bluuebunny/crossref_metadata_2025 huggingface dataset:
AN EARLY CENOZOIC NEOSELACHIAN SHARK FAUNA FROM THE SOUTHWEST PACIFIC
Authors: MANNERING AL A. , HILLER NORTON
Published: November 2008

Abstract:  An early Cenozoic shark fauna, comprising at least 16 taxa, is described from Paleocene sedimentary rocks on the South Island of New Zealand. Although representing a remote Southern Hemisphere location, the fauna includes forms closely comparable to contemporary species from the Northern Hemisphere, in addition to the new species Chlamydoselachus keyesi and Centroselachus goordi. Comparison with closely related extant species suggests the fauna may be interpreted as a deep water one, typical of the outer continental shelf and upper slope. However, after palaeogeography, sedimentology and mineralogy of the enclosing rock, and the nature of similar faunas from elsewhere are taken into consideration, the fauna is interpreted to have occupied a mid‐shelf environment.
A NEW SPECIES OF DICERORHINUS (RHINOCEROTIDAE) FROM THE PLIO‐PLEISTOCENE OF MYANMAR
Authors: ZIN‐MAUNG‐MAUNG‐THEIN  , TAKAI MASANARU , TSUBAMOTO TAKEHISA , THAUNG‐HTIKE  , EGI NAOKO , MAUNG‐MAUNG
Published: November 2008

Abstract:  A skull and mandible of the new species Dicerorhinus gwebinensis sp. nov. of Rhinocerotidae (Mammalia, Perissodactyla) is described. The material is collected from the upper part of the Irrawaddy sediments (Plio‐Pleistocene) in central Myanmar. D. gwebinensis sp. nov. is morphologically more similar to the extant species D. sumatrensis (Sumatran rhinoceros) than to other species of the genus but differs from D. sumatrensis in having the comparatively shorter nasal, the more concave dorsal profile of the skull, the more elevated occiput and presence of molar crista in M3/. This is the first discovery of Dicerorhinus in the upper Miocene to lower Pleistocene of the Indian subcontinent and Mainland Southeast Asia, and fills the chronological and geographical gap of this lineage in Asia. The Dicerorhinus clade probably migrated into Southeast Asia from East Asia by the Pliocene or early Pleistocene. This hypothesis is supported by the scarcity or absence of this clade in the Neogene mammalian fauna of the Indian Subcontinent.
A SPALACOLESTINE SPALACOTHERIID (MAMMALIA, TRECHNOTHERIA) FROM THE EARLY CRETACEOUS (BARREMIAN) OF SOUTHERN ENGLAND AND ITS BEARING ON SPALACOTHERIID EVOLUTION
Authors: SWEETMAN STEVEN C.
Published: November 2008

Abstract:  Bulk screening of Early Cretaceous (Barremian) Wealden Group strata of the Wessex Formation exposed on the south‐west and south‐east coasts of the Isle of Wight, southern England, has resulted in the recovery of fragmentary remains pertaining to a new spalacolestine spalacotheriid mammal, Yaverlestes gassoni gen. et sp. nov. These represent the first European record of the Spalacolestinae. The remains comprise a dentulous incomplete dentary and isolated upper and lower molariforms, the former representing the most substantial mammal remains yet recovered from the Wealden Group. Hitherto, six species of spalacotheriid mammal were known from the Lower Cretaceous of Europe. All are referred to the genus Spalacotherium but in the case of taxa diagnosed on the basis of isolated lower teeth and other specimens where the post‐canine dentition is incompletely known, it is now evident that these referrals should be treated with caution. Furthermore, the new Wessex Formation spalacotheriid and recently described spalacotheriids from the ?Barremian of Japan, and the Barremian and Aptian of China exhibit combinations of characters that suggest that spalacotheriids were more diverse and that their evolution was more complex than previously recognized. The systematic position of an isolated tooth from the basal Cretaceous Lourinhã Formation of Portugal is discussed and the tooth reassigned to the Spalacotheriidae. Together with the new Wessex Formation taxon, eight species are now known from the Lower Cretaceous of Europe. The discovery of a spalacolestine in the Barremian Wessex Formation supports the concept of faunal interchange between Europe, Asia and North America during the Early Cretaceous. It also supports derivation of North American spalacotheriids from a European or Eurasian ancestor.
FIRST RECORD OF THE INDO‐PACIFIC REEF CORAL GENUS ISOPORA IN THE CARIBBEAN REGION: TWO NEW SPECIES FROM THE NEOGENE OF CURAÇAO, NETHERLANDS ANTILLES
Authors: BUDD ANN F. , WALLACE CARDEN C.
Published: November 2008

Abstract:  The coral genus Isopora, a sister group of the modern dominant Acropora until now only known from the Pliocene to Recent of the Indo‐Pacific, is recorded in the Caribbean for the first time. Two new species, Isopora ginsburgi and Isopora curacaoensis, are described from the Neogene Seroe Domi Formation of Curaçao, Netherlands Antilles. Study of large collections made systematically through the sequence indicates that Isopora first occurred in the Caribbean during the Mio–Pliocene, at approximately the same time as the origination of many modern Caribbean reef coral dominants including Acropora cervicornis. It last occurred in the region during the late Pliocene as part of a pulse of extinction, in which several genera that live today in the Indo‐Pacific became extinct in the Caribbean. Throughout its Caribbean duration, Isopora co‐occurred with the two abundant modern Caribbean species of Acropora, A. cervicornis and A. palmata. Comparisons with Neogene collections made elsewhere in the Caribbean indicate that Isopora was restricted in distribution to the southern Caribbean. Isopora species are viviparous, while Acropora are oviparous, and this difference in reproductive strategy may have played a role in the extinction of Isopora in the Caribbean. The occurrences of Isopora reported in this study are the oldest records to date of Isopora worldwide, and are important for understanding the biogeographic separation between reef coral faunas in the Caribbean and Indo‐Pacific regions.
NEW MULTITUBERCULATE MAMMALS FROM THE HAUTERIVIAN/BARREMIAN TRANSITION OF EUROPE (IBERIAN PENINSULA)
Authors: BADIOLA AINARA , CANUDO JOSÉ I. , CUENCA‐BESCÓS GLORIA
Published: November 2008

Abstract:  New multituberculate mammals from the Hauterivian/Barremian transition of Europe are described. They were found in the late Hauterivian‐early Barremian fossiliferous locality of La Cantalera (Josa, Teruel, Spain), one of the Early Cretaceous sites in the Aragonese branch of the Iberian Ranges, in northeastern Iberia. The fossils have been assigned to at least three taxa on the basis of nine isolated teeth: a new pinheirodontid taxon, Cantalera abadi gen. et sp. nov.; a representative of the eobaatarid Eobaatar; a taxon described as Plagiaulacidae or Eobaataridae gen. et sp. indet.; and other as Plagiaulacida indet. These fossils have increased the resolution of European Early Cretaceous multituberculate mammalian biostratigraphy and palaeobiogeography: the oldest representative of Eobaatar is described here; a taxon is assigned to ?Plagiaulacidae, in which case it would be the first of this family in the Iberian Peninsula; and the discovery of a new late Hauterivian pinheirodontid taxon demonstrates greater biodiversity and a wider distribution for these multituberculates than was previously known. The mutituberculate fauna of La Cantalera consists of endemic taxa (Pinheirodontidae), which were restricted to what is now Western Europe, and others (Eobaataridae) which have also been described in Asia. Consistent with the Iberian record of late Barremian gobiconodontid mammals, the presence of Eobaatar in Iberia with representatives from the late Hauterivian to late Barremian, as well as in the Aptian or Albian of Mongolia, indicates that faunal exchanges between Europe and Asia could have existed for most of the Early Cretaceous, either sporadically or constantly.
Cost Liability and Residential Space Heating Expenditures of Welfare Recipients in Germany*
Authors: Rehdanz Katrin , Stöwhase Sven
Published: November 2008

Within the German welfare system, recipients’ heating expenditures are generally fully covered by the government. This paper empirically tests the hypothesis that households receiving welfare payments turn to overconsumption of residential space heating. We use micro‐data from two different data sources to explore whether the conditional heating expenditures of these households differ significantly from those of other households. Our empirical findings suggest that even when controlling for a range of other factors, this is indeed the case, as their heating expenditures lie about 7–8 per cent above those of other households. These results are fairly robust to sensitivity analyses. Comparing the results with those for a control group, expenditures for heating are still more than 5 per cent higher. Our results imply that there is potential scope for cost savings if this policy is changed.
A toxicity study of low‐dose rate half‐body irradiation and chemotherapy in dogs with lymphoma
Authors: Lurie D. M. , Kent M. S. , Fry M. M. , Théon A. P.
Published: November 2008

Thirteen dogs with previously untreated multicentric lymphoma were enrolled in a prospective study investigating the effects of low‐dose rate total body irradiation (TBI) and chemotherapy. Dogs received either 6 or 8 Gy TBI in half‐body fractions, 2 weeks apart. Toxicity consisted of mild to moderate haematological and gastrointestinal (GI) signs. One dog died from treatment complications. Anorexia was noted independent of dose. Haematological toxicity was more common and more severe after 8 Gy treatment. GI toxicity was more likely postcaudal half‐body irradiation with 8 Gy. Other than leukotrichia, late effects from radiation were not observed. Results indicated that haematological and nonhaematological toxicity was dose dependent. However, the protocol was well tolerated and treatment intensification using a 2‐week inter‐radiation interval was possible in all dogs treated with 6 Gy. Preliminary survival data for these dogs were very encouraging, providing a strong rationale to analyse the efficacy of low‐dose rate irradiation (LDRI) in canine lymphoma.
Treatment of refractory tardive dyskinesia with donepezil in an elderly patient with depression
Authors: YOSHIMI Asuka , TOGO Takashi , SUGIYAMA Naoya , UEHARA Kumi , OTSUKA Tatsui , KARASHIMA Aya , HIRAYASU Yoshio
Published: November 2008

Tardive dyskinesia (TD) is a neurological disorder caused by the prolonged administration of dopamine antagonists, usually antipsychotics and especially first‐generation antipsychotics. Herein, we report on an elderly patient suffering from TD with depression induced by amoxapine, an antidepressant that antagonizes dopamine receptors. This case report demonstrates the therapeutic effect of donepezil even for TD due to amoxapine, corroborating the view that donepezil is beneficial for the treatment of TD induced by dopamine antagonists. A randomized placebo‐controlled double‐blind trial is required to confirm the usefulness of donepezil in the treatment of dopamine antagonist‐induced TD.
Aripiprazole‐associated dystonia in a patient with vascular dementia
Authors: CHEN Shaw‐Ji , SHEN Yu‐Chih , CHEN Shao‐Tsu , LIN Chaucer C. H.
Published: November 2008

Aripiprazole is a novel atypical antipsychotic agent with unique pharmacological profiles as a partial dopamine receptor agonist. Few extrapyramidal signs have been reported previously following the use of aripiprazole. In the present study, we report on an 84‐year‐old female patient who suffered from vascular dementia with psychotic symptoms. She was treated with aripiprazole and acute dystonia was noted. This case report highlights the importance of slow titration of aripiprazole and close monitoring for extrapyramidal signs in elderly psychotic patients with vascular dementia.
Late Pleistocene glacial history of Jameson Land, central East Greenland, derived from cosmogenic10Be and26Al exposure dating
Authors: HÅKANSSON LENA , ALEXANDERSON HELENA , HJORT CHRISTIAN , MÖLLER PER , BRINER JASON P. , ALDAHAN ALA , POSSNERT GÖRAN
Published: November 2008

Previous work has presented contrasting views of the last glaciation on Jameson Land, central East Greenland, and still there is debate about whether the area was: (i) ice‐free, (ii) covered with a local non‐erosive ice cap(s), or (iii) overridden by the Greenland Ice Sheet during the Last Glacial Maximum (LGM). Here, we use cosmogenic exposure ages from erratics to reconcile these contrasting views. A total of 43 erratics resting on weathered sandstone and on sediment‐covered surfaces were sampled from four areas on interior Jameson Land; they give10Be ages between 10.9 and 269.1 kyr. Eight erratics on weathered sandstone and till‐covered surfaces cluster around ∼70 kyr, whereas10Be ages from erratics on glaciofluvial landforms are substantially younger and range between 10.9 and 47.2 kyr. Deflation is thought to be an important process on the sediment‐covered surfaces and the youngest exposure ages are suggested to result from exhumation. The older (>70 kyr) samples have discordant26Al and10Be data and are interpreted to have been deposited by the Greenland Ice Sheet several glacial cycles ago. The younger exposure ages (≤70 kyr) are interpreted to represent deposition by the ice sheet during the Late Saalian and by an advance from the local Liverpool Land ice cap in the Early Weichselian. The exposure ages younger than Saalian are explained by periods of shielding by non‐erosive ice during the Weichselian glaciation. Our work supports previous studies in that the Saalian Ice Sheet advance was the last to deposit thick sediment sequences and western erratics on interior Jameson Land. However, instead of Jameson Land being ice‐free throughout the Weichselian, we document that local ice with limited erosion potential covered and shielded large areas for substantial periods of the last glacial cycle.
Mothers without Companionship During Childbirth: An Analysis within the Millennium Cohort Study
Authors: Essex Holly N. , Pickett Kate E.
Published: November 2008

ABSTRACT:  Background:
Studies have highlighted the benefits of social support during labor but no studies focused on women who choose to be unaccompanied or who have no companion available at birth. Our goals were, first, to identify characteristics of women who are unaccompanied at birth and compare these to those who had support and, second, to establish whether or not being unaccompanied at birth is a risk marker for adverse maternal and infant health outcomes.
Methods:
The sample comprised 16,610 natural mother‐infant pairs, excluding women with planned cesarean sections in the Millennium Cohort Study. Multivariable regression models were used to examine, first, sociodemographic, cultural, socioeconomic, and pregnancy characteristics in relation to being unaccompanied and, second, being unaccompanied at birth in relation to labor and delivery outcomes, maternal health and health‐related behaviors, parenting, and infant health and development.
Results:
Mothers who were single (vs not single), multiparous (vs primiparous), of black or Pakistani ethnicity (vs white), from poor households (vs nonpoor), with low levels of education (vs high levels), and who did not attend antenatal classes (vs attenders) were at significantly higher risk of being unaccompanied at birth. Mothers unaccompanied at birth were more likely to have a preterm birth (vs term), an emergency cesarean section (vs spontaneous vaginal delivery) and spinal pain relief or a general anesthetic (vs no pain relief), a shorter labor, and lower satisfaction with life (vs high satisfaction) at 9 months postpartum. Their infants had significantly lower birthweight and were at higher risk of delayed gross motor development (vs normal development).
Conclusions:
Being unaccompanied at birth may be a useful marker of high‐risk mothers and infants in need of additional support in the postpartum period and beyond. (BIRTH 35:4 December 2008)
Grandmother Breastfeeding Support: What Do Mothers Need and Want?
Authors: Grassley Jane , Eschiti Valerie
Published: November 2008

ABSTRACT:  Background:
Grandmothers are an important source of support for new mothers. Their infant feeding experience and knowledge can influence mothers’ decisions to initiate and continue breastfeeding. The objective of this study was to explore mothers’ perceptions of grandmothers’ breastfeeding knowledge and support, as part of a larger study to design an intervention that facilitates the development of grandmothers’ support of breastfeeding.
Methods:
Thirty mothers participated in one of four focus groups held in a North Texas metropolitan area. We analyzed the text of each focus group interview using the content analysis method and identified five themes within and across groups that described mothers’ perceptions of grandmother breastfeeding support.
Results:
The essence of what mothers needed and wanted from grandmothers could be summarized as grandmother breastfeeding advocacy, which is defined by the two themes, “valuing breastfeeding” and “loving encouragement.” Three other themes, “acknowledging barriers,”“confronting myths,” and “current breastfeeding knowledge,” reflected mothers’ perceptions of what grandmothers need to become their advocates, particularly if they did not breastfeed their own children. Conclusions: Breastfeeding occurs within the context of an extended family in which grandmothers bring their own infant feeding practices and beliefs to their support of new mothers. Mothers need and want grandmothers’ support, but their advice and concerns may reflect cultural beliefs that do not protect breastfeeding. Including grandmothers in conversations about breastfeeding practices can be one way for health caregivers to enhance grandmothers’ knowledge and support of breastfeeding. (BIRTH 35:4 December 2008)
Late Cretaceous blueschist facies metamorphism in southern Thrace (Turkey) and its geodynamic implications
Authors: TOPUZ G. , OKAY A. I. , ALTHERR R. , SATIR M. , SCHWARZ W. H.
Published: November 2008

A blueschist facies tectonic sliver, 9 km long and 1 km wide, crops out within the Miocene clastic rocks bounded by the strands of the North Anatolian Fault zone in southern Thrace, NW Turkey. Two types of blueschist facies rock assemblages occur in the sliver: (i) A serpentinite body with numerous dykes of incipient blueschist facies metadiabase (ii) a well‐foliated and thoroughly recrystallized rock assemblage consisting of blueschist, marble and metachert. Both are partially enveloped by an Upper Eocene wildflysch, which includes olistoliths of serpentinite–metadiabase, Upper Cretaceous and Palaeogene pelagic limestone, Upper Eocene reefal limestone, radiolarian chert, quartzite and minor greenschist. Field relations in combination with the bore core data suggest that the tectonic sliver forms a positive flower structure within the Miocene clastic rocks in a transpressional strike–slip setting, and represents an uplifted part of the pre‐Eocene basement. The blueschists are represented by lawsonite–glaucophane‐bearing assemblages equilibrated at 270–310 °C and ∼0.8 GPa. The metadiabase dykes in the serpentinite, on the other hand, are represented by pumpellyite–glaucophane–lawsonite‐assemblages that most probably equilibrated below 290 °C and at 0.75 GPa. One metadiabase olistolith in the Upper Eocene flysch sequence contains the mineral assemblage epidote + pumpellyite + glaucophane, recording P–T conditions of 290–350 °C and 0.65–0.78 GPa, indicative of slightly lower depths and different thermal setting. Timing of the blueschist facies metamorphism is constrained to c. 86 Ma (Coniacian/Santonian) by Rb–Sr phengite–whole rock and incremental 40Ar–39Ar phengite dating on blueschists. The activity of the strike–slip fault post‐dates the blueschist facies metamorphism and exhumation, and is only responsible for the present outcrop pattern and post‐Miocene exhumation (∼2 km). The high‐P/T metamorphic rocks of southern Thrace and the Biga Peninsula are located to the southeast of the Circum Rhodope Belt and indicate Late Cretaceous subduction and accretion under the northern continent, i.e. the Rhodope Massif, enveloped by the Circum Rhodope Belt. The Late Cretaceous is therefore a time of continued accretionary growth of this continental domain.
Upper‐amphibolite facies partial melting of paragneisses from the Epupa Complex, NW Namibia, and relations to Mesoproterozoic anorthosite magmatism
Authors: BRANDT S. , KLEMD R.
Published: November 2008

The evolution of the mineral assemblages and P–T conditions during partial melting of upper‐amphibolite facies paragneisses in the Orue Unit, Epupa Complex, NW Namibia, is modelled with calculated P–T–X phase diagrams in the Na2O–CaO–K2O–FeO–MgO–Al2O3–SiO2–H2O system. The close concordance of predictions from the phase diagrams to petrographic observations and thermobarometric results documents that quantitative phase diagrams are suitable to explain the phase relationships in migmatitic upper‐amphibolite facies low‐ and medium‐pressure metapelites, which occur in many high‐grade metamorphic terranes worldwide. Different mineral assemblages in the migmatitic metapelites of the Orue Unit reflect regional discrepancies in the metamorphic grade: in a Northern Zone, early biotite–sillimanite–quartz assemblages were replaced via melt‐producing reactions by cordierite‐bearing assemblages. In a Southern Zone, they were replaced via melt‐producing reactions by garnet‐bearing assemblages while cordierite is restricted to rare metapelitic granofelses, which preserve Grt–Sil–Crd–Bt peak assemblages. Peak‐metamorphic conditions of 700–750 °C at 5.5–6.7 kbar in the Southern Zone and of ∼750 °C at 4.5 kbar in the Northern Zone are estimated by integrating thermobarometric calculations with data from calculated mineral composition isopleths. Retrograde back‐reactions between restite and crystallizing melt are recorded by the replacement of garnet by biotite–sillimanite and/or biotite–muscovite intergrowths.

Upper‐amphibolite facies metamorphism and partial melting (c. 1340–1320 Ma) in the rocks of the Southern Zone of the Orue Unit, which underwent probably near‐isobaric heating–cooling paths, are attributed to contact metamorphism induced by the coeval (c. 1385–1319 Ma) emplacement of the Kunene Intrusive Complex, a huge massif‐type anorthosite body. The lower‐pressure metapelites of the Northern Zone are interpreted to record contact metamorphism at an upper crustal level.
Mast Cells Activate the Renin Angiotensin System and Contribute to Migraine: A Hypothesis
Authors: Ba'albaki Hisham , Rapoport Alan
Published: November 2008

Migraine is a chronic disease with episodic attacks, which, when frequent or severe, can be associated with poor quality of life, increased health resource utilization, lost productivity, and significant disability. Preventive therapy can therefore have a significant beneficial clinical and economic impact. However, many migraineurs are treated suboptimally. There is increasing evidence that activation and degranulation of meningeal mast cells result in meningeal irritation, vascular dilation, and stimulation of nearby nociceptive nerve endings of the trigeminal nerve, thus potentially contributing to the pathogenesis of migraine headache. The renin angiotensin system and its peptides are well represented in the mammalian central nervous system and can also promote neurogenic inflammation. Interestingly, mast cells are capable of releasing renin and increasing local production of Angiotensin II. We therefore hypothesize that mast cells contribute to migraine headache through activation of the renin angiotensin system. This hypothesis may help explain the association between migraine and cardiovascular disease as well as observations that medications that modulate the renin angiotensin system can reduce migraine‐related morbidity in patients with frequently recurring migraine attacks.
Epilepsy surgery in children with seizures arising from the rolandic cortex
Authors: Behdad Amir , Limbrick Jr David D. , Bertrand Mary E. , Smyth Matthew D.
Published: November 2008

Purpose:  Medically intractable seizures arising from the sensorimotor (rolandic) cortex present a formidable challenge for epileptologists and epilepsy surgeons. The objective of this study was to evaluate the safety and efficacy of surgical treatment for seizures in this region.

Methods:  We retrospectively reviewed the medical records of 24 children and adolescents who underwent surgical management of refractory rolandic epilepsy at our institution.

Results:  Patient age at the time of surgery ranged between 1.9 and 19.2 years, and median postoperative follow‐up was 2.3 years. Three patients had clear lesions on preoperative magnetic resonance imaging (MRI) that correlated with noninvasive electroencephalography (EEG) and underwent single‐stage lesionectomies. Of the 21 patients who underwent invasive monitoring, 19 underwent therapeutic procedures, including lesionectomy, topectomy, and multiple subpial transections. Engel class I and II outcomes were seen in five of six patients (84.0%) after lesionectomy and in seven of nine patients (77.0%) and four of six patients (66.7%) after sensorimotor corticectomy or multiple subpial transections (MSTs), respectively. At last follow‐up, neurologic deficits were observed following 50.0% (n = 3 of 6) of lesionectomies and 67.0% (n = 7 of 9) of topectomies; no neurologic deficits were seen in patients undergoing motor cortex MSTs. No correlation existed between seizure outcome and duration of epilepsy, age at diagnosis, age at surgery, histopathology, or the presence or absence of a discrete lesion.

Discussion:  Surgery for appropriately selected children with intractable seizures arising from rolandic cortex was effective and associated with minimal neurologic morbidity in many cases. Engel I–II outcome was achieved in 77% of patients overall, and neurologic deficits were often mild and improved over time. Lesionectomy resulted in the best seizure control, followed by topectomy, and then MSTs.
A randomized trial of classical and medium‐chain triglyceride ketogenic diets in the treatment of childhood epilepsy
Authors: Neal Elizabeth G. , Chaffe Hannah , Schwartz Ruby H. , Lawson Margaret S. , Edwards Nicole , Fitzsimmons Georgiana , Whitney Andrea , Cross J. Helen
Published: November 2008

Purpose:  To conduct the first randomized trial on classical and medium‐chain triglyceride (MCT) versions of the ketogenic diet, examining efficacy and tolerability after 3, 6, and 12 months.

Methods:  One hundred forty‐five children with intractable epilepsy were randomized to receive a classical or an MCT diet. Seizure frequency was assessed after 3, 6, and 12 months. Treatment withdrawals were documented. Tolerability was assessed by questionnaire, and blood ketone levels were measured.

Results:  Of the 61 children who started a classical diet and the 64 who started an MCT diet, data from 94 were available for analysis: 45 classical and 49 MCT. After 3, 6, and 12 months there were no statistically significant differences in mean percentage of baseline seizures between the two groups (3 months: classical 66.5%, MCT 68.9%; 6 months: classical 48.5%, MCT 67.6%; 12 months: classical 40.8%, MCT 53.2%; all p > 0.05). There were no significant differences between groups in numbers achieving greater than 50% or 90% seizure reduction. Serum acetoacetate and β‐hydroxybutyrate levels at 3 and 6 months were significantly higher in children on the classical diet (p < 0.01); this was the case at 12 months for acetoacetate. There were no significant differences in tolerability except increased reports in the classical group of lack of energy after 3 months and vomiting after 12 months.

Discussion:  This study has shown classical and MCT ketogenic diet protocols to be comparable in efficacy and tolerability; both ways of implementing the diet have their place in the treatment of childhood epilepsy.
Outcome after extended callosal section in patients with primary idiopathic generalized epilepsy
Authors: Cukiert Arthur , Burattini Jose Augusto , Mariani Pedro Paulo , Cukiert Cristine Mella , Argentoni‐Baldochi Meire , Baise‐Zung Carla , Forster Cássio Roberto , Mello Valeria Antakli
Published: November 2008

Purpose:  We report the outcome of patients with refractory idiopathic generalized epilepsy (IGE) who were submitted to extended one‐stage callosal section.

Methods:  Eleven patients with IGE who were submitted to extended one‐stage callosal section were studied. Preoperative workup included history and neurologic examination, interictal, and ictal electroencephalography (EEG) recording, high resolution 1.5T magnetic resonance imaging (MRI) and intelligence quotient (IQ) testing. All patients were submitted to extended one‐stage microsurgical callosal section, leaving only the splenium intact.

Results:  Preoperative ictal patterns included repetitive spike and wave or polyspike and wave discharges or fast epileptic recruiting rhythm. MRI showed no focal lesions. Preoperatively, mean general IQ was 85. Postoperatively, at least a 75% reduction in the frequency of generalized tonic–clonic seizures was noted in all patients. In three patients absences disappeared completely, and the others had at least 90% reduction in seizure frequency. Only one patient had myoclonic seizures preoperatively, and these seizures disappeared after callosal section. After surgery, mean general IQ was 89. A very clear increase in attention level was noted in all patients. Postoperative interictal EEG recordings showed rupture of bilateral synchrony in all patients.

Discussion:  This article reports on a large and homogeneous series of patients with refractory IGE submitted for callosal section. There was a marked decrease in generalized seizure frequency and increase in the attention level in this patient population. Our results suggest that corticocortical interaction might have a role in IGE pathogenesis. Callosotomy is a safe, effective, and underused palliative procedure in these well‐selected patients with refractory IGE.
Monoamine variability in the chronic model of atypical absence seizures
Authors: Bercovici Eduard , Cortez Miguel A. , Wang Xiaomei , Snead III O. Carter
Published: November 2008

Purpose:  We studied the variability of the slow‐spike‐and‐wave discharges (SSWDs) derived from AY‐9944 (AY) treatment during brain development of Long‐Evans hooded (LEh) rats.

Methods:  Although all LEh rats received the standard dose of AY (7.5 mg/kg), we have observed an intersubject variability of the total SSWD duration at postnatal day (P) 55. Therefore, we set out to investigate the underlying brain levels of norepinephrine (NE), dopamine (DA), and serotonin (5‐HT) and its metabolite (5‐HIAA), as determined by high‐performance liquid chromatography (HPLC) analyses from four different brain regions: thalamus (Th), frontoparietal cortex (Cx), hippocampus (Hp), and brainstem (Bs).

Results:  All brains were obtained after two baseline electrocorticographic (ECoG) recordings with characteristic chronic, recurrent, bilaterally synchronous 4–6 Hz SSWD, at P 55 (336.25 ± 97.23 s/h) and P60 (494.50 ± 150.36 s) (r = 0.951, r2 = 0.904, p < 0.005, Pearson product). The thalamic NE levels and the brainstem NE, DA, and 5HT levels were all significantly correlated with baseline SSWD duration at P55 and P60 (p < 0.01, Pearson product).

Conclusion:  Our data indicate that brain monoamine levels may determine the intersubject variability of SSWD duration in AY rats with chronic atypical absence seizures.
New‐onset geriatric epilepsy care: Race, setting of diagnosis, and choice of antiepileptic drug
Authors: Hope Omotola A. , Zeber John E. , Kressin Nancy R. , Bokhour Barbara G. , VanCott Anne C. , Cramer Joyce A. , Amuan Megan E. , Knoefel Janice E. , Pugh Mary Jo
Published: November 2008

Purpose:  There is a growing movement to assess the quality of care provided to patients in the US, but few studies have examined initial care for epilepsy patients. We examined the relationships among patient race, setting of initial diagnosis, and initial treatment for older veterans newly diagnosed with epilepsy.

Methods:  We used Department of Veterans Affairs (VA) inpatient, outpatient, pharmacy and Medicare data (1999–2004) to identify patients 66 years and older with new‐onset epilepsy. High quality care was defined as avoiding a suboptimal agent (phenytoin, phenobarbital, primidone) as defined by experts. Predictors included demographic and clinical characteristics, and the context of the initial seizure diagnosis including the setting (e.g. emergency, neurology, hospital, primary care). We used mixed‐effects multivariable logistic regression modeling to identify predictors of initial seizure diagnosis in a neurology setting, and receipt of a suboptimal AED.

Results:  Of 9,682 patients, 27% were initially diagnosed in neurology and 70% received a suboptimal AED. Blacks and Hispanics were less likely to be diagnosed in neurology clinics (black OR = 0.7 95% CI 0.6–0.8; Hispanic OR = 0.6 95% CI 0.5–0.9). Diagnosis in a non‐neurology setting increased the likelihood of receiving a suboptimal agent (e.g. Emergency Department OR = 2.3 95% CI 2.0–2.7). After controlling for neurology diagnosis, black race was independently associated with an increased risk of receiving a suboptimal agent.

Discussion:  We demonstrated that differences in quality of care exist for both clinical setting of initial diagnosis and race. We discussed possible causes and implications of these findings.
Neutrophils of Centenarians Show Function Levels Similar to Those of Young Adults
Authors: Alonso‐Fernández Patricia , Puerto Marta , Maté Ianire , Ribera José Manuel , De La Fuente Mónica
Published: November 2008

OBJECTIVES: To analyze several functions and antioxidant parameters of peripheral blood neutrophils from healthy centenarians (men and women) and compare them with those of healthy young (aged 25–35) and middle‐aged (aged 65–75) men and women.

DESIGN: Cross‐sectional study.

SETTING: Community‐based.

PARTICIPANTS: Twenty‐one healthy centenarians (8 men), 30 young adults (15 men), and 30 middle‐aged adults (15 men).

MEASUREMENTS: Several neutrophil functions (adherence, chemotaxis, phagocytosis, and stimulated and nonstimulated intracellular superoxide anion levels) and antioxidant parameters (glutathione levels and catalase activity) were measured in peripheral blood neutrophil suspension in the three study groups.

RESULTS: Neutrophil functions of the middle‐aged group were worse than those of young adults and centenarians (lower chemotaxis and phagocytosis and higher adherence and superoxide anion levels). The neutrophil functions of the centenarians were closer to those of the young adults. Age‐related differences in neutrophil functions were fundamentally similar in men and women, except for intracellular superoxide anion levels, which were lower in young adult women than in young adult men. With normal aging, total glutathione levels decrease, but the centenarians in this study showed levels similar to those of young adults. Centenarians showed the highest catalase activity of the three groups.

CONCLUSION: Progressive impairment of the immune system accompanies aging. The better preservation of function and antioxidant systems in the neutrophils of centenarians could play a key role in the longevity of these subjects.
The Effect of Surgical Site Infection on Older Operative Patients
Authors: Kaye Keith S. , Anderson Deverick J. , Sloane Richard , Chen Luke F. , Choi Yong , Link Katherine , Sexton Daniel J. , Schmader Kenneth E.
Published: November 2008

OBJECTIVES: To determine the effect of surgical site infection (SSI) on mortality, duration of hospitalization, and hospital cost in older operative patients.

DESIGN: Retrospective matched‐outcomes study.

SETTING: Eight hospitals, including Duke University Medical Center, and seven community hospitals.

PARTICIPANTS: Patients aged 65 and older undergoing surgery from 1991 to 2003. Cases were defined as patients who developed deep incisional or organ or space SSI; controls were operative patients who did not develop SSI. Controls were frequency matched to cases according to type and year of operative procedure and to hospital in a 1:1 ratio.

MEASUREMENTS: Mortality, duration of hospitalization (including re‐admissions), and hospital charges for the 90 days after surgery.

RESULTS: One thousand three hundred thirty‐seven patients were enrolled in the study: 561 cases with SSI and 576 controls without SSI. In cases, the most common SSI pathogen was Staphylococcus aureus (n=275, 51.6%). Of S. aureus isolates, 58.2% were methicillin resistant. One hundred sixteen subjects died within 90 days of surgery (8.6%). In multivariable analysis, SSI was associated with greater mortality risk (odds ratio (OR)=3.51, 95% confidence interval (CI)=2.20–5.59), 2.9 times longer postoperative hospitalization (95% CI=2.61–3.13), and 1.9 times greater hospital charges (95% CI=1.78–2.10).

CONCLUSION: In elderly operative patients, SSI was associated with almost 4 times greater mortality, a mean attributable duration of hospitalization after surgery of 15.7 days (95% CI=13.9–17.6) and mean attributable hospital charges of $43,970 (95% CI=$31,881–56,060).
Effects of a Geriatrician‐Led Hip Fracture Program: Improvements in Clinical and Economic Outcomes
Authors: Miura Lisa N. , DiPiero Albert R. , Homer Louis D.
Published: November 2008

The hip fracture service (HFS) is an interdisciplinary, geriatrician‐led program instituted to improve the care of frail elderly people who present to the hospital with acute hip fracture. The HFS pilot project used existing hospital personnel and facilities and initiated new practices, including set protocols, preprinted orders, and standardized assessments, to achieve and evaluate patient triage and care and hospital cost savings. Outcome measures for 91 patients with acute hip fracture consecutively admitted to the HFS were compared with those of 72 historical controls managed under standard care in the prior year. Analysis demonstrated better outcomes in terms of length of stay (6.1±2.4 days for standard care, 4.6±1.1 days for the HFS; P<.001) and time to surgery (<24 hours after admission in 22.2% of standard care patients vs 50.5% of HFS patients; P<.001). Furthermore, the HFS model showed a reduction in total costs, resulting in a gain in net income, from a deficit of $908±4,977 (95% confidence interval (CI)=−$2,078–261) per patient in the standard group to a gain of $1,047±2,718 (95% CI=$481–1,613) per patient in the HFS group (P<.002). The findings suggest that care with set protocols overseen by a trained lead physician may improve the quality and cost effectiveness of managing elderly patients with hip fracture. Although the results must be interpreted with caution because of the pre‐post design, this pilot study provides a model of care for further hypothesis generation and more rigorous testing into the quality and financial benefits of a geriatrics‐led care process.
Pain Assessment in Persons with Dementia: Relationship Between Self‐Report and Behavioral Observation
Authors: Horgas Ann L. , Elliott Amanda F. , Marsiske Michael
Published: November 2008

OBJECTIVES: To investigate the relationship between self‐report and behavioral indicators of pain in cognitively impaired and intact older adults.

DESIGN: Quasi‐experimental, correlational study of older adults.

SETTING: Data were collected from residents of nursing homes, assisted living, and retirement apartments in north‐central Florida.

PARTICIPANTS: One hundred twenty‐six adults, mean age 83; 64 cognitively intact, 62 cognitively impaired.

MEASUREMENTS: Pain interviews (pain presence, intensity, locations, duration), pain behavior measure, Mini‐Mental State Examination, analgesic medications, and demographic characteristics. Participants completed an activity‐based protocol to induce pain.

RESULTS: Eighty‐six percent self‐reported regular pain. Controlling for analgesics, cognitively impaired participants reported less pain than cognitively intact participants after movement but not at rest. Behavioral pain indicators did not differ between cognitively intact and impaired participants. Total number of pain behaviors was significantly related to self‐reported pain intensity (β=0.40, P=.000) in cognitively intact elderly people.

CONCLUSION: Cognitively impaired elderly people self‐report less pain than cognitively intact elderly people, independent of analgesics, but only when assessed after movement. Behavioral pain indicators do not differ between the groups. The relationship between self‐report and pain behaviors supports the validity of behavioral assessments in this population. These findings support the use of multidimensional pain assessment in persons with dementia.
Chronic Pain and Obesity in Elderly People: Results from the Einstein Aging Study
Authors: McCarthy Lucas H. , Bigal Marcelo E. , Katz Mindy , Derby Carol , Lipton Richard B.
Published: November 2008

OBJECTIVES: To determine the prevalence of chronic pain in elderly people and its relationship with obesity and associated comorbidities and risk factors.

DESIGN: Cross‐sectional.

SETTING: Community.

PARTICIPANTS: A representative community sample of 840 subjects aged 70 and older.

MEASUREMENTS: The prevalence of chronic pain and its relationship with obesity (categories defined according to body mass index (BMI)), other medical risk factors, and psychiatric comorbidities were examined. Chronic pain was defined as pain of at least moderate severity (≥4 on a 10‐point scale) some, most, or all of the time for the previous 3 months.

RESULTS: The sample was mostly female (62.8%), and the average age was 80 (range 70–101). The prevalence of chronic pain was 52% (39.7% in men; 58.9% in women). Subjects with chronic pain were more likely to report a diagnosis of depression (odds ratio (OR)=2.5, 95% confidence interval (CI)=1.40–4.55) and anxiety (OR=2.3, 95% CI=1.22–4.64). Obese subjects (BMI 30–34.9) were twice as likely (OR=2.1, 95%CI=1.33–3.28) and severely obese subjects (BMI≥35) were more than four times as likely (OR=4.5, 95% CI=1.85–12.63) as those of normal weight (BMI 18.5–24.9) to have chronic pain. Obese subjects were significantly more likely to have chronic pain in the head, neck or shoulder, back, legs or feet, and abdomen or pelvis than subjects who were not obese. In multivariate models, obesity (OR=2.0, 95% CI=1.27–3.26) and severe obesity (OR=4.1, 95% CI=1.57–10.82) were associated with chronic pain after adjusting for age, sex, diabetes mellitus, hypertension, depression, anxiety, and education.

CONCLUSION: Chronic pain is common in this elderly population, affects women more than men, and is highly associated with obesity.
Predicting blood donation intentions and behavior among Australian blood donors: testing an extended theory of planned behavior model
Authors: Masser Barbara M. , White Katherine M. , Hyde Melissa K. , Terry Deborah J. , Robinson Natalie G.
Published: November 2008

BACKGROUND: Donor retention poses a significant problem to blood collection agencies around the world. Previous research using an augmented theory of planned behavior (TPB) approach has demonstrated that attitude, subjective norm, self‐efficacy, moral norm, anticipated regret, donation anxiety from prior blood donations, and self‐identity as a blood donor predicts experienced donors' intentions and that intentions, self‐efficacy, moral norm, and anticipated regret may impact upon people's actual blood donation behavior.

STUDY DESIGN AND METHODS: Established blood donors (n = 263) completed questionnaires assessing standard TPB constructs, anticipated regret, moral norm, donation anxiety, and self‐identity as a blood donor. Three months later, a second questionnaire assessing blood donation behavior in the intervening 3 months was mailed and returned by 182 donors.

RESULTS: With structural equation modeling, the final augmented TPB model provided an excellent fit to the data and included a direct path from intention to behavior and indirect paths to behavior through intention for attitude, self‐efficacy, and anticipated regret. Moral norm, donation anxiety, and donor identity indirectly predicted intention through attitude. In total, 51 percent of the variance in donors' attitudes, 86 percent of variance in donors' intentions, and 70 percent of the variance in donors' behavior were accounted for in the final model.

CONCLUSION: An augmented TPB framework proved efficacious in determining the predictors of the intentions and behavior of established blood donors. Further, this framework highlighted the importance of considering in the future how donors' motivations for donating blood may evolve as a function of the number of prior donations.
The Effects of Synchronous CMC on Speaking Proficiency and Anxiety: Text Versus Voice Chat
Authors: SATAR H. MÜGE , ÖZDENER NESRIN
Published: November 2008

This article reports on a study investigating the use of 2 synchronous computer‐mediated communication tools: text and voice chat. The experimental design employed 3 groups (text, voice, and control), each consisting of 30 novice‐level secondary school learners of English as a foreign language. Over a 4‐week period, the participants in the experimental groups engaged in 40–45‐minute‐long chat sessions in dyads, guided by a total of 8 tasks. The data were collected through preanxiety and postanxiety scales and speaking tests, and the participants' perspectives were investigated through the use of closed and open‐ended questionnaires. The results showed that the speaking proficiency of both experimental groups increased, whereas there was a decrease in the anxiety levels only for the text chat group. The results were then interpreted by taking into consideration the data from the questionnaires, and a protocol was proposed for the selection of tools for different learner groups.
What Drives Charter School Diffusion at the Local Level: Educational Needs or Political and Institutional Forces?
Authors: Zhang Yahong , Yang Kaifeng
Published: November 2008

While the number of charter schools has increased rapidly in the United States, few studies have examined whether charter schools are implemented in response to real and perceived educational needs or to political and institutional factors in the education policy arena. Unlike traditional policy adoption and diffusion studies that focus on the state level and use a dichotomous dependent variable—adoption or not—this article focuses on local school districts and uses the number of operating charter schools as the dependent variable. Accordingly, instead of applying event history analysis, this article conducts generalized event count regression to estimate models. Based on a data set that consists of Florida's 67 school districts across a six‐year time period, the results suggest that charter school diffusion is more heavily driven by political and institutional factors than by educational needs. The results also demonstrate a dynamic trend of charter school diffusion over time.
Theories of and in the Policy Process
Authors: Weimer David L.
Published: November 2008

Like public administration before it, public policy has an uneasy place in the discipline of political science. The stress is most obvious in the distinction between theories that attempt to explain the policy process and theories that are useful to those who seek to operate within the policy process. Accommodating this stress within the disciplinary boundaries of political science poses a difficult challenge.