bluuebunny/crossref_metadata_2025 huggingface dataset:
Population pharmacokinetic modelling of gentamicin and vancomycin in patients with unstable renal function following cardiothoracic surgery
Authors: Staatz Christine E. , Byrne Colette , Thomson Alison H.
Published: December 2005

Aims

To describe the population pharmacokinetics of gentamicin and vancomycin in cardiothoracic surgery patients with unstable renal function.

Methods

Data collected during routine care were analyzed using NONMEM. Linear relationships between creatinine clearance (CLCr) and drug clearance (CL) were identified, and two approaches to modelling changing CLCr were examined. The first included baseline (BCOV) and difference from baseline (DCOV) effects and the second allowed the influence of CLCr to vary between individuals. Final model predictive performance was evaluated using independent data. The data sets were then combined and parameters re‐estimated.

Results

Model building was performed using data from 96 (gentamicin) and 102 (vancomycin) patients, aged 17–87 years. CLCr ranged from 9 to 172 ml min−1 and changes varied from −76 to 58 ml min−1 (gentamicin) and −86 to 93 ml min−1 (vancomycin). Inclusion of BCOV and DCOV improved the fit of the gentamicin data but had little effect on that for vancomycin. Inclusion of interindividual variability (IIV) in the influence of CLcr resulted in a poorly characterized model for gentamicin and had no effect on vancomycin modelling. No bias was seen in population compared with individual CL estimates in independent data from 39 (gentamicin) and 37 (vancomycin) patients. Mean (95% CI) differences were 4% (−3, 11%) and 2% (−2, 6%), respectively. Final estimates were: CLGent (l h−1) = 2.81 × (1 + 0.015 × (BCOVCLCr‐BCOVCLCr Median) + 0.0174 × DCOVCLCr); CLVanc (l h−1) = 2.97 × (1 + 0.0205 ×  (CLCr‐CLCr Median)). IIV in CL was 27% for both drugs.

Conclusions

A parameter describing individual changes in CLcr with time improves population pharmacokinetic modelling of gentamicin but not vancomycin in clinically unstable patients.
Consumer perceptions of food‐related risks
Authors: Tucker Mark , Whaley Sherrie R. , Sharp Jeff S.
Published: December 2005

Recent research indicates that the majority of respondents in nineteen of thirty‐four countries feel their food is less safe than 10 years ago. Concerns over food safety may result in elevated levels of perceived risk, particularly when fuelled by intense media coverage. The purpose of this study was to assess Ohioans’ perceptions of various food safety risks and to identify factors influencing risk judgments. Mail survey data are reported for 4014 respondents with a total response rate of 56%. Findings reveal moderate perceived levels of risk for the food safety items assessed. Pesticide residues in food and contamination of drinking water generated the highest levels of perceived risk, while mad cow disease and genetically modified foods generated the lowest levels of perceived risk. Regression results indicate that attitude toward biotechnology was the strongest predictor of perceived risk, followed by perceptions of media system dependency. Findings from this research can assist food safety specialists in developing more effective education and risk communication programmes for target audiences.
The effect of binary cosolvent systems (glycerol–sucrose mixtures) on the heat‐induced gelation mechanism of bovine serum albumin
Authors: Baier Stefan K. , Julian McClements David
Published: December 2005

The influence of cosolvent composition on the thermal denaturation and gelation of bovine serum albumin (BSA) has been studied. Cosolvent composition was varied by changing the ratio of glycerol to sucrose in 40 wt% cosolvent solutions containing BSA. Differential scanning calorimetry measurements on 0.5 wt% BSA solutions showed that the thermal denaturation temperature of the protein increased with increasing sucrose content. Temperature scanning dynamic shear rheology and turbidity measurements on 4 wt% BSA solutions showed that the gelation temperature and final gel strength increased with increasing sucrose concentration. These observations were attributed to the fact that sucrose was more effective than glycerol at increasing the thermal stability and attraction between globular BSA molecules through a steric exclusion effect. The molecular origin of these effects is the tendency for the system to minimize the contact area of the protein molecules with the surrounding cosolvent solution.
Effectiveness of ozone for inactivation of Escherichia coli and Bacillus cereus in pistachios
Authors: Akbas Meltem Yesilcimen , Ozdemir Murat
Published: December 2005

The effectiveness of ozone for the decontamination of Escherichia coli and Bacillus cereus in kernels, shelled and ground pistachios was investigated. Pistachios were inoculated with known concentrations of E. coli and B. cereus. Pistachio samples were exposed to gaseous ozone in a chamber at three different concentrations (0.1, 0.5 and 1.0 ppm) for various times (0–360 min) at 20 °C and 70% relative humidity. The effectiveness of ozone against E. coli and B. cereus increased with increasing exposure time and ozone concentration. The physico‐chemical properties including: pH, free fatty acids and peroxide values, colour and fatty acid composition of pistachios did not change significantly after the ozonation treatments, except for the peroxide value of ground pistachios ozonized at 1.0 ppm for 360 min. Ozone concentration of 1.0 ppm was effective in reducing E. coli and B. cereus counts in kernels and shelled pistachios, while ozone concentrations <1.0 ppm were found to be appropriate in reducing the number of both bacteria in ground pistachios without having any change in their physico‐chemical properties.
Potential uses and applications of treated wine waste: a review
Authors: Arvanitoyannis Ioannis S. , Ladas Demetrios , Mavromatis Athanasios
Published: December 2005

Recently, there has been an upsurge in the exploitation of the waste materials generated by the wine industry. Wine waste is characterised by the presence of natural antioxidants much safer than synthetic antioxidants. Wine waste‐derived antioxidants have been recently used in the food industry. Moreover, wine waste can be potentially used as soil conditioner, as adsorbent for heavy metals, for fertiliser and for pullulan production. This review aims at presenting the most important and economically viable applications of treated wine waste.
Role of the spacer between the −35 and −10 regions in σs promoter selectivity in Escherichia coli
Authors: Typas Athanasios , Hengge Regine
Published: December 2005

In vitro, the σs subunit of RNA polymerase (RNAP), RpoS, recognizes nearly identical −35 and −10 promoter consensus sequences as the vegetative σ70. In vivo, promoter selectivity of RNAP holoenzyme containing either σs (Eσs) or σ70 (Eσ70) seems to be achieved by the differential ability of the two holoenzymes to tolerate deviations from the promoter consensus sequence. In this study, we suggest that many natural σs‐dependent promoters possess a −35 element, a feature that has been considered as not conserved among σs‐dependent promoters. These −35 hexamers are mostly non‐optimally spaced from the −10 region, but nevertheless functional. A ± 2 bp deviation from the optimal spacer length of 17 bp or the complete absence of a −35 consensus sequence decreases overall promoter activity, but at the same time favours Eσs in its competition with Eσ70 for promoter recognition. On the other hand, the reduction of promoter activity due to shifting of the −35 element can be counterbalanced by an activity‐stimulating feature such as A/T‐richness of the spacer region without compromising Eσs selectivity. Based on mutational analysis of σs, we suggest a role of regions 2.5 and 4 of σs in sensing sub‐optimally located −35 elements.
A characterization of DNA release in Pseudomonas aeruginosa cultures and biofilms
Authors: Allesen‐Holm Marie , Barken Kim Bundvig , Yang Liang , Klausen Mikkel , Webb Jeremy S. , Kjelleberg Staffan , Molin Søren , Givskov Michael , Tolker‐Nielsen Tim
Published: December 2005

Pseudomonas aeruginosa produces extracellular DNA which functions as a cell‐to‐cell interconnecting matrix component in biofilms. Comparison of extracellular DNA and chromosomal DNA by the use of polymerase chain reaction and Southern analysis suggested that the extracellular DNA is similar to whole‐genome DNA. Evidence that the extracellular DNA in P. aeruginosa biofilms and cultures is generated via lysis of a subpopulation of the bacteria was obtained through experiments where extracellular β‐galactosidase released from lacZ‐containing P. aeruginosa strains was assessed. Experiments with the wild type and lasIrhlI, pqsA, pqsL and fliMpilA mutants indicated that the extracellular DNA is generated via a mechanism which is dependent on acyl homoserine lactone and Pseudomonas quinolone signalling, as well as on flagella and type IV pili. Microscopic investigation of flow chamber‐grown wild‐type P. aeruginosa biofilms stained with different DNA stains suggested that the extracellular DNA is located primarily in the stalks of mushroom‐shaped multicellular structures, with a high concentration especially in the outer part of the stalks forming a border between the stalk‐forming bacteria and the cap‐forming bacteria. Biofilms formed by lasIrhlI, pqsA and fliMpilA mutants contained less extracellular DNA than biofilms formed by the wild type, and the mutant biofilms were more susceptible to treatment with sodium dodecyl sulphate than the wild‐type biofilm.
Minimal requirements for oxygen sensing by the aerotaxis receptor Aer
Authors: Watts Kylie J. , Johnson Mark S. , Taylor Barry L.
Published: December 2005

The PAS and HAMP domain superfamilies are signal transduction modules found in all kingdoms of life. The Aer receptor, which contains both domains, initiates rapid behavioural responses to oxygen (aerotaxis) and other electron acceptors, guiding Escherichia coli to niches where it can generate optimal cellular energy. We used intragenic complementation to investigate the signal transduction pathway from the Aer PAS domain to the signalling domain. These studies showed that the HAMP domain of one monomer in the Aer dimer stabilized FAD binding to the PAS domain of the cognate monomer. In contrast, the signal transduction pathway was intra‐subunit, involving the PAS and signalling domains from the same monomer. The minimal requirements for signalling were investigated in heterodimers containing a full‐length and truncated monomer. Either the PAS or signalling domains could be deleted from the non‐signalling subunit of the heterodimer, but removing 16 residues from the C‐terminus of the signalling subunit abolished aerotaxis. Although both HAMP domains were required for aerotaxis, signalling was not disrupted by missense mutations in the HAMP domain from the signalling subunit. Possible models for Aer signal transduction are compared.
Treatment of verruca vulgaris with topical cidofovir in an immunocompromised patient: a case report and review of the literature
Authors: Cha S. , Johnston L. , Natkunam Y. , Brown J.
Published: December 2005

Abstract: Lesions caused by verrucus vulgaris are commonly refractory to therapy and may become large, painful, or disfiguring in immunocompromised patients. Cidofovir is a potent nucleoside analog antiviral agent shown to have in vitro and in vivo activity against a broad spectrum of DNA viruses. We report a successful use of topical cidofovir to treat verruca vulgaris lesions in a highly immunocompromised patient, who was not considered a candidate for conventional therapy.
Prospective randomized control trial of isoniazid chemoprophylaxis during renal replacement therapy
Authors: Vikrant S. , Agarwal S.K. , Gupta S. , Bhowmik D. , Tiwari S.C. , Dash S.C. , Guleria S. , Mehta S.N.
Published: December 2005

Abstract:Background.Infectious diseases remain among the major morbid events in patients with end‐stage renal disease (ESRD) on renal replacement therapy (RRT). In developing countries, tuberculosis (TB) has been found to occur more frequently in these patients than in the general population. Efficacy of isoniazid (INH) chemoprophylaxis has been seen in other situations, such as human immunodeficiency virus infection. However, studies on INH prophylaxis in ESRD patients on RRT are limited.

Methods.In this prospective randomized controlled trial, from April 2000 to June 2001, a total of 109 ESRD patients registered for renal transplant and accepted for maintenance hemodialysis in our hospital were included and followed up until June 2004 to assess the role of INH prophylaxis in preventing development of TB. At the time of acceptance for hemodialysis, 54 patients were assigned to receive daily INH for 1 year and 55 patients were assigned to the control group. Primary outcome was development of TB. Secondary outcome was INH hepatotoxicity. To evaluate the effect of INH prophylaxis on the development of TB, a Kaplan–Meier survival estimate was used to plot TB‐free survival curve and log‐rank test was used for comparison.

Results.Overall, TB was diagnosed in 27 patients during RRT, with an incidence of 24.8%. TB developed in 9 (16.7%) patients in the INH group and in 18 (32.7%) patients in the control group. There was a significantly lower incidence of TB in the INH group as compared with the control group. The risk ratio of INH vs. control group for development of TB was 0.40 (95% confidence index [CI], 0.17–0.92;P=0.032). In the INH group 27 (50%) patients and in the control group 17 (30.9%) patients developed some hepatic dysfunction. However, significant hepatitis that required discontinuation of INH developed in only 9 (16.7%) patients in the INH group. Furthermore, significant hepatitis also developed in 6 (10.9%) patients in the control group. The majority of patients with significant hepatitis in both groups (INH as well as control) were subsequently found to be positive for hepatitis B and/or hepatitis C viral infection. Mild hepatitis (which did not require discontinuation of INH) was seen in 18 (33.3%) patients in the INH group and 11 (20%) patients in the control group. Viral hepatitis infection was not found in any of the milder cases of hepatitis in either group.

Conclusion.This study shows significant efficacy of INH chemoprophylaxis during RRT in preventing development of TB, when the INH was started during dialysis itself. INH chemoprophylaxis was safe and well tolerated in the majority of patients. However, mild hepatic dysfunction was common, both in the treatment as well as in the control group. As the incidence of viral hepatitis overall was high in our patients on RRT, it is difficult to identify INH‐induced hepatitis in this clinical setting.
Candida dubliniensis bloodstream infection: a fatal case in a lung transplant recipient
Authors: Mubareka S. , Vinh D.C. , Sanche S.E.
Published: December 2005

Abstract: Candida dubliniensis is an emerging opportunistic yeast initially identified as a cause of oropharyngeal candidiasis in human immunodeficiency virus‐infected individuals, and recently associated with invasive disease in other immunocompromised hosts. Certain diagnostic characteristics are shared with C. albicans, but differences in epidemiology, microbiology, and potentially clinical management are notable. We report a case of fatal C. dubliniensis bloodstream infection in a solid‐organ transplant recipient and review the literature.
Malignant melanoma in a patient with polyomavirus‐BK‐associated nephropathy
Authors: Boratyńska M. , Rybka K.
Published: December 2005

Abstract: A possible relationship between malignant melanoma and polyomavirus‐associated nephropathy in a renal transplant patient is presented. It is possible that BK polyomavirus (BKV) nephropathy and malignant melanoma developed independently. The coincidence may be related to over‐immunosuppression. The presented case suggests careful oncological surveillance in patients with BKV nephropathy.
Acanthamoeba infection in lung transplantation: report of a case and review of the literature
Authors: Vernon S.E. , Acar B.C. , Pham S.M. , Fertel D.
Published: December 2005

Abstract: A 49‐year‐old woman underwent bilateral lung transplantation for advanced idiopathic pulmonary fibrosis. During the postoperative period she received immunosuppressive medications as well as corticosteroids. Aspergillus fumigatus grew from a sputum sample, and she was treated with nebulized amphotericin. She was discharged on tacrolimus and prednisone. After initially doing well, she required re‐hospitalization for treatment of cytomegalovirus and Pseudomonas aeruginosa pneumonia. She was treated with ganciclovir and cefepime and, after a 2‐week hospitalization, was discharged. Seven months after transplantation she developed progressive sinusitis, treated with antibiotics and sinus debridement surgery. Aspergillus organisms were recovered and, at the periphery of the tangled masses of Aspergillus hyphae, numerous amebic cysts were also identified, which were morphologically consistent with Acanthamoeba spp. Subsequent electron microscopy and immunofluorescent staining confirmed this impression. She was initially treated with intravenous amphotericin, later changed to voriconazole and caspofungin. Debridement of the sinuses 3 weeks later revealed fungal hyphae but no amebae. Infections with Acanthamoeba have rarely been reported in lung transplantation but have been recognized in bonemarrow and renal transplant patients, and have been lethal in many cases, particularly in patients with immunosuppression due to human immunodeficiency virus infection. More recently, aggressive antimicrobial therapy has resulted in successful outcomes, as discussed herein.
The sensitivity and specificity of three common statistical rules for the classification of post‐operative cognitive dysfunction following coronary artery bypass graft surgery
Authors: Lewis M. S. , Maruff P. , Silbert B. S. , Evered L. A. , Scott D. A.
Published: December 2005

Background:  The application of statistical rules to determine post‐operative cognitive dysfunction (POCD) has varied, and partially explains the wide range of reported incidences of POCD in the literature. The current study assessed the sensitivity and specificity of three commonly used statistical rules in a sample of coronary artery bypass graft (CABG) patients and healthy non‐surgical controls.

Methods:  Two hundred and four CABG patients [mean age, 68.8 years; standard deviation (SD), 7.0 years] completed neuropsychological assessment pre‐operatively (baseline) and 1 week and 3 months post‐operatively. Ninety age‐ and gender‐matched non‐surgical controls (mean age, 67.8 years; SD, 7.9 years) completed the same tasks at the same time points. POCD was determined in each group using three rules: the 1SD decline on two or more tasks; the 20% decline on 20% of tasks rule; and a modified reliable change index.

Results:  The modified reliable change index demonstrated the greatest combination of sensitivity and specificity. The 20% decline on 20% of tasks rule detected the largest incidence of impairment in the CABG group, but showed large incidences of false positive classifications in the control group. The 1SD rule detected the lowest incidence of POCD in the CABG group, but detected a larger incidence of impairment in the control group.

Conclusions:  The use of the modified reliable change index is recommended, given the sensitivity to change it displayed and the low rates of false positive classification in the control sample. The use of control groups in future research is also recommended.
Temporal differentiation and spatial coexistence of sexual and facultative asexual lineages of an aphid species at mating sites
Authors: Halkett F. , Kindlmann P. , Plantegenest M. , Sunnucks P. , Simon J. C.
Published: December 2005

Cases of coexisting sexual and asexual relatives are puzzling, as evolutionary theory predicts that competition for the same ecological niches should lead to the exclusion of one or the other population. In the cyclically parthenogenetic aphid, Rhopalosiphum padi, sexual and facultative asexual lineages are admixed in space at the time of sexual reproduction. We investigated how the interaction of reproductive mode and environment can lead to temporal niche differentiation. We demonstrated theoretically that differential sensitivity of sexual and facultatively asexual aphids to an environmental parameter (mating host suitability) shapes the two strategies: whereas the sexual lineages switch earlier to the production of sexual forms, the facultative asexual lineages delay and spread out their investment in sexual reproduction. This predicted pattern of niche specialization is in agreement with the temporal structure revealed in natura by demographic and genetic data. We propose that partial loss of sex by one pool of aphids and subsequent reduction in gene flow between lineages may favour temporal specialization through disruptive selection.
Anesthetic management in a child with Arnold–Chiari malformation and bilateral vocal cord paralysis
Authors: SETZ A.C.W. , DE BOER H.D. , DRIESSEN J.J. , SCHEFFER G.J.
Published: December 2005

We report a case of a child who was scheduled for an emergency ventriculoperitoneal shunt procedure. The patient had a type II Arnold–Chiari malformation (ACM) and associated hydrocephalus and presented with near complete respiratory obstruction from bilateral abductor vocal cord palsy. Early diagnosis and management of airway abnormalities associated with ACM may be lifesaving. Chiari malformations and anesthesia management are discussed.
Conjunctival impression cytology in dogs
Authors: Bolzan Aline A. , Brunelli Adriana T. J. , Castro Márcio B. , Souza Marcos A. , Souza José L. , Laus José L.
Published: December 2005

Objective  Ocular conjunctivas of healthy dogs were studied by conjunctival impression cytology for evaluation of feasibility, protocol standardization, and normal cytologic pattern recognition of this technique.

Animals studied  Twenty healthy, adult, cross‐breed dogs.

Procedures  Samples of the bulbar conjunctiva were collected after instillation of topical anesthetic drops at the ocular surface. Impression cytology was performed by applying asymmetric strips of Millipore filter on the superior temporal bulbar conjunctiva near the limbus. The filter strip was gently pressed against the conjunctiva for 5 s and removed with a peeling motion. Samples were immediately fixed in 95% ethyl alcohol, stained with periodic acid‐Schiff and hematoxylin, and mounted on slides cover‐slipped using synthetic resin. The slides were examined by light microscopy.

Results  Microscopic examination of the impressions revealed superficial, intermediate and basal epithelial cells arranged in sheets. Keratinized epithelial cells, goblet cells and leukocytes, as well as cellular debris and mucus were observed.

Conclusions  Feasibility of impression cytology for sampling the bulbar conjunctiva of the dog and the standardization the the proposed protocol was shown. The results allowed the recognition the the normal cytologic pattern of healthy conjunctivas in dogs.
LET THERE BE IRONY: CULTURAL HISTORY AND MEDIA ARCHAEOLOGY IN PARALLEL LINES
Authors: ERNST WOLFGANG
Published: December 2005

Stephen Bann is well known as an art critic, art historian, cultural historian and museologist, but his writings have yet to be discovered from the point of view of media theory. This article applies Bann's proposal of an ‘ironical museum’ to a self‐reflective media culture, while at the same time establishing the difference between a media‐archaeological and an art‐historical approach, particularly in accounts of new media in the first half of the nineteenth century and in the present. To what extent was the historical imagination developed in the romantic period an effect of new media and new media technologies? It is argued that although the discourse of history has always depended on the media of its representation (verbal and visual), its character changed dramatically with the arrival of mechanical means for recording historical evidence. The ‘antiquarian’ method of archival investigation of the past, with its almost haptic taste for the mouldy, decaying fragment, is considered and compared to narrative aesthetics. A key question is considered from different disciplinary perspectives: can we speak of a cultural transition or a radical break with the emergence of photography? The essay concludes that what we learn from Stephen Bann's analyses is the significance of an ever‐alert awareness of the intricate relations between cultural and technological phenomena, a kind of media self‐irony which, apparently, was present in the past to antiquaries and historiographers, to painters, engravers and to creators of historical museums.
Persistent urinary incontinence and delivery mode history: a six‐year longitudinal study
Authors: MacArthur Christine , Glazener Cathryn MA , Wilson P Don , Lancashire Robert J , Herbison G Peter , Grant Adrian M
Published: December 2005

Objective  To investigate the prevalence of persistent and long term postpartum urinary incontinence and associations with mode of first and subsequent delivery.

Design  Longitudinal study.

Setting  Maternity units in Aberdeen (Scotland), Birmingham (England) and Dunedin (New Zealand).

Population  Women (4214) who returned postal questionnaires three months and six years after the index birth.

Methods  Symptom data were obtained from both questionnaires and obstetric data from case‐notes for the index birth and the second questionnaire for subsequent births. Logistic regression investigated the independent effects of mode of first delivery and delivery mode history.

Main outcome measures  Urinary incontinence—persistent (at three months and six years after index birth) and long term (at six years after index birth).

Results  The prevalence of persistent urinary incontinence was 24%. Delivering exclusively by caesarean section was associated with both less persistent (OR = 0.46, 95% CI 0.32–0.68) and long term urinary incontinence (OR = 0.50, 95% CI 0.40–0.63). Caesarean section birth in addition to vaginal delivery, however, was not associated with significantly less persistent incontinence (OR 0.93, 95% CI 0.67–1.29). There were no significant associations between persistent or long term urinary incontinence and forceps or vacuum extraction delivery. Other significantly associated factors were increasing number of births and older maternal age.

Conclusions  The risk of persistent and long term urinary incontinence is significantly lower following caesarean section deliveries but not if there is another vaginal birth. Even when delivering exclusively by caesarean section, the prevalence of persistent symptoms (14%) is still high.
Exploiting West Africa's children: trafficking, slavery and uneven development
Authors: Manzo Kate
Published: December 2005

This paper analyses child trafficking and slavery in relation to media coverage of West African children, international law and academic research within geography and development studies. The meaning and practice of child trafficking is examined in the context of related debates about child labour, exploitation and uneven development. The analysis highlights key differences between trafficking and slavery, thereby illuminating the varying forms of exploitation at work in different relations of power.
Old Europe, new Europe: for a geopolitics of translation
Authors: Bialasiewicz Luiza , Minca Claudio
Published: December 2005

This paper looks to the role of geographical metaphors in the ‘battle of words’ to describe Europe and its presumed identity. The facile adoption of banal cartographies such as those of a ‘New’ and ‘Old’ Europe highlights two concerns: first, that despite the imperial and isolationistic temptations of the current American administration, its geopolitical imagination remains firmly wedded to – indeed, cannot but define itself by – its relationship with the ‘Old Continent’. Secondly, it reveals an astonishing distance between such cartographic abstractions and the variety of non‐territorial metaphors – in particular, those of mediation and translation – that are increasingly being invoked to inscribe possible futures for the European project.
Asia–Europe–United States: the geoeconomics of uncertainty
Authors: Sidaway James D
Published: December 2005

This paper examines a key aspect of how the global geometries of finance and trade articulate the euro–dollar relationship. Here, European integration extends into a global financial and trading system replete with contradictions. The paper examines these, drawing upon a literature from international political economy, foregrounding the spatialities that they signal.
Assessing participatory GIS for community‐based natural resource management: claiming community forests in Cameroon
Authors: McCALL MICHAEL K , MINANG PETER A
Published: December 2005

This paper critically reviews and analyses participatory GIS (PGIS) and participatory mapping applications within participatory spatial planning for community‐based natural resource management in developing countries. There is an often implicit assumption that PGIS use is effective, in that it meets content needs, satisfies underlying local stakeholder interests and therefore is a tool for better governance. The analytical framework looks at participatory spatial planning performance with respect to key dimensions of governance, especially the intensity of community participation and empowerment, equity within communities and between ‘governed’ and ‘governing’, respect for indigenous knowledge, rights, ownership, legitimacy, and effectiveness. Specific development focus is given by a case study using participatory mapping and PGIS in community forest legitimization, planning and management in Tinto, Cameroon. ‘Good governance’ criteria are applied ex‐post to the implementation procedures, the geo‐information outputs, and the longer‐term outcomes of the PGIS processes. Impacts of incorporating PGIS were examined in terms of the types and degrees of participation in the process; access to, and the uses made of, the geographic information; whether the information outputs met stakeholders’ requirements; and the overall changes in equity and empowerment in the community. It was found that PGIS/participatory mapping processes contributed – positively, though not comprehensively – to good governance, by improving dialogue, redistributing resource access and control rights – though not always equitably – legitimizing and using local knowledge, exposing local stakeholders to geospatial analysis, and creating some actor empowerment through training. PGIS promoted empowerment by supporting community members’ participation in decision‐making and actions, and by enabling land use planning decisions beyond community forestry itself.
City–suburban electoral polarization in Great Britain, 1950–2001
Authors: Walks R Alan
Published: December 2005

The degree to which residents of British inner cities and suburbs have diverged in their voting behaviour over the post‐war period is analysed in this article. Examining aggregate election results by constituency, it is demonstrated that residents of inner cities and suburbs are indeed polarizing in their electoral choices. OLS regression analysis is conducted using constituency‐level data to determine the relevance of intra‐urban differences for understanding geographic variation in the vote in relation to those for region, size of conurbation and urban–rural distinctions. Results show that urban place of residence is particularly important for understanding the shifting geography of Conservative support. The implications of this research for electoral change in Britain are discussed.
Treating and Drinking Well Water in the Presence of Health Risks from Arsenic Contamination: Results from a U.S. Hot Spot
Authors: Shaw W. Douglass , Walker Mark , Benson Marnee
Published: December 2005

The Safe Drinking Water Act of 1974 regulates water quality in public drinking water supply systems but does not pertain to private domestic wells, often found in rural areas throughout the country. The recent decision to tighten the drinking water standard for arsenic from 50 parts per billion (ppb) to 10 ppb may therefore affect some households in rural communities, but may not directly reduce health risks for those on private wells. The article reports results from a survey conducted in a U.S. arsenic hot spot, the rural area of Churchill County, Nevada. This area has elevated levels of arsenic in groundwater. We find that a significant proportion of households on private wells are consuming drinking water with arsenic levels that pose a health risk. The decision to treat tap water for those on private wells in this area is modeled, and the predicted probability of treatment is used to help explain drinking water consumption. This probability represents behaviors relating to the household's perception of risk.
Heart Rate Variability During Sleep in Patients with Vasovagal Syncope
Authors: CINTRA FATIMA , POYARES DALVA , DO AMARAL ALESSANDRO , DE MARCHI GUILHERME , BARRETO SIMONE , TUFIK SERGIO , DE PAOLA ANGELO , GUILLEMINAULT CHRISTIAN
Published: December 2005

Background: There are a few studies showing no significant heart rate variability (HRV) over a 24‐hour period in vasovagal syncope (VVS) patients, but no research has examined HRV and its sympathetic and parasympathetic components during rapid eye movement (REM) and non‐REM sleep. The authors hypothesized that REM sleep might be a critical state in which VVS patients would show abnormal responses.

Objectives: To analyze the sympathetic and parasympathetic components of HRV during REM and SWS in patients with VVS compared to normal subjects, and in patients with positive HUTT compared to negative ones.

Methods: Thirty‐seven VVS patients and 20 normal age‐matched controls were submitted to polysomnography with 24‐hour Holter monitoring to assess HRV. Time and frequency domain techniques were carefully performed for 24 hours and during Stages 3 and 4 of REM and non‐REM sleep. Variation of sympathetic activity index (VSAI) was defined as the difference in the low frequency (LF) component of HRV between REM and Stages 3 and 4 of non‐REM sleep. An analysis of variance was performed to compare patients and controls; patients with positive and negative head‐up tilt testing.

Results: The LF component was lower in syncope compared to normal patients (1,769.54 ± 1,738.17, 3,225.37 ± 2,585.05, respectively, P = 0.03). There was a significant decrease in VSAI in the syncope group compared to the control group (−539.39 ± 1,930.78, 1,268.10 ± 2,420.20, respectively, P = 0.01). The other sleep variables analyzed including very LF, high frequency, low frequency/high frequency and time domain parameters did not reach statistical significance. Syncope patients also showed an increase in slow wave sleep (28.2 ± 10.5, 19.7 ± 7.8, P = 0.01).

Conclusions: VVS patients exhibited sympathetic suppression during REM sleep. Possible mechanisms are discussed in this article.
Atrial Fibrillation and Recurrent Ventricular Fibrillation During Hypokalemia in Brugada Syndrome
Authors: NOTARSTEFANO PASQUALE , PRATOLA CLAUDIO , TOSELLI TIZIANO , FERRARI ROBERTO
Published: December 2005

A 41‐year‐old man with Brugada syndrome (BS) and no previous episodes of aborted sudden death or syncope referred to local emergency room for an episode of symptomatic atrial fibrillation. Blood chemistry results showed hypokalemia (2.9 mEq/L). The other parameters were within the normal range. After few minutes, an episode of ventricular fibrillation treated with biphasic DC shock 150 J occurred. In successive 2 hours, the patient experienced recurrent episodes of ventricular tachycardia and fibrillation. Each biphasic DC shock 150 J was effective to restore sinus rhythm. No further episodes occurred after normalization of serum levels of potassium. Before discharge, an implantable cardioverter defibrillator was inserted to prevent sudden cardiac death. Hypokalemia increases the risk of arrhythmic events in BS.
Sustained Ventricular Tachycardia Following Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy
Authors: SIMON RON D.B. , CRAWFORD FRED A. , SPENCER WILLIAM H. , GOLD MICHAEL R.
Published: December 2005

A 49‐year‐old man with a history of hypertrophic obstructive cardiomyopathy (HOCM) presented in sustained monomorphic ventricular tachycardia (SMVT) 8 days post‐alcohol septal ablation. A dual chamber implantable cardioverter defibrillator ICD was implanted and the patient experienced another episode of VT 3 weeks later, which was terminated by an ICD shock. This case demonstrates probable scar‐induced reentrant VT post‐alcohol septal ablation, a likely rare but hypothesized complication of this procedure.
Bone reactions around transplanted roots
Authors: Garcia A. , Saffar J. L.
Published: December 2005

Abstract The aim of this experiment was to study endosteal bone reactions around roots transplanted into an edentulous crest, and the role, if any, of periodontal ligament (PDL) remnants preservation. After extraction of pre‐molars and healing of the crests, 20 roots in 5 dogs were transplanted into bone cavities prepared in the edentulous areas. Roots implanted in the lower and upper right cavities had their PDL remnants preserved while those grafted in the left cavities had their surface planed and dried. After 5 months, the roots with surrounding bone were removed. 2 bone areas were delineated at the mesial aspect of each root, one immediately adjacent to the alveolar wall and the other distal to it. Results demonstrated that bone volume was higher in the proximal versus distal area in the maxilla and mandible preserved groups. The adipocyte content of the marrow spaces, an index of bone maturation, was less pronounced in the proximal versus distal area in the preserved groups. The number of osteoclasts was higher in the proximal zone in the preserved groups as were the extents of the different bone remodeling activities. The results indicate that the organization of PDL around transplanted roots is associated with rearrangement of the bone tissue surrounding the grafts. This process of long duration might be an adaptation to the likely low mechanical strains applied on bone through the root. Transplantation of PDL‐damaged roots did not induce such events in the surrounding bone which had acquired the structure of an edentulous crest.
Improved metabolic control, clinical periodontal status and subgingival microbiology in insulin‐dependent diabetes mellitus
Authors: Sastrowijoto S. H. , van der Velden U. , van Steenbergen T. J. M. , Hillemans P. , Hart A. A. M. , de Graaff J. , Abraham‐Inpijn L.
Published: December 2005

Abstract The effect of improved metabolic control on the clinical periodontal condition and the subgingival microflora of diseased and healthy periodontal pockets in 6 ambulatory insulin‐dependent diabetes mellitus (IDDM) patients was prospectively studied. Duplicate measurements with a time‐interval of 3 days were made every 4 moths for assessment of the metabolic status, the clinical periodontal condition and the subgingival microflora. During the study, patients maintained personal oral hygiene measures as they usually did before the study. Neither supplementary dental prophylaxis nor oral hygiene measures were applied during the investigation. Long‐term metabolic control (HbA1c) improved significantly with intensive conventional insulin treatment. Gingival redness decreased significantly whereas gingival swelling showed a not significant trend to decrease. It is suggested that microvascular changes associated with improved metabolic control in diabetes mellitus may mediate the observed change in gingival redness. No effect could be demonstrated for probing pocket depth, probing attachment level, bleeding on probing and the plaque index. Statistical analysis of the effect of improved metabolic control on the subgingival microflora revealed that only the % of streptococci increased significantly in diseased periodontal pockets. In general, no significant changes were found in either healthy or diseased pockets with regard to the bacterial flora associated with periodontal disease. The results of the present study indicate that improved metabolic control in IDDM patients may have no potential impetus for an improved clinical periodontal condition nor on the subgingival bacterial flora. It is concluded that the periodontal condition in IDDM patients may only ameliorate when local oral hygiene measures are applied.
Changes in periodontal disease indicators in 35‐year‐old Oslo citizens from 1973 to 1984
Authors: Hansen B. Frode , Bjertness Espen , Gjermo Per
Published: December 2005

Abstract Periodontal disease indicators were evaluated according to the periodontal treatment need system (PTNS) in random samples of 35‐year‐old citizens of Oslo in 1973 and 1984. The study indicated that although periodontal disease was a common finding in both samples, there was a significant reduction in score C (indicating need for complex periodontal treatment) in 1984 compared to 1973. Whereas 37.9% of the subjects showed inflamed pockets deeper than 5 mm (score C) in 1973, only 22.9% scored C in 1984 (non‐Caucasians excluded) This reduction was most pronounced in females. The mean number of C‐quadrants in subjects needing complex periodontal treatment was also reduced from 2.0 in 1973 to 1.7 in 1984. Further analyses of the 1984 sample showed that the mean number of C‐quadrants was significantly lower in subjects with low OHI‐S scores and in regular dental visitors, whereas sex, years at school, toothbrushing frequency, interdental cleaning habits, previous periodontal therapy, self‐experienced need for treatment, health attitude or smoking habits, did not seem to influence the prevalence of score C.
Effect of root debridement on the elimination of Actinobacillus actinomycetemcomitans and Bacteroides gingivalis from periodontal pockets
Authors: Renvert Stefan , Wikström Maude , Dahlén Gunnar , Slots Jørgen , Egelberg Jan
Published: December 2005

Abstract The aims of this 6‐month longitudinal study were: (1) to investigate to what extent root debridement of pockets in adult periodontitis will reduce the subgingival presence of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis and some other bacterial groups; (2) to relate the microbiological results following debridement to clinical measurements of healing, 16 patients and a total of 111 periodontally involved sites with probing depth 6 mm served for the study. Duplicate subgingival microbial samples and duplicate clinical recordings were obtained 1 week apart at baseline and at 6 months following supra‐ and subgingival debridement. The results demonstrated reductions of the mean total viable counts and reductions of the mean counts of several of the cultured groups of micro‐organisms coupled with significant improvements of mean clinical measurements. B. gingivalis was eliminated from a majority of infected subgingival sites. A. actinomycetemcomitans, on the other hand, still remained after therapy in a high proportion of sites initially infected with this microorganism. Subgingival persistence of A. actinomycetemcomitans appeared to be associated with a reduced healing response following debridement. Further studies are needed to clarify why A. actinomycetemcomitans is poorly eliminated following debridement. Also, the long‐term clinical significance of the subgingival perseverance of A. actinomycetemcomitans needs to be elucidated.
On the inability of root debridement and periodontal surgery to eliminate Actinobacillus actinomycetemcomitans from periodontal pockets
Authors: Renvert Stefan , Wikström Maude , Dahlén Gunnar , Slots Jørgen , Egelberg Jan
Published: December 2005

Abstract In a previous study, we observed that root debridement was inefficient in eliminating Actinobacillus actinomycetemcomitans from adult periodontitis lesions. The present report describes the effects on A. actinomycetemcomitans of subsequent treatments of 6 patients that had at least 2 separate sites still harboring A. actinomycetemcomitans 6 months following debridement. 1 site or more in each individual was treated with renewed root debridement and at least 1 other site was treated by surgical excision of the gingival tissue. The results indicated that retreatment with either repeated root debridement or with surgical excision of the gingival tissue was not more effective in eliminating A. actinomycetemcomitans than initial debridement. The possible reasons for this limited therapeutic effect on the subgingival presence of A. actinomycetemcomitans are discussed.
5‐year follow up of periodontal intraosseous defects treated by root planing or flap surgery
Authors: Renvert Stefan , Nilvéus Rolf , Dahlén Gunnar , Slots Jørgen , Egelberg Jan
Published: December 2005

Abstract Intraosseous, periodontal defects in 12 subjects initially treated by root planing alone (21 defects) or by flap surgery (21 defects) were monitored during a 5‐year postoperative interval. Maintenance therapy during this interval was limited to reinforcement of oral hygiene and tooth polishing every 6 months. No subgingival instrumentation was performed at the defect sites. Longitudinal clinical measurements demonstrated that surgically‐treated lesions responded with somewhat more reduction of probing depth and more gain of probing bone level than root‐planed lesions. Mean gains of probing attachment level were similar for the 2 treatments. Some relapse of the clinical conditions could be observed towards the end of the 5‐year observation interval compared to the results at year 1 and year 2. However, the majority of defects subjected to either treatment showed 60‐month recordings of probing attachment and probing bone levels equal to or slightly improved compared to those at baseline. Counts from cultures of subgingival, microbial samples were obtained at 42, 48 and 60 months. No significant difference between the 2 therapies was observed for the investigated groups of micro‐organisms.
Improvement of gingival health by tooth brushing in individuals with large amounts of calculus
Authors: Gaare D. , Rolla G. , Aryadi F. Joelimar , van der Ouderaa F.
Published: December 2005

Abstract Dental calculus itself is not thought to affect gingival health, but its rough and porous surface retains plaque better than a calculus‐free surface. In a population with a high degree of supragingival calculus, the effect of toothbrushing after a careful professional prophylaxis (group A) has been compared with the effect of tooth‐brushing as the sole oral hygiene aid (group B). The subjects in this comparison were Indonesian soldiers, 20–25 years of age, none of whom had pathological pockets (CPITN≤2), but all had large amounts of calculus. They had no experience of modern oral hygiene practice but were given individual instruction in toothbrushing at the start of the study and were provided with toothpaste and toothbrush. Removal of calculus in group A took an average of 1 h per subject by an experienced clinician. Gingival health in both groups improved after 2 months: group A from 63% to 34% bleeding points and group B from 61% to 36%. There was thus no obvius benefit from the professional prophylaxis received by group A. The results are particularly relevant for populations in which professional prophylaxis is not normally available. However, they were obtained in a group of young, healthy individuals and may not be extrapolated to older and less healthy populations or to individuals with deep periodontal pockets. The improvement of gingival health through toothbrushing, in spite of the presence of calculus, supports the contention that plaque, rather than calculus as a non‐inflammatory scale, provides the pathogenic potential.
Case report of the Prader‐Willi syndrome
Authors: Greenwood R. E. , Small I. C. B.
Published: December 2005

Abstract A case of Prader‐Willi Syndrome in a 12‐year‐old girl is described, together with the dental findings which exhibit extensive periodontal disease for her age, which has hitherto not been recorded in the literature.