bluuebunny/crossref_metadata_2025 huggingface dataset:
Reluctant Muslims: embodied hegemony and moral resistance in a Giriama spirit possession complex
Authors: McIntosh Janet
Published: March 2004

This account of a form of spirit possession widely experienced among Giriama people of coastal Kenya challenges prevailing theories of possession as resistance. Giriama are routinely possessed by Muslim spirits which hold their bodies hostage, afflicting them with illness and vomiting until they agree to abandon their customary practices and embrace Islam. Those possessed apparently somatize a hegemonic system of oppressive meanings according to which Giriama ethnicity is essentially different from, and polluting to, Islam. Yet the same individuals who embody hegemony in this way may reflect upon their possession experience by articulating a defiant ideology of resistance against both the possessing spirit and the Muslim ethnic groups that the spirit represents. These observations thus highlight the complexity of the relationship between hegemony and the individual; they also provide a reminder that the idiom of possession does not necessarily articulate with power structures in a predictable and straightforward fashion.
Erratum: Attitudes Towards English in the Basque Autonomous Community
Authors: Lasagabaster David
Published: March 2004

Abstract: We regret that, due to a technical error, figures 1‐6 in the Research Report by David Lasagabaster (Lasagabaster, 2003) were incorrectly printed. We apologise to the author and reprint in full the corrected version of the paper on the following pages.

The learning of more than two languages in the school context is becoming very commonplace all over Europe, especially in the many places where a minority language is spoken. The situation of the Basque educational system is a very good case in point, as, apart from Basque and Spanish, English is also learnt at school. This study examines the attitudes of 1,097 university students towards the aforementioned three languages, using Baker's (1992) questionnaire on attitudes as the main instrument of the survey. In a previous study carried out with a smaller sample (133 students) in which the majority were Basque Philology degree students, it was observed that the participants' LI had a clear impact on their attitudes. In fact, those students who had Basque as their LI viewed the two international languages (Spanish and English) less favourably. In the case of the present sample, it was expected that students would not show such a negative attitude, as the range of degree courses being followed is much wider. Because the Basque language does not form the central core of the participants' studies, their attitudes towards Spanish and English will be more positive and farther from what Baker calls a bunker attitude.
Agency, Simulation and Self‐identification
Authors: Jeannerod Marc , Pacherie Elisabeth
Published: March 2004

Abstract: This paper is concerned with the problem of self‐identification in the domain of action. We claim that this problem can arise not just for the self as object, but also for the self as subject in the ascription of agency. We discuss and evaluate some proposals concerning the mechanisms involved in self‐identification and in agency‐ascription, and their possible impairments in pathological cases. We argue in favor of a simulation hypothesis that claims that actions, whether overt or covert, are centrally simulated by the neural network, and that this simulation provides the basis for action recognition and attribution.
The Grain of Domains: The Evolutionary‐Psychological Case Against Domain‐General Cognition
Authors: Atkinson Anthony P. , Wheeler Michael
Published: March 2004

Abstract: Prominent evolutionary psychologists have argued that our innate psychological endowment consists of numerous domain‐specific cognitive resources, rather than a few domain‐general ones. In the light of some conceptual clarification, we examine the central in‐principle arguments that evolutionary psychologists mount against domain‐general cognition. We conclude (a) that the fundamental logic of Darwinism, as advanced within evolutionary psychology, does not entail that the innate mind consists exclusively, or even massively, of domain‐specific features, and (b) that a mixed innate cognitive economy of domain‐specific and domain‐general resources remains a genuine conceptual possibility. However, an examination of evolutionary psychology's ‘grain problem’ reveals that there is no way of establishing a principled and robust distinction between domain‐specific and domain‐general features. Nevertheless, we show that evolutionary psychologists can and do live with this grain problem without their whole enterprise being undermined.
Meaning Theory and Communication
Authors: Horisk Claire
Published: March 2004

Abstract:  Strawson contends that the proper subject matter of a theory of meaning includes what is meant on an occasion of utterance. If his contention is correct, it rules out a recent proposal that Davidsonian semantic theory should limit its scope so that it does not capture the extension of what is meant or what is said. In this paper, I reject Strawson's arguments for his contention. Despite the persuasive ring of his claim that the essential character of linguistic rules is that they are rules for communicating, his case remains unproven.
A Different Conjunction Fallacy
Authors: Bonini Nicolao , Tentori Katya , Osherson Daniel
Published: March 2004

Abstract:  Because the conjunction p‐and‐q implies p, the value of a bet on p‐and‐q cannot exceed the value of a bet on p at the same stakes. We tested recognition of this principle in a betting paradigm that (a) discouraged misreading p as p‐and‐not‐q, and (b) encouraged genuinely conjunctive reading of p‐and‐q. Frequent violations were nonetheless observed. The findings appear to discredit the idea that most people spontaneously integrate the logic of conjunction into their assessments of chance.
SINBAD Neurosemantics: A Theory of Mental Representation
Authors: Ryder Dan
Published: March 2004

Abstract: I present an account of mental representation based upon the ‘SINBAD’ theory of the cerebral cortex. If the SINBAD theory is correct, then networks of pyramidal cells in the cerebral cortex are appropriately described as representing, or more specifically, asmodellingthe world. I propose that SINBAD representation reveals the nature of the kind of mental representation found in human and animal minds, since the cortex is heavily implicated in these kinds of minds. Finally, I show how SINBAD neurosemantics can provide accounts of misrepresentation, equivocal representation, twin cases, and Frege cases.
Comment on Ryder's SINBAD Neurosemantics: Is Teleofunction Isomorphism the Way to Understand Representations?
Authors: Usher Marius
Published: March 2004

Abstract:  The merit of the SINBAD model is to provide an explicit mechanism showing how the cortex may come to develop detectors responding to correlated properties and therefore corresponding to the sources of these correlations. Here I argue that, contrary to the article, SINBAD neurosemantics does not need to rely on teleofunctions to solve the problem of misrepresentation. A number of difficulties for the teleofunction theories of content are reviewed and an alternative theory based on categorization performance and statistical relations is argued to provide a better account and to come closer to the practice in neuroscience and to powerful intuitions on swampkinds and on broad/narrow content.
Moses Mendelssohn's Philosophy of Jewish Liturgy: A Post‐Liberal Assessment
Authors: Kepnes Steven D.
Published: March 2004

This paper represents an attempt to reflect on the significance of liturgy for postliberal Jewish thought. I do this by investigating the work of the eighteenth‐century Jewish enlightenment figure Moses Mendelssohn in the context of the postliberal thought of George Lindbeck. Mendelssohn not only shows how liturgy can be central to postliberal approaches to monotheism, but he also shows how enlightenment notions of a universal rational religion remain necessary and productive for postliberal interpretations of monotheism. In this latter move, Mendelssohn forms a corrective to Lindbeck's postliberalism.
Against Radical Orthodoxy: The Dangers of Overcoming Political Liberalism
Authors: Insole Christopher J.
Published: March 2004

The article considers the critique of political liberalism offered by the Radical Orthodoxy movement. The first part deals with the claim that the underlying framework for the “secular” human condition ‐which would include political liberalism‐ is ontological violence and ethical nihilism.

The second part of the article deals with the charge that liberalism leads to a social atomism and individualism which can be overcome with the help of a participatory‐analogical theology. I consider the invocation to unity, participation and transformation to be theologically incautious, and politically dangerous, in a way well understood by a tradition of political liberalism.
Killing for the Telephone Company: Why the Nation‐State is Not the Keeper of the Common Good
Authors: Cavanaugh William T.
Published: March 2004

Christian ethicists often assume that the state is the agency whose purpose it is to protect and promote the common good. This conclusion is based on a series of assumptions of fact: that the state is natural and primordial, that society gives rise to the state and not vice‐versa, and that the state is one limited part of society. In this essay I examine the origins of the state and the state‐society relationship according to those who study the historical record, and argue that the above assumptions of fact are untenable in the face of the evidence. The essay concludes by registering a theological challenge to the state's sometimes overreaching claims to be the keeper of the common good and the repository of sacred values that demands sacrifice on its behalf. In the face of these tendencies, one of the church's urgent tasks is to demystify the nation‐state and to treat it like the telephone company—i.e., as a provider of goods and services that contribute to a certain limited order.
Self‐Creation? On the Dignity of Human Beings
Authors: Bayer Oswald
Published: March 2004

It was not through biotechnological possibilities that human beings first discovered “self‐creation” as a question. Rather, the question fits into the horizon of the primordial human desire to be like God. Against this hamartiological insight, a soteriological expectation related to technology has arisen. The latter expectation must be rejected, but not in all respects. Rather, one has to stress the inventive and constructive aspect of the dignity to rule, which is implied in human linguistic reason (λογοσ).

There are, however, boundaries to be perceived and to be set. This becomes evident when embryo‐consuming research is at stake. In this context, the main question is: Wherein lies human “dignity”? This is the same question as: wherein lies the “being‐as‐person”? The author sees the fewest difficulties in attributing personhood to the beginning of life, which occurs with the fusion of ovum and sperm. This attribution is not justified by the material substrate as such. Rather, it is the result of intertwining the element, namely the lump of cells, and the word of institution, which “speaks together” the lump of cells and the person: This lump of cells is a person. Human beings are honored and enabled to use this instituting word, a φυσɛι, because according to Gen 2:7 and 19f, God granted unto human beings linguistic reason (λογοσ), and thus the power to define. In this intertwining of element and instituting word lies the human dignity, which is undeservedly conferred on humans as a categorical gift. This absolute gratuity implies the unconditional acknowledgment of the dignity and the personhood of human beings—before one can speak of any characteristics or abilities.

Psalm 8 underscores the elementary human dependency on unconditional acknowledgment as an inviolable person, an acknowledgment preceding all human characteristics and achievements. The psalm further intertwines this acknowledgment and the commission to rule, which is conferred on human beings, as an insoluble unity. What at first appear to be opposites is in fact a synopsis and inseparable connection of creaturely human determinations that correspond to God's simultaneously being the almighty creator and the compassionate, merciful father.

By using “dignity” and “person” as critical terms of negotiation, theology can engage in a conversation with the societal and political public. In rejecting the dominant determination of the “person” as an autonomous, self‐determinately active, individual rational being, theology finds an ally in juridical thinking, which also acknowledges the dignity even of persons unable to act.

Two consequences are to be drawn concerning biotechnology: perceiving the remaining dependency, vulnerability and vanity of human beings forces us to abandon illusions of “self‐creation” and immortality. Second, priorities are required that determine the goals and limits of research—especially in protecting the personal dignity of embryos—in the light of our accountability before God the creator and judge.
LOOKING BACK AT THE CONDENSED VERSION OF THE ROAD TO SERFDOM AFTER 60 YEARS
Authors: Blundell John
Published: March 2004

Hayek's The Road to Serfdom changed the world ‐ but it may not have done so if it were not for the publication of The Reader's Digest condensed version.
HISTORICAL LESSONS FOR EUROPE'S FUTURE IN THE WAKE OF THE EU CONVENTION
Authors: Robinson Paul
Published: March 2004

The EU's leaders are not taking constitutional reform seriously. An analysis of the history of the development of federal states suggests that they are unlikely to do so until a crisis precipitates action. The current constitutional arrangements and those proposed by the constitutional convention are a recipe for continued integration. Paradoxically, a brief, well‐drafted federal constitution might stop the process of integration.
The Impact of Interest Rates and The Housing Market on The UK Economy
Authors: Cooper Adrian
Published: March 2004

The Chancellor has asked Professor David Miles to examine the UK market for longer‐term fixed rate mortgages. This paper by Adrian Cooper, which is part of a study commissioned by the Miles Review, presents the results of a series of simulations using the OEF Model of the UK economy to investigate the contribution of the housing market to macroeconomic volatility and the implications of changing the structure of mortgage finance from the current variable rate system linked to short‐term interest rates to a fixed rate system linked to long rates. The main findings are that the housing market has been a contributor to past volatility in the UK economy, and that moving to a fixed rate structure would reduce the impact of a change in interest rates on key macroeconomic indicators.
No Evidence of Cerebral Oedema in Severe Acute Mountain Sickness
Authors: Fischer R , Vollmar C , Thiere M , Born C , Leitl M , Pfluger T , Huber RM
Published: March 2004

In a randomized, double-blind cross-over study 10 subjects were exposed to a simulated altitude of 4500 m for 10 h after administration of placebo, acetozolamide (250 mg bid) or theophylline (250 mg bid). T2-weighted magnetic resonances images (MRI) and diffusion weighted MRI were obtained directly after exposure to altitude under hypoxic conditions. Although eight of 10 subjects had moderate to severe acute mountain sickness (AMS), we found no evidence of cerebral oedema, irrespective of the medication taken. Almost all subjects showed a decrease in inner cerebrospinal fluid (iCSF) volumes (placebo −10.3%, P = 0.02; acetazolamide −13.2%, P = 0.008, theophylline −12.2%, n.s.). There was no correlation between AMS symptoms and fluid shift. However, we found a significantly positive correlation of large (>10 ml) iCSF volume and more severe AMS after administration of placebo ( r = 0.76, P = 0.01). Moderate to severe AMS after high altitude exposure for 10 h is associated with a decreased iCSF-volume independent of AMS severity or medication without signs of cerebral oedema.
Does the frequency of outpatient visits in addition to the regularly scheduled prenatal visits identify a poor pregnancy outcome?
Authors: M. Jagoe Jennifer , F. Magann Everett , P. Chauhan Suneet , Morrison John C.
Published: March 2004

Do extra outpatient visits, in addition to regularly scheduled visits, identify a pregnancy at risk of an adverse outcome? This prospective investigation analysed additional outpatient visits, by low‐risk obstetric patients. One hundred and sixty‐two women were evaluated with one to two additional visits and 66 had three or more visits. Antepartum and intrapartum pregnancy complications between groups was similar suggesting that frequency of additional visits does not identify a pregnancy at risk for an adverse outcome.
A woman's choice
Authors: Sparrow Margaret June
Published: March 2004

Abortion is now the most common gynaecological operation in New Zealand and Australia. Early legal abortion is a safe procedure whether carried out surgically or medically. In contrast, the traditional use of abortifacients has been mostly unscientific, illegal and shrouded in secrecy. Mifepristone as an option for induced abortion has only recently become available in New Zealand and is not yet available in Australia. The reasons for the delay in introducing a significant new abortion technique are political, professional, legal, socioeconomic and commercial. Istar, a not‐for‐profit company, was formed in New Zealand in 1999 to import mifepristone. The drug was approved for use in New Zealand on 30 August 2001. It was first used in October 2001 in Wellington for mid‐trimester abortions and in April 2002 for early medical abortions. Legal ambiguities were clarified in a High Court Judgment on 10 April 2003. The experience with mifepristone raises concerns about the introduction of new drugs for reproductive health care, given the commercial risks associated with their development. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists has a role to play in ensuring that safe abortion services are available for women. Advocates of women's rights in reproductive health care have made a significant impact in the last three decades and the conclusion that abortion must be the woman's choice is strongly supported.
Systematic review of the treatment of ovulatory infertility with clomiphene citrate and intrauterine insemination
Authors: Costello Michael F.
Published: March 2004

Background:   Controlled ovarian hyperstimulation (COH) with clomiphene citrate (CC) combined with intrauterine insemination (IUI) is often used as treatment for ovulatory infertility which includes unexplained, male, cervical, endometriosis, and tubal infertility.

Aims:   To review the effectiveness of CC and IUI in ovulatory infertility.

Methods:   Systematic review of pertinent randomised controlled trials (RCT) using the bibliographic databases MEDLINE and EMBASE. References of selected articles identified were hand‐searched for additional relevant citations.

Results:   Six published RCT were included in the overall review. Meta‐analysis demonstrated a higher cycle pregnancy rate (CPR) with CC and IUI compared to timed intercourse in the natural cycle (P < 0.001 and odds ratio = 4.6, 95% CI = 1.9–11.3). Treatment with gonadotrophins and IUI results in a higher CPR compared to CC and IUI (P = 0.005 and odds ratio = 2.9, 95% CI = 1.3–6.2). Further RCT are required comparing CC and IUI with IUI or CC alone before one can make firm conclusions.

Conclusions:   Clomiphene citrate combined with IUI is more effective than timed intercourse in the natural cycle at achieving pregnancy in couples with ovulatory infertility. However, treatment with gonadotrophins and IUI is superior to CC and IUI.
Dilemmas encountered with preimplantation diagnosis of aneuploidy in human embryos
Authors: Allan John , Edirisinghe Rohini , Anderson Jasen , Jemmott Rodney , Nandini A.V. , Gattas Michael
Published: March 2004

Background:   An increased embryo aneuploidy rate is associated with advancing maternal age. Preimplantation genetic diagnosis (PGD) using fluorescence in situ hybridisation (FISH) coupled with in vitro fertilisation (IVF)/embryo biopsy provides a powerful tool to improve the take home baby rates for this poor prognostic group.

Aim:   To report the preliminary findings of a PGD study for aneuploidy screening and to discuss the dilemmas encountered.

Methods:   Preimplantation genetic diagnosis was offered in egg pick up‐PGD and frozen embryo transfer‐PGD cycles. Embryo biopsy was carried out on day 3 and FISH was used to detect chromosomal abnormalities.

Results:   The outcome of 75 patients, 100 treatment cycles; 62 egg pick up‐PGD and 38 frozen embryo transfer‐PGD are presented. The embryo biopsy rate, blastomere survival, presence of nuclei and successful FISH rates for egg pick‐up and frozen embryo transfer cycles were similar giving a chromosomal abnormality rate of 57.5 and 51.2% for the respective treatment group. The positive pregnancy, clinical pregnancy and implantation rates were, for egg pick up‐PGD 22.7, 13.6 and 21.1% and for frozen embryo transfer‐PGD 13.8, 10.3 and 10.0%, respectively.

Conclusions:   Preimplantation genetic diagnosis coupled with IVF treatment seems to give satisfactory pregnancy rates. The high embryo aneuploidy rates, chromosomal mosaicism and other issues have presented significant ethical and management dilemmas for our physicians and patients alike. These issues highlight the importance of skillful pretreatment counselling for patients considering PGD.
The freshly killed pig: A model for surgical training in gynaecological oncology
Authors: Taylor John D. , Hammond Ian G.
Published: March 2004

Background:  Surgical training in gynaecological oncology is complex and alternatives to the ‘apprenticeship’ model are being explored. Animate and inanimate simulation may be useful, allowing trainees to gain experience without the risk of harm to patients. Live animal models and ex vivo isolated material is commonly used. We present the use of a freshly killed pig (FKP) for training in the urological and gastrointestinal surgery pertinent to gynaecological oncology.

Methods:  An Anatomy of Complications Workshop was held for 12 specialists and subspecialty Trainees in gynaecological oncology. Seven freshly killed pigs were used for surgical training in a range of urological and intestinal operations including repair of a transected ureter, ureteric reimplantation, Boari flap, ileal conduit, bowel resection and anastomosis and stoma formation. A pre‐workshop instructional video was sent to all participants. A live demonstration of each procedure preceded the participant's own closely supervised performance.

Evaluation:  All participants completed the procedures in the allocated time. The tissues felt ‘live’ throughout the 4 h session and were kept moist with a fine water spray. The use of sutures, ligatures and stapling instruments felt realistic. Formal participant feedback evaluation was enthusiastic about the FKP model.

Conclusion:  We have demonstrated that the FKP can be successfully used for training in urological and gastrointestinal procedures. The range of operations described in the present paper could be expanded for other surgical disciplines. This simulation is recommended to Trainees as a valuable addition to their training and development.
Functional characteristics of photochemically treated platelets
Authors: Jansen Gerard A.J. , Van Vliet Huub H.D.M. , Vermeij Hans , Beckers Erik A.M. , Leebeek Frank W.G. , Sonneveld Pieter , Van Rhenen Dick J.
Published: March 2004

BACKGROUND: A photochemical treatment (PCT) process using the psoralen compound amotosalen HCL (S59) and long wavelength UVA light was developed for inactivation of infectious pathogens and WBCs. In this study the effect of PCT on functional characteristics of the platelets was evaluated in vitro.

STUDY DESIGN AND METHODS: Platelet concentrates were treated photochemically using the experimental clinical processing system T‐bag S59 Reduction Device (SRD) (n = 4) or the commercially available integral processing system Wafer SRD (n = 4) and compared with control platelet concentrates in plasma/PAS III alone (n = 4). The evaluation included variables with respect to the overall quality of the product (e.g., HSR, pH), the function (aggregation and activation tests), apoptosis (annexin V and caspase 3), and lysis.

RESULTS: No differences were found in the product quality variables, in P‐selectin expression, and the apoptosis variables. PCT using the T‐bag SRD led to a significant decrease in aggregation capacity with collagen and thrombin and a significant increase in plasma LDH, whereas no differences for the Wafer SRD were found.

CONCLUSION: PCT using the experimental T‐bag SRD led to a significant decrease in platelet function. However, the commercially available Wafer SRD had only minor in vitro effects on the quality of the platelets.
Functional characteristics of buffy‐coat PLTs photochemically treated with amotosalen‐HCl for pathogen inactivation
Authors: Picker Susanne M. , Speer Relindis , Gathof Birgit S.
Published: March 2004

BACKGROUND: One blood system for PLTs (INTERCEPT, Baxter Transfusion Therapies) is based on photochemical treatment (PCT) with small molecules that target cross‐link nucleic acids (Helinx technology, Cerus Corp.) with amotosalen‐HCl (S‐59) and UVA light (320‐400 nm) to inactivate pathogens and WBCs.

STUDY DESIGN AND METHODS: A two‐arm in vitro study was conducted to compare pooled buffy‐coat‐derived PLT concentrates (PCs) treated with the INTERCEPT blood system, resuspended in PLT additive solution (PAS) III (InterSol, Baxter Transfusion Therapies), and stored for up to 7 days (test units, n = 20) with unpaired, nontreated PCs, resuspended in PAS II (T‐Sol, Baxter Transfusion Therapies), and prepared at the same center in the same manner (control units, n = 18).

RESULTS: PLT dose (× 1011/unit ± SD) on Day 1 immediately following PCT was 3.0 ± 0.4 for test units and 3.2 ± 0.4 for control units. After 7 days of storage, the pH of all test units was maintained above 6.8. No marked trend was observed in the hypotonic shock response (HSR). Values among study groups were similar at the end of observation period: 68 ± 11 percent for control unites versus 67 ± 8 percent for test units (p > 0.05). Aggregation response to ristocetin was slightly lower in test units: at Day 7, 65 ± 10 percent versus 76 ± 6 percent (p < 0.05). Significantly higher (p < 0.001) glucose consumption, lactate production, and CD62P expression were observed in test units.

CONCLUSION: Compared to nontreated PLTs, the PCT process was associated with a variety of differences of in vitro analyses. Although significant, these changes were relatively small in most cases. Characteristics correlated with survival in vivo such as HSR and swirling were comparable between both study groups, indicating that the viability of the majority of cells appears to have persisted throughout 7 days of storage. The impact of this finding, however, remains to be investigated in clinical trials performed with 7‐day stored PLTs.
Evaluation of a new generation of plastic culture bottles with an automated microbial detection system for nine common contaminating organisms found in PLT components
Authors: Brecher M.E. , Hay S.N. , Rothenberg S.J.
Published: March 2004

BACKGROUND: A microbial detection system (BacT/ALERT 3D, bioMérieux [formerly Organon Teknika]) has previously been validated with a variety of bacterial contaminants in PLTs. The recovery of nine organisms seeded into PLTs with new plastic culture bottles was studied in comparison to the current glass bottles. The use of plastic instead of glass would be expected to reduce the risk of injury.

STUDY DESIGN AND METHODS: Isolates of Bacillus cereus, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Staphylococcus epidermidis, Serratia marcescens, Streptococcus viridans, and Propionibacterium acnes were inoculated into Day 2 (>24 hr <48 hr) apheresis PLT units to 10 and 100 CFUs per mL. Replicate samples (4 mL) were inoculated into both current‐ and new‐generation standard aerobic and anaerobic bottles.

RESULTS: All organisms (with the exception of P. acnes) were detected in a mean time of 9.3 to 18.9 hours (10 CFUs/mL) or 8.7 to 18.2 hours (100 CFUs/mL). In aggregate (with the exception of P. acnes), the plastic and glass aerobic bottles had a mean difference in detection of 1.2 hours (p < 0.0001), and the plastic and glass anaerobic bottles had a mean difference of 3.3 hours (p < 0.0001). In all cases, the mean detection time was superior or clinically comparable (within 0.1 hr) with the new plastic bottles. P. acnes (an anaerobic organism) was detected with the new and current anaerobic bottles in a mean of 72.8 and 90.4 hours (10 CFUs/mL) or 64.0 and 80.8 hours (100 CFUs/mL), respectively. The narrower bottle neck and smaller inoculation septum present with the new‐generation plastic bottles were inoculated with comparable ease to that of the glass bottles.

CONCLUSIONS: These data demonstrate that the new plastic bottles are clinically comparable or superior to the current glass standard aerobic and anaerobic culture bottles.
Survival after transfusion as assessed in a large multistate US cohort
Authors: Kleinman Steven , Marshall Deborah , AuBuchon James , Patton Mary
Published: March 2004

BACKGROUND: The only survival and mortality data on a general population of transfused patients in the United States is more than two decades old. More contemporary data are needed to reflect more current patient populations and transfusion practices.

STUDY DESIGN AND METHODS: Data were extracted from Constella Health Strategies Sciences’ managed‐care administrative claims database that contains private health care claims. Patients were selected if they had at least one professional or facility claim indicating transfusion in 1995. Only the first transfusion in the time period was included so that each patient was counted only once and all claims were unduplicated. Survival for five years after transfusion was the primary outcome measure.

RESULTS: A total of 6779 patients were included in the analysis. A total of 4658 (69%) patients were alive 1 year after transfusion, 4056 (60%) were alive at 2 years, and 3092 (46%) were alive 5 years after transfusion. Overall annual mortality was 31 percent in Year 1 after transfusion, 14 percent in Year 2, and 10 percent in each of Years 3 through 5. Transfusion mortality was much higher in recipients older than age 65 at the time of transfusion, who comprised 60 percent of transfused patients.

CONCLUSION: These data from the mid 1990s can be used in models of the effectiveness of risk reduction interventions and in models of the disease consequences of infections transmitted through blood transfusions.
Transfusion of apheresis PLTs from IgA‐deficient donors with anti‐IgA is not associated with an increase in transfusion reactions
Authors: Winters Jeffrey L. , Moore S. Breanndan , Sandness Charlie , Miller Dylan V.
Published: March 2004

BACKGROUND: Passive transfer of antibodies through transfusion has been reported to cause adverse consequences. Approximately 1 in 700 individuals of Northern European ancestry lack IgA with up to 40 percent reported as having anti‐IgA. Whether these antibodies when passively transfused were associated with reactions was examined.

STUDY DESIGN AND METHODS: Records were reviewed to identify IgA‐deficient (<0.05 mg/dL detectable IgA) apheresis PLT donors with anti‐IgA. Transfusion outcomes of products from these donors were compared to outcomes of control transfusions from donors who were not IgA‐deficient.

RESULTS: Four IgA‐deficient donors with anti‐IgA donated a total of 25 apheresis PLT products transfused to 22 recipients. Of the transfused products, 1 (4.0%) was associated with fever that was classified as unrelated to transfusion. In the control group, 60 donors donated 78 apheresis PLT products transfused to 56 recipients. Among these, an allergic reaction was identified (1.3%). The reaction rates between both groups were not different whether the single event in the anti‐IgA group was considered a reaction (chi‐squared value 0.735, p = 0.3914) or considered unrelated to transfusion (chi‐square value 0.324, p = 0.5694).

CONCLUSION: The transfusion of products containing anti‐IgA does not appear to be associated with a greater frequency of reactions.
Cerebral oxygenation and hemodynamics during blood donation studied by near‐infrared spectroscopy
Authors: Menke J. , Stöcker H. , Sibrowski W.
Published: March 2004

BACKGROUND: Blood donation is a safe human model for acute blood loss. This study investigated associated changes in regional cerebral oxygenation and cerebral blood volume (CBV) by near‐infrared spectroscopy (NIRS).

STUDY DESIGN AND METHODS: Fifty healthy blood donors donated 450 mL of whole blood within 4 to 9 minutes. Changes in regional cerebral oxygen saturation (rSO2) and cerebral tissue Hb concentration (HbT) were semiquantitatively measured by NIRS. Venous Hb concentration was measured before and after blood donation. The predonation and postdonation CBV was estimated from HbT and venous Hb concentration. Differences between pre‐ and postdonation study parameters were analyzed by paired t tests (p < 0.05).

RESULTS: Within the study group, rSO2 decreased by 0.44 sat percent (p < 0.01) on average during blood donation, which is still within the range of individual physiologic baseline variation. The average venous Hb concentration decreased significantly by 4.6 percent, whereas HbT increased significantly by 2.5 percent and CBV increased even by 7.5 percent on average.

CONCLUSION: The increase in CBV indicates cerebral vasodilation, which seems to be the major compensation mechanism during acute blood loss. The decrease in rSO2 was relatively small, indicating that cerebral oxygenation was maintained within the physiologic range.
Deletion of arginine codon 229 in the Rhce gene alters e and f but not c antigen expression
Authors: Chen Y.X. , Peng J. , Novaretti M. , Reid M.E. , Huang C.‐H.
Published: March 2004

BACKGROUND: Rh CcEe antigens occur as ce, Ce, cE, or CE alleles in the RBC membrane. Their epitope structures and the location of their cis interacting products remain to be defined.

MATERIALS AND METHODS: A rare blood sample from a white male whose parents are first cousins was identified. Hemagglutination was performed using standard methods. RH structure and genotype was assessed by Southern blots. Rh transcripts were obtained by gene‐specific RT‐PCR and sequenced. The mutation was verified by genomic PCR assays.

RESULTS: The donor's RBCs typed D+C–c+E–e–f(Rh6)– with a normal c dose, suggesting the Dc– phenotype. Further tests revealed a weak and qualitatively altered e expression. Southern blots indicated a genotype of Dce/dce without other gross changes. RT‐PCR detected a triplet deletion (Δ685AGA687) in the Rhce gene that specifies codon 229 for arginine (Arg229). Sequencing of the region around the mutated exon 5 confirmed the donor to be homozygous for the AGA deletion.

DISCUSSION: Arg229 is invariant on external loop 4 and close to the Ala226Pro change specific for e/E polymorphism. The qualitative and quantitative alteration of e antigen defines Arg229 as a crucial component for e/E epitope presentation. Given a normal dose of c antigen, the disruption of f (Rh6) by Arg229 deletion suggests that external loop 4 is a major structural element contributing to the expression of RHCE cis interacting antigenic products.
The molecular basis of the Rhesus antigen Ew
Authors: Strobel Erwin , Noizat‐Pirenne France , Hofmann Sabine , Cartron Jean Pierre , Bauer Matthias F.
Published: March 2004

BACKGROUND: The Rhesus antigen Ew (ISBT designation 004 011) was first described in 1955. It is defined by a specific antibody, but its molecular genetic basis has not yet been resolved.

STUDY DESIGN AND METHODS: Two individuals serologically characterized to express the rare Rhesus antigen Ew were analyzed by sequencing of all 10 exons of the RHCE gene.

RESULTS: A nucleotide exchange at position 500 (T500A) resulting in a Met167Lys amino acid substitution was found in both individuals. Moreover, we show that an individual carrying the Ew antigen is capable to produce an alloantibody against the wild‐type E antigen.

CONCLUSION: The single‐point mutation T500A in exon 4 of the RHCE gene is a molecular basis of the rare Rhesus antigen Ew.
The Crossroads of Culture and Health Among the Roma (Gypsies)
Authors: Vivian Carrie , Dundes Lauren
Published: March 2004

Purpose:

To alert health care providers to commonly encountered cross‐cultural impediments to optimal health care delivery for the Roma (also known as Gypsies) and to offer suggestions for avoiding culturally based problems in treating this subculture.

Organizing framework:

Understanding of sociocultural bases of health‐related behaviors is necessary for culturally competent and effective health care.

Methods:

Review of literature and personal interviews.

Findings:

Cultural factors that can affect health care delivery include: concepts of pollution, cleanliness, ideal weight, death, and views of medical procedures such as immunizations and surgery. Responsiveness of health care providers to expectations of Roma about their involvement of family and the hierarchy of age and sex also can enhance patient‐provider relationships that in turn can improve compliance and satisfaction with health care regimens.

Conclusion:

The Roma have some culturally distinct beliefs and behaviors related to their health and health care. Knowledge of these characteristics and accommodations to cultural differences are important in their health care.
Determinants of Placental Vascularity
Authors: Torry Donald S. , Hinrichs Monica , Torry Ronald J.
Published: March 2004

Problem:  Vascular growth during implantation and placentation is critical for successful gestation and it is thought that vascular insufficiencies during placentation contribute to a number of obstetrical complications. However, relatively little is known regarding the regulation of angiogenesis in the placenta.

Method of study:  We review literature concerning the potential significance of inadequate placental vascularity as a contributor to the obstetrical complications of spontaneous abortion, fetal growth restriction and preeclampsia. Gene expression assays were used to compare fluctuations of placenta growth factor (PlGF) and PlGF receptor expression in normal and preeclamptic trophoblast in vitro.

Results:  Studies have shown that common obstetrical complications manifest altered placental vascularity. Both intrinsic defects (gene knockouts) and extrinsic factors (O2 tension, cytokines, etc) may be responsible for the defects. Some of these factors have been shown to influence trophoblast vascular endothelial growth factor (VEGF)/PlGF expression suggesting this particular family of angiogenic proteins play an important role in placental angiogenesis.

Conclusion:  Placental vascularization reflects a complex interaction of regulatory factors. Understanding the regulation of vascular growth in the placenta will provide much needed insight into placenta‐related vascular insufficiencies.
Reproductive Functions of Corticotropin‐Releasing Hormone. Research and Potential Clinical Utility of Antalarmins (CRH Receptor Type 1 Antagonists)
Authors: Kalantaridou Sophia N , Makrigiannakis Antonis , Zoumakis Emmanouil , Chrousos George P
Published: March 2004

Background:  The hypothalamic‐pituitary‐adrenal (HPA) axis exerts a complex, mostly inhibitory, effect on the female reproductive system. In addition, the principal regulator of this axis, the hypothalamic neuropeptide corticotropin‐releasing hormone (CRH) and its receptors have been identified in most female reproductive tissues, including the ovary, uterus, and placenta. Furthermore, CRH is secreted in peripheral inflammatory sites where it exerts strong inflammatory actions. Antalarmins (CRH receptor type 1 antagonists) have been used to elucidate the roles of CRH in stress, inflammation and reproduction.

Method of study:  We review existing data on the effects of CRH in the female reproductive system.

Results:  Ovarian CRH participates in female sex steroid production, follicular maturation, ovulation and luteolysis. Uterine CRH participates in decidualization, implantation, and early maternal tolerance. Placental CRH participates in the physiology of pregnancy and the onset of parturition. Circulating placental CRH is secreted mostly during the latter half of pregnancy and is responsible for the concurrently increasing physiologic hypercortisolism of this period. After labor and delivery, this hypercortisolism is ensued by a transient suppression of hypothalamic CRH secretion, which may explain the postpartum blues and depression and the increased autoimmune manifestations depression of period, the postpartum period.

Conclusions:  These data show that CRH is present in female reproductive tissues, and is regulating key reproductive functions with an inflammatory component, such as ovulation, luteolysis, implantation, and parturition.
Macrophages and Apoptotic Cell Clearance During Pregnancy
Authors: Abrahams Vikki M. , Kim Yeon Mee , Straszewski Shawn L. , Romero Roberto , Mor Gil
Published: March 2004

Background:  During implantation, apoptosis is critical for the appropriate tissue remodeling of the maternal decidua and invasion of the developing embryo, yet the regulation of apoptosis is also imperative for a successful pregnancy. The quick and effective removal of apoptotic cells by tissue macrophages represents an essential process, which prevents the release of self‐antigens, and in the case of pregnancy, paternal alloantigens.

Methods of study:  Recent studies have shown that the process of apoptotic cell clearance is not a neutral event, but rather an active one that induces macrophage production of anti‐inflammatory cytokines and survival factors. Apoptotic cell clearance is, therefore, necessary for the resolution of inflammatory conditions, which during pregnancy could have lethal consequences.

Conclusions:  The function of the maternal immune system during implantation and throughout pregnancy is, therefore, an important area of investigation. This review will discuss the role of decidual macrophages in apoptotic cell clearance during pregnancy.
Immune Interactions at the Maternal–Fetal Interface: a Focus on Antigen Presentation
Authors: Huddleston Heather , Schust Danny J.
Published: March 2004

Problem:  Viruses and fetuses face similar immunologic challenges. Each must evade immune detection and destruction. The virus must avoid host recognition of intracellular infection; the fetus allogenic recognition. Each has manipulated the process of antigen presentation to allow survival in an immunologic environment otherwise predictably hostile. How have these approaches co‐evolved? What can they teach us about viral pathogenesis and immunologic interactions at the maternal‐fetal interface?

Method of study:  Review of relevant literature.

Results:  Special classical and non‐classical MHC class I products are spared from downregulation in the placenta and from viral immunoevasive strategies.

Conclusions:  Viruses rely upon some of the same strategies to avoid immune detection as do trophoblast cells. In the future, viral infections may prove a useful tool for studies of immunology at the maternal‐fetal interface.
Use of Mammalian Eggs for Assessment of Human Sperm Function: Molecular and Cellular Analyses of Fertilization by Intracytoplasmic Sperm Injection
Authors: Terada Yukihiro , Nakamura Sou‐ichi , Morita Junko , Tachibana Masahito , Morito Yuki , Ito Kiyoshi , Murakami Takashi , Yaegashi Nobuo , Okamura Kunihiro
Published: March 2004

Problems:  Intracytoplasmic sperm injection (ICSI ) has been described as the ‘cure’ for male sterility because a single sperm can now be directly introduced into an egg with some chance of pregnancy. While ICSI has revolutionized the practice of assisted reproductive techniques (ART), there are few molecular and cellular studies about its safety and efficacy. Even by using ICSI, fertilization in humans succeeds only if the sperm effectively accomplishes a number of tasks including ‘post‐ICSI events’ in fertilization. To assess the function of human sperm after ICSI, we used heterologous ICSI with human sperm into animal eggs. Egg activation, sperm decondensation and sperm centorosomal function were examined in sperm from fertile men and infertile patients.

Methods:  Sperm from fertile men and infertile patients were injected into hamster, rabbit and bovine eggs by Piezo micromanipulator, and studied in decondensation of sperm nuclei, egg activation and microtubule organization.

Results:  Decondensation human sperm head following ICSI into hamster eggs occurred initially form basal lesion, and apical portion of sperm nuclei which is surrounded by acrosome and perinuclear theca, still condensed in early pronuclear stage. Radial array of microtubules from sperm centrosome ‘sperm aster’ which is essential for pronuclear movement was observed in 30% rabbit eggs following ICSI with human sperm. By heterologous ICSI system with fertile human sperm and bovine eggs, 83.3% of eggs was activated and 60% eggs had sperm aster, indicating that bovine Piezo ICSI system is appropriate for assessing human sperm oocyte activation ability and human sperm centrosomal function. Oocyte activation and sperm centrosomal function were significantly low in sperm from men with globozoospermia and men with dysplasia of fibrous sheath.

Conclusion:  These assays indicate differences of the process of fertilization between in vitro fertilization and ICSI, and reflect the human sperm function especially for the ‘post‐ICSI events’ in fertilization. More molecular and cellular analyses in fertilization by ICSI are needed for improvement of ART.
Mastitis and Fertility in Cattle – Possible Involvement of Inflammation or Immune Activation in Embryonic Mortality*
Authors: Hansen Peter J. , Soto Paolete , Natzke Roger P.
Published: March 2004

Causes for pre‐implantation embryo loss, which can be as high as 50% or more of fertilized embryos, are multifactorial and largely undescribed. Studies in cattle using mastitis as a model indicate that one cause of early embryonic loss is infectious disease or activation of immune responses at sites outside the reproductive tract. Infection of the mammary gland in dairy cattle is associated with a reduction in pregnancy rate (proportion of inseminated cows that become pregnant) and an increase in the number of inseminations required to establish pregnancy. Also, intravenous challenge with bacterial peptidoglycan and polysaccharide at ∼days 3–5 after breeding reduced subsequent pregnancy rate in sheep that had been previously immunized against the same material. The mechanism by which extrauterine activation of immune and inflammatory responses leads to embryonic loss is not clear although cytokines probably play a crucial role. Effects could be exerted at the level of the hypothalamic–pituitary axis, ovary, reproductive tract or embryo. Interferon (IFN)‐α, for example, which can reduce pregnancy rate in cattle when injected around 13–19 days after breeding, increases body temperature, inhibits secretion of luteinizing hormone, and reduces circulating concentrations of progesterone. Other cytokines or products of cytokine activation could cause embryonic loss by causing hyperthermia (as elevated temperature blocks oocyte function and embryonic development), exerting toxic effects on the corpus luteum [for example, IFN‐γ, tumor necrosis factor‐α (TNF‐α) and prostaglandin F2α], stimulating endometrial prostaglandin synthesis [TNF‐α and interleukin(IL)‐1β], reducing endometrial cell proliferation (IL‐1β), and interfering with oocyte maturation and embryonic development (TNF‐α, nitric oxide, and prostaglandin F2α). Although largely neglected by reproductive immunologists, study of the involvement of the immune system in pre‐implantation embryonic loss is likely to lead to new methods for enhancing fertility.