bluuebunny/crossref_metadata_2025 huggingface dataset:
Genital shedding of herpes simplex virus type 2 in childbearing-aged and pregnant women living in Gabon
Authors: Ozouaki Francis , Ndjoyi-Mbiguino Angélique , Legoff Jérôme , Onas Isabelle Ndombi , Kendjo Eric , Si-Mohamed Ali , Mbopi-Kéou François-Xavier , Malkin Jean-Elie , Bélec Laurent
Published: January 2006

The prevalence of genital shedding of herpes simplex virus (HSV)-2 and related risk factors was evaluated in a prospective population of 355 women attending the Maternity Joséphine Bongo, in Libreville, Gabon. We found a high prevalence (66%) of HSV-2 seropositivity, with a high proportion, 14%, of women harbouring HSV-2 DNA shedding in their genital secretions. HSV-2 genital shedding was positively associated with previous episodes of genital blisters, current genital ulcer, current genital blister, HIV seropositivity and HSV-2 seropositivity. The high prevalence of HSV-2 in childbearing-aged population indicates that young women living in Gabon are at high risk for HIV acquisition in HIV-seronegative women sexually exposed to HIV, for HIV transmission in HIV-infected women co-infected by HSV-2 and finally for HSV-2 vertical transmission during pregnancy.
Evaluation of time for non-GU medicine physicians to diagnose HIV infection in patients presenting with HIV-related illnesses
Authors: Lee V , Foley E , Patel R
Published: January 2006

Some individuals with HIV in the UK are only diagnosed when they are admitted to hospitals with AIDS-defining illnesses. Early diagnosis and intervention are important to reduce the morbidity and mortality of HIV infection. Delays in diagnosing HIV infection may be expected to result in an increased risk of disease progression and complications. This retrospective cohort study was conducted between January 2002 and December 2003. Two hundred and nineteen new HIV infections were diagnosed in three hospitals in the south of England during the study period. Of these, 58 patients (35M, 23F) were diagnosed in non-GUM settings. The mean age was 39 years. Over 70% of the diagnoses were made within seven days. Eight percent of the diagnoses were made more than 50 days from the time of first presentation. The surgeons appeared no slower at diagnosing HIV infection in their patients than medical specialties. Late diagnosis of HIV infection remains a significant problem. HIV infection should be considered as part of the differential diagnoses to ensure early diagnosis and intervention.
Neisseria gonorrhoeae: a rare cause of preseptal cellulitis?
Authors: Green Justin A , Lim John , Barkham Timothy
Published: January 2006

We describe a case of preseptal cellulitis that presented initially to the ophthalmology department in our hospital. Neisseria gonorrhoeae, a very rare cause of this common condition, was isolated from a swab and the patient successfully treated with appropriate therapy. We review some aspects of non-sexual transmission as the patient denied recent sexual contact and we were unable to isolate the organism from any other site.
Which measure of contact tracing performance? – using audit as the evidence base
Authors: McClean Hugo , Haworth Pat , Clarke Janette ,   on behalf of the Yorkshire Multi-District Genito-Urinary Medicine Clinical Audit Group
Published: January 2006

Different measures of contact tracing were computed in a large UK regional audit, and good correlation was found between the percentage of index cases with at least one contact seen and other measures of contact tracing. The importance of definition in the writing of standards to inform clinical practice is emphasized.
Clinical illness as a marker for initiation of HIV antiretroviral therapy in a rural setting, Rakai, Uganda
Authors: Spacek Lisa A , Gray Ronald H , Wawer Maria J , Sewankambo Nelson K , Serwadda David , Wabwire-Mangen Fred , Kiwanuka Noah , Kigozi Godfrey , Nalugoda Fred , Quinn Thomas C ,   Rakai Project Study Group
Published: January 2006

The aim of this study is to assess whether HIV-related illness and World Health Organization (WHO) clinical stage can be used to guide initiation of antiretroviral therapy (ART) in rural Rakai District, Uganda. A retrospective cohort analysis of 910 HIV-seroprevalent individuals randomly sampled from a community cohort was conducted.

The associations between HIV-related clinical illness and HIV viral loads >55,000 copies/mL and death were evaluated as a guide for initiation of ART. Reporting one or more HIV-related illnesses was associated with high specificity for identifying HIV viral load >55,000 copies/mL and predicting death within 30 months. There were more deaths in those with one symptom at baseline (16.3%) and two or more symptoms (25.0%) than in those reporting no symptoms (9.6%; P = 0.001).

HIV-related illness and WHO stage predicted disease progression. The specificity of clinical illness to predict viral load >55,000 copies/mL was high and could be used to rule in HIV disease requiring ART.
Sexual behaviours of HIV-seropositive men and women following release from prison
Authors: Stephenson Becky L , Wohl David A , McKaig Rosemary , Golin Carol E , Shain Lara , Adamian Monica , Emrick Cathy , Strauss Ronald P , Fogel Cathie , Kaplan Andrew H
Published: January 2006

Twenty-five percent of the US HIV-infected population is released from a prison or jail each year. As the extent of risky sexual behaviours after prison release is largely unknown, we interviewed a cohort ( n = 64) of HIV-infected, recently released (mean 45 days, SD 28) prisoners about their current sexual risk behaviours. Almost half (47%, n = 64) of the released prisoners reported sexual activity after release, mostly with regular partners. Although 26% ( n = 27) reported engaging in unprotected sexual activity with their regular partners, none ( n = 4) reported unprotected sex with their non-regular partners. Furthermore, 33% percent ( n = 15) of the releasees with regular partners reported engaging in unprotected sex with HIV-seronegative partners. These results suggest that regular partners of HIV-infected prison releasees are at risk of acquiring HIV infection, and secondary risk-reduction strategies are needed for HIV-infected prison releasees.
Client acceptability of the use of computers in a sexual health clinic
Authors: Tideman R L , Pitts M K , Fairley C K
Published: January 2006

Computers in sexual health medicine largely remain provider-centred for use in client care, data collection, administration and education. As a formative study for further work we undertook a cross-sectional survey of 679 consecutive new clients attending Melbourne Sexual Health clinic (MSHC) between 9 September 2002 and 15 October 2002 to establish client familiarity and experience with computers and acceptance of computer use in the clinic. A response rate of 616/679 (91%) was achieved.

Important findings were

1. 491/612 (80%) participants reported experience with a personal computer.

2. The majority 488/609 (80%) of clients expected computer technologies to be used in the clinic.

3. The proportion of clients not willing to supply their registration, general health or sexual behaviour details using a computer was 9%, 7% and 21%, respectively.

4. Clients assessed as being at higher risk of acquiring a sexually transmitted infection were no more reluctant than others to provide their details using a computer-assisted self-interview.
Screening HIV-positive pregnant women for antiretroviral therapy: utility of self-reported symptoms
Authors: Nguyen Ruby HN , Gange Stephen J , Serwadda David , Kigozi Godfrey , Kiwanuka Noah , Sewankambo Nelson K , Wabwire-Mangen Fred , Quinn Thomas C , Wawer Maria , Gray Ronald H
Published: January 2006

In developing countries, Mother-to-Child Transmission-Plus programmes propose to identify lifelong antiretroviral therapy (ART)-eligible women during antenatal care. Identification using AIDS-related symptoms is the most feasible screening procedure in resource-limited settings. It is not known if symptomatology in pregnant women is correlated with clinical criteria for ART initiation based on CD4+ cell count or HIV-1 viral load. In this population of HIV-positive pregnant women from Rakai District, Uganda, 8–23% were eligible for treatment by CD4+ cell count criteria, and <1% met WHO staging criteria for AIDS. Using one or more symptoms to predict CD4+ cell count <350 cells/mm3, sensitivity was 100%, specificity 11%, positive predictive value (PPV) 25%, and negative predictive value (NPV) 100%. When using one or more symptoms to predict viral load ≥100,000 cps/mL, sensitivity was 100%, specificity 10%, PPV 6%, and NPV 100%. Initiation of treatment based on self-reported symptoms will over-treat because the majority of pregnant women with symptoms would not be eligible for treatment under current guidelines, but asymptomatic pregnant women are unlikely to require ART.
Prevalence of Chlamydia trachomatis in sexual contacts of gonorrhoea
Authors: Madhogaria S , Duru C , Hart J , Curran B , Jungmann E
Published: January 2006

The British national and local clinic guidelines recommend epidemiological treatment for Chlamydia trachomatis (CT) in patients with gonococcal infection but not their contacts. We aimed to determine the prevalence of CT amongst all gonorrhoea contacts attending over a 30 months period through a retrospective notes review. Of 223 contacts, gonorrhoea was diagnosed in 110 (49.3%) while CT was diagnosed in 54 (24.2%). CT was significantly more prevalent in younger people [(37.8% of contacts <25 years versus 9.6% of contacts ≥25 years ( P = 0.000)]. All patients with CT identified as heterosexual except one. Amongst heterosexuals, there was no significant difference in the prevalence between males and females, being 31.6% and 27.8% respectively ( P = 0.5995). CT was prevalent in 29.1% of N. gonorrhoeae positive contacts and 19.5% of N. gonorrhoeae negative contacts ( p = 0.0935). The high prevalence suggests that epidemiological treatment for CT in gonorrhoea contacts is indicated.
UK Guideline for the use of post-exposure prophylaxis for HIV following sexual exposure
Authors: Fisher Martin , Benn Paul , Evans Barry , Pozniak Anton , Jones Mike , MacLean Suzie , Davidson Oliver , Summerside Jack , Hawkins David ,   Clinical Effectiveness Group (British Association for Sexual Health and HIV)
Published: January 2006

We present the British Association for Sexual Health and HIV (BASHH) guidelines for post-exposure prophylaxis after sexual exposure (PEPSE) to HIV. This document includes a review of the current data to support the use of PEPSE, considers how to calculate the risks of HIV infection after a potential exposure, and provides recommendations on when PEPSE would and would not be considered. Other areas included are the possible impact on sexual behaviour, cost-effectiveness, and issues relating to service provision. Throughout the document, consideration is given to the place of PEPSE within the broader context of HIV prevention strategies and sexual health.
Modified-Release Tacrolimus
Authors: Chisholm Marie A , Middleton Matthew D
Published: February 2006

Objective:

To review the pharmacokinetics, efficacy, adverse effects, and clinical trials of modified-release tacrolimus (MR-4) concerning its equivalence to non-modified-release tacrolimus.

Data Sources:

A PubMed/MEDLINE search was conducted (1966–July 2005) using the following terms: MR-4, tacrolimus, FK506, Prograf, transplantation, calcineurin inhibitors, and immunosuppression. Additional data sources included meeting abstracts, bibliographies from identified publications, and information from the manufacturer.

Study Selection and Data Extraction:

All English-language, published, randomized clinical trials evaluating MR-4 were included in this review. Clinical trials that used tacrolimus for the prevention of solid-organ graft rejection were also selected from the data sources.

Data Synthesis:

Studies demonstrated that MR-4 has pharmacokinetic profiles similar to those of tacrolimus in healthy volunteers, renal transplant recipients, and liver transplant recipients. Similar efficacy and safety profiles have also been demonstrated. Data also suggest that the target whole blood trough concentration range of MR-4 is similar to that of tacrolimus and that it is safe to convert from tacrolimus twice daily to MR-4 once daily using a 1:1 conversion.

Conclusions:

Short-term clinical trials indicated that MR-4 has efficacy and safety profiles similar to those of tacrolimus. MR-4's once-daily dosing offers an advantage over the currently available calcineurin inhibitors in preventing graft rejection. However, adherence studies with MR-4 that measure clinical and economic outcomes are needed.
Nonconvulsive Status Epilepticus Due to Ifosfamide
Authors: Kilickap Saadettin , Cakar Mustafa , Onal Ibrahim K , Tufan Abdurrahman , Akoglu Hadim , Aksoy Sercan , Erman Mustafa , Tekuzman Gulten
Published: February 2006

Objective:

To report 2 cases of nonconvulsive status epilepticus (NCSE) following infusion of ifosfamide.

Case Summaries:

Two patients who received ifosfamide-containing chemotherapy developed NCSE. One woman received ifosfamide 1000 mg/m2 (1 h infusion on days 1–5); confusion, lethargy, and speech deterioration developed on day 3. The second patient developed similar symptoms on day 3 of treatment with 2500 mg/m2. Both patients responded to intravenous administration of diazepam 10 mg and were given levetiracetam as maintenance therapy.

Discussion:

The severity and presentation of central nervous system toxicity due to ifosfamide varies greatly and involves a spectrum ranging from subclinical electroencephalogram changes to coma. NCSE, an epileptic disorder in which typical convulsive activity is absent, has previously been reported in only 4 patients receiving ifosfamide. Levetiracetam may be used for maintenance antiepileptic therapy after diazepam administration.

Conclusions:

Among the many presentations of ifosfamide neurotoxicity, clinicians should consider NCSE as a possible explanation for changes in consciousness in a patient receiving this agent. An objective causality assessment by use of the Naranjo probability scale revealed that NCSE due to ifosfamide was probable.
Considerations for Supplementing with Coenzyme Q10 During Statin Therapy
Authors: Levy Hedva Barenholtz , Kohlhaas Heather K
Published: February 2006

Objective:

To review the literature concerning the effects of statin use on coenzyme (Co) Q10 concentrations and explain the rationale behind considering CoQ10 supplementation.

Data Sources:

A MEDLINE search was conducted through January 2006. Search terms included ubiquinone, coenzyme Q10, HMG-CoA reductase inhibitors, statins, myotoxicity, and clinical trials.

Data Synthesis:

Statin therapy reduces blood CoQ10 concentrations. Studies exploring how this affects the development of myotoxicity have been small and dissimilar, thus limiting the ability to draw strong conclusions. Isolated studies suggested that statins induce mitochondrial dysfunction, but the clinical implications of this effect are limited. Limited data suggest that patients with familial hypercholesterolemia, heart failure, or who are over 65 years of age might represent at-risk populations who would benefit from CoQ10 supplementation.

Conclusions:

Routine CoQ10 supplementation for all patients taking statins to prevent myotoxicity is not recommended. However, certain subpopulations might be at risk and warrant further study.
Erythropoietin Dose Requirements When Converting from Subcutaneous to Intravenous Administration Among Patients on Hemodialysis
Authors: Moist Louise M , Muirhead Norm , Wazny Lori D , Gallo Kerri L , Heidenheim A Paul , House Andrew A
Published: February 2006

Background:

The optimal route for administration of exogenous erythropoietin remains controversial, particularly after the increased incidence in pure red cell aplasia. In Canada, the majority of hemodialysis units have converted to the intravenous route for administration of erythropoietin to potentially decrease the risk of pure red cell aplasia.

Objective:

To compare the difference in the weight-adjusted, weekly erythropoietin dose (units/kg/wk) administered by the subcutaneous compared with the intravenous route in a chronic hemodialysis population followed for 12 months.

Methods:

This prospective cohort study recruited patients receiving subcutaneous erythropoietin for at least 3 months while undergoing dialysis in a tertiary care hemodialysis program. Participants were switched to intravenous erythropoietin, and the average weekly dose was recorded at 1, 2, 3, 6, and 12 months. Anemia management and hemoglobin, iron, and delivered dialysis dose targets remained constant throughout the study.

Results:

The erythropoietin dose increased by 24.5 units/kg/wk (95% Cl 12.7 to 36.3; p < 0.001), representing a 20.2% increase (95% Cl 10.5% to 29.9%; p < 0.001) 12 months after conversion from the subcutaneous to intravenous route of administration. Both patients with and without residual renal function at baseline required a significant increase in the intravenous dose.

Conclusions:

A 20.2% increase in erythropoietin dose was required to maintain hemoglobin targets between 11 and 12 g/dL after conversion from a subcutaneous to intravenous formulation. Healthcare funding agencies need to reexamine the cost benefit of using intravenous erythropoietin in the hemodialysis population with a low incidence of pure red cell aplasia.
Age of acquisition effects on an object‐name verification task
Authors: Catling J. C. , Johnston R. A.
Published: January 2006

Naming latencies for words, objects and faces have been shown to be affected by the age at which an item is acquired (AoA). Originally, this effect was explained in terms of differential access to name representations. However, a number of recent studies have found AoA effects in tasks which do not require access to names (e.g. Brysbaert, Van Wijnendaele, & De Deynes, 2000; Lewis, 1999; Moore, Smith Spark, & Valentine, 2004; Moore & Valentine, 1999). Ellis and Lambon Ralph (2000) propose an alternative account of AoA, predicting that the effect should arise in any task where previously stored information is retrieved. The current study explored the effect of AoA on an object‐name verification task. Experiments 1 and 2 demonstrated that early acquired objects were verified significantly faster than later acquired objects. A third experiment collected naming latencies for the same picture stimuli in order to allow a comparison of the magnitude of the AoA effect for object verification and naming. The implications of these findings for accounts of AoA and its locus of effect are discussed.
Do adult readers know how they read? Evidence from eye movement patterns and verbal reports
Authors: Hyönä Jukka , Nurminen Anna‐Mari
Published: January 2006

The present study was carried out to investigate individual differences in reading styles among competent adult readers and to examine whether readers are aware of their reading style. Individual reading strategies were studied by having the participants read a long expository text while their eye fixation patterns were registered. A cluster analysis was performed on the eye movement data to distinguish between different reading styles. The analysis revealed three types of readers that were coined, following Hyönä, Lorch, and Kaakinen (2002), fast linear readers, slow linear readers, and topic structure processors. Readers' procedural awareness of their reading behaviour was assessed by a questionnaire. The verbal reports obtained by the questionnaire were then correlated with the corresponding eye behaviour to investigate the extent to which the readers behave the way they report doing. The correlations showed that adult readers are well aware of their general reading speed and reasonably aware of their lookback and rereading behaviour. The amount of time spent looking back in text also correlated positively with the relative success in recalling the main points expressed in the text. It is concluded that systematic and extensive looking back in text is indicative of strategic behaviour.
Face‐specific configural processing of relational information
Authors: Leder Helmut , Carbon Claus‐Christian
Published: January 2006

Face processing relies on configural processing, which is thought to be particularly disrupted by inversion. We compared inversion effects in recognition experiments for three types of stimuli, using faces (Experiment 1) and houses (Experiment 2). Stimuli varied by their colour only (colour), by the spatial relations between components (relational), or by the components themselves (eyes, mouths, doors). For faces, relational versions revealed strong inversion effects, component versions moderate, and colour versions no inversion effect. Recognition of houses revealed no inversion effects at all. We suggest that the inversion effects observed for faces in the component condition are due to relational changes, which must accompany any change in components. This proposal may account for the rather inconsistent effects of inversion reported in the literature. Furthermore, we suggest configural processing seems to be somehow face‐specific.
Haven't we met before? The effect of facial familiarity on repetition priming
Authors: Stevenage Sarah V. , Spreadbury John H.
Published: January 2006

Within the word recognition literature, word‐frequency and hence familiarity has been shown to affect the degree of repetition priming. The current paper reports two experiments which examine whether familiarity also affects the degree of repetition priming for faces. The results of Experiment 1 confirmed that familiarity did moderate the degree of priming in a face recognition task. Low familiarity faces were primed to a significantly greater degree than high familiarity faces in terms of accuracy, speed, and efficiency of processing. Experiment 2 replicated these results but additionally, demonstrated that familiarity moderates priming for name recognition as well as face recognition. These results can be accommodated within both a structural account of repetition priming (Burton, Bruce & Johnston, 1990) and an Episodic Memory account of repetition priming (see Roediger, 1990), and are discussed in terms of a common mechanism for priming, learning and the representation of familiarity.
Obsessive‐compulsive disorder across developmental trajectory: Cognitive processing of threat in children, adolescents and adults
Authors: Farrell Lara , Barrett Paula
Published: January 2006

Background . While the cognitive theory of obsessive‐compulsive disorder (OCD) is one of the most widely accepted accounts of the maintenance of the disorder in adults, no study to date has systematically evaluated the theory across children, adolescence and adults with OCD.

Method . This paper investigated developmental differences in the cognitive processing of threat in a sample of children, adolescents and adults with OCD. Using an idiographic assessment approach, as well as self‐report questionnaires, this study evaluated cognitive appraisals of responsibility, probability, severity, thought‐action fusion (TAF), thought‐suppression, self‐doubt and cognitive control. It was hypothesised that there would be age related differences in reported responsibility for harm, probability of harm, severity of harm, thought suppression, TAF, self‐doubt and cognitive control.

Results . Results of this study demonstrated that children with OCD reported experiencing fewer intrusive thoughts, which were less distressing and less uncontrollable than those experienced by adolescents and adults with OCD. Furthermore, responsibility attitudes, probability biases and thought suppression strategies were higher in adolescents and adults with OCD. Cognitive processes of TAF, perceived severity of harm, self‐doubt and cognitive control were found to be comparable across age groups.

Conclusions . These results suggest that the current cognitive theory of OCD needs to address developmental differences in the cognitive processing of threat. Furthermore, for a developmentally sensitive theory of OCD, further investigation is warranted into other possible age related maintenance factors. Implications of this investigation and directions for future research are discussed.
Training for vigilance: The effect of knowledge of results format and dispositional optimism and pessimism on performance and stress
Authors: Szalma James L. , Hancock Peter A. , Dember William N. , Warm Joel S.
Published: January 2006

This study investigated the impact of knowledge of results (KR) format on the performance and stress associated with a vigilance task. Also examined was the effect of the interaction of KR‐format (Hit‐KR, False Alarm‐KR, Miss‐KR, and a composite of all three formats) with dispositional optimism and pessimism on performance outcome and reported stress state. Hypotheses based upon a theory of feedback intervention were tested. KR regarding correct detections and the composite‐KR (KR regarding correct detections, false alarms, and missed signals) enhanced perceptual sensitivity. However, False Alarm‐KR and Miss‐KR did not. Contrary to expectations based on the theory, performance was unrelated to the traits across all KR conditions. However, the effects of KR‐format on self‐reports of stress depended on the individual's level of pessimism and optimism. In addition, KR format and personality affected the multiple dimensions of stress state in different ways.
Change blindness and visual memory: Visual representations get rich and act poor
Authors: Varakin D. Alexander , Levin Daniel T.
Published: January 2006

Change blindness is often taken as evidence that visual representations are impoverished, while successful recognition of specific objects is taken as evidence that they are richly detailed. In the current experiments, participants performed cover tasks that required each object in a display to be attended. Change detection trials were unexpectedly introduced and surprise recognition tests were given for nonchanging displays. For both change detection and recognition, participants had to distinguish objects from the same basic‐level category, making it likely that specific visual information had to be used for successful performance. Although recognition was above chance, incidental change detection usually remained at floor. These results help reconcile demonstrations of poor change detection with demonstrations of good memory because they suggest that the capability to store visual information in memory is not reflected by the visual system's tendency to utilize these representations for purposes of detecting unexpected changes.
Atorvastatin Reduces the Expression of COX-2 mRNA in Peripheral Blood Monocytes from Patients with Acute Myocardial Infarction and Modulates the Early Inflammatory Response
Authors: Deng Ping , Zhao Shui-ping , Dai Hai-ying , Guan Xian-song , Huang Hong-guang
Published: January 2006

Background: We examined the effect of atorvastatin on the expression of COX-2 in peripheral blood monocytes from patients with early stage of acute myocardial infarction (AMI), and the plasma C-reactive protein (CRP) concentrations were also examined.

Methods: Patients with AMI (n = 40) and with stable coronary heart disease (CHD; n = 18) were registered, and patients with AMI were randomly separated to a group that received routine therapy (group A, n = 20) or to a group that received routine therapy plus atorvastatin at 20 mg/day (group B, n = 20) for a week. Peripheral blood monocytes from patients with AMI both before and after treatment and from patients with stable CHD were isolated and cultured for 24 h. COX-2 mRNA expression was analyzed by reverse transcription-PCR. We measured concentrations of CRP in plasma by ELISA.

Results: COX-2 expression was activated in peripheral blood monocytes from patients with AMI [0.92 (0.13)] compared with patients with stable CHD [0.19 (0.08)]; after a week of treatment, COX-2 expression in group B (reduced by 66%) was obviously lower than in group A (reduced by 24%; P <0.05). Plasma concentrations of CRP from patients with AMI [43.3 (14.9) mg/L] were increased compared with those from patients with stable CHD [1.65 (0.78) mg/L; P <0.05]; after a week of treatment, CRP concentrations in group B (reduced by 62%) were lower than in group A (reduced by 35%; P <0.05). COX-2 expression in peripheral blood monocytes from patients with AMI was positively correlated with plasma CRP concentration (r = 0.662; P <0.05).

Conclusions: COX-2 may promote acute inflammatory process after AMI. Atorvastatin may improve the antiinflammatory effects through the COX-2 pathway.
Full Breastfeeding Duration and Associated Decrease in Respiratory Tract Infection in US Children
Authors: Chantry Caroline J. , Howard Cynthia R. , Auinger Peggy
Published: February 2006

OBJECTIVE. The American Academy of Pediatrics recommends exclusive breastfeeding for an infant's first 6 months of life. When compared with exclusive breastfeeding for 4 months, greater protection against gastrointestinal infection, but not respiratory tract infection, has been demonstrated for the 6-month duration. The objective of this study was to ascertain if full breastfeeding of ≥6 months compared with 4 to <6 months in the United States provides greater protection against respiratory tract infection.

METHODS. Secondary analysis of data from the National Health and Nutrition Examination Survey III, a nationally representative cross-sectional home survey conducted from 1988 to 1994, was performed. Data from 2277 children aged 6 to <24 months, who were divided into 5 groups according to breastfeeding status, were compared. Children who required neonatal intensive care were excluded. SUDAAN software was used to account for the complex sampling design. Logistic regression adjusted for confounding factors. Outcome measures included adjusted odds of acquiring pneumonia, ≥3 episodes of cold/influenza, ≥3 episodes of otitis media (OM), or wheezing in the past year or acquiring first OM at <12 months of age.

RESULTS. In unadjusted analyses, infants who were fully breastfed for 4 to <6 months (n = 223) were at greater risk for pneumonia than those who were fully breastfed for ≥6 months (n = 136) (6.5% vs 1.6%). There were not statistically significant differences in ≥3 episodes of cold/influenza (45% vs 41%), wheezing (23% vs 24%), ≥3 episodes of OM (27% vs 20%), or first OM at <12 months of age (49% vs 47%). Adjusting for demographic variables, childcare, and smoke exposure revealed statistically significant increased risk for both pneumonia (odds ratio [OR]: 4.27; 95% confidence interval [CI]: 1.27–14.35) and ≥3 episodes of OM (OR: 1.95; 95% CI: 1.06–3.59) in those who were fully breastfed for 4 to <6 months compared with ≥6 months.

CONCLUSIONS. This nationally representative study documents increased risk of respiratory tract infection including pneumonia and recurrent OM in children who were fully breastfed for 4 vs 6 months. These findings support current recommendations that infants receive only breast milk for the first 6 months of life.
Identification of Inflicted Traumatic Brain Injury in Well-Appearing Infants Using Serum and Cerebrospinal Markers: A Possible Screening Tool
Authors: Berger Rachel Pardes , Dulani Tina , Adelson P. David , Leventhal John M. , Richichi Rudolph , Kochanek Patrick M.
Published: February 2006

OBJECTIVE. Inflicted traumatic brain injury (iTBI) is the leading cause of death from TBI in infants. Misdiagnosis of iTBI is common and results in increased morbidity and mortality. Biomarkers may be able to assist in screening infants who are at high risk for iTBI and whose injury might otherwise be missed. We investigated whether serum and/or cerebrospinal fluid (CSF) concentrations of neuron-specific enolase (NSE), S100B, and myelin-basic protein (MBP) are sensitive and specific for iTBI in high-risk infants.

METHODS. A prospective case-control study was conducted of 98 well-appearing infants who presented with nonspecific symptoms and no history of trauma. Serum or CSF was collected. NSE, S100B, and MBP concentrations were measured by enzyme-linked immunosorbent assay. Abnormal marker concentrations were defined a priori. Patients were followed for 12 months to assess for subsequent abuse.

RESULTS. Fourteen patients received a clinical diagnosis of iTBI. Using preestablished cutoffs, NSE was 77% sensitive and 66% specific and MBP was 36% sensitive and 100% specific for iTBI. S100B was neither sensitive nor specific for iTBI. Five patients who were not identified with iTBI at enrollment were identified at follow-up as being possible victims of abuse; 4 had an increased NSE concentration at enrollment.

CONCLUSIONS. Serum and/or CSF concentrations of NSE and MBP may be useful as a screening test to identify infants who are at increased risk for iTBI and may benefit from additional evaluation with a head computed tomography scan. S100B is neither sensitive nor specific for iTBI in this study population. The ability to identify iTBI that might otherwise be missed has important implications for decreasing the morbidity and the mortality from iTBI.
Time Well Spent? Relating Television Use to Children's Free-Time Activities
Authors: Vandewater Elizabeth A. , Bickham David S. , Lee June H.
Published: February 2006

OBJECTIVES. This study assessed the claim that children's television use interferes with time spent in more developmentally appropriate activities.

METHODS. Data came from the first wave of the Child Development Supplement, a nationally representative sample of children aged 0 to 12 in 1997 (N = 1712). Twenty-four-hour time-use diaries from 1 randomly chosen weekday and 1 randomly chosen weekend day were used to assess children's time spent watching television, time spent with parents, time spent with siblings, time spent reading (or being read to), time spent doing homework, time spent in creative play, and time spent in active play. Ordinary least squares multiple regression was used to assess the relationship between children's television use and time spent pursuing other activities.

RESULTS. Results indicated that time spent watching television both with and without parents or siblings was negatively related to time spent with parents or siblings, respectively, in other activities. Television viewing also was negatively related to time spent doing homework for 7- to 12-year-olds and negatively related to creative play, especially among very young children (younger than 5 years). There was no relationship between time spent watching television and time spent reading (or being read to) or to time spent in active play.

CONCLUSIONS. The results of this study are among the first to provide empirical support for the assumptions made by the American Academy of Pediatrics in their screen time recommendations. Time spent viewing television both with and without parents and siblings present was strongly negatively related to time spent interacting with parents or siblings. Television viewing was associated with decreased homework time and decreased time in creative play. Conversely, there was no support for the widespread belief that television interferes with time spent reading or in active play.
Molyneux kérdései - a reprezentáció filozófiai problémájától az intermodális transzferig
Authors: Fazekas Péter , Zemplén Gábor
Published: January 2006

Az alábbi tanulmányban Molyneux gondolatkísérletétől kiindulva körbejárjuk a filozófia és a pszichológia néhány kiemelt kérdését. William Molyneux John Locke-nak címzett levelében azt a kérdést vetette fel, hogy egy vakon született ember, aki tapintás útján képes felismerni és megkülönböztetni egy gömböt és egy hasábot, a látását visszanyerve, pusztán a látása segítségével képes lenne-e ugyanerre. Tanulmányunk első részében elemezzük a kérdés kapcsán kialakult, kezdetben elméleti, majd a hályogműtétek és az azokhoz kapcsolódó kísérletek kapcsán empirikus kérdésekkel kibővülő vitát. Megmutatjuk, hogy a 17-18. századi filozófiai álláspontok részben korábbi (akár antik) percepcióelméleti felfogásokhoz kapcsolódnak. Tárgyaljuk a kísérletes technikák kérdését és azok fejlődését, amelyek közvetlenül is kapcsolódnak az eredetileg gondolatkísérletként feltett kérdéshez. Megmutatjuk, hogy az utóbbi 50 év kritikus periódusokkal és agyi plaszticitással kapcsolatos kísérleti eredményei alapvetően kérdőjelezik meg az eredeti Molyneux-kérdés megválaszolhatóságát. A született vak idegpályái megfelelő ingerlés hiányában nem fejlődnek ugyanúgy, mint egy látóéi, továbbá vizuális kérgi területei más modalitásokhoz kötődő funkciókat vehetnek át. A konkrét kísérletes megvalósíthatóságon túl, egy absztraktabb szinten, Molyneux kérdése az intermodális transzfer meglétére kérdez rá. Ezen értelmezés szerint a probléma tehát az, hogy a taktilis és a vizuális modalitáson keresztül felépített reprezentációk hatással lehetnek-e egymásra tanult összevetések hiányában. Erre a kérdésfeltevésre a klasszikus kísérletes választ Meltzoff, valamint Streri és Gentaz kísérletei adják meg, amelyek támogatják az intermodális transzfer meglétét, már közvetlenül a születés után is. A kísérleti eredmények bemutatásán túl tanulmányunkban részletesen kitérünk két elméleti keretre is, amelyek értelmező háttereit adhatják a megfigyelések tényanyagának. Monique Radeau elképzelése szerint a csecsemők egységes amodális érzékelő rendszerrel születnek, amely aztán az egyedfejlődés születést követő szakaszaiban differenciálódik a megfelelő érzékszervekké. Kevin O'Regan és Alva Noëún. szenzomotoros megközelítése, pedig azt hangsúlyozza, hogy az észlelés folyamata tulajdonképpen a környezet aktív explorációjának tekinthető, amelyet az észleletek megváltozását leíró szabályszerűségek - az ún. szenzomotoros kontingenciák - közvetítik. Elemzésünk során rámutatunk, hogy ez utóbbi, a jelenlegi érdeklődés középpontjában álló, a klasszikus reprezentációs megközelítést elutasító hozzáállás sem képes arra, hogy egyértelmű választ adjon Molyneux „absztrakt", intermodalitást érintő kérdésére. Tanulmányunk utolsó részében Molyneux kérdésének egy olyan átfogalmazását adjuk, amely lehetővé teszi, hogy a probléma a klasszikus kérdésfeltevéstől elfordult kísérleti oldal figyelmét ismét magára vonva a neurológiai kutatások homlokterébe kerüljön.
Evaluation of the Ecological Compatibility of Butterfly Peacock Cichlids and Largemouth Bass in Puerto Rico Reservoirs
Authors: Neal J. Wesley , Noble Richard L. , Lilyestrom Craig G.
Published: January 2006

Introduction of peacock cichlids Cichla spp. into tropical and subtropical systems where they can successfully overwinter and reproduce has been a common practice in fisheries management. We evaluated the compatibility of nonnative butterfly peacock cichlids Cichla ocellaris and largemouth bass Micropterus salmoides in Puerto Rico reservoirs using (1) controlled juvenile interaction experiments, (2) examination of hatching periodicity and diet overlap of juveniles in a reservoir environment, and (3) comparison of adult catch data from 10 Puerto Rico reservoirs. In the juvenile interaction experiments, butterfly peacock cichlid juveniles in ponds with largemouth bass had slower growth in length (P = 0.020) and weight (P = 0.003) and lower survival (P = 0.002) than in ponds with only butterfly peacock cichlids. In reservoirs, largemouth bass spawning typically occurred 2–3 months before butterfly peacock cichlid spawning, which resulted in substantial size differences between the juveniles of the two species. Butterfly peacock cichlids fed almost exclusively on threadfin shad Dorosoma petenense; the largemouth bass diet included threadfin shad but was much more diverse. Correlation coefficients were negative for comparisons of adult largemouth bass and butterfly peacock cichlid catch rates in the reservoirs sampled. Pooled catch data from all reservoirs showed a significant inverse relationship in relative abundance (P = 0.026). Catch rates from reservoirs with and without butterfly peacock cichlid populations indicated that largemouth bass densities were higher in single‐predator systems (mean = 85.1/h) than in dual‐predator systems (9.8/h).
On the ropes: civil engineers get closer to rail bridges
Authors: James Chris
Published: January 2006

Bridges and viaducts are an essential part of transport infrastructure, particularly on railway networks where the variety of structural type, size and age usually exceeds that of the highway network. Inspection and examination form a large part of the management of these structures, which are often high and in remote locations. This paper details how rope-access techniques are being increasingly used for the inspection of such structures in the UK and argues the benefits for more civil engineers to be trained in rope-access work.
Life-Course Socioeconomic Position and Obesity in African American Women: The Pitt County Study
Authors: James Sherman A. , Fowler-Brown Angela , Raghunathan Trevillore E. , Van Hoewyk John
Published: February 2006

Objectives. We studied obesity in African American women in relationship to their socioeconomic position (SEP) in childhood and adulthood.

Methods. On the basis of parents’ occupation, we classified 679 women in the Pitt County (North Carolina) Study into low and high childhood SEP. Women’s education, occupation, employment status, and home ownership were used to classify them into low and high adulthood SEP. Four life-course SEP categories resulted: low childhood/low adulthood, low childhood/high adulthood, high childhood/low adulthood, and high childhood/high adulthood.

Results. The odds of obesity were twice as high among women from low versus high childhood SEP backgrounds, and 25% higher among women of low versus high adulthood SEP. Compared to that in women of high SEP in both childhood and adulthood, the odds of obesity doubled for low/low SEP women, were 55% higher for low/high SEP women, and were comparable for high/low SEP women.

Conclusions. Socioeconomic deprivation in childhood was a strong predictor of adulthood obesity in this community sample of African American women. Findings are consistent with both critical period and cumulative burden models of life-course socioeconomic deprivation and long-term risk for obesity in African American women.
Simulation Modeling and Tobacco Control: Creating More Robust Public Health Policies
Authors: Levy David T. , Bauer Joseph E. , Lee Hye-ryeon
Published: February 2006

Although previous empirical studies have shown that tobacco control policies are effective at reducing smoking rates, such studies have proven of limited effectiveness in distinguishing how the effect of policies depend on the other policies in place, the length of adjustment period, the way the policy is implemented, and the demographic groups considered.

An alternative and complementary approach to purely statistical equations is simulation models. We describe the SimSmoke simulation model and how we used it to assess tobacco control policy in a specific case study. Simulation models are not only useful for policy prediction and planning but also may help to broaden our understanding of the role of different public health policies within a complex, dynamic social system.
Practical Challenges of Systems Thinking and Modeling in Public Health
Authors: Trochim William M. , Cabrera Derek A. , Milstein Bobby , Gallagher Richard S. , Leischow Scott J.
Published: February 2006

Objectives. Awareness of and support for systems thinking and modeling in the public health field are growing, yet there are many practical challenges to implementation. We sought to identify and describe these challenges from the perspectives of practicing public health professionals.

Methods. A systems-based methodology, concept mapping, was used in a study of 133 participants from 2 systems-based public health initiatives (the Initiative for the Study and Implementation of Systems and the Syndemics Prevention Network). This method identified 100 key challenges to implementation of systems thinking and modeling in public health work.

Results. The project resulted in a map identifying 8 categories of challenges and the dynamic interactions among them.

Conclusions. Implementation by public health professionals of the 8 simple rules we derived from the clusters in the map identified here will help to address challenges and improve the organization of systems that protect the public’s health.
Synthese von Polyin‐Naturstoffen
Authors: Shi Shun Annabelle L. K. , Tykwinski Rik R.
Published: January 2006

In den vergangenen fünfzig Jahren wurden Hunderte von Polyinen aus natürlichen Proben isoliert. Diese oftmals unbeständigen Verbindungen finden sich gleichsam in alltäglichen Quellen wie Gartengemüse und weniger geläufigen Quellen wie Bakterienkulturen. Die Strukturen von natürlichen Polyinen unterscheiden sich sehr stark, und entsprechend vielfältig sind die biologischen Eigenschaften dieser Naturstoffe. Frühe Syntheseansätze nutzten zum Aufbau des Polyin‐Gerüsts vorzugsweise die kupferkatalysierte oxidative Homo‐ und Heterokupplung von Alkinen. Eine Renaissance der Polyin‐Naturstoffsynthese hat in den vergangenen 25 Jahren jedoch innovative Synthesetechniken hervorgebracht: Übergangsmetallkatalysierte Alkinylierungen und asymmetrische Umwandlungen haben das Repertoire der Polyin‐Naturstoffsynthese merklich erweitert. Der Aufsatz stellt diese Verbesserungen vor und geht auf die natürliche(n) Quelle(n) und die biologische Bedeutung vieler Substanzen ein.
Aminosäurehaltige Makrocyclen – anwendungsnahe Systeme oder nur Syntheseziele?
Authors: Gibson Susan E. , Lecci Cristina
Published: January 2006

Synthese, Struktur und physikalische Eigenschaften von Makrocyclen faszinieren Chemiker seit vielen Jahren. Verbindungen dieser Klasse eignen sich für Anwendungen auf so unterschiedlichen Gebieten wie dem Ionentransport durch Membranen, der Entwicklung neuer Antibiotika oder der Katalyse. Im vorliegenden Aufsatz geben die Autorinnen einen Überblick über die Chemie nichtpeptidischer Makrocyclen, die Derivate von Aminosäuren enthalten. Die Einteilung nach Funktionen – nicht nach Struktur oder Synthese – gibt dabei die Richtung vor: So wird deutlich, dass das Potenzial der vielseitigen Verbindungen, die einfallsreiche Synthesechemiker erdacht haben, noch lange nicht von der anwendungsorientierten Forschung ausgeschöpft worden ist.
Titelbild: Transcription and Amplification of Molecular Chirality to Oppositely Biased Supramolecular π Helices (Angew. Chem. 7/2006)
Authors: Ajayaghosh Ayyappanpillai , Varghese Reji , George Subi Jacob , Vijayakumar Chakkooth
Published: January 2006

Eine Inversion der Helizität und die Bildung ungewöhnlicher kondensierter links‐ und rechtsgängiger Superhelices aus gelbildenden linearen π‐konjugierten Molekülen durch einen “Feldwebel‐und‐Soldaten”‐Zugang, in dem die achiralen Moleküle (Soldaten) die Befehle der chiralen Moleküle (Feldwebel) missverstehen, beschreiben A. Ajayaghosh et al. auf S. 1159 ff. Das Titelbild zeigt Janus, den doppelgesichtigen griechischen Gott, der – als Beispiele für die Wunder der natürlichen Schöpfung – eine linksgängige DNA‐Helix und eine rechtsgängige Muschelschale in den Händen hält.