Claire , Sinsin Brice , Darchambeau François , Van Damme Patrick
Published: March 2009

The growing interest in medicinal plants from both international industry and local markets requires management of tree bark harvesting from natural forests in order to prevent inappropriate exploitation of target species. This study was designed to determine the bark re‐growth response of a selected number of medicinal tree species as a basis for the development of an optimal bark harvesting method.

In 2004, bark was harvested from 925 trees belonging to 12 species in 38 sites in a dry forest in Benin, West Africa. Two years later, the response of trees to bark harvesting was examined with respect to re‐growth (edge or sheet), development of vegetative growth around the wound, and the sensitivity of the wound to insect attack.

Two species, Khaya senegalensis and Lannea kerstingii, showed complete wound recovery by edge growth. At the other extreme, Afzelia africana, Burkea africana and Maranthes polyandra had very poor edge growth. M. polyandra showed good sheet growth, whereas the other 11 species had none or poor sheet growth after total bark harvesting. In contrast, partial bark removal allowed better sheet growth in all 12 species studied.

Insect sensitivity was species‐specific. Insect attacks were negatively correlated with non‐recovered wound area, but there was a marked species effect for the same rate of regeneration. L. kerstingii and K. senegalensis had very good and similar re‐growth, but L. kerstingii was very susceptible to insect attack, whereas K. senegalensis appeared to be very resistant. Only a few individuals developed vegetative growth, and each tree usually developed only one or two agony shoots, but there was no significant difference between species.

Synthesis and applications. This is the first study to provide data on the ability of trees to close wounds after bark harvesting in West Africa. We report large variability in the response of different species to our bark harvesting technique, and identify just two out of the 12 study species as suitable for sustainable bark harvesting. Based on our results, we developed a decisional step method to help forest managers select the best techniques for managing medicinal tree species as an alternative to bark harvesting, for example, coppice management, harvesting leaves instead of bark, stand establishment, and collaboration with timber companies.
Species abundance distributions reveal environmental heterogeneity in modified landscapes
Authors: Dornelas Maria , Moonen Anna Camilla , Magurran Anne E. , Bàrberi Paolo
Published: March 2009

Environmental heterogeneity influences biodiversity patterns such as species richness and community composition, but we do not know how it shapes community structure in terms of the number of rare and abundant species. This question is particularly relevant to modified landscapes such as agro‐ecosystems, where intensive management creates highly homogeneous landscapes, which often lead to loss of rare taxa and dominance by a few aggressive species.

It can be difficult to evaluate the effects of management on communities in different localities due to regional differences in species richness and composition. Because species abundance distributions (SADs) express assemblage structure in comparable units, they can be used to characterize communities irrespective of species composition, and for this reason provide a novel means of assessing the effects of management.

We analysed the SADs of weed communities across a gradient of environmental heterogeneity generated by different management treatments. We tested the hypothesis that environmental heterogeneity promotes multimodality in SADs by comparing observed patterns with those predicted for simulated random samples from homogeneous communities.

Observed SADs from a homogeneous environment did not deviate from predictions. By contrast, SADs from increasingly heterogeneous environments were progressively and consistently multimodal.

These results demonstrate that environmental heterogeneity, resulting from variation in management treatments, leaves a signature on the SAD.

Synthesis and applications. Our study shows that Species Abundance Distributions are informative indicators of environmental heterogeneity in modified landscapes. Weed communities include both rare species, which are often of conservation interest and pose little threat to crops, and abundant species, which can be problematic. Our analysis suggests that creating environmental heterogeneity by varying management treatments across the landscape can be an effective way of promoting biodiversity and decreasing the abundance of problematic species.
Standing genetic variation in FRIGIDA mediates experimental evolution of flowering time in Arabidopsis
Authors: SCARCELLI NORA , KOVER PAULA X.
Published: March 2009

The role of standing genetic variation in adaptive evolution remains unclear. Although there has been much progress in identifying candidate genes that underlie adaptive traits, we still lack direct evidence that natural allelic variation in these genes can actually mediate adaptive evolution. In this study, we investigate the role of natural allelic variation in two candidate flowering time genes, in response to selection for early flowering in Arabidopsis thaliana: FRIGIDA (FRI) and FLOWERING LOCUS C (FLC). We performed artificial selection for early flowering under ‘spring‐’ and ‘winter‐annual’ growth conditions using an outbred population of A. thaliana produced by intermating 19 natural accessions. FRI and FLC are involved in A. thaliana's response to winter conditions, and nonfunctional and weak alleles at these loci are know to reduce flowering time, particularly under spring‐annual conditions. Our results provide direct evidence that natural allelic variation in FRI can provide rapid and predictable adaptive evolution in flowering time under spring‐annual conditions. We observed a strong response to selection, in terms of reducing flowering time, in both growth conditions (~2 standard deviation reduction). Concomitantly, the frequency of functional FRI alleles under spring‐annual conditions was reduced by 68%, in agreement with predicted changes. No significant changes in allele frequencies were observed in FRI in the winter‐annual growth condition or in FLC for either growth conditions. These results indicate that changes in flowering time are mediated by different genetic factors under spring‐ and winter‐annual growth conditions, and that other loci must also be contributing to the response to selection.
The host transcriptome remains unaltered during the establishment of coral–algal symbioses
Authors: VOOLSTRA CHRISTIAN R. , SCHWARZ JODI A. , SCHNETZER JULIA , SUNAGAWA SHINICHI , DESALVO MICHAEL K. , SZMANT ALINA M. , COFFROTH MARY ALICE , MEDINA MÓNICA
Published: March 2009

Coral reefs are based on the symbiotic relationship between corals and photosynthetic dinoflagellates of the genus Symbiodinium. We followed gene expression of coral larvae of Acropora palmata and Montastraea faveolata after exposure to Symbiodinium strains that differed in their ability to establish symbioses. We show that the coral host transcriptome remains almost unchanged during infection by competent symbionts, but is massively altered by symbionts that fail to establish symbioses. Our data suggest that successful coral–algal symbioses depend mainly on the symbionts' ability to enter the host in a stealth manner rather than a more active response from the coral host.
Ovarian dynamics and oosorption in two species of predatory lady beetles (Coleoptera: Coccinellidae)
Authors: KAJITA YUKIE , EVANS EDWARD W.
Published: March 2009

Abstract Ovarian development and oviposition dynamics of two species of lady beetle, Coccinella septempunctata L. and C. transversoguttata richardsoni Brown, are examined in laboratory experiments in which pea aphids (Acyrthosiphon pisum Harris) are provided ad libitum and then removed. Both species respond to prey removal by stabilizing at lower body weights, and by laying progressively fewer and smaller eggs of reduced viability, until oviposition ceases altogether after several days of starvation. Dissections of females after prey removal reveal similar patterns of oosorption in both species. However, C. septempunctata reduces oviposition more rapidly after prey removal than does C. transversoguttata. When prey are again provided, C. septempunctata soon lay as many eggs as previously but C. transversoguttata lay fewer. Females, especially of C. septempunctata, that stop producing and resorb eggs in the absence of prey lay more eggs subsequently than do females that feed continually on prey provided ad libitum and lay eggs throughout the experiment. Thus, although both species are responsive to a rapid change in prey availability, C. septempunctata appears to be especially responsive. Rapid responses to changes in prey availability may contribute to the greater abundance and reproductive success of this introduced species relative to the native C. transversoguttata in western North American alfalfa fields that exhibit widely varying pea aphid densities. However, both species engage in oosorption as a means of reserving resources under poor prey conditions and enhancing future reproductive effort when prey conditions improve.
Antibiotics and paediatric acute respiratory infections in rural Vietnam: health‐care providers’ knowledge, practical competence and reported practice
Authors: Hoa Nguyen Quynh , Larson Mattias , Chuc Nguyen Thi Kim , Eriksson Bo , Trung Nguyen Vu , Stålsby Cecilia Lundborg
Published: March 2009

Objective  To assess knowledge, practical competence and reported practices among health‐care providers about antibiotics to treat acute respiratory infections in children under five in rural Vietnam.

Method  Health‐care providers prescribing or dispensing western drugs for children self‐completed a structured questionnaire. Recommendations concerning antibiotic use from WHO and national guidelines were used to assess the appropriateness of reported treatment of acute respiratory infections.

Results  Ninety‐six per cent of 409 eligible health care providers participated. Only 27% demonstrated correct knowledge regarding the consequences of resistance. Seventy‐nine per cent would use antibiotics for common colds with fever, and 21% in cases with no fever. Nineteen per cent had overall knowledge compliant with recommended guidelines. Stated antibiotic use in written scenarios for common colds (81%) was not significantly different from that for non‐referral cases of pneumonia (87%). The proportion of antibiotic use in the common cold scenario was significantly lower among health‐care providers who had the correct overall knowledge. According to reported symptoms from the most recent encounter with a sick child, the diseases seen were 62% mild acute respiratory infections, 19% severe, and 19% non‐respiratory infections. Among those, antibiotics, most commonly beta‐lactams, were used in 90%, 87% and 78% of cases, respectively.

Conclusions  Antibiotics are often prescribed or dispensed to treat common colds. Interventions to change prescribing and dispensing practices should be developed and implemented in collaboration with local and national paediatricians. Continuous training of health‐care providers, particularly drug sellers, is important.
Open label randomized comparison of dihydroartemisinin–piperaquine and artesunate–amodiaquine for the treatment of uncomplicated Plasmodium falciparum malaria in central Vietnam
Authors: Thanh Nguyen Xuan , Trung Trieu Nguyen , Phong Nguyen Chinh , Thien Nguyen Xuan , Dai Bui , Dennis Shanks G. , Chavchich Marina , Edstein Michael D.
Published: March 2009

Objective  Artesunate–amodiaquine (AAQ) is efficacious for the treatment of uncomplicated Plasmodium falciparum malaria in Africa, but little is known about its efficacy in Southeast Asia. We compared the efficacy of dihydroartemisinin–piperaquine (DHP) and AAQ against falciparum malaria in central Vietnam.

Methods  Open, randomized clinical trial of 116 patients (36 children aged 6–14 years, 80 adults aged 15–60 years) were randomly allocated a 3‐day course of either DHP (∼2.3 mg/kg dihydroartemisinin plus ∼18.5 mg/kg of piperaquine per day) or AAQ (∼4.4 mg/kg of artesunate plus ∼10.6 mg/kg of amodiaquine per day). The follow‐up period was 42 days.

Results  The two drug combinations were well tolerated by all age groups with no obvious drug associated adverse events. Of the patients who completed 42 days of follow‐up, 49 were on DHP (15 children, 34 adults) and 49 were on AAQ (14 children, 35 adults). The 42 day cure rates adjusted for reinfection identified by PCR genotyping for the two groups were similar [100% (49/49) and 98% (48/49) for DHP and AAQ, respectively]. With fewer reinfections, DHP appears to possess greater post‐treatment prophylactic activity than AAQ.

Conclusion  AAQ, an inexpensive artemisinin‐based combination, could be an additional option to DHP for the treatment of multidrug‐resistant falciparum malaria in Vietnam.
Chromoblastomycosis: combined treatment with pulsed itraconazole therapy and liquid nitrogen cryotherapy
Authors: Ranawaka Ranthilaka R. , Amarasinghe Nishan , Hewage Dantha
Published: March 2009

Background  Three patients with histology‐ and culture‐proven chromoblastomycosis reported to the Colombo South Teaching Hospital, Sri Lanka, in 2005. All three were men (age range, 48–53 years). The duration of symptoms varied from 1 to 8 years and the lesions were on the lower limbs.

Methods  The patients were treated simultaneously with liquid nitrogen cryotherapy and itraconazole pulses, i.e. 200 mg twice daily for 7 days per month, 1 week on and 3 weeks off. Cryotherapy was given every fortnight using large cotton swabs attached to ekels or the cryogun.

Results  Two patients showed a good clinical response within 4 months, with negative histopathology and culture in 4–6 months. The third patient was very resistant to treatment and needed a step‐up of the itraconazole dose.

Conclusion  A combination of fortnightly liquid nitrogen cryotherapy and pulsed monthly itraconazole is cost‐effective and shortens the duration of therapy compared with the use of itraconazole or cryotherapy alone.
Phakomatosis cesioflammea with late‐onset glaucoma and acquired nevus spilus‐like lesion – 15 years of follow‐up
Authors: Chiu Hsiu‐Hui , Chen Gwo‐Shing , Wu Chieh‐Shan , Ke Chiao‐li Khale , Cheng Shih‐Tsung
Published: March 2009

Phakomatosis pigmentovascularis is a very rare disease characterized by coexistence of a capillary malformation with various melanocytic lesions, including dermal melanocytosis (Mongolian spots), nevus spilus, and nevus of Ota. As of now about 200 cases have been reported, most are of Japanese origin and about half of reported cases are associated with various systemic involvement. We present a 15‐year‐old Taiwanese male with phakomatosis cesioflammea who developed, during adolescence, a nevus spilus‐like lesion and late‐onset open angle glaucoma, suggesting that long‐term ophthalmic follow‐up is necessary in this type of patient.
Skin cancer mortality in Germany before and after the post‐communist transition
Authors: Stang Andreas , Lampert Thomas , Uhlemann Thomas , Trocchi Pietro
Published: March 2009

Background and Objectives  Until now mortality trends of melanoma and nonmelanoma skin cancer (NMSC) in Germany have been studied only in West Germany. We were interested in comparing mortality trends of melanoma and NMSC in West and East Germany before and after the post‐communist transition. By analyses of health care utilization data in West and East Germany, we explored potential reasons for mortality differences between these regions.

Methods  We analyzed mortality data of skin melanoma and NMSC of West and East Germany (1980–2005). We calculated sex‐specific age‐standardized mortality rates using the World Standard Population. We calculated age‐specific mortality rates (20–39, 40–59, 60–79, 80+ years).

Results  Age‐standardized skin melanoma mortality rates tended to be lower in East Germany than West Germany before reunification. After reunification rates became very similar. Age‐standardized mortality rates of NMSC were continuously higher in East than West Germany. The mortality rate differences among East and West Germans in 1996–2005 are mainly due to 2.34‐ and 2.24‐fold higher mortality rates among men and women aged 80 years, respectively, who live in East Germany.

Conclusions  Even 15 years after reunification, mortality of NMSC is still higher in East than West Germany, although incidence rates of squamous cell cancers of the skin are not higher in East Germany. Differences in the participation in early cancer detection and health care utilization in West and East Germany do not sufficiently explain our findings.
Severity of disease, rather than xerosis, correlates with pruritus in patients with atopic dermatitis
Authors: Hachisuka Junichi , Takeuchi Satoshi , Kido Makiko , Fukiwake Noriko , Furue Masutaka
Published: March 2009

Background  Atopic dermatitis (AD) is a chronic, relapsing skin disease characterized by xerosis and pruritus. As pruritus is an unpleasant sensation and the associated scratching aggravates the skin eruption considerably, it is important to control this symptom when treating AD. Dry skin is generally considered to be a potential cause of pruritus in xerotic skin diseases, but a clear correlation between pruritus and atopic xerosis has not been demonstrated.

Aim  To examine the contribution of atopic xerosis to the development of pruritus in AD.

Methods  Twenty‐two patients with AD (12 males and 10 females; mean age, 27.5 years) were examined. Xerosis and the severity of disease were evaluated using the Objective Severity Assessment of Atopic Dermatitis (OSAAD) and the SCORing Atopic Dermatitis (SCORAD) index, respectively. A modified SCORAD index was calculated by removing the symptoms potentially associated with pruritus (intensity of itching and insomnia) from the standard SCORAD index. Pruritus was evaluated using both a visual analog scale and the Verbal Itch Score.

Results  The severity of AD (modified SCORAD index) correlated better than atopic xerosis (OSAAD score) with both pruritus scores, possibly indicating that the use of appropriate anti‐inflammatory agents may be helpful in controlling pruritus as well as skin eruption in AD.

Conclusion  Our data suggest that the severity of disease (or skin inflammation) provides a greater contribution than xerosis to the development of pruritus in AD.
Usefulness of culture test and direct examination for the diagnosis of oral atrophic candidiasis
Authors: Terai Haruhiko , Shimahara Masashi
Published: March 2009

Background  Culture test and direct microscopy, which are currently used in the diagnosis of oral candidiasis, can yield false‐negative results.

Methods  Forty patients with atrophic candidiasis of the tongue were evaluated. The diagnosis was confirmed by a favorable outcome consisting of tongue pain improvement and regeneration of filiform papilla after antifungal treatment in all patients. Specimens were examined by fungal culture and direct microscopy following rapid staining; the usefulness of these procedures for diagnosis was reevaluated retrospectively after treatment.

Results  In the culture test, 30 patients (75.0%) were positive for candidal species, most of which were confirmed to be Candida albicans. Twenty‐three (57.5%) were positive for pseudohyphae of fungi on direct examination. Twenty‐two (55.0%) were positive and nine (22.5%) were negative for both. With regard to the diagnosis of oral atrophic candidiasis, these examinations revealed false‐negative results of 25% in the culture examination and 42.5% in the direct examination.

Conclusion  Careful clinical observation of the patient for signs, such as prolonged disease duration, pain on eating, and no benefit from topical steroid treatment, and cytologic examination are important in the diagnosis of this disease.
Effects of tacrolimus ointment on the expression of substance P, nerve growth factor, and neurotrophin‐3 in atopic dermatitis
Authors: Kim Hye‐One , Lee Cheol‐Heon , Ahn Hye‐Kyung , Park Chun‐Wook
Published: March 2009

Background  There is increasing evidence that neuropeptides may be involved in the pathogenesis of atopic dermatitis (AD).

Objectives  To investigate the effects of tacrolimus on the neuropeptides substance P (SP), nerve growth factor (NGF), and neurotrophin‐3 (NT‐3) in the skin, and SP and NGF in the serum, of patients with AD.

Methods  Lesional skin specimens were obtained from eight AD patients and eight normal controls. For 8 weeks, AD patients applied 0.03% tacrolimus ointment to all affected areas twice daily. Blood samples and skin biopsies were then repeated. The participants’ serum SP and NGF levels, as well as the SP, NGF, and NT‐3 immunoreactive cell counts, were evaluated in the epidermal, dermal, and perivascular areas of lesional skin before and after treatment.

Results  The immunoreactive cell counts of SP, NGF, and NT‐3 in skin were higher in AD patients than in normal controls. Most cell counts decreased significantly after treatment; however, the change in serum SP and NGF was not statistically significant.

Conclusions  We demonstrated semiquantitative differences in neuropeptides in the skin of AD patients. In addition, topical tacrolimus reduced the levels of neuropeptides in the tissues of AD patients.
Lipoprotein (a) in patients with psoriasis: associations with lipid profiles and disease severity
Authors: Pietrzak Aldona , Kądzielewski Jacek , Janowski Konrad , Roliński Jacek , Krasowska Dorota , Chodorowska Grażyna , Paszkowski Tomasz , Kapeć Ewa , Jastrzębska Iwona , Tabarkiewicz Jacek , Lotti Torello
Published: March 2009

Background  Lipoprotein (a) [Lp(a)] is a genetically determined molecule whose role has been implied in cardiovascular pathology, and whose levels have been reported to be elevated in patients with psoriasis.

Aim  To assess the serum levels of Lp(a) in patients with psoriasis, and to investigate the associations of Lp(a) with other lipids and with psoriasis severity.

Methods  Thirty‐four patients with psoriasis and 26 healthy control subjects took part in the study. Serum levels of Lp(a) and total, high density lipoprotein (HDL), low density lipoprotein (LDL), and very low density lipoprotein (VLDL) cholesterol fractions were measured in all participants. The levels of triglycerides and total cholesterol were measured using enzymatic colorimetric tests; HDL and LDL cholesterol concentrations were determined by precipitation methods; the VLDL concentration was calculated according to the formula: VLDL cholesterol = triglycerides/5.

Results  Patients with psoriasis showed significantly higher serum levels of Lp(a) relative to controls. Even when controlling for normolipidemic vs. hyperlipidemic status, abnormal levels of Lp(a) (> 30 mg/dL) were observed significantly more often in patients than in controls. In both patients and controls, Lp(a) levels correlated positively with total and HDL cholesterol levels. In patients, Lp(a) levels correlated positively with psoriasis severity.

Conclusions  Lp(a) may be a factor contributing to an increased cardiovascular risk in patients with psoriasis. A pathogenetic link may exist between this lipoprotein and psoriatic pathophysiology.
Patients’ perceptions and experiences of transitions in diabetes care: a longitudinal qualitative study
Authors: Lawton Julia , Rankin David , Peel Elizabeth , Douglas Margaret
Published: March 2009

Objective  To examine patients’ perceptions and experiences over time of the devolvement of diabetes care/reviews from secondary to primary health‐care settings.

Design  Repeat in‐depth interviews with 20 patients over 4 years.

Participants and setting  Twenty type 2 diabetes patients recruited from primary‐ and secondary‐care settings across Lothian, Scotland.

Results  Patients’ views about their current diabetes care were informed by their previous service contact. The devolvement of diabetes care/reviews to general practice was presented as a ‘mixed blessing’. Patients gained reassurance from their perception that receiving practice‐based care/reviews signified that their diabetes was well‐controlled. However, they also expressed resentment that, by achieving good control, they received what they saw as inferior care and/or less‐frequent reviews to others with poorer control. While patients tended to regard GPs as having adequate expertise to conduct their practice‐based reviews, they were more ambivalent about nurses taking on this role. Opportunities to receive holistic care in general practice were not always realized due to patients seeing health‐care professionals for diabetes management to whom they would not normally present for other health issues.

Conclusions  It is important to educate patients about their care pathways, and to reassure them that frequency of reviews depends more on clinical need than location of care and that similar care guidelines are followed in hospital clinics and general practice. A patients’ history of service contact may need to be taken into account in future studies of service satisfaction.
Early onset of renal cancer in a family with Birt–Hogg–Dubé syndrome
Authors: Kluijt I , De Jong D , Teertstra HJ , Axwijk PH , Gille JJP , Bell K , Van Rens A , Van Der Velden AWG , Middelton L , Horenblas S
Published: March 2009

Birt–Hogg–Dubé syndrome is a hereditary syndrome characterized by benign disease of skin and lungs and a risk of malignant renal tumors. We describe a clinical and genetic study of a large Dutch family with a novel mutation in the FLCN gene. Renal cancer at very young age occurred in one branch of this family, while in other branches, cutaneous and pulmonary symptoms predominated. A variety of congenital anomalies and connective tissue abnormalities were observed, possibly associated with the gene mutation.
Machine vision algorithm for whiteflies (Bemisia tabaci Genn.) scouting under greenhouse environment
Authors: Solis‐Sánchez L. O. , García‐Escalante J. J. , Castañeda‐Miranda R. , Torres‐Pacheco I. , Guevara‐González R.
Published: March 2009

One of the main problems in greenhouse crop production is the presence of pests. Detection and classification of insects are priorities in integrated pest management (IPM). This document describes a machine vision system able to detect whiteflies (Bemisia tabaci Genn.) in a greenhouse by sensing their presence using hunting traps. The extracted features corresponding to the eccentricity and area of the whiteflies projections allow to establish differences among pests and other insects on both the trap surfaces and dust generated artefacts. Because of whiteflies geometrical characteristics, it was possible to design an efficient (related to manual counting) machine vision algorithm to scout and count units of this pest within a greenhouse environment. These algorithm results show high correlation indexes for both, sticky screens (R2 = 0.97) and plant leaf situations (R2 = 1.0). The machine vision algorithm reduces the scouting time and the associated human error for IPM‐related activities.
Cloning and expression of heat shock protein genes in two whitefly species in response to thermal stress
Authors: Yu H. , Wan F.‐H.
Published: March 2009

Two whitefly species,Trialeurodes vaporariorumandBemisia tabacibiotype B were shown to have different temperature tolerance and seasonal dynamics. To determine whether this variation in thermal tolerance is related to different expression patterns of heat shock protein (hsp) genes during temperature stress, we obtained complete cDNA sequences for hsp90, hsp70 and hsp20, and analysed their expression profiles across temperature gradients by real‐time quantitative polymerase chain reaction (PCR). Six full‐length cDNAs were cloned and sequenced from these two species. The full‐length cDNAs of hsp90s contain 2166 and 2157 bp open‐reading frames (ORF) which encode proteins with calculated molecular weights of 83 013 and 82 857 Da inT. vaporariorumandB. tabaci, respectively. The 1947 and 1959 bp ORFs of whitefly hsp70s comprise 649 and 653 amino acids with the calculated masses of 70 885 and 71 008 Da inT. vaporariorumandB. tabaci, respectively. Both complete cDNAs of hsp20 ofT. vaporariorumandB. tabacicontain 585 bp ORFs and deduced amino acid sequences had molecular weights of 21 559 and 21 539 Da, respectively. The hsp expression profile results showed that temperatures for onset (Ton) or maximal (Tmax) induction of hsp expression inT. vaporariorumwere generally 2–6°C lower than those inB. tabaci. These results suggest that theTon(orTmax) of hsps can represent the differences in temperature tolerance of these two whitefly species, and may be used to determine their natural geographical distribution and natural population seasonal dynamics. Significant upregulation of most hsps were observed when temperature stress was lifted, except that hsp70 and hsp20 ofB. tabacidid not respond to the cold stress, indicating that response to heat and cold stress may have a different genetic and physiological basis in two whitefly species. These results highlight the importance of understanding the complexity of the heat shock response across multiple isoforms while attempting to link them to whole‐organism traits such as thermal tolerance.
Molecular Identification of Phytophthora spp. Affecting some Economically Important Crops in Eastern India through ITS‐RFLP and Sequencing of the ITS Region
Authors: Guha Roy Sanjoy , Bhattacharyya Somnath , Mukherjee Samir Kumar , Khatua Dinesh Chandra
Published: March 2009

Molecular identification of the Phytophthora spp. affecting betelvine (Piper betel), brinjal (Solanum melongena), guava (Psidium guajava), roselle (Hibiscus subdariffa), black pepper (Piper nigrum), sesame (Sesamum indicum), taro (Colocasia esculenta), chilli (Capsicum annuum), pointed gourd (Trichosanthes dioica), papaya (Carica papaya) was performed through rDNA ITS‐RFLP and also additionally by sequencing the Internal Transcriber spacer (ITS) ITS1 and ITS2 regions. Phytophthora nicotianae, Phytophthora capsici, Phytophthora colocasiae, Phytophthora melonis and Phytophthora palmivora isolates from these 10 different crops were accessioned and the ITS sequences were deposited in Genbank. ITS sequences for Phytophthora isolates from most of these crops are being reported here for the first time. In this study, a review of all earlier Indian reports based on morphology from the above crops and their molecular corroboration has been attempted. This study revealed that not only is P. nicotianae the most prevalent species but also there is the presence of both P. nicotianae and P. capsici, but not P. palmivora on betelvine; as well as possible first reports of P. nicotianae on pepper, P. capsici on chilli and P. palmivora on papaya from this vegetable growing Eastern region of the country. Mating type assays and RAPD markers were used to assess the genotypic diversity of the population. This detection of diversity is a first and critical step for helping to devise and adopt strategies for control and quarantine of these pathogens in this region.
Immunohistochemical expression of IGF‐I and GSK in the spinal cord of Kii and Guamanian ALS patients
Authors: Kihira Tameko , Suzuki Ai , Kondo Tomoyoshi , Wakayama Ikuro , Yoshida Sohei , Hasegawa Kazuko , Garruto Ralph M.
Published: March 2009

Insulin‐like growth factor‐I (IGF‐I) is a potent survival factor for motor neurons in animals, and glycogen synthase kinase‐3β (GSK‐3β) is suspected to play roles in apoptosis and tau phosphorylation. Here we report the immunological expression of IGF‐I, GSK‐3β, phosphorylated‐GSK‐3α/β (p‐GSK‐3α/β) and phosphorylated‐tau in the spinal cord and hippocampus of Kii and Guam amyotrophic lateral sclerosis (ALS) patients. Sixteen ALS patients (10 Japanese sporadic, 3 Kii and 3 Guam ALS) and 14 neurological controls (10 Japanese and 4 Guamanian) were examined. The immunoreactivity for each antibody was rated by the percentages of positive neurons to total anterior horn neurons in each patient and was analyzed statistically. Many normal‐looking neurons from Japanese sporadic ALS, Kii ALS and Guam ALS patients, as well as from Japanese and Guam controls, were positive for anti‐IGF‐I antibody. A positive correlation between IR scores for anti‐IGF‐I antibody and clinical durations of Japanese sporadic ALS patients was found in this study (P < 0.0001). This suggested that IGF‐I might have a protective effect against ALS degeneration. In Japanese sporadic ALS patients, abnormal as well as normal‐looking neurons showed significant high IR scores for anti‐GSK‐3β antibody than those of controls. Anterior horn neurons from Guam and Kii ALS patients characteristically showed weak staining for anti‐GSK‐3β antibody but were markedly positive for anti‐pGSK‐3α/β antibody compared to those from both Japanese controls and Japanese sporadic ALS patients, and showed the co‐localization of IGF‐I and p‐GSK‐3α/β. This suggested that the IGF‐I signaling pathway in Guam and Kii ALS patients might function to phosphorylate GSK‐3β to protect neurons from ALS degeneration. Neurofibrillary tangles (NFTs) in the hippocampus and spinal cord from Kii and Guam ALS patients showed the co‐localization of PHF‐tau and p‐GSK‐3α/β by a confocal laser scanning technique. The predominant expression of p‐GSK‐3α/β compared to GSK‐3β in spinal motor neurons and the co‐localization of p‐GSK‐3α/β and PHF‐tau in NFT‐laden neurons in the hippocampus and spinal cord were characteristic findings of Kii and Guam ALS patients.