bluuebunny/crossref_metadata_2025 huggingface dataset:
Overcoming the innovation‐alliance paradox: a case study of an explorative alliance
Authors: Linnarsson Håkan , Werr Andreas
Published: January 2004

Alliances are an increasingly common way of organizing the uncertain exploration phase of radical innovation. It may, however, be argued that there is inherent tension between the logic of alliances and the logic of innovation. Whereas innovation is generally argued to require flexibility, political protection and extensive communication, the commonly mentioned key characteristics of alliances are detailed contractual regulation, political struggles and limited information exchange. Based on an in‐depth case study of a largely successful alliance for innovation between a European bank and a European telecommunications operator, this paper argues that the tensions between an innovation logic and an alliance logic may be overcome by creating a multilevel governance structure for the alliance, with a learning agenda on both the operational and strategic levels. The different levels of the structure are described and their contribution to the success of the alliance discussed.
Innovation management and organizational learning: a discursive approach
Authors: Chanal Valérie
Published: January 2004

This paper deals with how to design innovative organizations through theoretical and managerial insights. The theoretical framework is based on the structuration theory, with a focus on language and conversations within and across innovation projects. As a setting for the theoretical model, two case studies are presented and discussed: the first analyses an innovation project’s structuration through conversations via e‐mails. The second is an action research whose purpose is to design a project‐oriented organization to improve the innovation capability of an industrial firm. These two field studies lead to a final appraisal of the relevance of a discursive approach to better understand innovation processes and their contribution to organizational learning.
Success factors in transition countries
Authors: Bastic Majda
Published: January 2004

The competitiveness of the transition countries depends on the ability of their companies to develop successful new products. Using 14 success factors proposed by Cooper and Kleinschmidt, their impact on the success of Slovenian new products was analysed, in order to obtain information needed to facilitate the development of new products in the transition countries. The comparison of the results obtained by Slovenian study with the results of other similar studies showed significant difference. It can be explained by the lack of the companies’ ability to innovate.
Exact sampling from anti‐monotone systems
Authors: Häggström O. , Nelander K.
Published: January 2004

A new approach to Markov chain Monte Carlo simulation was recently proposed by Propp and Wilson. This approach, unlike traditional ones, yields samples which have exactly the desired distribution. The Propp–Wilson algorithm requires this distribution to have a certain structure called monotonicity. In this paper an idea of Kendall is applied to show how the algorithm can be extended to the case where monotonicity is replaced by anti‐monotonicity. As illustrating examples, simulations of the hard‐core model and the random‐cluster model are presented.
Chemical Variability in Clays and Pottery from a Traditional Cooking Pot Production Village: Testing Assumptions in Pereruela*
Authors: Buxeda I Garrigós J. , Cau Ontiveros M. A. , Kilikoglou V.
Published: January 2004

This paper explores analytically the contemporary pottery‐making community of Pereruela (north‐west Spain) that produces cooking pots from a mixture of red clay and kaolin. Analyses by different techniques (XRF, NAA, XRD, SEM and petrography) showed an extremely high variability for cooking ware pottery produced in a single production centre, by the same technology and using local clays. The main source of chemical variation is related to the use of different red clays and the presence of non‐normally distributed inclusions of monazite. These two factors induce a high chemical variability, not only in the output of a single production centre, but even in the paste of a single pot, to an extent to which chemical compositions from one ‘workshop’, or even one ‘pot’, could be classified as having different provenances. The implications for the chemical characterization and for provenance studies of archaeological ceramics are addressed.
Strontium Isotopes in the Investigation of Early Glass Production: Byzantine and Early Islamic Glass from the Near East*
Authors: Freestone I. C. , Leslie K. A. , Thirlwall M. , Gorin‐Rosen Y.
Published: January 2004

87Sr/86Sr ratios have been determined for glasses from four production sites, dated to between the sixth and the 11th centuries, in the Eastern Mediterranean region. On the basis of elemental analyses, the glasses at each location are believed to have been melted from different raw materials. Two glass groups, from Bet Eli‘ezer and Bet She‘an, in Israel, are believed to have been based upon mixtures of Levantine coastal sands and natron, and have 87Sr/86Sr ratios close to 0.7090, plus high elemental strontium, confirming a high concentration of modern marine shell (87Sr/86Sr ~ 0.7092) in the raw materials. The isotopic compositions of these two groups of glasses differ slightly, however, probably reflecting a varying ratio of limestone to shell because the sands that were utilized were from different coastal locations. Natron‐based glasses from a workshop at Tel el Ashmunein, Middle Egypt, have 87Sr/86Sr values of 0.70794–0.70798, and low elemental strontium, consistent with the use of limestone or limestone‐rich sand in the batch. High‐magnesia glasses based on plant ash, from Banias, Israel, have 87Sr/86Sr values of 0.70772–0.70780, probably reflecting the isotopic composition of the soils that were parental to the plants that were ashed to make the glass. Strontium and its isotopes offer an approach to identifying both the raw materials and the origins of ancient glasses, and are a potentially powerful tool in their interpretation.
The Production of Lead–Tin Yellow at Merovingian Schleitheim (Switzerland)*
Authors: Heck M. , Rehren Th. , Hoffmann P.
Published: January 2004

A Merovingian crucible fragment, with internally adhering yellow glass, and yellow glass beads of the same region and period were investigated by non‐destructive XRF, optical microscopy and SEM‐EDS. Although the microstructure and chemical composition of the yellow pigment (lead–tin yellow type II, ‘PbSnO3’) are almost identical in both the beads and the crucible, in the latter the pigment occurs in a much higher concentration. However, the glass base in the beads and the crucible is very different, indicating that the beads were not manufactured directly from the crucible. Instead, the crucible most likely served to produce lead–tin yellow, which was subsequently mixed elsewhere with a colourless soda–lime glass to produce yellow glass beads.
A Second Investigation into the Chemical Composition of the Roman Provincial (Procuratorial) Coinage of Judaea, AD 6–66*
Authors: Lönnqvist K. K. A.
Published: January 2004

An investigation of the chemical composition of the first Roman provincial coinage of Judaea, minted in ad 6–66, was conducted. A total of 103 copper‐alloy coins were analysed by ICP‐AES. It was determined that different copper alloys were used for the coinage, a leaded tin‐bronze and a pure tin‐bronze alloy. The investigation also showed that the copper alloy was made in four different formulae with regard to the alloying elements added to copper. Trace element profiles point to the existence of a shared pool of metal for Roman coins and metalwork.
The Determination of Lead Isotope Ratios by Multiple Collector Icp‐Ms: A Case Study of Early Bronze Age Artefacts and their Possible Relation With Ore Deposits of the Erzgebirge*
Authors: Niederschlag E. , Pernicka E. , Seifert Th. , Bartelheim M.
Published: January 2004

Lead isotope analyses of Early Bronze Age metal artefacts from the Aunjetitz (Únĕtice) culture in central Germany and Bohemia were determined in order to find out whether they could be related to ore sources of the Erzgebirge. Historical mining began only in the 12th century ad, but despite the lack of convincing field evidence it has frequently been suspected that this region was already being exploited in prehistoric times. For the determination of the lead isotope ratios, the new technique of multiple collector inductively coupled plasma mass spectrometry (MC‐ICP‐MS) was employed, which combines relatively easy sample preparation with highly precise and accurate measurements. The results show that there is still no evidence for prehistoric mining in the Erzgebirge, but the Rammelsberg deposit in the Harz Mountains might have supplied some of the copper. Mining of stream tin in the Erzgebirge remains a possibility, but no positive evidence can be extracted from the data.
Adhesive Production and Pottery Function During the Iron Age at the Site of Grand Aunay (Sarthe, France)*
Authors: Regert M. , Vacher S. , Moulherat C. , Decavallas O.
Published: January 2004

A combination of elemental, functional and molecular analyses performed on amorphous organic residues dating from the Iron Age was developed in order to identify these remains and to understand their relationship with ceramic vessels in which some of them were found. These analyses made it possible to distinguish between ceramic vessels used for the production or storage of adhesive materials, mainly birch bark tar, and those dedicated to the preparation of culinary commodities, which contained animal fats. The organization of the production of adhesives is described and the addition of beeswax to birch bark tar is reported for the first time. The use of birch bark tar for coating ceramic vessels is also discussed.
Maize and Bone: Residues of Grinding in Northwestern Argentina*
Authors: Del Pilar Babot M. , Apella María C.
Published: January 2004

Archaeometric and archaeobotanical analyses of grinding residues inside an archaeological milling stone tool from the Cueva de los Corrales 1 site in northwestern Argentina are shown. Multiple analytical techniques are used to identify ground substances, and their results are compared and complemented. They give direct and reliable evidence of maize (Zea mays L.) and burned bone grinding in the pre‐hispanic Argentine north‐west, although the latter is little related to milling tasks.
A Novel Application of Molecular Techniques to Pacific Archaeofish Remains*
Authors: Nicholls A. , Matisoo‐Smith E. , Allen M. S.
Published: January 2004

Until recently, the identification of fish bone from Pacific archaeological sites generally relied upon morphological analysis of a relatively restricted number of skeletal elements. Limited morphological variation within fish families, amongst other things, has often restricted Pacific archaeofish determinations to the level of family or, in some cases, genus. We suggest that these relatively imprecise determinations may mask important aspects of prehistoric human fishing practices and subsistence patterns. This paper describes a molecular technique that allows for more precise taxonomic determinations, initially applied to the large and diverse family of Serranidae. The technique involves extraction, amplification, sequencing and analysis of mitochondrial DNA variation in the 16s ribosomal RNA gene. Following development of protocols and primers for modern reference materials, the technique was applied to an archaeological faunal assemblage from Aitutaki, southern Cook Islands.
The Application of Steroidal Biomarkers to Track the Abandonment of a Roman Wastewater Course at the Agora (Athens, Greece)*
Authors: Bull I. D. , Elhmmali M. M. , Roberts D. J. , Evershed R. P.
Published: January 2004

A subterranean, stone‐built, sediment‐filled culvert discovered during excavations at the Agora (Athens, Greece) was dated to the Roman period on the basis of its characteristic construction and associated finds, including coins. The location of the culvert relative to other adjacent watercourses and an ancient river bed suggested that the structure was a sewer. This was confirmed through a multi‐molecular biomarker approach based on analysis of the bile acids associated with sediment filling the sewer, using gas chromatography (GC) and gas chromatography/mass spectrometry (GC/MS). The acid fraction contained predominantly deoxycholic and lithocholic acids, while the neutral steroid fraction comprised a complex mixture of Δ5 sterol and 5β‐ and 5α‐stanols, dominated by coprostanol, suggesting the presence of faecal matter of predominantly human origin. The concentrations of neutral and acidic faecal biomarkers were observed to vary in tandem, with the highest concentrations being found in the sediment at the base of the fill in the culvert. A reduction in concentration occurred with decreasing depth of the fill, with concentrations in the uppermost samples being little different from control samples of sediment taken beyond the confines of the culvert. The enhanced concentration of bile acids relative to 5β‐stanols compared with fresh human faeces must reflect the enhanced diagenetic stability of the former, thereby making bile acids the possibly preferred biomarker for this type of study. The quantitative data obtained suggest that the culvert fell rapidly out of use, possibly coinciding with the Slavic incursion in AD 582–3.
Conceptualizing Teaching as Science: John Dewey in Dialogue with the National Research Council
Authors: Seals Greg
Published: January 2004

John Dewey and the National Research Council (NRC) both discuss the problem of translating scientific research into contexts of schooling, but differ about the proper solution to the problem. The NRC would solve it by empirical investigation. Dewey finds value in that approach, but also wants educational theorists to construct general heuristics to guide scientists in creating research agendas of intrinsic interest to education practitioners. Dewey's plan faces an apparently insurmountable difficulty. General heuristics of the sort Dewey needs are not widely recognized to exist. In light of the presumed fact of education's inability to articulate a general framework to guide teaching practice, the NRC plan becomes preferred by default. I propose that Experience and Education provides a frame of reference from which pedagogical practice appears as a field of scientific endeavor in its own right. Conceptualizing teaching as a science suggests ways to rework the NRC plan.
Gentlemanly Orthodoxy: Critical Race Feminism, Whiteness Theory, and the APA Manual
Authors: Thompson Audrey
Published: January 2004

Although often viewed as burdensome, academic writing guidelines are rarely treated as actively problematic. Even progressive scholars are unlikely to challenge the cultural assumptions or political investments of academic style guides. Yet standards regarding clarity, precision, appropriateness, sensitivity, and objectivity are not politically innocent. In codifying formal guidelines for the presentation of research, academic style manuals reflect and reinscribe the racialized and gendered (among other) power relations characteristic of the academy. Drawing on critical race feminism and whiteness theories, this paper considers how scholarly investments in whiteness and patriarchy organize the influential APA writing guidelines. The present analysis refers specifically to the APA Manual, but similar analyses might apply to aspects of the Chicago and MLA manuals and the Bluebook, among other style guides.
Social Justice Education, Moral Agency, and the Subject of Resistance
Authors: Applebaum Barbara
Published: January 2004

This paper explores the concept of white complicity and provides illustrations of how traditional conceptions of moral agency support the denial of such complicity. Judith Butler's conception of subjectivity is then examined with the aim of assessing its usefulness as a foundation for social justice pedagogy. Butler's conception of subjectivity is of interest because it offers insights into how dominant group identities are unintentionally complicit in the perpetuation of hegemonic social norms. While Butler's conception of subjectivity is shown to be useful in understanding white complicity, questions around the notion of agency that follow from such a conception of subjectivity are raised and briefly discussed. Finally, I show the implications of Butler's conception of self and agency for social justice pedagogy.
History, Myth, and the Politics of Educational Reform
Authors: Reddick Robert Nelson
Published: January 2004

This paper analyzes the politics of education in the United States by considering the ideas and lives of Emma Willard and Catharine Beecher, nineteenth century educational reformers. It argues that understanding these women as American Antigones, as working through the contradictions between their public writing and their private lives, provides a perspective on the history of educational reform that combines myth and history. This perspective refuses idealized accounts of “lost” moments or possibilities in the past, grounding educational reform in the project of reimagining gender relations within families and schools in the present.
Globalization and Education
Authors: Singh Parlo
Published: January 2004

This paper reviews four books on globalization and education. It begins with a brief overview of theories of globalization, focusing specifically on cultural globalization. The paper then moves on to examine how each of the books deploys and develops a theory of globalization in relation to the topic of education. It also examines the utopian vision of education outlined within the books, as well all as the methods used to undertake research in an era of globalization.
What Future for Social Science?
Authors: Schrag Francis
Published: January 2004

Each of the authors discussed in this review essay deplores the attempts of scholars in the human sciences to ape their colleagues in the natural sciences and economics. Their criticisms are not dissimilar, nor are they without merit, but it is important to ask the following questions: What would they offer in its place? What kind of warrantability do the alternatives promise? Can researchers avoid the dominant paradigms and still have something valuable to say to policymakers? The bulk of the review focuses on Bent Flyvbjerg's Making Social Science Matter, the best‐reasoned critique, and the one that offers the clearest alternative to the status quo.
Reduced competitive ability due toWolbachiainfection in the parasitoid waspTrichogramma kaykai
Authors: Huigens M. E. , Hohmann C. L. , Luck R. F. , Gort G. , Stouthamer R.
Published: January 2004

Several hymenopteran parasitoids are infected with parthenogenesis‐inducing (PI)Wolbachia. Infected wasps produce daughters instead of sons from unfertilized eggs. Thus far, little is known about the direct effects of PIWolbachiaon their host's fitness. Here, we report reduced competitive ability due toWolbachiainfection in a minute parasitoid wasp,Trichogramma kaykaiPinto and Stouthamer (Hymenoptera: Trichogrammatidae). Immature survival of infected individuals in a host parasitized by a single infected female, laying a normal clutch of eggs, was lower than those parasitized by a single uninfected individual. When the offspring of infected and uninfected females shared the same host, the infected immatures had significantly lower survival rates than their uninfected counterparts. The survival rate of infected immatures was higher when they competed with other infected immatures from a different infected parent than in competition with uninfected immatures of conspecific wasps. Thus, the hostTrichogrammacan suffer a substantial reduction in fitness when it is infected with the PIWolbachia. We discuss why such a reduction is to be expected when populations of infected and uninfected individuals co‐occur, and how the reduced competitive ability of PIWolbachiainfluences the spread of the bacteria in the field.
Developing pheromone traps and lures for Maruca vitrata in Benin, West Africa
Authors: Downham M. C. A. , Tamò M. , Hall D. R. , Datinon B. , Adetonah S. , Farman D. I.
Published: January 2004

In previous work successful trapping of the legume podborer, Maruca vitrata Fabricius (Lepidoptera: Pyralidae), was accomplished using a synthetic pheromone blend consisting of (E,E)‐10,12‐hexadecadienal, (E,E)‐10,12‐hexadecadienol, and (E)‐10‐hexadecenal in a 100 : 5 : 5 ratio. In the present work, experiments were conducted in cowpea fields in Benin to compare different trap designs, and other aspects of the lures. A water‐trap made from a plastic jerry‐can was found to be superior to commercial funnel‐ and sticky‐trap designs, and 120 cm was the optimum height for captures. Generally, lures consisted of polyethylene vials containing 0.1 mg of pheromone. Results showed that shielding the lures from the adverse effects of sunlight with aluminium foil did not increase trap catches of M. vitrata. The degree of isomeric purity of the (E,E)‐10,12‐hexadecadienal and (E,E)‐10,12‐hexadecadienol blend components, in the range 73–99%, had no significant effect on captures, while lures of 80% isomeric purity showed no loss of effectiveness for up to 4 weeks. Similar results were observed with lures from a commercial source containing 0.46 mg of pheromone in the blend ratio 100 : 11 : 6 and 95% isomeric purity. Residue analysis showed that vial lures exposed for 2 weeks in the field still contained 73% of the initial amount of (E,E)‐10,12‐hexadecadienal, compared to rubber septa dispensers, which only retained 22%. Females comprised 11–50% of total catches, confirming earlier, unexpected results for synthetic lures. The observations that effective traps can be made from locally available plastic containers, and that pheromone blend composition and purity are not critical, should reduce costs and improve the feasibility of traps as practical monitoring tools for M. vitrata.
Influence of handling and conditioning protocol on learning and memory of Microplitis croceipes
Authors: Tertuliano M. , Olson D.M. , Rains G.C. , Lewis W.J.
Published: January 2004

Microplitis croceipes (Cresson) (Hymenoptera: Braconidae) learns odors in association with both hosts and food. The food‐associated ‘seeking’ behavior of M. croceipes was investigated under various training protocols utilizing the conditioning odor, 3‐octanone. We investigated the effects of odor training, or its lack, training duration, training frequency, time elapsed after training, wasp hunger state, and training reinforcement, on the food‐seeking responses of M. croceipes females. We found that odor‐trained females show strong food seeking responses, whereas non‐odor‐trained females do not respond to the odor, and that a single 10 s association with the odor whilst feeding on sugar water subsequently conditioned the wasps to exhibiting significant responses to it. Increases in training time to more than 10 s did not improve their responses. Repetition of the food–odor associations increased a wasp's recall, as well as its response over time, compared to a single exposure. Repeated exposure to the learned odor in the absence of a food reward decreased the responses of less hungry individuals. However, the level of response increased significantly following a single reinforcement with the food–odor association. Understanding the factors that influence learning in parasitoids can enhance our ability to predict their foraging behavior, and opens up avenues for the development of effective biological detectors.
Experience with methyl salicylate affects behavioural responses of a predatory mite to blends of herbivore‐induced plant volatiles
Authors: De Boer Jetske G. , Dicke Marcel
Published: January 2004

Many natural enemies of herbivorous arthropods use herbivore‐induced plant volatiles to locate their prey. These foraging cues consist of mixtures of compounds that show a considerable variation within and among plant–herbivore combinations, a situation that favours a flexible approach in the foraging behaviour of the natural enemies. In this paper, we address the flexibility in behavioural responses of the predatory mite Phytoseiulus persimilis Athias‐Henriot (Acari: Phytoseiidae) to herbivore‐induced plant volatiles. In particular, we investigated the effect of experience with one component of a herbivore‐induced volatile blend: methyl salicylate (MeSA). We compared the responses of three groups of predatory mites: (1) those reared from egg to adult on Tetranychus urticae Koch (Acari: Tetranychidae) on lima bean plants (Phaseolus lunatus L. that produces MeSA), (2) those reared on T. urticae on cucumber (Cucumus sativus L. that does not produce MeSA), and (3) those reared on T. urticae on cucumber in the presence of synthetic MeSA. Exposure to MeSA during the rearing period (groups 1 and 3) resulted in an attraction to the single compound MeSA in a Y‐tube olfactometer. Moreover, exposure to MeSA affected the choice of predatory mites between two volatile blends that were similar, except for the presence of MeSA. Predators reared on lima bean plants preferred the volatile blend from T. urticae‐induced lima bean (including MeSA) to the volatile blend from jasmonic‐acid induced lima bean (lacking MeSA), but predators reared on cucumber preferred the volatile blend from the latter. Predatory mites reared on cucumber in the presence of synthetic MeSA did not discriminate between these two blends. Exposure to MeSA for 3 days in the adult phase, after rearing on cucumber, also resulted in attraction to the single compound MeSA. We conclude that a minor difference in the composition of the volatile blend to which a predatory mite is exposed can explain its preferences between two odour sources.
Generalized Epilepsy with Febrile Seizures Plus (GEFS+): Clinical Spectrum in Seven Italian Families Unrelated to SCN1A, SCN1B, and GABRG2 Gene Mutations
Authors: Bonanni Paolo , Malcarne Michela , Moro Francesca , Veggiotti Pierangelo , Buti Daniela , Ferrari Anna Rita , Parrini Elena , Mei Davide , Volzone Anna , Zara Federico , Heron Sarah E. , Bordo Laura , Marini Carla , Guerrini Renzo
Published: January 2004

Summary:  Purpose: We describe seven Italian families with generalized epilepsy with febrile seizures plus (GEFS+), in which mutations of SCN1A, SCN1B, and GABRG2 genes were excluded and compare their clinical spectrum with that of previously reported GEFS+ with known mutations.

Methods: We performed a clinical study of seven families (167 individuals). The molecular study included analysis of polymerase chain reaction (PCR) fragments of SCN1A and SCN1B exons by denaturing high‐performance liquid chromatography (DHPLC) and direct sequencing of GABRG2 in all families. We excluded SCN1A, SCN1B, and GABRG2 genes with linkage analysis in a large pedigree and directly sequenced SCN2A in a family with neonatal–infantile seizures onset. We compared the epilepsy phenotypes observed in our families with those of GEFS+ families harboring mutations of SCN1A, SCN1B, and GABRG2 and estimated the percentage of mutations of these genes among GEFS+ cases by reviewing all published studies.

Results: Inheritance was autosomal dominant with 69% penetrance. Forty‐one individuals had epilepsy: 29 had a phenotype consistent with GEFS+; seven had idiopathic generalized epilepsy (IGE); in three, the epilepsy type could not be classified; and two were considered phenocopies. Clinical phenotypes included FS+ (29.2%), FS (29.2%), IGE (18.2%), FS+ with focal seizures (13%) or absence seizures (2.6%), and FS with absence seizures (2.6%). Molecular study of SCN1A, SCN2A, SCN1B, and GABRG2 did not reveal any mutation. Results of our study and literature review indicate that mutations of SCN1A, SCN2A, SCN1B, and GABRG2 in patients with GEFS+ are rare.

Conclusions: The most frequently observed phenotypes matched those reported in families with mutations of the SCN1A, SCN1B, and GABRG2 genes. IGE and GEFS+ may overlap in some families, suggesting a shared genetic mechanism. The observation that 13% of affected individuals had focal epilepsy confirms previously reported rates and should prompt a reformulation of the “GEFS+” concept to include focal epileptogenesis.
Direct Cost of Medical Management of Epilepsy among Adults in Italy: A Prospective Cost‐of‐Illness Study (EPICOS)
Authors: Beghi Ettore , Garattini Livio , Ricci Elena , Cornago Dante , Parazzini Fabio ,   EPICOS Group
Published: January 2004

Summary:  Purpose: To investigate the costs of epilepsy from a nationwide survey comparing adult patients included in different prognostic categories.

Methods: A 12‐month prospective observational study was conducted in 15 epilepsy centers from Northern, Central, and Southern Italy. The study population included a random sample of individuals aged 18 years and older with newly diagnosed (ND) epilepsy, seizure remission (R), occasional seizures (OS), active non–drug‐resistant (NDR) seizures, drug‐resistant (DR) seizures, or surgical candidates (SC). Estimates of the direct costs of care of epilepsy were based on the use of diagnostic examinations, laboratory tests, specialist consultations, hospital admissions, day‐hospital days, and drugs, taking the Italian National Health Service perspective.

Results: The sample included 631 patients (ND 62, R 158, OS 155, NDR 114, DR 128, and SC 14). The SC group had the highest total cost per patient (€3,619) followed by DR (€2,190), ND (€976), NDR (€894), OS (€830), and R (€561). For each epilepsy group, the main components of the total cost were drugs and hospital admissions. Drug costs increased from the R group to the DR group. The new antiepileptic drugs (AEDs) were the largest part of the cost of treatment.

Conclusions: The costs of epilepsy in referral patients vary significantly according to the time course of the disease and the response to treatment. Hospital admissions and drugs are the major sources of expenditure.
Mutations of Neuronal Voltage‐gated Na+ Channel α1 Subunit Gene SCN1A in Core Severe Myoclonic Epilepsy in Infancy (SMEI) and in Borderline SMEI (SMEB)
Authors: Fukuma Goryu , Oguni Hirokazu , Shirasaka Yukiyoshi , Watanabe Kazuyoshi , Miyajima Tasuku , Yasumoto Sawa , Ohfu Masaharu , Inoue Takahito , Watanachai Aruchalean , Kira Ryutaro , Matsuo Muneaki , Muranaka Hideki , Sofue Fumiko , Zhang Bo , Kaneko Sunao , Mitsudome Akihisa , Hirose Shinichi
Published: January 2004

Summary:  Purpose: Severe myoclonic epilepsy in infancy (SMEI) is a distinct epilepsy syndrome. Patients with borderline SMEI (SMEB) are a subgroup with clinical features similar to those of core SMEI but are not necessarily consistent with the accepted diagnostic criteria for core SMEI. The aim of this study was to delineate the genetic correlation between core SMEI and SMEB and to estimate the frequency of mutations in both phenotypes.

Methods: We examined 96 healthy volunteers and 58 unrelated individuals whose clinical features were consistent with either core SMEI (n = 31) or SMEB (n = 27). We screened for genetic abnormalities within exons and their flanking introns of the genes encoding major subunits of the Na+ channels (SCN1A, SCN2A, SCN1B, and SCN2B) by using a direct sequencing method.

Results: In both core SMEI and SMEB, various mutations of SCN1A including nonsense and missense mutations were identified, whereas no mutations of SCN2A, SCN1B, and SCN2B were found within the regions examined. All mutations were heterozygous and not found in 192 control chromosomes. Mutations were identified in 26 (44.8%) of the 58 individuals and were more frequent (p < 0.05) in core SMEI (19 of 31) than in SMEB (seven of 27), as assessed by the continuity‐adjusted χ2 test. Mutations resulting in a molecular truncation were found only in core SMEI. Among the mutations, two missense mutations were found in both core SMEI and SMEB.

Conclusions: Our findings confirm that SMEB is part of the SMEI spectrum and may expand the recognition of SMEI and suggest other responsible or modifying genes.
Recurrence after a First Unprovoked Cryptogenic/Idiopathic Seizure in Children: A Prospective Study from São Paulo, Brazil
Authors: Scotoni Anna E. , Manreza Maria L. G. , Guerreiro Marilisa M.
Published: January 2004

Summary:  Purpose: To evaluate the recurrence risk after a first unprovoked seizure in a large population of children and adolescents of a developing country.

Methods: This prospective study was conducted at two tertiary hospitals, between September 1989 and August 1998. Children were enrolled if they had a first unprovoked cryptogenic/idiopathic seizure and maximal interval to the enrollment ≤90 days. EEG and computed tomography (CT) were performed in most patients. Potential predictors of recurrence were compared by using the Cox proportional hazards model in univariate and multivariate analyses. Survival analysis was performed by using the Kaplan–Meier curves.

Results: Two hundred thirteen children were included. Recurrence occurred in 34% of the patients, and mean time for recurrence was 12 months. Statistical analysis showed significance for seizure recurrence only for patients with abnormal EEGs. CT was performed in 182 patients, and abnormalities were found in 9.5%. Small calcifications were the most frequent finding, and this was not a predictor for recurrence.

Conclusions: The risk of recurrence after a first unprovoked seizure in children from a developing country is similar to that found in developed countries. An abnormal EEG is a risk factor for seizure recurrence in children with a cryptogenic/idiopathic seizure. Calcifications on CT do not increase the risk of recurrence.
Sulthiame in the Primary Therapy of West Syndrome: A Randomized Double‐blind Placebo‐controlled Add‐on Trial on Baseline Pyridoxine Medication
Authors: Debus Otfried Martin , Kurlemann Gerhard ,   Study Group
Published: January 2004

Summary:  Purpose: West syndrome (WS) is still one of the most difficult to treat epilepsies in infancy. Sulthiame (STM), which is commonly used in some countries in the treatment of benign focal epilepsies in childhood, has been suggested to be effective in WS too. This prospective, randomized placebo‐controlled study was designed to prove or refute this hypothesis.

Methods: Thirty‐seven infants aged between 3.5 and 15 months with newly diagnosed WS received baseline therapy with pyridoxine (PDX). The children were randomized in a double‐blind fashion to STM (n = 20) or placebo (n = 17), starting at day 4 at a moderate dose of 5 mg/kg body weight. Without complete cessation of infantile spasms (ISs) and resolution of hypsarrhythmia as the definition criteria of a response, the dose was doubled at day 7. The final examination was undertaken at the end of day 9.

Results: Based on the intention to treat, six (30%) of 20 patients responded to STM (p < 0.025), as did six (35%) of 17 infants fulfilling the study criteria (p < 0.01). Patients with tuberous sclerosis did not respond to STM (n = 3) No patient responded to placebo. One patient in the verum group was withdrawn because of reversible somnolence.

Conclusions: As no child in the placebo group responded to the baseline PDX therapy, nor did any child in the STM group during the first 3 days of baseline therapy, PDX does not seem to be effective in WS. STM has a positive effect in the primary therapy of WS, comparable to that of vigabatrin.
Factor XIII Deficiency Associated with Valproate Treatment
Authors: Teich Martin , Longin Elke , Dempfle Carl‐Erik , König Stephan
Published: January 2004

Summary:  Purpose: We present two children who developed a deficiency of factor XIII with valproate (VPA) treatment. This coagulation disorder has not been described in association with VPA treatment in children, and only very recently in one adult patient.

Results: Both patients showed recurrent epistaxis as major clinical sign of a combination of decreased coagulation parameters (factor XIII deficiency with thrombocytopenia and decreased von Willebrand factor, respectively). A few days after reduction or withdrawal of VPA treatment, clinical symptoms disappeared, and laboratory findings were within normal range.

Conclusions: VPA is known to influence the synthetic function of the liver and the number and function of megakaryocytes. Therefore an alteration of the factor XIII level by VPA is conceivable. Our case reports suggest that bleeding symptoms during VPA treatment may be caused or aggravated by a decreased factor XIII activity. A determination of factor XIII activity should be considered before surgical procedures during VPA treatment to minimize the risk of (severe) postsurgical bleeding complications.
Evaluation with α−[11C]Methyl‐l‐tryptophan Positron Emission Tomography for Reoperation after Failed Epilepsy Surgery
Authors: Juhász Csaba , Chugani Diane C. , Padhye Uma N. , Muzik Otto , Shah Aashit , Asano Eishi , Mangner Tom J. , Chakraborty Pulak K. , Sood Sandeep , Chugani Harry T.
Published: January 2004

Summary:  Purpose: Reoperation after failed cortical resection can alleviate seizures in patients with intractable neocortical epilepsy, provided that previously nonresected epileptic regions are accurately defined and removed. Most imaging modalities have limited value in identifying such regions after a previous surgery. Positron emission tomography (PET) using α−[11C]methyl‐l‐tryptophan (AMT) can detect epileptogenic cortical areas as regions with increased tracer uptake. This study analyzed whether increased cortical AMT uptake can detect nonresected epileptic foci in patients with previously failed neocortical resection.

Methods: Thirty‐three young patients (age 3–26 years; mean age, 10.8 years) with intractable epilepsy of neocortical origin, and a previously failed cortical resection performed at various epilepsy centers, underwent further presurgical evaluation for reoperation. AMT‐PET scans were performed 6 days to 7 years after the first surgery. Focal cortical areas with increased AMT uptake were objectively identified and correlated to ictal EEG data as well as clinical variables (age, postsurgical time, etiology).

Results: Cortical increases of AMT uptake were detected on the side of the previous resections in 12 cases. In two patients scanned shortly (within a week) after surgery, diffuse hemispheric increases were observed, without any further localization value. In contrast, in 10 (43%) of 23 patients scanned >2 months but within 2.3 years after surgery, focal cortical increases occurred, concordant with seizure onset on ictal EEG. Age, etiology (lesional vs. cryptogenic), epileptiform EEG activity during PET, or time of the last seizure were not significantly related to the presence of increased AMT uptake. All patients with localizing AMT‐PET, who underwent reoperation, became seizure free (n = 5) or showed considerable improvement of seizure frequency (n = 2).

Conclusions: AMT‐PET can identify nonresected epileptic cortex in patients with a previously failed neocortical epilepsy surgery and, with proper timing for the scan, can assist in planning reoperation.
Resective Surgery for Intractable Focal Epilepsy in Patients with Low IQ: Predictors for Seizure Control and Outcome with Respect to Seizures and Neuropsychological and Psychosocial Functioning
Authors: Bjørnæs Helge , Stabell Kirsten Engberg , Heminghyt Einar , Røste Geir Ketil , Bakke Søren Jacob
Published: January 2004

Summary: Purpose:To investigate possible predictive factors for seizure control in a group of children and adults with low IQs (IQ, ≤70) who underwent resective surgery for intractable focal epilepsy and to study outcome with respect to seizures and neuropsychological functioning. We also studied psychosocial outcome in the adult patients.

Methods:Thirty‐one patients (eight children younger than 18 years) with a Wechsler Full Scale IQ of 70 or less underwent comprehensive neuropsychological assessments before and 2 years after surgery. Adults also completed the Washington Psychosocial Seizure Inventory (WPSI). Univariate analyses were used to identify variables differentiating between patients who became seizure free and those who did not. Pre‐ and postoperative test results were compared byttest for dependent samples.

Results:Forty‐eight percent of the patients became seizure free, 52% of those with temporal lobe resection and 38% of those with extratemporal resection. Only one variable was predictive for seizure outcome: duration of epilepsy. In one third of the patients, who had the shortest duration of epilepsy (<12 years), 80% became seizure free. Significant improvement was seen regarding vocational adjustment in adults (WPSI). Seizure‐free adults improved their Full Scale IQ scores. No cognitive changes were found in seizure‐free children or in patients who did not become seizure free.

Conclusions:A good seizure outcome was obtained after resective surgery in patients with intractable focal epilepsy and low IQ, provided that treatment was done relatively shortly after onset of epilepsy. No adverse effects were seen on cognitive and psychosocial functioning.
Status Epilepticus in a Population‐based Virginia Twin Sample
Authors: Corey Linda A. , Pellock John M. , DeLorenzo Robert J.
Published: January 2004

Summary:  Purpose: To characterize status epilepticus (SE) and estimate its frequency of first occurrence, as well as to assess the contribution of genetic factors to risk of SE occurrence in a sample of Virginia‐born twins ascertained from the population‐based Mid‐Atlantic Twin Registry.

Methods: The occurrence of SE was determined in 13,506 unselected Virginia‐born twin pairs ascertained from birth records. Twins included in the study were between ages 2 and 75 years when surveyed. History of seizures and SE was validated through medical records and by detailed personal or parental interviews.

Results: Among 381 twins included in 332 pairs with a verified history of seizures, 70 (18.4%) were validated to have had at least one episode of SE. The frequency of first SE in this sample was 309 per 100,000 twins. First SE occurred in conjunction with 21 of 158 febrile and 49 of 223 afebrile seizure cases, respectively. Mean length of SE episode was 76.2 ± 14.9 min. Age at first SE occurrence ranged from 2 months to 59 years. All concordant twin pairs in the sample were monozygotic (MZ), with a proband‐wise concordance rate estimated for SE in this population of 0.31 [95% confidence interval (CI), 0.14–0.52) overall, and 0.67 (95% CI, 0.35–0.90) in pairs concordant for epilepsy.

Conclusions: These results provide a direct estimate of the frequency of SE in a defined population of twins and afford further evidence for a genetic contribution to risk for SE.
Seizure Recurrence after Planned Discontinuation of Antiepileptic Drugs in Seizure‐free Patients after Epilepsy Surgery: A Review of Current Clinical Experience
Authors: Schmidt Dieter , Baumgartner Christoph , Löscher Wolfgang
Published: January 2004

Summary: Purpose:Although epilepsy surgery, especially temporal lobe epilepsy surgery, is well established to control seizures in patients remaining on antiepileptic drug (AED) treatment, less information is available about how many seizure‐free surgical patients will relapse after discontinuation of AEDs under medical supervision.

Methods:A literature review yielded six retrospective clinical observations.

Results:After planned discontinuation of AEDs in patients rendered seizure free after epilepsy surgery, most often various forms of temporal lobe surgery, the mean percentage recurrence rate in adults in four studies was 33.8%[95% confidence interval (CI), 32.4–35.2%], with maximum follow‐up ranging from 1 to 5 years. Seizure recurrence increased during the follow‐up of 1 to 3 years and occurred within 3 years of AED discontinuation. In one study of children with temporal lobe epilepsy, the recurrence rate was 20%. More than 90% of adult patients with seizure recurrence regained seizure control with reinstitution of previous AED therapy. Seizure recurrence was unaffected by the duration of postoperative AED treatment; as a consequence, delaying discontinuation beyond 1 to 2 years of complete postoperative seizure control seems to have no added benefit. The occurrence of rare seizures or auras after surgery did not eliminate the possibility of eventual successful AED discontinuation.

Conclusions:AED discontinuation is associated with a seizure recurrence in one in three patients rendered seizure free by epilepsy surgery. These results will be useful in counseling patients about discontinuing AED treatment after successful epilepsy surgery.
Stimulus‐induced Rhythmic, Periodic, or Ictal Discharges (SIRPIDs): A Common EEG Phenomenon in the Critically Ill
Authors: Hirsch Lawrence J. , Claassen Jan , Mayer Stephan A. , Emerson Ronald G.
Published: January 2004

Summary:  Purpose: To describe an underrecognized EEG phenomenon in critically ill patients undergoing continuous EEG monitoring (cEEG). We named these EEG patterns stimulus‐induced rhythmic, periodic, or ictal discharges (SIRPIDs).

Methods: We reviewed 150 consecutive patients undergoing cEEG during a 9‐month period and compared those with and without SIRPIDs. SIRPIDs were defined as periodic, rhythmic, or ictal‐appearing discharges that were consistently induced by alerting stimuli.

Results: We identified 33 patients with SIRPIDs (22%). SIRPID patterns included periodic epileptiform discharges in 21 patients (nine lateralized) and rhythmic patterns with evolution that fulfilled criteria for ictal discharges in 18 patients (12 unilateral). Eight patients had prior epilepsy; 24 had acute brain injury. Half the patients (17 of 33) had seizures, clinical or subclinical, during the acute illness in addition to SIRPIDs, and half (16 of 33) did not. No significant difference was found in the incidence of clinical seizures in patients with SIRPIDs (30%) compared with those without (45%). Clinical status epilepticus was more common in patients with focal (43%) or ictal‐appearing (33%) SIRPIDs than in those without SIRPIDs (17%).

Conclusions: Rhythmic, periodic, or ictal‐appearing EEG patterns are commonly elicited by stimulation in critically ill, encephalopathic patients. Recording video, documenting patient stimulation, or repetitively examining patients during cEEG is necessary to recognize these patterns and to differentiate SIRPIDs from spontaneous seizures. Further research is necessary to determine the pathophysiologic, prognostic, and therapeutic significance of SIRPIDs.
A New Benign Adult Familial Myoclonic Epilepsy (BAFME) Pedigree Suggesting Linkage to Chromosome 2p11.1‐q12.2
Authors: Striano Pasquale , Chifari Rosanna , Striano Salvatore , De Fusco Maurizio , Elia Maurizio , Guerrini Renzo , Casari Giorgio , Canevini Maria Paola
Published: January 2004

Summary:  Benign adult familial myoclonic epilepsy (BAFME) is an autosomal dominant condition characterized by cortical tremor and generalized seizures, mapped on chromosome 8q24 by Japanese authors. Recently the same phenotype also was reported in European families, with linkage on chromosome 2. We present a new family with suggestion of linkage to chromosome 2p11.1‐2q12.2 (lod score value, 1.55). This observation would confirm that BAFME is a worldwide, genetically heterogeneous condition, probably with Japanese families linked to 8q24 and European families to 2p11.1‐q12.2.
Remarriage, Unmarried Cohabitation, Living Apart Together: Partner Relationships Following Bereavement or Divorce
Authors: De Jong Gierveld Jenny
Published: January 2004

Substantial proportions of people enter into new partner relationships after bereavement or divorce. Nowadays in Europe, unmarried cohabitation and living‐apart‐together relationships are frequently opted for at repartnering. Drawing on the Netherlands’ Living Arrangements and Social Networks survey of men and women aged 55 to 89 years (N = 4,494), this article explicates the determinants that lead widowed or divorced people to enter into old and new types of partner relationships. Cox proportional hazard regression analyses revealed that age at most recent union dissolution, the number of partner dissolutions, working during and after the most recent union dissolution, and other demographic variables are important in weighing the pros and cons of different types of living arrangements.