bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating Anesthesia and Surgical Procedure Times from Medicare Anesthesia Claims
Authors: Silber Jeffrey H. , Rosenbaum Paul R. , Zhang Xuemei , Even-Shoshan Orit
Published: January 2007

Background

Procedure times are important variables that often are included in studies of quality and efficiency. However, due to the need for costly chart review, most studies are limited to single-institution analyses. In this article, the authors describe how well the anesthesia claim from Medicare can estimate chart times.

Methods

The authors abstracted information on time of induction and entrance to the recovery room ("anesthesia chart time") from the charts of 1,931 patients who underwent general and orthopedic surgical procedures in Pennsylvania. The authors then merged the associated bills from claims data supplied from Medicare (Part B data) that included a variable denoting the time in minutes for the anesthesia service. The authors also investigated the time from incision to closure ("surgical chart time") on a subset of 1,888 patients.

Results

Anesthesia claim time from Medicare was highly predictive of anesthesia chart time (Kendall's rank correlation tau = 0.85, P < 0.0001, median absolute error = 5.1 min) but somewhat less predictive of surgical chart time (Kendall's tau = 0.73, P < 0.0001, median absolute error = 13.8 min). When predicting chart time from Medicare bills, variables reflecting procedure type, comorbidities, and hospital type did not significantly improve the prediction, suggesting that errors in predicting the chart time from the anesthesia bill time are not related to these factors; however, the individual hospital did have some influence on these estimates.

Conclusions

Anesthesia chart time can be well estimated using Medicare claims, thereby facilitating studies with vastly larger sample sizes and much lower costs of data collection.
Analysis of polynuclear aromatic and aliphatic components in soil humic acids using ruthenium tetroxide oxidation
Authors: Ikeya K. , Ishida Y. , Ohtani H. , Yamamoto S. , Watanabe A.
Published: January 2007

Although condensed aromatic components are considered to be one of the major structural units of soil humic acids (HAs) and to be responsible for the dark colour of HAs, their amount and composition remain largely unknown. In ruthenium tetroxide oxidation (RTO), condensed aromatic components are detectable as their degradation products, mainly benzenepolycarboxylic acids (BPCAs). We applied this technique to soil HAs with various degrees of humification (darkening). The yields of water‐ and dichloromethane‐soluble products from HAs upon RTO after methylation ranged from 210 to 430 mg g−1 and 10–40 mg g−1, respectively. Eight kinds of BPCAs with two to six carboxyl groups, and seven kinds of BPCAs with additional side chains (tentative assignment) were obtained as methylated counterparts. The yield of each BPCA and the sum of the yields of BPCAs (12–85 mg g−1 HAs) increased with increasing degree of humification and aromatic C content. The compositions of BPCAs indicated that the degree of condensation was greater in the HAs with greater degrees of humification. The sum of the yields of aliphatic compounds ranged from 0.1 to 6.5 mg g−1, and decreased with increasing degree of humification. The C12 to C30 monocarboxylic acid methyl esters accounted for > 56% of the aliphatic compounds assigned, which may be present mainly as end alkyl groups in the HA molecules. We also obtained the methylated counterparts of C14 to C24 dicarboxylic acids; these were possibly derived from polymethylene bridges between adjacent aromatic rings.
Prevention of serious vascular events by aspirin amongst patients with peripheral arterial disease: randomized, double‐blind trial
Authors:   Critical Leg Ischaemia Prevention Study (CLIPS) Group
Published: January 2007

Objective.  To assess the prophylactic efficacy of aspirin and a high‐dose antioxidant vitamin combination in patients with peripheral arterial disease (PAD) in terms of reduction of the risk of a first vascular event (myocardial infarction, stroke, vascular death) and critical limb ischaemia.

Design.  Randomized, placebo‐controlled, double‐blind clinical trial with 2 × 2 factorial design.

Setting.  Thirty‐seven European angiology/vascular medicine units.

Subjects.  A total of 366 outpatients with stage I‐II PAD documented by angiography or ultrasound, with ankle/brachial index <0.85 or toe index <0.6; 210 patients completed the follow‐up.

Interventions.  Four treatment groups: (i) oral aspirin (100 mg daily), (ii) oral antioxidant vitamins (600 mg vitamin E, 250 mg vitamin C and 20 mg β‐carotene daily), (iii) both or (iv) neither, given for 2 years.

Main outcome measure.  Major vascular events (cardiovascular death, myocardial infarction or stroke) and critical leg ischaemia.

Results.  Seven of 185 patients allocated aspirin and 20 of 181 allocated placebo suffered a major vascular event (risk reduction 64%, P = 0.022); five and eight patients, respectively, suffered critical leg ischaemia (total 12 vs. 28, P = 0.014). There was no evidence that antioxidant vitamins were beneficial (16/185 vs. 11/181 vascular events). Neither treatment was associated with any significant increase in adverse events. Inclusion of this trial in a meta‐analysis of other randomized trials of anti‐platelet therapy in PAD makes the overall results highly significant (P < 0.001) and suggests that low‐dose aspirin reduces the incidence of vascular events by 26%.

Conclusions.  For the first time direct evidence shows that low‐dose aspirin should routinely be considered for PAD patients, including those with concomitant type 2 diabetes.
Glycogen synthase kinase‐3 is required for optimal de novo synthesis of inositol
Authors: Azab Abed N. , He Quan , Ju Shulin , Li Guiling , Greenberg Miriam L.
Published: January 2007

Studies have shown that the inositol biosynthetic pathway and the enzyme glycogen synthase kinase‐3 (GSK‐3) are targets of the mood‐stabilizing drugs lithium and valproate. However, a relationship between these targets has not been previously described. We hypothesized that GSK‐3 may play a role in inositol synthesis, and that loss of GSK‐3 may lead to inositol depletion, thus providing a mechanistic link between the two drug targets. Utilizing a yeast Saccharomyces cerevisiae gsk‐3Δ quadruple‐null mutant, in which all four genes encoding homologues of mammalian GSK‐3 are disrupted, we tested the hypothesis that GSK‐3 is required for de novo inositol biosynthesis. The gsk‐3Δ mutant exhibited multiple features of inositol depletion, including defective growth in inositol‐lacking medium, decreased intracellular inositol, increased INO1 and ITR1 expression, and decreased levels of phosphatidylinositol. Treatment of wild‐type cells with a highly specific GSK‐3 inhibitor led to a significant increase in INO1 expression. Supplementation with inositol alleviated the temperature sensitivity of gsk‐3Δ. Activity of myo‐inositol‐3 phosphate synthase, the rate‐limiting enzyme in inositol de novo biosynthesis, was decreased in gsk‐3Δ. These results demonstrate for the first time that GSK‐3 is required for optimal myo‐inositol‐3 phosphate synthase activity and de novo inositol biosynthesis, and that loss of GSK‐3 activity causes inositol depletion.
Single dose of MDMA causes extensive decrement of serotoninergic fibre density without blockage of the fast axonal transport in Dark Agouti rat brain and spinal cord
Authors: Kovács G. G. , Andó R. D. , Ádori C. , Kirilly E. , Benedek A. , Palkovits M. , Bagdy G.
Published: January 2007

Prolonged neurotoxicity of the recreational drug, MDMA (3,4‐methylenedioxymethamphetamine) on serotoninergic axon terminals has been suggested. The effect of a single (15 mg/kg) dose of intraperitoneally administered MDMA on serotoninergic fibre density, defined by tryptophan hydroxylase (TpH) and serotonin transporter (5‐HTT) immunoreactivity, has been evaluated in the spinal cord and brain areas in Dark Agouti rats, 7 and 180 days after MDMA applications. Immunostaining for amyloid precursor protein (APP) has been performed to examine possible defects of the fast axonal transport, and 5‐HTT mRNA expressions were quantified in neurones of medullary raphe nuclei. Seven days after MDMA treatment, a substantial decrease in the density of TpH‐immunoreactive fibres was detectable in the frontal cortex, the caudate‐putamen, the CA1 region of the hippocampus, and marked decreases were found in the spinal cord. These changes in TpH density showed a high correlation with 5‐HTT densities. In contrast, APP‐immunoreactive axonal bulbs were not detected in any of the brain regions studied. Seven days after MDMA administrations, significantly elevated 5‐HTT mRNA expressions were found in the raphe pallidus and obscurus. Our results suggest that a single dose of MDMA elicits widespread depletion of TpH and 5‐HTT immunoreactivity in serotoninergic axons without morphological sign of the blockage of the fast anterograde axonal transport. Our results do not support the notion of MDMA‐induced axotomy of serotoninergic neurones. The up‐regulation of 5‐HTT mRNA expressions 1 week after MDMA injections might indicate the potential recovery of the serotonin system.
Relationship between neuronal loss and ‘inflammatory plaques’ in early onset Alzheimer's disease
Authors: Shepherd C. E. , Grace E. M. , Mann D. M. A. , Halliday G. M.
Published: January 2007

We have previously described a novel ‘inflammatory plaque’ in the cortex of early onset Alzheimer's disease (EOAD) cases with presenilin 1 mutations (PS1). These plaques are associated with a significant inflammatory infiltrate consisting of reactive microglia and astrocytes. We speculated that these inflammatory plaques might be responsible for the more severe disease process seen in EOAD. In the present study using the superior frontal cortex, 63 EOAD cases with mutations in PS1, presenilin 2 (PS2) and amyloid precursor protein (APP) were categorized as either having inflammatory plaques (13 cases, two APP and 11 PS1) or not. To determine the impact on cell loss, seven EOAD cases with inflammatory plaques (EOIP) and seven EOAD cases without (EONIP) were selected and neuronal cell counts performed. These were compared with neuronal counts taken from the same cortical region of seven control and six sporadic AD cases. Cases with EOAD had significantly less neurones per field compared with sporadic AD and control cases (EOAD = 19.5 ± 0.8 neurones/field, spAD = 23.7 ± 1.2 neurones/field, controls = 30.37 ± 1.2 neurones/field). However, no significant difference in the number of neurones per field was seen in EOAD cases with or without inflammatory plaque pathology (EOIP = 19.2 ± 1.4, EONIP = 19.7 ± 0.8). These data demonstrate that EOAD cases exhibit greater neuronal cell loss in the superior frontal cortex than sporadic AD and that this effect is independent of the presence or absence of inflammatory plaque pathology.
A neuropathological study of two autopsy cases of syndromic hemimegalencephaly
Authors: Boer K. , Troost D. , Spliet W. G. M. , Redeker S. , Crino P. B. , Aronica E.
Published: January 2007

Hemimegalencephaly (HMEG) is a malformation of cortical development characterized by unilateral enlargement of the cerebral hemisphere, severe architectural and cellular abnormalities and association with intractable epilepsy. HMEG may represent an isolated lesion of the central nervous system, but may also be associated with several neurocutaneous syndromes. In the present study we discuss the neuropathological findings of two autopsy cases of HMEG associated with linear naevus sebaceous syndrome. Both cases showed the presence of linear naevus sebaceous on extensive areas of the face. The neurochemical profile of the glial and neuronal components in the affected hemisphere was determined using immunocytochemical markers and was compared with the unaffected contralateral hemisphere and normal control tissue. The observed cytomegalic neurones expressed receptors for distinct neurotransmitters, neuropeptides and growth factors. Analysis of components of the phosphoinositide 3‐kinase pathway revealed expression of phospho‐S6 ribosomal protein in cytomegalic neurones. Autopsy findings confirm the complexity of the histologic phenotypic manifestations in HMEG and proved useful in determining the spectrum of cytoarchitectural and neurochemical abnormalities, underlying the molecular pathogenesis and epileptogenesis of this brain malformation.
Isolation and characterization of cgchi3, a nodule‐specific gene from Casuarina glauca encoding a class III chitinase
Authors: Fortunato Ana , Santos Patricia , Graça Inês , Gouveia Maria Manuela , Martins Sandra Marina , Pinto Ricardo Cândido Pereira , Pawlowski Katharina , Ribeiro Ana
Published: January 2007

Chitinases (EC 3.2.1.14) catalyse the hydrolysis of chitin, a homopolymer of β‐1,4‐linked N‐acetyl‐d‐glucosamine residues. Plant chitinases are involved in a wide variety of processes; in particular, their expression has been found to be enhanced in symbiotic and pathogenic plant–microbe interactions. During this work we have cloned and characterized a gene encoding a class III chitinase from actinorhizal nodules of Casuarina glauca (cgchi3). CGCHI3 was found to be encoded by a single gene that was specifically activated in nodules as compared with uninoculated control roots and leaves. The expression of this gene was further enhanced in nodules after salicylic acid treatment and completely repressed after wounding. In situ hybridisation analysis revealed that cgchi3 is an early nodulin gene, being expressed in the meristem and in the uninfected cortical cells of young nodules. Based on the obtained results we suggest that this gene is involved in nodule development. This is the first report on a class III chitinase coding gene that is specifically activated during actinorhizal symbiosis.
Phylogeographic variation among isolates of theSirococcus conigenusP group
Authors: Konrad H. , Stauffer C. , Kirisits T. , Halmschlager E.
Published: January 2007

In this study the phylogeographic variation among isolates of theSirococcus conigenusP group and the phylogenetic relationships ofS. conigenuswithSirococcus clavigignenti‐juglandacearumand other species previously placed in the genusSirococcuswere investigated. A collection of 33 isolates originating fromPicea,PinusandLarixin Europe, North America and Bhutan were characterized by sequence analyses of the internal transcribed spacer (ITS) region (including ITS1, 5.8S ribosomal DNA, ITS2) of the nuclear rDNA and a portion of theβ‐tubulin gene. In phylogenetic analyses most isolates from pine, spruce and larch formed a distinct clade, representing the P group ofS. conigenus, which was separated from the T group of this pathogen. Four isolates fromPiceain Europe and Canada formed a third clade withinS. conigenusand these isolates are referred to as the S group. The P group consisted of five distinct ITS haplotypes, which partly differed in their optimum growth temperature and their growth rates at 25°C on malt extract agar. Nested clade analysis resolved the five haplotypes into three distinct clades and revealed significant genetic/geographic associations for some of the haplotypes. Parsimony analysis of the small subunit (18S) ribosomal DNA sequences confirmed the phylogenetic affinities betweenS. conigenusandS. clavigignenti‐juglandacearum. In contrast,Godronia cassandraeandHormococcus conorum, which formerly had been placed in the genusSirococcus, were found to be only distantly related toS. conigenusandS. clavigignenti‐juglandacearum.
Sirococcus shoot blight onPicea spinulosain Bhutan
Authors: Kirisits T. , Konrad H. , Halmschlager E. , Stauffer C. , Wingfield M. J. , Chhetri D. B.
Published: January 2007

During a recent survey of forest tree diseases in Western and Central Bhutan, Sirococcus shoot blight and an associatedSirococcussp. were found on saplings and mature trees of Eastern Himalayan spruce (Picea spinulosa). Based on morphological characteristics and DNA sequence comparisons of the ITS region of the rDNA operon, representative isolates from Bhutan were unequivocally identified asSirococcus conigenus. The DNA sequence data also showed that these isolates belong to the P group ofS. conigenus. To our best knowledge, this is the first report of Sirococcus shoot blight from the Himalayas or any other part of Asia.Sirococcus conigenusdoes not appear to cause dramatic damage at the moment, but this fungus has the potential to cause severe disease problems onP. spinulosain Bhutan.
Spatial distribution and persistence of Heterobasidion parviporum genets on a Norway spruce site
Authors: Piri T. , Korhonen K.
Published: January 2007

Spatial distribution of Heterobasidion genets over a period of ca 50 years in two successive generations of Norway spruce (Picea abies) was unravelled. The genets were first identified in 1993 in a naturally regenerated 43‐year‐old spruce stand that had been thinned the previous winter. Heterobasidion parviporum was found in 17.5% of the old stumps of the previous spruce generation. Nine genets were identified on the study plot; seven of them were present in old stumps of the previous tree generation and two only in the new spruce generation. Eighteen spruce trees of the new generation were infected, 15 of them by vegetative growth of genets originating from the old stumps. The study plot was investigated again in 2005. No new genets had been established after thinning, and three old genets had died out. The remaining genets had infected five new trees, most likely from the thinning stumps of diseased trees. At the age of 56 years, 16.1% of the residual spruces were infected by Heterobasidion. The results of this study suggest that if spore infection to stumps of spruce can be prevented, the decay frequency caused by H. parviporum will not necessarily increase in successive generations.
Competition among the adults of three grasshoppers (Orthop., Acrididae) on an alpine grassland
Authors: Liu C.Z. , Zhou S.R. , Yan L. , Huang F.N.
Published: January 2007

Abstract:  The intraspecific and interspecific competition among the adults of three common grasshoppers, Angaracris rhodopa (Fischer‐Waldheim), Chorthippus dubius (Zubovsky) and Chorthippus fallax (Zubovsky) was investigated on Ganjia High Mountain Grassland in north‐west China. The results indicated a strong intraspecific competition within species at high densities. The interspecific competition between the larger‐sized species, A. rhodopa, and the smaller‐sized species, C. dubius or C. fallax, was weak, while competition between C. dubius and C. fallax was strong. An asymmetric competitive interaction in mortality and fecundity associated with the diet and size was observed among the three species. Competition was strong between the two species that had a similar diet. The large‐sized species had higher mortality rates and lower fecundity than the smaller‐sized species. Intraspecific competition between the three species was mainly affected by food limitation, while interspecific competition was mainly associated with food limitation as well as the grasshoppers’ adaptation to the environment.
The role of intercropping different cereal species in controlling lepidopteran stemborers on maize in Kenya
Authors: Songa J. M. , Jiang N. , Schulthess F. , Omwega C.
Published: January 2007

Abstract:  The effects of mixed cropping systems containing maize, sorghum, millet and beans on infestations of cereals by lepidopteran stemborers and on associated parasitoids, as well as on yields and land equivalent ratios (LER) were assessed during four consecutive rainy seasons at two sites in the semi‐arid eastern region of Kenya. Systems containing the non‐host bean were more efficient in reducing pest densities than those with millet or sorghum only. Higher parasitism in diversified systems compared to monocrops was due to density‐dependent effects rather than superior suitability of such systems to parasitoids. The maize–bean system, which had the highest proportion of bean plants, had LERs >1.65 while most other systems had LERs <1. It is concluded that mixed cropping with several cereal species has little advantages in terms of yield loss abatement due to stemborers and land use efficiency. However, including the drought‐tolerant crops such as sorghum and millet in the system stabilizes food security in drought‐prone areas such as eastern Kenya.
Cultural and communication awareness for general practice registrars who are international medical graduates: A project of CoastCityCountry Training
Authors: Duncan Geraldine F. , Gilbey David
Published: January 2007

Objective:  (1) To generate discussion about Australian culture and language with GP registrars using the medium of poetry; and (2) to introduce discussion about language and communication skills in a role‐play format that GP registrars would embrace as part of their clinical training.

Design:  (1) A variety of Australian poems was selected to reflect six themes: men, women, the Bush, ANZACS, Aboriginal Australia and migrants, which would provide a basis for discussion on a range of cultural issues to aid a medical professional trained overseas in developing further understanding of aspects of Australian culture. (2) A series of role plays was developed to reflect the clinical themes of each Day Release education program. These were enacted in a small group setting by preselected GP registrars with feedback from a medical educator and an English as a Second Language teacher.

Setting:  The Riverina/Murrumbidgee area of New South Wales, one of the three local training groups of CoastCityCountryTraining.

Participants:  GP registrars attached to the Riverina/Murrumbidgee Local Training Group.

Main outcome measures:  To show that discussion of poetry and participation in role plays are active language‐ and cultural‐learning environments capable of enhancing understanding of a range of issues about Australia that are relevant to a GP registrar.

Results:  There was increased participation by GP registrars in accessing the set material prior to each session. It was noted that there was also increased active involvement of all registrars in discussion within the group throughout the year. Discussion allowed clarification of aspects of Australian culture to participants with different international medical backgrounds, as well as providing an opportunity for GP registrars to share their own experiences.
A randomized controlled trial for maintaining peripheral intravenous lock in children
Authors: Mok Esther , Kwong Tany KY , Chan Moon Fai
Published: January 2007

The most effective and safe method of maintaining peripheral intravenous lock in children is an important clinical question that has been identified by the researchers. The results of recent studies comparing saline versus 10 units/ml of heparin saline flush using a 24‐gauge catheter in neonatal and pediatric populations are conflicting and inconclusive. The objectives of this study were to evaluate the effectiveness and safety of three flush solutions: normal saline, 1 unit/ml of heparin saline and 10 units/ml of heparin saline for maintaining peripheral intravenous locks in children, and to establish a research‐based practice in the study hospital. In a prospective, randomized controlled, double‐blind trial, one hundred and twenty‐three subjects ranging in age from 1–10 years with 123 intravenous locks were randomly chosen to receive 1 unit/ml of heparin saline, 10 units/ml of heparin saline and normal saline to evaluate length of catheter use, survival rate and incidence of intravenous complications. The study found no statistically significant differences in length of catheter use, estimated catheter survival and the incidence of intravenous complications among the three groups. The group that received 1 unit/ml of heparin saline demonstrated the highest rate of survival. The mean length of catheter use of the group that received 1 unit/ml of heparin saline (49.8 hours) was 17 hours longer than the group that received normal saline (32.5 hours). There are no significant differences among the three types of flushing solution in terms of the catheter longevity and incidence of intravenous complications.
Deletion analyses of SMN1 and NAIP genes in Malaysian spinal muscular atrophy patients
Authors: WATIHAYATI MOHD S. , ZABIDI‐HUSSIN AZHAR M.H. , TANG THEAN H. , MATSUO MASAFUMI , NISHIO HISAHIDE
Published: January 2007

Background: The survival motor neuron 1 (SMN1) gene has been recognized to be responsible for spinal muscular atrophy (SMA) because it is homozygously deleted in more than 90% of SMA patients, irrespective of their clinical severity, whereas the neuronal apoptosis inhibitory protein (NAIP) gene is now considered to be a modifying factor of the severity of SMA. In Malaysia, it remains to be elucidated whether deletion of the SMN1 gene is also a main cause of SMA or whether deletion of the NAIP gene is found in the SMA patients.

Methods: To clarify the pathogenesis of SMA in Malaysia, a deletion analysis of the SMN1 and NAIP genes was performed in 24 Malaysian SMA patients. Deletion analysis of exons 7 and 8 of the SMN1 gene was performed according to the method described by van der Steege et al., while deletion analysis of exon 5 of the NAIP gene was performed according to a method described by Roy et al.

Results: Homozygous deletion of SMN1 exon 7 and exon 8 were identified in 19 out of 24 patients (79%). As to the NAIP gene, deletion of exon 5 was detected in six out of 24 patients (25%). NAIP gene deletion was correlated with severity of the disease.

Conclusions: Deletion of the SMN1 exon 7 is a major cause of SMA in Malaysia, and NAIP gene deletions are not rare in type I SMA in Malaysia. The lower percentage of the SMN1 gene deletion may be due to the possibility that the present study included some patients without SMN1 gene abnormality and/or some patients with non‐deletion type mutations in the SMN1 gene.
Low‐level chronic mercury exposure in children and adolescents: Meta‐analysis
Authors: NG DANIEL KWOK‐KEUNG , CHAN CHUNG‐HONG , SOO MAN‐TING , LEE ROBERT SHING‐YAN
Published: January 2007

Background:  Mercury is a well‐known neurotoxin. There are three kinds of mercury exposure: elemental mercury poisoning, inorganic mercury poisoning and organomercury poisoning. Organomercury is the most toxic. Twenty‐four hour urine for mercury and blood mercury are the gold standards for diagnosis of mercury poisoning, including low‐level chronic mercury exposure. Other tests for mercury level are discussed. The purpose of the present paper was to review recent data on the nature, pathophysiology, pharmacokinetics, diagnostic methods, treatment and the linkage to neurodevelopmental disabilities of mercury exposure in children.

Methods:  A literature search was undertaken of MEDLINE (1980–2003), and American Academy of Pediatrics, American Medical Association, American Dental Association, World Health Organization and Center for Disease Control websites. The search string ‘mercury’ was used in MEDLINE and articles were selected as appropriate by two independent reviewers. All relevant information was reviewed and data were extracted by two independent reviewers.

Results:  Based on the meta‐analysis of the accuracy of hair mercury, hair mercury levels correlated with mercury level in blood (sample size weighted correlation coefficient,  = 0.61), with 24 h urine (  = 0.46) and with cord blood (  = 0.64). However, the correlation for hair mercury level with 24 h urine level and blood level was not high enough to replace them in clinical decision‐making of individual patient. Epidemiological evidence has shown that low‐level mercury poisoning is not a cause of autism (relative risk = 0.49, 95%CI = 0.36–0.66). The risk of neurodevelopmental disabilities from low‐level exposure to methylmercury from the regular consumption of fish is still controversial even after combining results from different epidemiological studies worldwide. There is a lack of data in the literature about the effect of chelation therapy in children with neurodevelopmental disabilities.

Conclusion:  Mercury poisoning should be diagnosed only with validated methods. There is no evidence to support the association between mercury poisoning and autism.
A Pseudomonas putida cardiolipin synthesis mutant exhibits increased sensitivity to drugs related to transport functionality
Authors: Bernal Patricia , Muñoz‐Rojas Jesús , Hurtado Ana , Ramos Juan L. , Segura Ana
Published: January 2007

Biological membranes have evolved different mechanisms to modify their composition in response to chemical stimuli in a process called ‘homeoviscous adaptation’. Among these mechanisms, modifications in the ratio of saturated/unsaturated fatty acids and in cis/trans fatty acid isomers, cyclopropanation and changes in the phospholipids head group composition have been observed. To further understand the role of phospholipid head groups in solvent stress adaptation, we knocked out the cls (cardiolipin synthase) gene in Pseudomonas putida DOT‐T1E. As expected, cls mutant membranes contained less cardiolipin than those of the wild‐type strain. Although no significant growth rate defect was observed in the cls mutant compared with the wild‐type strain, mutant cells were significantly smaller than the wild‐type cells. The cls mutant was more sensitive to toluene shocks and to several antibiotics than the parental strain, suggesting either that the RND efflux pumps involved in the extrusion of these drugs were not working efficiently or that membrane permeability was altered in the mutant. Membranes of the cls mutant strain seemed to be more rigid than those of the parental strain, as observed by measurements of fluorescence polarization using the DPH probe, which intercalates into the membranes. Ethidium bromide is pumped out in Pseudomonas putida by at least one RND efflux pump involved in antibiotic and solvent resistance, and the higher rate of accumulation of ethidium bromide inside mutant cells indicated that functioning of the efflux pumps was compromised as a consequence of the alteration in phospholipid head group composition.
Molecular phylogeny of fig wasp pollinators (Agaonidae, Hymenoptera) of Ficus section Galoglychia
Authors: Erasmus J. Christoff , Van Noort Simon , Jousselin Emmanuelle , Greeff Jaco M.
Published: January 2007

The obligate mutualism between fig trees and their fig wasp pollinators, together with the general tendency for each host species to be pollinated by one fig wasp species, led to the hypothesis that these two lineages have cospeciated. The pollinators of African figs of section Galoglychia form a diverse group of genera whose species seem to be less constrained to a specific host than other pollinating fig wasp genera. Various authors have suggested remarkably different phylogenetic relationships between the seven genera associated with section Galoglychia. These uncertainties concerning the classification make it difficult to understand the historical patterns of association between these wasps and their hosts. The phylogenetic tree for the pollinators was reconstructed with 28S, COI and ITS2 DNA sequence data and compared with morphological classification of the hosts. Pollinator genera were monophyletic in all analyses. However, the relative position of some genera remains unresolved. Investigation of host−fig association suggests that there have been frequent host jumps between host subsections. This indicates that cospeciation between fig trees and fig wasps is not as stringent as previously assumed. In addition, pollinators of the genus Alfonsiella associated with three host figs (Ficus craterostoma, F. stuhlmannii and F. petersii) are morphologically very similar in South Africa. We investigated the possibility that these pollinators form a complex of species with host‐based genetic differentiation. Molecular analyses supported the distinction of the pollinator of F. craterostoma as a good species, but the pollinators of F. stuhlmannii and F. petersii clustered within the same clade, suggesting that these two host species share a single pollinator, Alfonsiella binghami. Based on both molecular data and morphological re‐evaluation, a new Alfonsiella species is described, Alfonsiella pipithiensis sp. nov., which is the pollinator of F. craterostoma in southern Africa. A key to both females and males of all described species of Alfonsiella is provided.
Prostate‐specific antigen (PSA) and PSA velocity for prostate cancer detection in men aged <50 years
Authors: Sun Leon , Moul Judd W. , Hotaling James M. , Rampersaud Edward , Dahm Phillipp , Robertson Cary , Fitzsimons Nicholas , Albala David , Polascik Thomas J.
Published: January 2007

Many of the papers in this section are specifically related to the complexities of PSA testing and prostatic biopsy. Increasingly PSA testing has become a constituent part of urological practice, and although most would maintain that its is the best urological marker for prostate cancer that we have, its failings have led us to examine its performance in microscopic detail, to help us to use it better for detecting prostatic cancer.

In the same way, high‐grade prostatic intraepithelial neoplasia has become important in our understanding of the progression of the pathology of prostate cancer. Several papers in this section re‐emphasise the importance of this finding, and suggest that it remains a highly significant indicator of the likely development of prostate cancer.

OBJECTIVE

To identify threshold values of prostate‐specific antigen (PSA) levels and PSA velocity (PSAV) to optimize the assessment of the risk of prostate cancer in young men, as prostate cancer is detected increasingly in men aged <50 years.

PATIENTS AND METHODS

Data for a group of 12 078 men, including 1622 with prostate cancer, were retrieved from the Duke Prostate Center Database. Based on the latest date for a PSA assay, these men were divided into two age groups of <50 and ≥ 50 years, with 904 and 11 174 men in each group, respectively. Receiver operating characteristic curves (ROC) of PSA and PSAV were calculated and the cancer risk was assessed.

RESULTS

The prevalence of prostate cancer was 4.4% (40 men) for men aged <50 years and 14.2% (1582 men) for men aged ≥ 50 years. For the group with cancer the median PSA in men aged <50 years was significantly lower than that in men aged ≥ 50 (1.3 vs 6.3 ng/mL, P < 0.001). ROC curves of PSA and PSAV showed a breakpoint at a PSA level of 2.3 ng/mL and a PSAV of 0.60 ng/mL/year for men aged <50 years. Both the sensitivity and specificity in the younger group at a PSA level of 2.5 ng/mL were higher than in the older group.

CONCLUSIONS

In men aged <50 years the operating characteristics of PSA are more sensitive and specific than in older men. Diagnostic PSA levels in men aged <50 years are significantly lower than suggested by guidelines. Using a 2.0–2.5 ng/mL PSA level threshold for biopsy in men aged <50 years and a PSAV threshold lower than the traditional 0.75 ng/mL/year is reasonable in contemporary practice. Further studies are warranted to validate these thresholds.
Spermatogenesis in the contralateral testis of patients with testicular germ cell cancer: histological evaluation of testicular biopsies and a comparison with healthy males
Authors: Dieckmann Klaus‐Peter , Linke Jörg , Pichlmeier Uwe , Kulejewski Magdalena , Loy Volker
Published: January 2007

Associate Editor

Michael G. Wyllie

Editorial Board

Ian Eardley, UK

Jean Fourcroy, USA

Sidney Glina, Brazil

Julia Heiman, USA

Chris McMahon, Australia

Bob Millar, UK

Alvaro Morales, Canada

Michael Perelman, USA

Marcel Waldinger, Netherlands

OBJECTIVE

To assess histologically signs of testicular dysgenesis (TD) in the contralateral testes of patients with testicular germ cell tumours (GCTs) and to compare these findings with the spermatogenetic quality in healthy men, as the contralateral testis is considered to be involved with dysgenetic features such as poor sperm production, and accordingly, GCTs are hypothesized to be part of the ‘TD syndrome’ (TDS). One testicular biopsy is thought to represent spermatogenesis in the entire testis. We evaluated this view by using testicular two‐site biopsies.

PATIENTS AND METHODS

2318 patients with testicular GCT had a contralateral testicular two‐site biopsy. Testicular biopsies taken on forensic autopsy from 1388 presumably healthy men served as controls. Spermatogenesis was rated histologically according to a modified Johnsen score. Clinical factors were recorded to explore associations with reduced spermatogenesis. Differences in spermatogenesis scoring results among two‐site biopsies were noted. Statistical analysis involved Wilcoxon–Mann–Whitney and Jonckheere–Terpstra tests for comparing patients and controls, and for studying associations with clinical factors. Classification and regression‐tree analysis was used to explore multivariate associations.

RESULTS

Histologically, patients had significantly poorer spermatogenesis than healthy men. Clinically, hypospermatogenesis was significantly associated with testicular atrophy, undescended testes, male infertility, and advanced clinical stage; 5.4% of cases (95% confidence interval 4.43–6.27) had discordant findings of >2 points on double biopsy and 9.8% had differences of 1 point. Discordance was significantly associated with poor spermatogenesis and testicular atrophy.

CONCLUSIONS

We confirmed histologically that there is markedly reduced spermatogenesis in the contralateral testes of patients with GCT. This result lends credence to the view that GCT is part of the so‐called TDS. But as hypospermatogenesis is associated with advanced clinical stage, impairment of sperm production might at least partly be acquired secondary to the endocrine activity of GCT. There were clinically relevant discordant results on double biopsy in 5.4%, predominantly in infertile patients and in atrophic testes. Thus the histological evaluation of male infertility is best done by multiple biopsies.
Analysis of progression and survival after 10 years of a randomized prospective study comparing mitomycin‐C and bacillus Calmette‐Guérin in patients with high‐risk bladder cancer
Authors: Gårdmark Truls , Jahnson Staffan , Wahlquist Rolf , Wijkström Hans , Malmström Per‐Uno
Published: January 2007

OBJECTIVE

To report the 10‐year follow‐up of a study randomizing between instillations of bacillus Calmette‐Guérin (BCG) and mitomycin‐C (MMC) for treating high‐risk and not muscle‐invasive urinary bladder cancer to assess progression, the need for more aggressive treatment and survival (cancer‐specific and overall), as many of the published studies comparing different treatments for disease that is not muscle‐invasive have a short follow‐up.

PATIENTS AND METHODS

Between 1987 and 1992, 261 patients were included; they had frequently recurring Ta/T1G1–G2, T1G3 or primary Tis‐dysplasia. The patients were randomized to treatment with either 40 mg of MMC or 120 mg of BCG (Danish strain 1331) given weekly for 6 weeks, then monthly up to a year and finally every third month for a further year. The 250 evaluable patients were followed using hospital files and national registers on causes of death.

RESULTS

The median follow‐up for survivors was 123 months. The disease progressed in 58 (23%) of the patients, 34 in the MMC group and 24 in the BCG group (P = 0.26). Of the 140 patients who died, 68 were in the BCG and 72 in the MMC group (log‐rank P = 0.98); most (95, 68%) died from other causes.

CONCLUSION

Based on the follow‐up of the present patients it cannot be concluded that the drugs originally administered, MMC or BCG, differed in their effect on progression, need for subsequent treatment or survival.
Winter severity limits red fox populations in Eurasia
Authors: Bartoń Kamil A. , Zalewski Andrzej
Published: January 2007

Aim  We investigated geographical variation in the density of the red fox in relation to climatic variables, habitat productivity and seasonality to identify those factors that were the best predictors of fox density.

Location  Published data on red fox abundance were collated from 69 locations over Europe and Asia.

Methods  Using generalized linear models and the information‐theoretic approach, we analysed the contribution of climatic measures (winter and summer temperature, mean snow depth and duration), primary productivity and seasonality indices [based on the fraction of photosynthetically active radiation (FPAR) index] to account for variation in red fox density.

Results  Red fox density in winter ranged from 0.001–2.8 individuals km−2; the average density was 0.21 individuals km−2. Variation in red fox density was best explained by the winter temperature and seasonality. Density decreased with declining winter and summer temperatures, increasing degree of seasonality and increasing duration of snow cover. There was no relationship with habitat productivity.

Main conclusions  Our results indicate that winter climatic conditions and seasonality, but not habitat productivity, may limit red fox density in Eurasia. One explanation for the limitation of the red fox population may be the fox's physiological capability to cope with abiotic conditions. Concurrently, the severity of winter may lead to reduced availability of the fox's prey. That, together with a shorter reproductive period may result in lower reproductive output as well as lower survival of adults and cubs.
The Nature of Unemployment among Young Men in Urban Ethiopia
Authors: Serneels Pieter
Published: January 2007

This paper investigates the nature of unemployment among young men in urban Ethiopia and finds that it is concentrated among relatively well‐educated first‐time job seekers who aspire to a public sector job and spend on average close to four years in unemployment. This is consistent with a segmented labor market model where youngsters queue in unemployment for a good job, as confirmed by an empirical test of the theoretical prediction. We observe a negative (causal) relationship between household welfare and both the incidence and duration of unemployment, indicating that unemployment is concentrated among the relatively worse off urban households, which from a national perspective represent the middle classes, and find suggestive evidence that part of this effect is due to malnutrition during childhood. Job search through social networks is only effective after one has become unemployed, suggesting that networks provide insurance only after exposure to the risk.
Growth, Employment and Taxation with Distortions in the Goods and Labour Market
Authors: Roeger Werner
Published: January 2007

This paper analyses taxation in the presence of distortions in goods and labour markets in an endogenous growth model. The government disposes of capital, labour and consumption taxes. It is shown that the market solution leads to suboptimally low levels of growth and employment. However, available tax instruments are sufficient to attain the first-best growth path in this economy. The paper further explores the relative distortion of capital and labour taxes. For plausible parametrisations of the model, lowering capital taxes dominate reductions in labour taxes in welfare terms.
Introduction: Understanding Public Policy through Its Instruments—From the Nature of Instruments to the Sociology of Public Policy Instrumentation
Authors: LASCOUMES PIERRE , LE GALES PATRICK
Published: January 2007

Public policy instrumentation and its choice of tools and modes of operation are treated either as a kind of evidence (governing means making regulations, taxing, entering into contracts, communicating, etc.) or as if the questions it raises (the properties of instruments, justifications for choosing them, their applicability, etc.) are part of a rationality of methods without any autonomous meaning. This paper aims to explain the significance of a political sociology approach to public policy instruments in accounting for processes of public policy change: (1) public policy instrumentation is a major issue in public policy, since it reveals a (fairly explicit) theorization of the relationship between the governing and the governed: every instrument constitutes a condensed form of knowledge about social control and ways of exercising it; and (2) instruments at work are not neutral devices: they produce specific effects, independently of the objective pursued (the aims ascribed to them), which structure public policy according to their own logic.
Intellectual Obsolescence and Intellectual Makeovers: Reflections on the Tools of Government after Two Decades
Authors: HOOD CHRISTOPHER
Published: January 2007

This article reflects on the mixture of ideology, technological change, and interests that have made government instrumentalities central to the analysis of public policy over the two decades since the publication of the author’s Tools of Government in 1983, and distinguishes three main strains of analysis of policy instruments: analytic approaches that count forms of institutions as tools, analytic approaches that focus on the politics of tool selection, and generic approaches that aim to be institution‐ and technology‐free. The article argues first that the three main strains differ over the questions they ask rather than comprising different ways of answering the same question (though it distinguishes competing forms of generic approach); second, that beneath surface obsolescence, the generic policy tools analysis has not become fundamentally outdated over two decades; and third, that changes in technology makes technology‐free analysis all the more necessary as a tool of comparison.
Methodological evolution and clinical application of C.G. Jung's Word Association Experiment: a follow‐up study
Authors: Vezzoli Caterina , Bressi Cinzia , Tricarico Giorgio , Boato Paolo
Published: January 2007

Abstract:  We became interested in the clinical application of the Word Association Experiment (AE) when we decided to use Jung's theory of complexes in the psycho‐diagnostic evaluation and treatment of patients applying to our Psychotherapy Out‐patients Unit (Psychiatric Clinic, Milan University).

In psychopathological situations, complexes with a particularly high emotional charge become autonomous and disturbing, inhibiting the ego's functions. The representations and affective states corresponding to these complexes become dominant, conditioning the expression of symptoms and the subject's relational modes.

In this experimental study we started out from the basic theory that our psycho‐therapeutic work should lead to a progressive change in the patient's initial complex set up. Jung's Word Association Experiment allows us to identify those words which indicate and stimulate a specific activation of the complexes for each subject via specific markers of complexes. We therefore decided to determine whether AE, administered during the first phase of clinical‐diagnostic evaluation and after one year of treatment, revealed any changes occurring in the patients' set up of complexes.