bluuebunny/crossref_metadata_2025 huggingface dataset:
Optic nerve head parameters of an indigenous population living within Central Australia
Authors: Landers John A , Henderson Tim R , Craig Jamie E
Published: September 2006

Abstract

Purpose:  Clinical examination of the optic disc is an essential element in the assessment of its health. Previous work has described normal optic disc appearance among different races. No such description of optic discs exists for indigenous Australians, who are at low risk of developing glaucoma. This study was designed to evaluate optic disc parameters of indigenous Australians.

Methods:  A sample of 208 indigenous Australians were recruited as they presented to remote clinics in Central Australia. Each subject underwent optic disc photography using a Topcon TRC‐NW100 digital fundus camera. Optic discs were measured and analysed with Topcon ImageNet 2000 software.

Results:  Among other parameters, mean vertical disc diameter and disc area were 2.13 ± 0.21 mm (mean ± SD) and 3.13 ± 0.57 mm2, respectively, for right eyes and 2.14 ± 0.21 mm and 3.16 ± 0.58 mm2 for left eyes. When compared with published studies, these parameters were significantly larger than Caucasians, but similar to African individuals.

Conclusion:  Our results suggest that indigenous Australians have optic discs that are larger than those of Caucasians, but similar to those of Africans who are considered to at a greater risk of glaucoma. Factors other than optic disc area are likely to underlie the higher prevalence of primary open angle glaucoma among African individuals.
Cataract and its surgery in Timor‐Leste
Authors: Brian Garry , Palagyi Anna , Ramke Jacgueline , Du Toit Rence , Naduvilath Thomas
Published: September 2006

Abstract

Purpose:  To determine the prevalence of visually significant and unoperated blinding cataract, and the coverage, characteristics and outcome of cataract surgery in Timor‐Leste.

Methods:  Based on the World Health Organization Rapid Assessment of Cataract Surgical Services protocol, a population‐based cross‐sectional survey was conducted in 2005. By two‐stage cluster random sampling, 50 clusters of 30 people aged 40 years and older were selected. Each eye with a presenting visual acuity worse than 6/18 and/or a history of cataract surgery was examined.

Results:  Of the 1470 people enumerated, 96.2% were examined. Of the eyes examined, 11.5% were blind (presenting vision less than 6/60). Cataract caused 66.3% of this, and 40.2% of vision impairment (presenting vision less than 6/18). For those people who were blind (7.7%; presenting vision less than 6/60 in the better eye), cataract was the most frequent cause (76.1%). Cataract surgery had occurred in 2% of participants. Gender and domicile were not associated with cataract blindness or surgery. Cataract Surgical Coverage (6/60) was 16.3% for Eyes and 20.2% for Persons. Surgical outcomes were poor, falling well short of World Health Organization guidelines. Astigmatism and posterior capsule opacity were important contributors to this.

Conclusions:  Until census data are available, age‐gender‐domicile correction of sample findings cannot be calculated. In the meantime, it is estimated there are 11 500 cataract blind in Timor‐Leste. Long‐term, indigenous cataract surgical services need to be capable of significantly increased output. Better surgical outcomes are required to ensure scarce resources are well used. Laser capsulotomy needs to be planned for as surgical numbers increase.
Tracheal sealing by auto‐inflation in tracheal tube cuffs
Authors: WEISS MARKUS , SHORTEN GEORGE , STUTZ KATHARINA , BERNET VERA
Published: September 2006

Background:  The purpose of this study was to determine if inspiratory pressure from intermittent positive pressure ventilation may be sufficient to inflate the cuff (thus ‘auto‐inflation’) and thereby seal the trachea.

Methods:  In a laboratory model we investigated the ability of cuffs of seven 5.0 mm internal diameter (ID) tracheal tubes (Sheridan CF, Mallinckrodt Hi‐Contour, Mallinckrodt Sealguard, Mallinckrodt Safety‐Flex, Portex Soft Seal, Rueschelit Super‐Safety Clear and Microcuff PET) to seal the trachea by auto‐inflation, i.e. by using the inspiratory pressure to expand and keep open the cuff within the trachea. A mechanical lung connected to a model trachea made from clear, rigid polyvinylchloride (PVC) (12 mm ID) was used to simulate changes in inspiratory pressures. Respirator settings were: fresh gas flow (air) 6 l·min−1; positive end‐expiratory pressure 5 cmH2O; respiratory rate 20 br·min−1; I : E ratio = 1 : 2; inspiratory pressure 5, 10, 15, 20, and 25 cmH2O. Percentage of expiratory to inspiratory tidal volume (E : I Vt volume ratio) was calculated.

Results:  Using lubricated Mallinckrodt Seal Guard tube cuffs E : I Vt volume ratio was almost 100% at a peak inspiratory pressure of 10 cmH2o whereas in tube cuffs particularly made of PVC an E : I ratio was achieved only at higher inspiratory pressures, if at all.

Conclusions:  Auto‐inflation in the Mallinckrodt Seal Guard with high volume–low pressure polyurethane cuff can produce adequate tracheal sealing in the model trachea used. The implication is that such auto‐inflation should decrease the risk of tracheal injury from acute or persistent cuff hyperinflation.
Diversity and abundance of sulfate‐reducing microorganisms in the sulfate and methane zones of a marine sediment, Black Sea
Authors: Leloup Julie , Loy Alexander , Knab Nina J. , Borowski Christian , Wagner Michael , Jørgensen Bo Barker
Published: September 2006

The Black Sea, with its highly sulfidic water column, is the largest anoxic basin in the world. Within its sediments, the mineralization of organic matter occurs essentially through sulfate reduction and methanogenesis. In this study, the sulfate‐reducing community was investigated in order to understand how these microorganisms are distributed relative to the chemical zonation: in the upper sulfate zone, at the sulfate–methane transition zone, and deeply within the methane zone. Total bacteria were quantified by real‐time PCR of 16S rRNA genes whereas sulfate‐reducing microorganisms (SRM) were quantified by targeting their metabolic key gene, the dissimilatory (bi)sulfite reductase (dsrA). Sulfate‐reducing microorganisms were predominant in the sulfate zone but occurred also in the methane zone, relative proportion was maximal around the sulfate–methane transition, c. 30%, and equally high in the sulfate and methane zones, 5–10%. The dsrAB clone library from the sulfate–methane transition zone, showed mostly sequences affiliated with the Desulfobacteraceae. While, the dsrAB clone libraries from the upper, sulfate‐rich zone and the deep, sulfate‐poor zone were dominated by similar, novel deeply branching sequences which might represent Gram‐positive spore‐forming sulfate‐ and/or sulfite‐reducing microorganisms. We thus hypothesize that terminal carbon mineralization in surface sediments of the Black Sea is largely due to the sulfate reduction activity of previously hidden SRM. Although these novel SRM were also abundant in sulfate‐poor, methanogenic areas of the Black Sea sediment, their activities and possibly very versatile metabolic capabilities remain subject of further study.
In vitro cell growth of marine archaeal‐bacterial consortia during anaerobic oxidation of methane with sulfate
Authors: Nauhaus Katja , Albrecht Melanie , Elvert Marcus , Boetius Antje , Widdel Friedrich
Published: September 2006

Anoxic sediment from a methane hydrate area (Hydrate Ridge, north‐east Pacific; water depth 780 m) was incubated in a long‐term laboratory experiment with semi‐continuous supply of pressurized [1.4 MPa (14 atm)] methane and sulfate to attempt in vitro propagation of the indigenous consortia of archaea (ANME‐2) and bacteria (DSS, Desulfosarcina/Desulfococcus cluster) to which anaerobic oxidation of methane (AOM) with sulfate has been attributed. During 24 months of incubation, the rate of AOM (measured as methane‐dependent sulfide formation) increased from 20 to 230 μmol day−1 (g sediment dry weight)−1 and the number of aggregates (determined by microscopic counts) from 0.5 × 108 to 5.7 × 108 (g sediment dry weight)−1. Fluorescence in situ hybridization targeting 16S rRNA of both partners showed that the newly grown consortia contained central archaeal clusters and peripheral bacterial layers, both with the same morphology and phylogenetic affiliation as in the original sediment. The development of the AOM rate and the total consortia biovolume over time indicated that the consortia grew with a doubling time of approximately 7 months (growth rate 0.003 day−1) under the given conditions. The molar growth yield of AOM was approximately 0.6 g cell dry weight (mol CH4 oxidized)−1; according to this, only 1% of the consumed methane is channelled into synthesis of consortia biomass. Concentrations of biomarker lipids previously attributed to ANME‐2 archaea (e.g. sn‐2‐hydroxyarchaeol, archaeol, crocetane, pentamethylicosatriene) and Desulfosarcina‐like bacteria [e.g. hexadecenoic‐11 acid (16:1ω5c), 11,12‐methylene‐hexadecanoic acid (cy17:0ω5,6)] strongly increased over time (some of them over‐proportionally to consortia biovolume), suggesting that they are useful biomarkers to detect active anaerobic methanotrophic consortia in sediments.
Thoraco‐abdominal approach to large retroperitoneal tumours
Authors: Buse Stephan , Gilfrich Christian , Wagener Nina , Pfitzenmaier Jesco , Haferkamp Axel , Hohenfellner Markus
Published: September 2006

OBJECTIVES

To evaluate the thoraco‐abdominal approach for resection of retroperitoneal tumours, as this approach is rarely used because, although exposure is excellent, morbidity is presumed to be increased.

PATIENTS AND METHODS

From October 2003 to September 2005, 21 patients (six female, 15 male), aged 14–76 years, underwent resection of very large and/or T4 retroperitoneal tumours through a thoraco‐abdominal approach.

RESULTS

In 16 (76%) patients tumour resection was complete. There were no significant complications during surgery. After surgery, there were complications in six patients (29%), in four of whom there was no long‐term impairment. One patient died at 75 days after surgery from a complicated retroperitoneal haematoma. The mean (range) estimated blood loss was 2883  (50–20 000) mL, the intensive‐care unit stay was 3.85 (0–30) days and the intermediate‐care unit stay 2.6 (0–9) days. With a mean follow‐up of 9.6 (1–19) months, 15 patients (72%) are recurrence‐free, two (10%) have progressive disease, and four (19%) have died from malignancy.

CONCLUSIONS

The thoraco‐abdominal approach permits excellent exposure of the retroperitoneum for large and/or T4 tumours, allowing radical surgery in cases considered otherwise inoperable. Additional advantages are the possibilities of early vascular control and easy surgical extension of the procedure. These facts, combined with the reasonable morbidity found in our series, support the integration of the thoraco‐abdominal approach in the regular options for urological surgery.
The predictive value of helical computed tomography for collecting‐system entry during nephron‐sparing surgery
Authors: Derweesh Ithaar H. , Herts Brian R. , Motta‐Ramirez Gaspar A. , Ismail Hazem R. , Obuchowski Nancy , Venerio Joseph , Remer Erick M. , Gill Inderbir S. , Novick Andrew C.
Published: September 2006

The role played by Andrew Novick and his team in the Cleveland Clinic in the development of nephron‐sparing surgery for RCC has been obvious to all who are involved in the speciality of urological oncology. Interestingly, the laparoscopic revolution is also concentrating its efforts in this area also, through Inderbir Gill and others. In this section, the Cleveland Clinic team describe a technique which will help with the fine‐tuning of this method of treating renal cancer.

Also in this section is a study from Boston by Michael Barry and his co‐workers on the rising prevalence of androgen deprivation among men in the PSA era. There are also other papers on prostate cancer, particularly what I think will be one of a series of great interest from Northern Ireland on PSA testing. The other papers in this section will also be of great interest.

OBJECTIVES

To assess the ability of helical computed tomography (CT) including multiplanar reformatting and volume rendering (3D CT) to predict collecting system entry at surgery, as helical CT can be used to delineate renal tumour and normal renal anatomy before nephron‐sparing surgery (NSS).

PATIENTS AND METHODS

Knowledge of the possibility of collecting system entry during surgery might either dissuade some surgeons from NSS in elective situations or influence the operative approach or ablative technology in cases where NSS is imperative, or prepare the surgeon for the possibility of collecting system repair. We reviewed all 3D CT (349 scans) obtained before NSS at our institution over three consecutive years. Tumour size, central tumour extension, and presence of calyceal involvement were prospectively recorded at the time of 3D rendering. Collecting system entry was analysed for these three CT variables, and for three clinical variables (tumour side, size and surgical approach) collected retrospectively from the medical records. Multivariate logistic regression was used to assess the sensitivity, specificity, and positive and negative predictive values.

RESULTS

Of 344 patients, 170 had collecting system entry reported at surgery. There were statistically significant associations between collecting system entry and central tumour location by CT (sensitivity 58.8%, specificity 80.5%, P < 0.001), calyceal involvement at CT (sensitivity 53.5%, specificity 78.2%, P < 0.001), and tumour size on CT of >4 cm (sensitivity 39.4%, specificity 74.7%, P = 0.005). There were no significant associations with side or type of surgery (P > 0.83).

CONCLUSION

Helical CT is a reliable predictor of calyceal entry at surgery.
Preliminary evidence that the allogeneic response might trigger antitumour immunity in patients with advanced prostate cancer
Authors: Muir Gordon , Rajbabu Krishnamoorthy , Callen Charles , Fabre John W.
Published: September 2006

OBJECTIVE

To explore the possibility that allogeneic responses might, by chance, encompass cross‐reactive T cell clones specific for neo‐antigenic tumour determinants, and thereby activate antitumour immunity; such cross‐reactions are well documented for antiviral immunity, and genetic instability in developing cancers generates many neo‐antigenic determinants as potential targets for immune responses, but the biology inevitably favours tumour progression.

PATIENTS AND METHODS

Fourteen patients with hormone‐refractory prostate cancer received full‐thickness skin allografts from different, unrelated donors (fellow patients) until each had received six grafts. Serum prostate‐specific antigen (PSA) level was used as a surrogate for tumour mass.

RESULTS

One patient had a remarkable decline in PSA level, with levels at 1 year lower than before grafting. A second patient had stable PSA levels for almost 2 years. A third patient had stable PSA levels for 10–12 months before they resumed an exponential rise. Of four patients with PSA levels of >10 ng/mL, three required surgery or radiotherapy for obstructive symptoms during or shortly after grafting.

CONCLUSION

Transplant rejection involves mechanistically atypical T cell recognition of allogeneic major histocompatibility complex antigens, with massive polyclonal T cell activation. This unique aspect of T cell biology might represent a novel approach for initiating cross‐reactive antitumour responses.
The impact of obesity on laparoscopic radical prostatectomy
Authors: Eden Christopher G. , Chang Christopher M. , Gianduzzo Troy , Moon Daniel A.
Published: September 2006

OBJECTIVE

To investigate the effect of obesity on the operative variables of patients undergoing laparoscopic radical prostatectomy (LRP).

PATIENTS AND METHODS

The database entries and case‐notes of 532 consecutive patients undergoing LRP from March 2000 to August 2005 were examined retrospectively. Complete data were available on 505 (95%) patients, 108 (21%) of whom were obese (body mass index, BMI, ≥ 30 kg/m2). All patients had clinical stage T ≤ 3aN0M0 prostate cancer and had their procedure done or supervised by the same surgeon.

RESULTS

The patients’ prostate‐specific antigen level, Gleason score, clinical stage and prostate weight were similar. The mean values for patients deemed not obese and obese were: for operative duration (182 and 197 min, P = 0.01), blood loss (310 and 250 mL, P = 0.66), hospital stay (3.0 and 3.3 nights, P = 1.00), complications (3.5% and 4.6%, P = 0.77), positive margins (15.4% and 20.6%, P = 0.26) and biochemical recurrence (3.8% and 3.7%, P = 1.00) at a mean follow‐up of 9.7 and 12.0 months, respectively.

CONCLUSION

The operation was significantly longer for obese patients, by a mean of 15 min; all other variables were comparable in the two groups. The results from this study suggest that obese patients can expect a similar outcome to their non‐obese counterparts after LRP, when operated on by an experienced surgeon.
The pathology of bladder cancer: an update on selected issues
Authors: Pavone‐Macaluso Michele , Lopez‐Beltran Antonio , Aragona Federico , Bassi Pierfrancesco , Fitzpatrick John M.
Published: September 2006

OBJECTIVE

To achieve a closer relationship between urologists and pathologists and to use a common language and identical objectives in the pathology of bladder cancer.

METHODS AND RESULTS

Special emphasis was given to an analysis of the new World Health Organization (WHO) grading system, to the interpretation of the last Tumour‐Nodes‐Metastasis staging rules, and to identifying new markers of prognostic significance in clinical practice. A consensus was achieved on the main points.

CONCLUSIONS

The 2004 WHO grading system must become acceptable to clinicians, perhaps by a minimal modification of the present terminology. Simple transurethral resection‐biopsy should be expressed in terms of clinical rather than pathological staging. Although there are substantial improvements, no new markers can be recommended for routine use in histopathology at present.
Early onset insulin‐dependent diabetes mellitus as an initial manifestation of aceruloplasminaemia
Authors: Muroi R. , Yagyu H. , Kobayashi H. , Nagata M. , Sato N. , Ideno J. , Fujita N. , Ando A. , Okada K. , Takiyama Y. , Nagasaka S. , Miyajima H. , Nakano I. , Ishibashi S.
Published: September 2006

Background  Aceruloplasminaemia is an autosomal recessive disorder caused by specific mutations in the ceruloplasmin gene. Aceruloplasminaemia is clinically characterized by diabetes mellitus, pigment degeneration of the retina, and neurological abnormalities, such as cerebellar ataxia, extrapyramidal signs, and dementia. We present a patient with aceruloplasminaemia who, until progressive neurological abnormalities were noticed, had been treated for more than 30 years as having Type 1 diabetes mellitus requiring multiple insulin injection therapy.

Case reportd  The patient was a 58‐year‐old man. At the age of 23 years, he developed diabetes that required multiple insulin injection therapy. At the age of 39 years, he was commenced on continuous subcutaneous insulin infusion (CSII) therapy. Despite CSII therapy, the patient's blood glucose levels were poorly controlled (HbA1c, ∼9.5%). He was diagnosed as having aceruloplasminaemia at 58 years of age when he presented with progressive cerebellar ataxia, extrapyramidal signs of recent onset and pigment degeneration of the retina.

Conclusionsd  It is possible that some diabetic patients with aceruloplasminaemia are mistakenly diagnosed as having Type 1 diabetes mellitus, as they have reduced insulin secretion and develop diabetes at a younger age, before neurological abnormalities associated with aceruloplasminaemia are apparent. Therefore, aceruloplasminaemia should be considered in patients with insulin‐dependent diabetes mellitus who develop progressive neurological abnormalities of unknown aetiology along with a microcytic hypochromic anaemia and retinal degeneration.
Effect of metformin plus roziglitazone compared with metformin alone on glycaemic control in well‐controlled Type 2 diabetes
Authors: Stewart M. W. , Cirkel D. T. , Furuseth K. , Donaldson J. , Biswas N. , Starkie M. G. , Phenekos C. , Hamann A.
Published: September 2006

Aims  To investigate the effect of metformin plus roziglitazione (RSGMET) compared with metformin alone (MET) on glycaemic control in well‐controlled Type 2 diabetes.

Methods  Subjects (drug naïve or those on glucose‐lowering monotherapy) were randomized (n = 526), following a 4‐week placebo run‐in period, to RSGMET [4 mg rosiglitazone (RSG)/500 mg MET] or MET 500 mg. From weeks 2–18, medication was escalated every 4 weeks (based on gastrointestinal tolerability), then remained at RSGMET 8 mg/2 g or MET 3 g for 14 weeks.

Results  RSGMET reduced HbA1c from 7.2 ± 0.6 to 6.7 ± 0.8% at week 32, compared with a reduction from 7.2 ± 0.6 to 6.8 ± 0.9% with MET (treatment difference −0.13%; P = 0.0357). More subjects achieved an HbA1c value of ≤ 6.5% at week 32 with RSGMET (51.6 vs. 43.7%), but the treatment difference was not significant (odds ratio 1.37, P = 0.0949). RSGMET produced larger reductions from baseline in mean fasting plasma glucose (adjusted difference −0.62 mmol/l, P < 0.0001), with the odds ratio of achieving a target of < 7.0 mmol/l being 2.33 (P < 0.0001). Statistically significant differences in favour of RSGMET relative to MET were seen for homeostatic model assessment (HOMA)‐derived estimates of insulin sensitivity and pancreatic B‐cell function, C‐reactive protein (CRP), and systolic blood pressure. Overall rates of gastrointestinal adverse events (relevant to the known profile of MET) were comparable, but with a lower incidence of diarrhoea (8 vs. 18%) with RSGMET. Hypoglycaemia was reported in ≤ 7% subjects per group.

Conclusions  RSGMET provided similar short‐term glycaemic control to MET with greater improvements in estimates of insulin sensitivity, B‐cell function and CRP, with less diarrhoea and low risk of biochemical hypoglycaemia, suggesting that early use of combination therapy may be appropriate.
Phenotypic and genetic analyses of T‐cell‐mediated immunoregulation in patients with Type 1 diabetes
Authors: Tsutsumi Y. , Jie X. , Ihara K. , Nomura A. , Kanemitsu S. , Takada H. , Hara T.
Published: September 2006

Aims  To investigate the contribution of regulatory T cells and co‐stimulatory molecules in CD4+ T cells to the development of Type 1 diabetes (T1D).

Methods  Twelve patients with T1D, nine patients with systemic lupus erythematosus (SLE), and 12 age‐matched healthy control subjects participated. We analysed the proportions of CD25+CD4+ T cells and natural killer T cells (NKT cells), and the expression levels of Foxp3, CTLA‐4, CD28, ICOS, PD‐1 and BTLA in peripheral blood mononuclear cells and purified CD4+ T cells.

Results  There were no significant differences in the proportions of CD25+ CD4+ T cells or NKT cells among the three groups. PD‐1 expression levels of peripheral CD4+ T cells from T1D patients were significantly lower than those from healthy control subjects (P = 0.00066). In contrast, PD‐1 expression levels were similar in SLE patients and healthy control subjects. The expression levels of Foxp3, CTLA‐4, CD28, ICOS and BTLA were similar in the three groups.

Conclusions  Decreased expression of the PD‐1 gene in CD4+ T cells may contribute to the development and/or maintenance of autoimmune T1D. As the population studied was small and heterogeneous, further studies are required to confirm the findings.
Short‐term suppression of plasma free fatty acids fails to improve insulin sensitivity when intramyocellular lipid is elevated
Authors: Johnson N. A. , Stannard S. R. , Rowlands D. S. , Chapman P. G. , Thompson C. H. , Sachinwalla T. , Thompson M. W.
Published: September 2006

Aims  Metabolic responses to manipulation of the plasma free fatty acid (FFA) concentration were assessed in six healthy men via cross‐over design to determine whether FFAs independently influence insulin sensitivity.

Methods  Intramyocellular lipid (IMCL) was measured by proton magnetic resonance spectroscopy and insulin sensitivity via frequently sampled intravenous glucose tolerance test (IVGTT) after 67 h of two identical low carbohydrate/high fat (LC) diets which were used to elevate IMCL and plasma FFAs. To uncouple the influence of FFAs and IMCL on insulin sensitivity, FFAs were suppressed 30 min prior to and during IVGTT in one treatment [LC + nicotinic acid (NA)] by NA ingestion.

Results  Vastus lateralis IMCL was significantly elevated in LC (13.3 ± 1.1 × 10−3) and LC + NA (13.5 ± 1.1 × 10−3) (P < 0.01 for both), but was not different between conditions (P > 0.05). Plasma FFAs were raised in LC (0.79 ± 0.08 mmol/l) and LC + NA (0.80 ± 0.11 mmol/l) (P < 0.01 for both) and were significantly reduced by NA ingestion prior to (0.36 ± 0.05 mmol/l, P < 0.01) and during IVGTT (P < 0.05) in LC + NA. Despite marked differences in plasma FFA availability, insulin sensitivity and glucose tolerance were not different between LC and LC + NA (P > 0.05 for both).

Conclusions  Plasma FFAs appear to exert no immediate effect on insulin sensitivity/glucose tolerance independent of their action on intracellular lipid moieties. Further research is required to elucidate the duration of FFA suppression required to restore insulin sensitivity following lipid‐induced insulin resistance.
Perception of, and anxiety levels induced by, laser treatment in patients with sight‐threatening diabetic retinopathy. A multicentre study
Authors: Trento M. , Tomelini M. , Lattanzio R. , Brancato R. , Coggiola A. , Benecchi R. , Scoccianti L. , Insacco C. , Bandello F. , Montanaro M. , Cavallo F. , Porta M.
Published: September 2006

Aims  To investigate how laser treatment is perceived, in terms of anxiety and awareness, by diabetic patients attending four centres in Northern Italy with specific interest and expertise in diabetic retinopathy, where work settings and flow are organized differently.

Methods  The Hospital Anxiety and Depression Scale (HADS), Family Apgar‐List of Threatening Experiences (FA‐LTE), State‐Trait Anxiety Inventories 1 and 2 (STAI‐1 and STAI‐2) questionnaires were completed by 259 patients, 131 waiting for laser treatment and 128 control subejcts awaiting non‐intervention visits. Open questions were also asked on whether patients had ever heard the word ‘laser’ and whether they could describe laser treatment.

Results  High scores were detected by HADS, STAI‐1 and STAI‐2 among patients waiting for photocoagulation. Anxiety was greater in women and people with poor schooling. After controlling for centres, gender, previous laser treatment and schooling, HADS and STAI‐1 remained significantly lower among persons waiting for non‐intervention visits. Having received photocoagulation previously did not modify anxiety. Anxiety was lower in those centres where facilities and resources were more patient‐oriented. Most patients could neither describe photocoagulation nor explain why they were about to receive it, but had a negative perception and some described it with words evoking cruelty and pain.

Conclusions  These data suggest that laser treatment is experienced as an event that causes anxiety. Preoperative education and counselling may help to reduce fear and patients’ avoidance of treatment.
The effect of metformin on blood glucose control in overweight patients with Type 1 diabetes
Authors: Khan A. S. A. , McLoughney C. R. , Ahmed A. B.
Published: September 2006

Aims  In a randomized, double‐blind, cross‐over study, we investigated the effect of metformin on blood glucose control and daily insulin dose in overweight patients with Type 1 diabetes.

Methods  We studied 15 C‐peptide‐negative patients, aged 48 ± 12 years, with a body mass index of 31.3 ± 2.6 kg/m2. Each patient had a ‘screening visit’, followed by a 4‐week ‘run‐in’ period. This was followed by two separate 16‐week ‘study’ (treatment) periods, separated by a 4‐week ‘wash‐out’ period. Patients received either metformin or placebo during the ‘study’ periods, in random order.

Results  HbA1c was significantly lower following 16 weeks of treatment with metformin (7.8 ± 1.1%) compared with baseline (8.5 ± 1.4%; P < 0.005) and placebo (8.6 ± 1.2%; P < 0.005). Fasting plasma glucose, following 16 weeks of metformin treatment, was significantly lower (8.3 ± 2.8 mmol/l) compared with baseline (12.4 ± 3.0 mmol/l; P < 0.01) and placebo (12.6 ± 3.4 mmol/l; P < 0.01). Compared with baseline (60 ± 14 units), total daily insulin dose was significantly lower following the addition of metformin (50 ± 13 units; P < 0.05) and this final total daily insulin dose in the metformin group was lower compared with placebo (58 ± 12 units, P < 0.05). Body weight did not change following metformin or placebo treatment.

Conclusion  Metformin can effectively improve glycaemic control and reduce the total daily insulin dose in overweight people with Type 1 diabetes.
Psychological morbidity and problems of daily living in people with visual loss and diabetes: do they differ from people without diabetes?
Authors: Robertson N. , Burden M. L. , Burden A. C.
Published: September 2006

Aims  To examine psychological adjustment and changes in the activities of daily living in relation to visual loss in diabetes.

Methods  This was an incident cohort, longitudinal, observational study contrasting the adjustment of individuals with visual loss associated with diabetes and those whose visual loss arose from other conditions; in the year subsequent to registration for blindness and 12 months later, 124 individuals participated in the study (51 with diabetes and 73 without). Participants provided demographic and biomedical information, and completed the Brief COPE, Hospital Anxiety and Depression Scale, SF‐36, Instrumental Activities of Daily Living scale and Social Avoidance and Distress Scale via interview. People with diabetes were compared with those without.

Results  Both diabetic and non‐diabetic groups showed elevated and comparable levels of psychological morbidity, sustained over time. Significant differences in functional adjustment were found at initial interview: people with diabetes having more problems coping but these were no longer present 1 year later.

Conclusions  There was a significant and enduring elevation of anxiety and depression in those who were newly registered blind or visually handicapped. Taking these findings into account, psychological assessment should be developed for all those experiencing visual loss.
Relative Value Relevance of Alternative Accounting Treatments for Unrealized Gains: Implications for the IASB
Authors: Owusu‐Ansah Stephen , Yeoh Joanna
Published: September 2006

We investigate the relative value relevance of the alternative accounting methods for unrealized gains on investment properties in New Zealand (NZ). Using both the Likelihood‐ratio test and the F‐test, we find that, while preferred by the NZ standard setter, recognition of unrealized gains in the income statement is not superior to (or significantly different from) recognition of unrealized gains in revaluation reserve in terms of their value relevance. The results are robust to the different research methods we used. Our results have implications for the International Accounting Standards Board in terms of: (i) recognizing changes in fair values of investment properties in the income statement under the revised IAS 40: Investment Property in countries where “realization” refers to net income available for distribution; (ii) its intent to issue a standard on a single statement of comprehensive income; and (iii) its initiative to reduce or eliminate alternative accounting treatments for similar fact situations in its standards.
Making sense of corporate social responsibility in international business: experiences from Shell
Authors: Schouten Esther M.J. , Remmé Joop
Published: September 2006

International business organizations are regularly addressed on their corporate social responsibility (CSR). As illustrated in this paper, it is not yet clear exactly what CSR means to organizations and how to deal with it. In this paper, the authors explore how a sensemaking approach helps to understand the business challenges of CSR within an organizational context. The theories of Karl Weick are applied to the experiences of CSR in Royal Dutch Shell. The authors argue that the key to CSR in international business organizations is to engage stakeholders and start a process of joint sensemaking. Three main competencies are crucial in this: the competency to engage stakeholders through listening and understanding; the creation of an organizational language so that CSR makes sense to members of the organization; and recognizing the momentum of taking action.
Triple bottom‐line reporting as social grammar: integrating corporate social responsibility and corporate codes of conduct
Authors: Painter‐Morland Mollie
Published: September 2006

This paper argues that many objections against, and limitations of, corporate codes of conduct can be addressed if a meaningful integration can be established between CSR and ethics management practices within corporations. It is proposed that the notion of the triple bottom‐line finally presents corporations with a mechanism to establish this integration. The paper draws on the second South African King Report on Corporate Governance, which succeeded in integrating corporate governance, ethics management and triple bottom‐line reporting by advocating what it called ‘Integrated Sustainability’. The paper argues that this is an example of how ethics management initiatives like code development become more meaningful, if they can be related to the corporation's CSR initiatives and reporting practices. Integration between ethics management and CSR in the context of triple bottom‐line reporting reframes corporate success in a way that makes both ethics management and CSR activities more meaningful. In fact, it is argued that in the absence of a social grammar that establishes this integration, neither codes nor CSR can foster meaningful organizational integrity.
Corporate social responsibility communication: stakeholder information, response and involvement strategies
Authors: Morsing Mette , Schultz Majken
Published: September 2006

While it is generally agreed that companies need to manage their relationships with their stakeholders, the way in which they choose to do so varies considerably. In this paper, it is argued that when companies want to communicate with stakeholders about their CSR initiatives, they need to involve those stakeholders in a two‐way communication process, defined as an ongoing iterative sense‐giving and sense‐making process. The paper also argues that companies need to communicate through carefully crafted and increasingly sophisticated processes. Three CSR communication strategies are developed. Based on empirical illustrations and prior research, the authors argue that managers need to move from ‘informing’ and ‘responding’ to ‘involving’ stakeholders in CSR communication itself. They conclude that managers need to expand the role of stakeholders in corporate CSR communication processes if they want to improve their efforts to build legitimacy, a positive reputation and lasting stakeholder relationships.
Sense and sensitivity: the roles of organisation and stakeholders in managing corporate social responsibility
Authors: Pater Alberic , Van Lierop Karlijn
Published: September 2006

While companies are increasingly convinced of the relevance of CSR, many are still struggling to define their responsibility. Part of the answer to this question can be found in the dual approach towards CSR. The authors unravel the concept of CSR into two components: responsibility and responsiveness. Regarding the firm's responsiveness towards society, companies can adopt two positions. They might adopt an inside‐out approach towards CSR and emphasise their own ambitions. Alternatively, they can approach stakeholders from an outside‐in perspective, wherein stakeholder claims dominate. The authors argue that both perspectives are inadequate with regard to complex societal issues. Therefore, a third approach towards societal interaction is proposed. This is characterised by a process of collective sensemaking, aimed at understanding the issue and defining responsibilities.
Empowering small shareholders: a comparison of three instruments
Authors: Van Der Burg Tsjalle , Prinz Aloys
Published: September 2006

In this paper, three instruments for empowering small, individual shareholders are compared: proxy investing, proxy voting institutions and infomediaries. The working of each instrument is discussed with special emphasis on the problems of information gathering and coalition forming. Subsequently, each instrument is analysed with respect to appropriateness, costs and effectiveness. No instrument turns out to be clearly superior to the others. Although proxy investing is the most popular concept among small (individual) shareholders at present, the long‐run potential of proxy voting institutions and infomediaries may be higher. Since more research could be helpful to establish which of these two options is best, both non‐profit organisations and governments could in the meantime stimulate experiments with proxy voting institutions and infomediaries for small shareholders.
The Effects of Board Composition and Board Size on the Informativeness of Annual Accounting Earnings
Authors: Ahmed Kamran , Hossain Mahmud , Adams Mike B.
Published: September 2006

This study extends earlier research on corporate governance by examining whether the information‐usefulness of annual accounting earnings varies with the fraction of outside directors serving on the board and board size. Using panel data from New Zealand (NZ) firms for the financial years 1991–97, we find that earnings informativeness is negatively related to board size but is not related to the fraction of outside directors serving on the board. Our results are robust to controlling for various firm‐specific factors that are known to be associated with earnings informativeness.
Does Compliance with the German Corporate Governance Code Have an Impact on Stock Valuation? An empirical analysis
Authors: Goncharov Igor , Werner Joerg Richard , Zimmermann Jochen
Published: September 2006

Since 2002 company law requires listed German corporations to declare their degree of conformity to the German Corporate Governance Code (GCGC). We examine whether there is a pricing effect connected to the declared degree of compliance for a sample of (big) publicly traded German companies listed in the DAX 30 and MDAX. We find that the degree of compliance with the Code is value‐relevant after controlling for an endogeneity bias. This shows that the capital markets find the rules in the code meaningful and that there is capital market pressure to adopt the Code regulation. Our findings also suggest that the capital market fills a possible “control vacuum” resulting from the withdrawal of commercial banks from their (former) influential role in the German “insider control” corporate governance model.
Executive Compensation in Socially Responsible Firms
Authors: Frye Melissa B. , Nelling Edward , Webb Elizabeth
Published: September 2006

This study examines chief executive officer (CEO) compensation and turnover in socially responsible (SR) firms. We compare characteristics of SR firms with a matched sample of firms based on industry and size. Analysis of CEO compensation indicates that the link between CEO pay and firm performance is weaker for SR firms than for non‐SR firms. CEO turnover tests indicate that SR firms are more likely to experience CEO turnover following poor performance. Stock option grants to CEOs of SR firms do not appear to result in future risk‐taking behaviour, whereas such grants are significantly related to future risk at non‐SR firms.
Looking Through the Eyes of Others: assessing mutual expectations and experiences in order to shape dialogue and collaboration between business and NGOs with respect to CSR
Authors: Jonker Jan , Nijhof André
Published: September 2006

What are the main differences in expectations between NGOs and companies who interact with each other with respect to corporate social responsibility (CSR)? This is the leading question for a research project within the framework of the Dutch National Research Program on CSR (2003–2004). The research starts with the observation that companies and NGOs are increasingly interacting regarding CSR. Exploring the mutual expectations in the early stages of an interaction can deliver valuable information about the possibilities for cooperation. In order to study these expectations and experiences, a web‐based tool is developed. The application of this tool results in the relevant gaps between mutual expectations and the comparison of expectations expressed in the beginning of the interaction with the actual experiences.
“Comply or Explain”: market discipline and non‐compliance with the Combined Code
Authors: MacNeil Iain , Li Xiao
Published: September 2006

The “comply or explain” principle adopted by the UK’s Combined Code on Corporate Governance has now been in operation for 12 years. In this paper we focus on two aspects of this regime. The first is the nature of the explanations that have been given by companies with an established record of non‐compliance (“serial non‐compliers”) and the role of the market in permitting deviations from the Combined Code. In particular, we consider the significance of share price performance as a factor that is relevant in justifying non‐compliance and the extent to which investors appear to rely on this indicator rather than engage in the more difficult task of judging the relative merits of the Code provisions against alternatives. Our approach differs from much of the research linking corporate governance with financial performance in that it focuses on the potential influence of financial performance (as measured by share price) on governance structure rather than vice versa. Our study of FTSE 100 serial non‐compliers suggests that there is a prima facie link between share price performance and investors’ tolerance of non‐compliance with the Combined Code. The second issue we examine is the link between the principle of “comply and explain” and the self‐regulatory status of the Code. We conclude that the benefits of flexibility generally associated with the self‐regulatory status of the Code are overstated and that the Code could be integrated into mainstream company law.
Assessing the potential impact of salmon fisheries management on the conservation status of harbour seals (Phoca vitulina) in north‐east Scotland
Authors: Thompson P. M. , Mackey B. , Barton T. R. , Duck C. , Butler J. R. A.
Published: September 2006

Conservation efforts are often constrained by uncertainty over the factors driving declines in marine mammal populations. In Scotland, there is concern over the potential impact of unrecorded shooting of seals, particularly where this occurs near Special Areas of Conservation. Here, we show that the abundance of harbour seals Phoca vitulina in the Moray Firth, north‐east Scotland, declined by 2–5% per annum between 1993 and 2004. Records from local salmon fisheries and aquaculture sites indicated that 66–327 harbour seals were shot each year between 1994 and 2002. Matrix models and estimates of potential biological removal indicate that this level of shooting is sufficient to explain observed declines. Nevertheless, uncertainty over the number and identity of seals shot means that other factors such as changes in food availability may be contributing. Recent conservation measures markedly reduced the recorded levels of shooting in 2003 and 2004. In 2005, a coordinated management plan was developed to protect salmon fisheries interests while minimizing impacts on local seal populations. Comprehensive monitoring of future population trends and improved regulation of culls are now required to provide more robust assessments of the impact of human persecution on harbour seal populations in the Moray Firth and in other parts of the UK.
Examination of PPP1R3B as a candidate gene for the type 2 diabetes and MODY loci on chromosome 8p23
Authors: Dunn J. S. , Mlynarski W. M. , Pezzolesi M. G. , Borowiec M. , Powers C. , Krolewski A. S. , Doria A.
Published: September 2006

The product of the PPP1R3B gene (GL) is the regulatory subunit of PP1 ‐ a serine/threonine phosphatase involved in the modulation of glycogen synthesis in the liver and skeletal muscle. The PPP1R3B gene is located on chromosome 8p23 in a region that has been linked with type 2 diabetes and maturity‐onset diabetes of the young (MODY). We examined whether sequence variants at the PPP1R3B locus are responsible for the linkage with diabetes observed at this location. RT‐PCR analysis revealed the existence of two alternative promoters. These and the two exons of this gene were sequenced in the probands of 13 Joslin families showing the strongest evidence of linkage at 8p23. A total of 20 variants were observed: two in the 5′ flanking region, one in the intron (9 bp 5′ of exon 2), and 17 in the 3′ UTR. The intronic variant generated a new acceptor splice site, resulting in an alternative splice variant with a longer 5′ UTR. However, neither this nor other variants segregated with diabetes in the 13 ‘linked’ families. Furthermore, allele frequencies were similar in 90 family probands from the Joslin Study and 347 unrelated controls. Thus, genetic variability in the PPP1R3B gene does not appear to contribute to diabetes in our mostly Caucasian families. However, a role cannot be excluded in other populations such as the Japanese, among whom linkage to diabetes is also observed at 8p23 and a non‐synonymous mutation has been detected in the PPP1R3B gene.
Lack of Association Between Genetic Variation in 9 Innate Immunity Genes and Baseline CRP Levels
Authors: Kozlowski Piotr , Miller David T. , Zee Robert Y. L. , Danik Jacqueline Suk , Chasman Daniel I. , Lazarus Ross , Cook Nancy R. , Ridker Paul M. , Kwiatkowski David J.
Published: September 2006

It is well‐known that baseline levels of C‐reactive protein (CRP) are an independent cardiovascular risk factor. We hypothesized that genetic variation with significant influence on CRP levels might be found in genes of the innate immunity system. We performed a candidate gene association study examining common single nucleotide polymorphisms in 9 innate immunity genes (CARD15, IRAK1, IRAK4, LBP, LY86, MEFV, TLR2, TLR4 and NFKB1) in relation to CRP levels. Seven hundred and seventeen subjects from the Women's Health Study population were studied: 359 and 358 samples with extremely low (<0.2 mg/liter) and high (>5 mg/liter) CRP levels, respectively. SNPs were identified from publicly available resequencing data, using a minor allele frequency threshold of >5% and a linkage disequilibrium (LD)‐based strategy (r2 > 0.8) to select 63 LD‐independent markers. One non‐synonymous SNP in TLR4 and two non‐synonymous SNPs in CARD15, previously associated with atherosclerosis and Crohn's disease, respectively, were also studied. Univariate, haplotype and gene‐gene interaction analyses all indicated no significant association with CRP levels. Although this work excludes a significant association of common SNPs in these nine genes with CRP levels, it is possible that rarer alleles in these genes, or variation in other innate immunity genes, could be associated with variation in CRP.