bluuebunny/crossref_metadata_2025 huggingface dataset:
A prospective study of the financial costs of multiple sclerosis at different stages of the disease
Authors: Orlewska E. , Mierzejewski P. , Zaborski J. , Kruszewska J. , Wicha W. , Fryze W. , Drozdowski W. , Skibicka I. , Mirowska‐Guzel D. , Czlonkowski A. , Czlonkowska A.
Published: December 2004

The aim of our study was to estimate the costs of multiple sclerosis (MS) in Poland according to severity of disease. Total, direct and indirect costs were compared in 148 patients divided into three groups categorized by disease severity: stage I Expanded Disability Status Scale (EDSS <3.5), stage II (EDSS 4.0–6.0) and stage III (EDSS >6.5). Cost evaluation was performed from the societal perspective and covered the 5‐month period. Simple sensitivity analysis was performed by varying the tariffs and valuing caregiving at 40% of the average wage. The mean total cost/patient for 5 months was estimated at 10 955, 15 603 and 18 464 PLN for stage I, II and III, respectively [exchange rate: 4 PLN = 1 EUR; purchasing power pariety: 1 EUR = 2.05 PLN] (P < 0.0001). Regardless of EDSS stage indirect costs exceeded direct costs. Both direct and indirect costs increased with MS progression. For indirect cost the main item was productivity loss. This study confirms that MS represents a high economic burden, with indirect costs greatly exceeding direct costs. As costs increase with disease progression, treatment efforts should focus on patients in the early stages of MS.
Cognitive performance in people with Parkinson's disease and mild or moderate depression: effects of dopamine agonists in an add‐on to l‐dopa therapy
Authors: Rektorová I. , Rektor I. , Bareš M. , Dostál V. , Ehler E. , Fanfrdlová Z. , Fiedler J. , Klajblová H. , Kulišt’ák P. , Ressner P. , Svátová J. , Urbánek K. , Velísková J.
Published: December 2004

In a randomized prospective multi‐centre study, we evaluated the cognitive performances of a group of 41 non‐demented patients, all with advanced Parkinson's disease (PD) and a current depressive episode, in whom the effects of pramipexole (PPX) and pergolide (PRG) in an add‐on to l‐dopa therapy were also studied and published with regard to motor symptoms of PD, motor complications and depression. The Trail Making Test, the Stroop test and four subtests (arithmetic, picture completion, digit symbols and similarities) of the Wechsler Adult Intelligence Scale‐Revised were performed prior to and 8 months after the administration of either PPX or PRG. We found no statistically significant difference between the two tested drugs or between the first and the last visit in any of the above‐listed neuropsychological tests. All patients’ motor outcomes significantly improved and we conclusively demonstrated the anti‐depressive effect of PPX. The dissociation of dopaminomimetic effects on the different tested domains indicates that there are different pathological mechanisms of cognitive, motor and affective disturbances in advanced PD patients. In our non‐demented group of fluctuating depressed PD subjects, both PPX and PRG administration in combination with l‐dopa were safe in terms of the effect on cognitive performance.
Caffeine-Withdrawal Headache. The Vågå Study of Headache Epidemiology
Authors: Sjaastad O , Bakketeig LS
Published: December 2004

In connection with the Vågå study of headache epidemiology, a search was made for caffeine-withdrawal headache in 1741 parishioners. Female to male ratio 1.05; mean age 44.2 years (range 18-65 years). A face-to-face interview technique was used. The mean consumption of coffee was 4.7 cups a day. Males on an average consumed more coffee (5.1 ± 3.3 cups/day) than females (4.4 ± 3.1 cups/day). Neither in those with a high consumption of coffee: ≥10 cups a day ( n = 134), nor in those with a considerable variation in consumption: ≥10 cups/day ( n = 31) did there seem to be a definite increase in headache resembling caffeine-withdrawal headache, for instance during weekends. In seven parishioners, however, there did seem to be such a headache, and in two of them, the evidence was rather convincing. This headache generally seemed to be mild and global and occurred mainly in the morning hours on weekends. There was no nausea, no throbbing quality of the pain, and no reported use of analgesics. Coffee seemed to abate the headache. This frequency (0.4%) should, clearly, be regarded as a minimum figure. Caffeine-withdrawal headache at the grassroots level may be a rather rare, generally vague, symptom-poor headache.
Petrology and geothermobarometry of granulite facies metapelites from the Hisøy‐Torungen area, south Norway: new data on the Sveconorvegian P–T–t path of the Bamble sector
Authors: KNUDSEN T.‐L.
Published: December 2004

ABSTRACT The high‐grade rocks (metapelite, quartzite, metagabbro) of the Hisøy‐Torungen area represent the south‐westernmost exposures of granulites in the Proterozoic Bamble sector, south Norway. The area is isoclinally folded and a metamorphic P–T–t path through four successive stages (M1‐M4) is recognized.

Petrological evidence for a prograde metamorphic event (M1) is obtained from relict staurolite + chlorite + albite, staurolite + hercynite + ilmenite, cordierite + sillimanite, fine‐grained felsic material + quartz and hercynite + biotite ± sillimanite within metapelitic garnet. The phase relations are consistent with a pressure of 3.6 ± 0.5 kbar and temperatures up to 750–850°C. M1 is connected to the thermal effect of the gabbroic intrusions prior to the main (M2) Sveconorwegian granulite facies metamorphism. The main M2 granulite facies mineral assemblages (quartz+ plagioclase + K‐feldspar + garnet + biotite ± sillimanite) are best preserved in the several‐metre‐wide Al‐rich metapelites, which represent conditions of 5.9–9.1 kbar and 790–884°C. These P–T conditions are consistent with a temperature increase of 80–100°C relative to the adjacent amphibolite facies terranes. No accompanying pressure variations are recorded. Up to 1‐mm‐wide fine‐grained felsic veinlets appear in several units and represent remnants of a former melt formed by the reaction: Bt + Sil + Qtz→Grt + lq. This dehydration reaction, together with the absence of large‐scale migmatites in the area, suggests a very reduced water activity in the rocks and XH2O = 0.25 in the C–O–H fluid system was calculated for a metapelitic unit. A low but variable water activity can best explain the presence or absence of fine‐grained felsic material representing a former melt in the different granulitic metapelites. The strongly peraluminous composition of the felsic veinlets is due to the reaction: Grt +former melt ± Sil→Crd + Bt ± Qtz + H2O, which has given poorly crystalline cordierite aggregates intergrown with well‐crystalline biotite. The cordierite‐ and biotite‐producing reaction constrains a steep first‐stage retrograde (relative to M2) uplift path. Decimetre‐ to metre‐wide, strongly banded metapelites (quartz + plagioclase + biotite + garnet ± sillimanite) inter‐layered with quartzites are retrograded to (M3) amphibolite facies assemblages. A P–T estimate of 1.7–5.6 kbar, 516–581°C is obtained from geothermobarometry based on rim‐rim analyses of garnet–biotite–plagioclase–sillimanite–quartz assemblages, and can be related to the isoclinal folding of the rocks. M4 greenschist facies conditions are most extensively developed in millimetre‐wide chlorite‐rich, calcite‐bearing veins cutting the foliation.
Migraine Prevalence and Some Related Factors in Turkey
Authors: Çelik Yahya , Ekuklu Galip , Tokuç Burcu , Utku Ufuk
Published: December 2004

Objectives.—The aim of our study is to determine the prevalence of migraine in Provincial Center of Edirne.

Methods.—A systematic random sample of 386 inhabitants over 14 years old were interviewed face to face. Diagnosis of migraine was based on the International Headache Society (IHS) classification.

Results.—Migraine was identified in 77 subjects (60 female, 17 male). The lifetime prevalence of migraine was found to be 19.9% (95% CI: 18.3–21.5) (9.34% (95% CI: 8.6–10) in males, 29.3% (95% CI: 27–31.6) in females).

Conclusions.—These results show that while migraine prevalence in Turkish females is higher than that reported in previous studies from Europe and United States, lifetime prevalence is similar in all populations.
Comparison of Intravenous Valproate With Intravenous Lysine‐Acetylsalicylic Acid in Acute Migraine Attacks
Authors: Leniger Tobias , Pageler Lutz , Stude Philipp , Diener Hans Christoph , Limmroth Volker
Published: December 2004

Objective.—The study compared efficacy and tolerability of intravenous valproate (iVPA) with intravenous lysine‐acetylsalicylic acid (iLAS) in acute migraine attacks.

Background.—iLAS has been proven to be a highly effective treatment in acute migraine attacks, but it is not available in many countries and contraindicated in patients with asthma or peptic ulcers. Current data suggest that iVPA may be effective in the treatment of acute migraine attacks.

Design/Methods.—In this randomized, double‐blind, parallel‐group phase‐II study, 40 patients with acute migraine attacks (onset <5 hours, severe or moderate headache on a four‐point IHS scale) alternately received iVPA 800 mg or iLAS 1000 mg. Primary outcome criteria were the percentage of patients reporting pain relief after 1 hour and patients who remained sustained pain free for 24 hours following drug administration. Secondary outcome criteria were relief of pain and associated migrainous symptoms (nausea, photophobia, and phonophobia) at 1, 2, 24, and 48 hours following drug administration.

Results.—There were no significant differences in demographic and clinical features between both treatment groups. Percentage of pain relief after 1 hour in the iVPA and iLAS groups were 25% and 30%, respectively, and of sustained pain free for 24 hours were 20% and 30%, respectively, without significant differences (P= 1 and P= .72, respectively). Both drugs improved associated migrainous symptoms without significant differences at the different time points, but again with a trend in favor of iLAS. No adverse events were observed.

Conclusion.—Both drugs were effective in acute migraine attacks with a trend in favor of iLAS. As both drugs were well tolerated, further studies with higher doses of iVPA for the treatment of acute migraine attacks are recommended.
A Multifactorial Intervention to Reduce Prevalence of Delirium and Shorten Hospital Length of Stay
Authors: Naughton Bruce J. , Saltzman Susan , Ramadan Fadi , Chadha Noshi , Priore Roger , Mylotte Joseph M.
Published: December 2004

Objectives: To improve outcomes for cognitively impaired and delirious older adults.

Design: Pretest, posttest.

Setting: A university‐affiliated hospital.

Participants: Physicians and nurses in the emergency department (ED) and on an acute geriatric unit (AGU).

Intervention: Multifactorial and targeted to the processes of care for cognitively impaired and delirious older adults admitted to medicine service from the ED.

Measurements: Prevalence of delirium, admission to AGU, psychotropic medication use, hospital length of stay.

Results: Patient characteristics did not differ between baseline and the two outcome cohorts 4 and 9 months postintervention. Prevalence of delirium was 40.9% at baseline, 22.7% at 4 months (P<.002), and 19.1% at 9 months (P<.001). More delirious patients were admitted to the AGU than to non‐AGU units at 4 months (P<.01) and 9 months (P<.01). Postintervention medication use in the hospital differed from baseline. Antidepressant use was greater at 4 months (P<.05). Benzodiazepine and antihistamine use were lower at 9 months (P>.01). Antidepressant and neuroleptic use were higher (P<.02) and antihistamine use was lower (P<.02) at 4 months on the AGU than for the baseline group. Benzodiazepine (P<.01) and antihistamine (P<.05) use were lower at 9 months. Each case of delirium prevented saved a mean of 3.42 hospital days.

Conclusion: A multifactorial intervention designed to reduce delirium in older adults was associated with improved psychotropic medication use, less delirium, and hospital savings.
Behavioral and Mood Effects of Snoezelen Integrated into 24‐Hour Dementia Care
Authors: Van Weert Julia C. M. , Van Dulmen Alexandra M. , Spreeuwenberg Peter M. M. , Ribbe Miel W. , Bensing Jozien M.
Published: December 2004

Objectives: To investigate the effectiveness of snoezelen, integrated in 24‐hour daily care, on the behavior and mood of demented nursing home residents.

Design: Quasiexperimental pre‐ and posttest design.

Setting: Twelve psychogeriatric wards of six nursing homes, spread over different parts of the Netherlands.

Participants: One hundred twenty‐five patients with moderate to severe dementia and care dependency were included in the pretest and 128 in the posttest; 61 were completers (included in both pre‐ and posttest).

Intervention: Experimental subjects received an individual 24‐hour snoezel program, based on family history taking and stimulus preference screening. Caregivers were trained, and (organizational) adaptations were made to fulfill the conditions for resident‐oriented snoezel care. The control group received usual nursing home care.

Measurements: Observations were made on the wards using subscales of the Dutch Behavior Observation Scale for Psychogeriatric Inpatients, the Dutch version of the Cohen‐Mansfield Agitation Inventory, and the Cornell Scale for Depression in Dementia. Independent assessors observed video recordings of morning care and rated residents' behavior and mood using INTERACT and FACE, respectively.

Results: Residents receiving snoezel care demonstrated a significant treatment effect with respect to their level of apathetic behavior, loss of decorum, rebellious behavior, aggressive behavior, and depression. During morning care, the experimental subjects showed significant changes in well‐being (mood, happiness, enjoyment, sadness) and adaptive behavior (responding to speaking, relating to caregiver, normal‐length sentences).

Conclusion: Snoezel care particularly seems to have a positive effect on disturbing and withdrawn behavior. The results suggest that a 24‐hour integrated snoezel program has a generalizing effect on the mood and behavior of demented residents.
Relationship Between Self‐Assessed Masticatory Disability and 9‐Year Mortality in a Cohort of Community‐Residing Elderly People
Authors: Nakanishi Noriyuki , Fukuda Hideki , Takatorige Toshio , Tatara Kozo
Published: December 2004

Objectives: To examine the relationship between self‐assessed masticatory disability and mortality.

Design: Prospective.

Setting: Community based.

Participants: Total of 1,405 randomly selected people aged 65 and older living in Settsu, Osaka Prefecture, in October 1992.

Measurements: Data on health status as indicated by disability scores, history of health management, self‐assessed masticatory ability, and psychosocial conditions were collected by means of interviews during home visits at the time of enrollment. Nine‐year follow‐up was completed for 1,245 (88.6%; 398 deceased and 847 alive).

Results: Self‐assessed masticatory disability was significantly associated with being 75 and older, having overall disability, not using dental health checks or general health checks, not participating in social activities, not feeling that life is worth living (no ikigai), and finding relationships with people difficult. As for the association between self‐assessed masticatory disability and mortality, the estimated survival rate for those with self‐assessed masticatory disability was lower than that for those without for each group stratified by sex and age (65–74 and ≥75), and the equality of survival curves according to self‐assessed masticatory disability was significant for each group. After controlling for potential predictors of mortality, self‐assessed masticatory disability remained as a significant predictor of mortality (adjusted hazard ratio=1.63, 95% confidence interval=1.30–2.03, P<.001).

Conclusion: These results indicate that self‐assessed masticatory disability may be associated with a greater risk of mortality in community‐residing elderly people.
Unmet Desire for Caregiver‐Patient Communication and Increased Caregiver Burden
Authors: Fried Terri R. , Bradley Elizabeth H. , O'Leary John R. , Byers Amy L.
Published: December 2004

Objectives: To examine the adequacy of caregiver‐patient communication in serious illness and its relationship to caregiver burden.

Design: Cross‐sectional cohort study.

Setting: Participants' homes.

Participants: One hundred ninety‐three persons aged 60 and older seriously ill with cancer, congestive heart failure, or chronic obstructive pulmonary disease and their caregivers.

Measurements: Communication concerns, measured in terms of agreement with statements regarding desire for and difficulty with communication about the patient's illness. Caregiver burden, measured using a 10‐item subset of the Zarit Burden Inventory, with scores ranging from 0 to 40 and higher scores indicating greater burden.

Results: Of caregivers, 39.9% desired more communication, and 37.3% reported that communication was difficult. Of patients, 20.2% desired more communication, and 22.3% reported that communication was difficult. Disagreement regarding communication concerns was frequent in caregiver‐patient pairs; of caregivers who desired more communication, 83.1% of patients did not, and of patients who desired more communication, 66.7% of caregivers did not. Caregivers who desired more communication had significantly higher caregiver burden scores than did caregivers who did not (9.2 vs 4.7, P<.001), even after adjusting for patient's diagnosis, income, and functional status and caregivers' age, sex, and relationship to the patient.

Conclusion: A large proportion of caregivers and seriously ill older persons had an unmet desire for increased communication, although they frequently disagreed with each other about this desire. Caregivers' desire for increased communication may be a modifiable determinant of caregiver burden.
Association Between Mild Vascular Cognitive Impairment and Impaired Activities of Daily Living in Older Stroke Survivors Without Dementia
Authors: Stephens Sally , Kenny Rose Anne , Rowan Elise , Kalaria Raj N. , Bradbury Michael , Pearce Ruth , Wesnes Keith , Ballard Clive G.
Published: December 2004

Objectives: To determine the relationship between mild vascular cognitive impairment (mVCI) and functional disability in older stroke survivors without dementia.

Design: Cohort study.

Setting: Stroke patients from representative hospital‐based stroke registers.

Participants: Three hundred thirty‐nine stroke survivors without dementia, aged 75 and older.

Measurements: Neuropsychological assessments were completed 3 months poststroke. Activities of daily living (ADLs) were evaluated using the Bristol scale. Operationalized criteria, including cognitive impairment no dementia (CIND), were applied for mVCI.

Results: Significant impairments of ADLs were evident in mVCI (CIND vs no CIND; basic care: z=3.2; P=.001, intermediate care: z=3.6; P<.001, complex management: z=4.5; P<.001) but varied according to the profile of cognitive impairments. Patients with attentional or global impairments had more severe functional disability than patients with isolated memory deficits, with an intermediate level of dysfunction in patients with executive impairments.

Conclusion: The findings emphasize the importance of identifying early cognitive impairments to optimize rehabilitation, care planning, and secondary prevention of dementia in stroke patients.
Treatment of Vasodepressor Carotid Sinus Syndrome with Midodrine: A Randomized, Controlled Pilot Study
Authors: Moore Allan , Watts Michael , Sheehy Tina , Hartnett Ann , Clinch David , Lyons Declan
Published: December 2004

Objectives: To evaluate the efficacy of treatment of the vasodepressor form of carotid sinus hypersensitivity (carotid sinus syndrome (CSS)) with midodrine.

Design: A prospective, double‐blind, randomized, controlled trial of crossover design.

Setting: A dedicated outpatient facility with access to tilt‐table, digital arterial photoplethysmography, and 24‐hour ambulatory blood pressure (BP) monitoring equipment.

Participants: Ten older adults (4 male, 6 female, mean age 75, range 66–86 years) with a history of unexplained syncope who displayed an asymptomatic decrease in systolic BP (SBP) of more than 50 mmHg or a symptomatic decrease of more than 30 mmHg within 30 seconds of carotid sinus massage (CSM).

Measurements: Symptom reproduction and BP and heart rate changes were evaluated after CSM in supine and semierect positions on the right and then left sides. These measurements were performed on the final day of placebo and active‐treatment phases. Ambulatory 24‐hour BP monitoring took place on the penultimate and final days of each treatment phase.

Results: Eight patients were symptomatic after their initial CSM. The mean±standard deviation SBP decrease after initial CSM was 54±22 mmHg. Initial mean 24‐hour ambulatory BP was 127/70±7/5 mmHg. Eight patients reported symptoms after CSM at the end of the placebo phase. The mean SBP decrease at the end of the placebo phase was 49±12 mmHg. The mean 24‐hour ambulatory BP was 127/69±9/7 mmHg. One patient reported symptoms after CSM at the end of the active‐treatment phase. The mean SBP decrease at the end of the active‐treatment phase was 36±9 mmHg. The mean 24‐hour ambulatory BP at the end of the treatment phase was 133/75±7/6 mmHg. The differences in symptom reporting and mean SBP decrease after CSM were both significant (P<.01 and P=.03, respectively).

Conclusion: The results of this pilot study suggest that treatment of vasodepressor CSS with midodrine significantly reduced the rate of symptom reporting and attenuated SBP decreases after CSM but increased mean 24‐hour ambulatory BP.
The mitochondrial membrane potential in human platelets: a sensitive parameter for platelet quality
Authors: Verhoeven Arthur J. , Verhaar Robin , Gouwerok Eric G.W. , De Korte Dirk
Published: December 2004

BACKGROUND:  Deterioration of platelet (PLT) quality during storage is accompanied by an increase in lactate production, indicating a decrease in mitochondrial function. In this study, the optimal conditions under which the fluorescent dye JC‐1 can be used to detect changes in mitochondrial function in PLTs were established.

STUDY DESIGN AND METHODS:  PLTs were incubated at 37°C in synthetic medium under various conditions of JC‐1 loading. In the presence of a high membrane potential, this dye accumulates in the mitochondria with a concomitant increase in red fluorescence. After JC‐1 loading, the ratio of red (FL2) to green (FL1) fluorescence was determined by flow cytometry.

RESULTS:  The FL2‐to‐FL1 ratio of PLTs (3 × 107/mL, loaded with 0.5 µmol/L JC‐1) amounted to about 5 in 1‐day‐old PLTs. At higher dye concentrations, the FL2‐to‐FL1 ratio was significantly lower, suggesting uncoupling by the dye itself. Plasma concentrations above 3 percent significantly affected the JC‐1 signal. The FL2‐to‐FL1 ratio showed a dose‐dependent decrease to an uncoupler of oxidative phosphorylation or to inhibition of the respiratory chain. JC‐1‐loaded PLTs showed a clear decrease in FL2‐to‐FL1 ratio after prolonged storage or upon ultraviolet (UV) illumination. Only after UV treatment did changes in JC‐1 signal correlate with changes in CD62P expression.

CONCLUSION:  The FL2‐to‐F1 ratio of PLTs loaded with JC‐1 is a reliable and sensitive indicator of the mitochondrial membrane potential, provided that the proper experimental conditions have been applied.
Application of molecular genetic methods in diagnostics and epidemiology of food‐borne bacterial pathogens
Authors: LUKINMAA SUSANNA , NAKARI ULLA‐MAIJA , EKLUND MARJUT , SIITONEN ANJA
Published: December 2004

Salmonella enterica, Campylobacter and Yersinia species, Shiga toxin‐producing Escherichia coli (STEC), Listeria monocytogenes and Clostridium perfringens are the bacterial pathogens constituting the greatest burden of food‐borne disease in Finland. Several molecular genetic methods have been applied to diagnose, discriminate and survey these bacteria. PCR, PCR‐RFLP and PFGE are the most widely and successfully used. However, these methods are unable to replace conventional and internationally standardised phenotyping. Electronic database libraries of the different genomic profiles will enable continuous surveillance of infections and detection of possible infection clusters at an early stage. Furthermore, whole‐genome sequence data have opened up new insights into epidemiological surveillance. Laboratory‐based surveillance performed in a timely manner and exploiting adequate methods, and co‐operation at local, national and international levels are among the key elements in preventing food‐borne diseases. This paper reviews different applications of molecular genetic methods for investigating enteric bacterial pathogens and gives examples of the methods successfully used in diagnostics and epidemiological studies in Finland.
Effects of tricalcium phosphate bone graft materials on primary cultures of osteoblast cells in vitro
Authors: Aybar Buket , Bilir Ayhan , Akçakaya Handan , Ceyhan Tasşkın
Published: December 2004

Abstract: The aim of this study was to evaluate β‐tricalcium phosphate (β‐TCP Cerasorb® Curasan‐Germany) graft materials on specific parameters of rat osteoblast activity in vitro. Primary culture osteoblastic cells were isolated from neonatal rat calvaria by sequential collagenase digestion. To analyze the effect of biomaterials on cell proliferation, cell numbers and viability of the cells were cultured on the graft material for 24, 48 or 96 h. Osteoblast cells cultured in DMEF‐12 media supplemented with 10% fetal calf serum were used as the control group. [3H]thymidine was added during the last 2 h of the incubation. The cell numbers of each well were counted. Cell viability was estimated by counting the number of cells, which excluded trypan blue solution. Scanning electron microscopy was used to observe for visualizing the interactions between osteoblastic cells and TCP graft material. The proportion of cells undergoing DNA synthesis, estimated by thymidine uptake, was significantly (P<0.05) greater on the control group after the 24‐ and 48‐h incubations. Regarding the cell numbers the difference was not statistically significant for the three time points. The number of viable cells recovered was similar for the two groups. No morphological differences were observed in cell morphology on TCP graft material and the control group. The results demonstrate that TCP graft material has no adverse effect on cell count, viability and morphology, and this material provides a matrix that favors limited cell proliferation.
A histological evaluation of the involvement of Bio‐Oss® in osteoblastic differentiation and matrix synthesis
Authors: Tapety Fabricio I. , Amizuka Norio , Uoshima Katsumi , Nomura Shuichi , Maeda Takeyasu
Published: December 2004

Abstract: This study was designed to investigate the responses of bone cells to a deproteinized bovine bone material, Bio‐Oss® (Geistlich‐Pharma, Wolhunsen, Switzerland), which was grafted in artificial bone defects of rat femurs. Standardized bone defects in the cortical bone of the right femurs were grafted with Bio‐Oss® particles. Narrow penetrations were prepared on the bottom of the cavity, enabling osteogenic cells to migrate from the bone marrow. A defect in the left femur without Bio‐Oss® was used as a control. The treated femurs were histochemically examined at 1, 3, 5, 7, and 14 days after the operation. At day 1, no osteogenic migration into the cavities occurred in either the control or experimental groups. At day 3, alkaline phosphatase (ALPase) immunohistochemistry showed a migration of the positive cells at the bottom of the cavities of the experimental groups, but not in the control ones. At day 5, new bone formation was recognized at the bottom of the cavity of both groups. In the experimental group, ALPase‐positive cells were localized on Bio‐Oss® and/or on the thin bone matrix that covered this material. The superficial layer of Bio‐Oss® underlying the newly formed bone exhibited osteocalcin immunoreactivity. Transmission electron microscopy revealed osteoblasts depositing bone matrices – including collagen fibers – on the surface of Bio‐Oss®. At days 7 and 14, woven bone occupied the previous cavities of both control and experimental groups, accompanied by osteoclasts. Thus, Bio‐Oss® appears to serve as a scaffold for osteogenic cells as well as to promote osteoblastic differentiation and matrix synthesis.
Caries prevalence, oral health behavior, and attitudes in children residing in radiation‐contaminated and ‐noncontaminated towns in Ukraine
Authors: Spivak Karina , Hayes Catherine , Maguire James H.
Published: December 2004

Abstract –

Introduction: Several studies investigating the oral health status of children living in Ukraine after the Chernobyl catastrophe revealed an increase of caries in children residing in radionucleotide‐contaminated areas.

Purpose: (1) To compare prevalence of dental caries in contaminated and noncontaminated towns; and (2) to determine if there is a difference between dental behaviors and attitudes of children residing in contaminated and noncontaminated areas that may have contributed to differences in caries prevalence.

Methods: Children aged 13–14 were randomly selected in two towns of approximately the same population size (33 000): Ovruch (n = 119) from a contaminated area and Mirgorod (n = 100) from a noncontaminated area. Data on behaviors and attitudes were collected via a self‐administered questionnaire having six domains: (i) family background; (ii) dental anxiety; (iii) dental utilization; (iv) oral hygiene; (v) use of fluoride toothpaste; and (vi) sugar consumption. Oral examinations included information on carious lesions, restorations, missing teeth, and soft tissue abnormalities. Caries prevalence was compared using a t‐test. Regression analysis was conducted to determine the independent contribution of oral hygiene behaviors and dental utilization.

Results: There was a significant difference in caries prevalence in the contaminated town (mean DMFT = 9.1 ± 3.5) versus the noncontaminated town (mean DMFT = 5.7 ± 1.4; P < 0.000). Oral hygiene practices, age, and utilization of dental services were not found to be associated with differences in DMFT score between the two communities.

Conclusion: There was a significantly higher caries prevalence in a radiation‐contaminated town compared to a noncontaminated town of Ukraine. The difference was not explained by differences in oral health knowledge, attitudes or behaviors.
An assessment of the validity and reliability of dental self‐report items used in a National Child Nutrition Survey
Authors: Jamieson Lisa M. , Thomson W. Murray , McGee Rob
Published: December 2004

Abstract  – 

Objectives:  To examine the clinical validity and reliability of dental self‐report items used in a national child nutrition survey.

Methods: The study involved completion of dental self‐report questionnaires by 6–9‐year‐old children who attended one of the three schools with ethnic distributions, similar to schools in the national survey, and their care‐givers. Children were then dentally examined.

Results: Two hundred and four children (response rate 74.2%) returned questionnaires and were dentally examined. The highest degree of child and care‐giver concordance for the self‐reported dental items was for the ‘has had an extraction due to dental caries’ item (kappa = 0.92), while the lowest was for the ‘brushes twice or more per day’ item (kappa = 0.61). The prevalence of dental caries in the deciduous dentition was 67.6%. The mean dfs, mean DFS and mean number of missing primary teeth because of caries were 6.15 (SD 6.51), 0.83 (SD 1.28) and 0.30 (SD 0.82), respectively. Caries severity was higher in children who reported brushing infrequently, having received a filling, having had an extraction because of caries, having been kept awake at night because of dental pain or having had a general anaesthetic for dental treatment. Values for self‐report and clinical reliability were above 0.80 in all instances.

Conclusions: The dental self‐report items showed a high level of concordance between child and care‐giver, and appeared to be clinically valid. The findings suggest that using dental self‐report measures for children may be valuable in dental epidemiological investigations.
Bone marrow necrosis successfully treated with corticosteroid
Authors: Santana Alfredo N. C. , Ramos Renata G. , Zanandrea Eduardo F. , Brandão‐Neto Rodrigo A.
Published: December 2004

Abstract:  A 60‐yr‐old white woman with CREST syndrome (calcinosis cutis, Raynaud's phenomenon, esophageal involvement, sclerodactyly, telangectasia), idiophatic portal hypertension and esophageal varices presented with a 2‐month history of bone pain and severe anemia, requiring erythrocyte transfusion every 5–7 d. Initial laboratory findings were hemoglobin (Hb) 4.4 g/dL, platelets 15 × 109/L, white blood cell count (WBC) 2.7 × 109/L. Bone marrow biopsy showed large areas of BMN, and cultures of bone marrow aspirate were negative. The patient was started on intravenous pulse methylprednisolone (1000 mg/d for 3 d) followed by oral prednisone (1 mg/kg/d), and did not require erythrocyte transfusion thereafter. On the 40th day, our patient had Hb 11.6 g/dL, platelets 120 × 109/L, WBC 6.2 × 109/L. Here, we describe the first report of BMN in a patient with CREST syndrome, the first description of successful treatment with intravenous pulse corticosteroid and discuss the possible immune mechanisms involved in the present case.
Pulmonary parenchymal infiltrates in a patient with CD20‐positive multiple myeloma
Authors: Yokote Taiji , Akioka Toshikazu , Miyamoto Hiroyuki , Oka Satoko , Hara Satoshi , Yamano Takeshi , Takasu Tasaburo , Tsuji Motomu , Hanafusa Toshiaki
Published: December 2004

Abstract: A 53‐yr‐old woman developed a dry cough after the completion of multi‐agent chemotherapy. The biopsy specimens showed diffuse infiltrates with multiple myeloma (MM) cells. Immunohistochemistry revealed positive staining in MM cells with surface CD20, surface CD38, and cytoplasmic IgG. This report represents the first reported case of pulmonary parenchymal infiltrates in a patient with CD20‐positive MM.
Detection of unique neutrophil non‐muscle myosin heavy chain‐A localization by immunofluorescence analysis in MYH9 disorder presented with macrothrombocytopenia without leukocyte inclusions and deafness
Authors: Kunishima Shinji , Matsushita Tadashi , Shiratsuchi Motoaki , Ikuta Takuya , Nishimura Junji , Hamaguchi Motohiro , Naoe Tomoki , Saito Hidehiko
Published: December 2004

Abstract:  MYH9 disorders are autosomal‐dominant macrothrombocytopenias with leukocyte inclusions caused by mutations in the MYH9 gene, which encodes the non‐muscle myosin heavy chain‐A (NMMHCA). We report a patient with an MYH9 disorder who presented with macrothrombocytopenia without leukocyte inclusions and severe bilateral sensory deafness. Conventional May–Grünwald–Giemsa staining failed to detect granulocyte cytoplasmic inclusions, whereas immunofluorescence analysis clearly demonstrated abnormal neutrophil NMMHCA localization. Genetic analyses revealed a novel heterozygous 18 base deletion in MYH9, leading to a six‐amino acid in‐frame deletion (N76_S81del) in NMMHCA. These results further support the usefulness of immunofluorescence analysis in differential diagnosis of MYH9 disorders.
Periodontitis as risk factor for acute myocardial infarction. A case control study of Spanish adults
Authors: Cueto A. , Mesa F. , Bravo M. , Ocaña‐Riola R.
Published: December 2004

Objective:  The present study was designed to determine, in a case‐control study of a Spanish population, whether periodontitis is a risk factor for acute myocardial infarction.

Background:  Although part of cardiovascular risk could be explained by periodontal disease, available meta‐analyses find significant heterogeneity and recommend the need for further observational and intervention studies.

Methods:  A case‐control study was conducted of 149 Spanish patients aged between 40 and 75 years, with 72 cases (acute myocardial infarction) and 77 controls (trauma patients). Periodontitis was measured as the percentage of sites with clinical attachment loss greater than 3 mm. A multivariate logistic regression model was constructed to estimate the adjusted effect of periodontitis on acute myocardial infarction, after considering the potential confounding effect of a large pool of risk factors.

Results:  In a bivariate analysis, males, older patients, smokers, and those with hypertension, diabetes or hypercholesterolemia, showed an increased risk of acute myocardial infarction. The cases, compared to controls, showed worse results for all periodontal variables studied: gingival retraction, pocket depth, and periodontitis. The final multiple logistic model included sex, age, tobacco habit, hypertension, diabetes, hypercholesterolemia, regular exercise, and periodontitis. The association between periodontitis (dichotomized) and acute myocardial infarction was high and significant in both the unadjusted (odds ratio = 4.42, p < 0.001) and adjusted analyses (odds ratio = 3.31, p = 0.005).

Conclusion:  There is evidence of an association between periodontitis and acute myocardial infarction after adjusting for well‐known risk factors for acute myocardial infarction.
Hyperthermia: a failure of the motor cortex and the muscle
Authors: Todd Gabrielle , Butler Jane E. , Taylor Janet L. , Gandevia S. C.
Published: December 2004

Fatigue is increased during hyperthermia, and torque declines more rapidly in sustained maximal voluntary contractions (MVCs). This can be caused by a greater decline in voluntary activation of muscle (i.e. ‘central fatigue’). The present study aimed to localize the site of failure of voluntary drive during hyperthermia. Seven subjects made brief (2–3 s) and sustained (2 min) MVCs of elbow flexor muscles in two experiments. Core temperature was normal (∼37°C) in the first experiment, and elevated (∼38.5°C) by passive heating in the second. During some MVCs, transcranial magnetic stimulation of the motor cortex (TMS) was delivered, and the evoked torque (superimposed twitch) and EMG responses were measured. During hyperthermia, voluntary torque was reduced by ∼2.4% during brief MVCs (P= 0.03), and decreased further (∼12%) during sustained MVCs (P= 0.01). The superimposed twitch amplitude in the sustained MVC was ∼50% larger (P= 0.01). Thus, the ability to drive the muscle maximally in a sustained fashion was decreased, and some motor cortical output, which could have increased torque, remained untapped by voluntary drive. The additional central fatigue was not associated with altered motor cortical ‘excitability’, as EMG responses produced by TMS were similar at the two temperatures. However, the peak relaxation rate of muscle increased by ∼20% (P= 0.005) during hyperthermia. Hence, faster motor unit firing rates would be required to produce fusion of force. The increased central fatigue during hyperthermia may represent a failure of descending voluntary drive to compensate for changed muscle properties, despite the availability of additional cortical output.
Quantitative functional analysis of protein complexes on surfaces
Authors: Lee Hye Jin , Yan Yuling , Marriott Gerard , Corn Robert M.
Published: December 2004

A major challenge in cell and molecular physiology research is to understand the mechanisms of biological processes in terms of the interactions, activities and regulation of the underlying proteins. Functional and mechanistic analyses of the large number of proteins that participate in the regulation of cellular processes will require new approaches and techniques for high throughput and multiplexed functional analyses of protein interactions, protein conformational dynamics and protein activity. In this review we focus on the development and application of proteomics and associated technologies for quantitative functional analysis of proteins and their complexes that include: (1) the application of surface plasmon resonance (SPR) imaging for multiplexed, label‐free analyses of protein interactions, binding constants for biomolecular interactions and protein activities; and (2) high content analysis of protein motions within functional multiprotein complexes.
A New Model to Simulate Gas Injection in Gas Chamber Pumps
Authors: Pilo-Restuccia S. , Rojas-Solo´rzano L.
Published: December 2004

Currently, there exist large heavy-oil reserves in countries like Venezuela and Canada. In Venezuela, heavy oil represents 69% of the reserves, and its exploitation is not always feasible using traditional pumping technologies. In particular, this is the case of some in-lake oil wells in Venezuela, which are impossible to exploit by means of any known efficient way of oil lifting. An alternative is the gas-chamber pumping (GCP), an intermittent artificial lift method used in diverse areas of USA, in shallow wells with heavy oil and in areas where a source of high-pressure gas exists. Few works are reported on the modeling of the phenomena associated to GCP, the most rigorous being the one published by PDVSA-Intevep in the year 2000. This model, however, omits some key aspects related with gas injection, which affects its precision to simulate or design GCP systems. The present work develops a model to rigorously simulate the stage of gas injection into the chamber, incorporating aspects like the flow of gas from the supply manifold up to the wellhead, the gas expansion within the injection valve, the descending flow along a coiled tubing, and the heat transfer associated. The pressurization process and chamber venting are also modeled. The model predictions are in excellent agreement with experimental data [1].
A Validation Methodology for a Combined Heating Cooling and Power (CHCP) Pilot Plant
Authors: Cardona E. , Piacentino A.
Published: December 2004

A great number of variables significantly influence the energetic, environmental and economic results of CHP (Combined Heating and Power) and CHCP (Combined Heating Cooling and Power) plants operation, and as a consequence their project activity is rather complex. In order to select the best layout and properly size the machines, detailed data on hourly electric, thermal, and cooling demand are necessary, so that a series of plant life cycle simulations may have to be carried out. Unfortunately, such detailed data are rarely available, because energy consumptions data for existing buildings are usually derived from aggregated monthly or bimonthly gas and electricity bills. Even more difficulties are encountered for new types of buildings, for which no consumptions data are available. In such cases, the most common procedure consists in performing, using case-oriented criteria, an estimate of the thermal and cooling consumption levels, and to refine it during construction, if necessary. This is the case of an existing medium size CHCP pilot plant for office buildings that covers the electrical, thermal, and cooling loads of two office buildings situated in a Mediterranean area (Palermo, Sicily, Italy). Estimated demand profiles were used; the effect on thermal demand of the conversion of the cooling load into thermal one through an absorption chiller was assessed. This is a very significant aspect in all warm climates zones. Cumulative curves were obtained for the aggregate thermal demand, by summing the heat direct applications and the heat consumptions for feeding the absorption chiller. In this paper the existing plant was compared with other plant configurations, varying both for machine sizes and management criterion, in order to affirm whether or not the plant selected by the designer in a simplified manner was or not an appropriate solution. The comparison was performed from an energetic and economic viewpoint.
Defect Detection for Bearings Using Envelope Spectra of Wavelet Transform
Authors: Shi D. F. , Wang W. J. , Qu L. S.
Published: December 2004

In order to overcome the shortcomings in the traditional envelope analysis in which manually specifying a resonant frequency band is required, a new approach based on the fusion of the wavelet transform and envelope spectrum is proposed for detecting and localizing defects in rolling element bearings. This approach is capable of completely extracting the characteristic frequencies related to the defect from the resonant frequency band. Based on the Shannon entropy of wavelet-based envelope spectra, a criterion to select optimal scale to monitor the condition of bearings is also presented. Experiment results show that the proposed approach is sensitive and reliable in detecting defects on the outer race, inner race, and rollers of bearings.
No-Jerk Skyhook Control Methods for Semiactive Suspensions
Authors: Ahmadian Mehdi , Song Xubin , Southward Steve C.
Published: December 2004

This paper presents two alternative implementations of skyhook control, named “skyhook function” and “no-jerk skyhook,” for reducing the dynamic jerk that is often experienced with conventional skyhook control in semiactive suspension systems. An analysis of the relationship between the absolute velocity of the sprung mass and the relative velocity across the suspension are used to show the damping-force discontinuities that result from the conventional implementation of skyhook control. This analysis shows that at zero crossings of the relative velocity, conventional skyhook introduces a sharp increase (jump) in damping force, which, in turn, causes a jump in sprung-mass acceleration. This acceleration jump, or jerk, causes a significant reduction in isolation benefits that can be offered by skyhook suspensions. The alternative implementations of skyhook control included in this study offer modifications to the formulation of conventional skyhook control such that the damping force jumps are eliminated. The alternative policies are compared to the conventional skyhook control in the laboratory, using a base-excited semiactive system that includes a heavy-truck seat suspension. An evaluation of the damping force, seat acceleration, and the electrical currents supplied to a magnetorheological damper, which is used for this study, shows that the alternative implementations of skyhook control can entirely eliminate the damping-force discontinuities and the resulting dynamic jerks caused by conventional skyhook control.
Dynamic Modeling and Vibration Control of Electrorheological Mounts
Authors: Choi Seung-Bok , Hong Sung-Ryong
Published: December 2004

This paper presents two different types of electrorheological (ER) mounts that can support a static load of 200 kg. One is a flow mode type, and the other is a squeeze mode type. After analyzing the governing equations of motion, two ER mounts are designed and manufactured. The field-dependent displacement transmissibilities are evaluated in the frequency domain. In addition, vibration control responses of two ER mounts are experimentally investigated by implementing a skyhook controller.