bluuebunny/crossref_metadata_2025 huggingface dataset:
The management of patent ductus arteriosus in Australia and New Zealand
Authors: Hoellering Adam B , Cooke Lucy
Published: March 2009

Aim:  This study aimed to establish current management practice for patent ductus arteriosus (PDA) among individual consultant neonatologists in Australia and New Zealand, to examine the influences that drives practice and highlight the importance of future randomised controlled trials in the region.

Methods:  Eligible subjects were identified from the Directory of Neonatal Intensive Care Units in Australia and New Zealand, 2007. A questionnaire was sent online to each consultant and was followed up with a letter and telephone call. Seven questions addressed management approach, the drug used and the treatment regimen, threshold for referral for surgical ligation and the literature influencing practice. Data were collected from 22 August 2007 to 22 November 2007.

Results:  The overall response rate was 95%. For infants ≤28 weeks or ≤1000 g, all consultants treat PDA by one of four distinct management approaches. Expectant management was favoured by 35%, echocardiographic targeted prophylaxis 32%, presymptomatic treatment 16% and prophylaxis by 17%. There were marked regional variations in practice. Within individual units, more than one approach is used in 14 out of 24 units. Long courses of indomethacin are used to treat PDA by 86%. For 22% of consultants, management is not influenced by published literature.

Conclusions:  Differences of opinion in the literature are reflected by the heterogeneity in clinical practice across regions and within units. Crucial questions undergoing evaluation are whether data extrapolated from a previous area are relevant to PDA in modern neonatology and whether targeting treatment early can translate to improved clinical outcome.
An autopsy case of diffuse neurofibrillary tangles with calcification: Early stage pathologic findings
Authors: Iwasaki Yasushi , Ito Masumi , Mori Keiko , Deguchi Akira , Nagaoka Masamitsu , Yoshida Mari , Hashizume Yoshio
Published: March 2009

A 66‐year‐old man with no medically remarkable past or family history gradually showed personality changes, memory disturbance, sleeplessness and abnormal behavior. Neurologic examination showed no focal signs and neither parkinsonism nor cerebellar ataxia was recognized. He died 4 years after the onset of dementia due to chronic renal failure. Neuropathologic examination revealed neuronal loss and gliosis in the temporal cortex, particularly in the subiculum, parahippocampal gyrus and entorhinal cortex, and insular cortex. NFTs were observed to be widespread in the cerebral cortex, especially the temporal cortex and brainstem, while senile plaques were not observed. Gallyas‐Braak silver staining revealed the presence of numerous NFTs, glial inclusions and neuropil threads throughout the cerebral neocortex, limbic system, hippocampus and brainstem. The subiculum showed the most severe involvement; severe atrophy, severe neuron loss, and numerous ghost tangles (extracellular NFTs) were apparent. Although NFTs contained both monoclonal anti‐3repeat‐tau antibody (RD3) and RD4 immunoreactivity, this differed between the intracellular NFTs and ghost tangles. RD3 immunoreactivity was mainly observed in ghost tangles and neuropil threads, whereas RD4 immunoreactivity was mainly observed in intracellular NFTs and glial inclusions. Calcification was also found to be widespread in the cerebral cortex and white matter, basal ganglia, thalamus, cerebellar cortex, white matter and dentate nucleus. These characteristic neuropathologic findings lead to the pathologic diagnosis of diffuse neurofibrillary tangles with calcification (DNTC). It is argued that this patient showed early stage pathologic signs of DNTC due to a short disease duration, which may provide clues regarding the progression of this rare disease.
Erythropoietin attenuates white matter damage, proinflammatory cytokine and chemokine induction in developing rat brain after intra‐uterine infection
Authors: Shen Ying , Yu Hui‐Min , Yuan Tian‐Ming , Gu Wei‐Zhong , Wu Yi‐Dong
Published: March 2009

To investigate the possible ameliorating effect of recombinant human erythropoietin (rhEPO) on white matter damage, pro‐inflammatory cytokine and chemokine induction in developing rat brain after intra‐uterine Escherichia coli infection. E. coli was inoculated into uterine cervix of the time‐pregnant rats and the control was injected with normal saline. Following maternal E. coli inoculation, the pups received a single intraperitoneal injection of rhEPO at a dose of 5000 IU/kg body weight immediately after birth. Immunohistochemical staining and Western blot analysis for 2′, 3′‐cyclic nucleotide 3′‐phosphodiesterase (CNPase), neurofilament (NF) and glial fibrillary acidic protein (GFAP) were performed to assess white matter damage in pup brains at post‐natal day 1 (P1), P3 and P7. Pro‐inflammatory cytokines and chemokines were detected by real‐time quantitative RT‐PCR at the mRNA levels to evaluate the inflammatory response in pup brains at P1, P3 and P7. A single dose of rhEPO treatment (5000 IU/kg body weight) attenuated white matter damage in developing rat brain after intra‐uterine E. coli infection. The protein levels of CNPase and NF in pup brains at P7 significantly increased after post‐natal rhEPO treatment as compared with the intra‐uterine E. coli‐treated group. Also, post‐natal rhEPO injection markedly attenuated the intra‐uterine E. coli infection‐induced increases in GFAP protein expression and the mRNA levels of pro‐inflammatory cytokines and chemokines. Post‐natal EPO administration as a single dose may exert a neuroprotective effect on white matter damage by reducing pro‐inflammatory cytokine and chemokine induction in developing rat brain after intra‐uterine E. coli infection.
Review article: Pathogenic role of complement activation in anti‐neutrophil cytoplasmic auto‐antibody‐associated vasculitis
Authors: VAN TIMMEREN MIRJAN M , CHEN MIN , HEERINGA PETER
Published: March 2009

Small‐vessel vasculitides associated with anti‐neutrophil cytoplasmic auto‐antibodies (ANCA) are severe systemic diseases that may affect any organ. Increasing evidence from clinical, animal and in vitro studies indicates that ANCA are causally involved in disease pathogenesis mainly through activation of neutrophils resulting in endothelial cell injury. Recent studies suggest a previously unsuspected but crucial role for alternative pathway complement activation in ANCA disease pathogenesis. In this brief review, we will discuss the evidence for complement system activation in ANCA‐associated vasculitides and propose a working model that links ANCA, neutrophils and complement activation in causing an inflammatory amplification loop that may explain the severe leukocytoclastic inflammation that is typical for ANCA‐associated vasculitis.
Learning from experience: Using action research to discover consumer needs in post‐seclusion debriefing
Authors: Ryan Rob , Happell Brenda
Published: March 2009

Approximately 16% of consumers are secluded during an inpatient admission. Despite the harmful psychological consequences resulting from the use of physical force, restraint, control, and temporary sequestration of therapeutic communication, there is little evidence of nursing practices to support consumers who are secluded. This paper will outline the findings from an action research project examining post‐seclusion debriefing practice. A series of focus groups was undertaken with mental health nurses (MHN) and consumer consultants (CC) to investigate current practice, identify consumer/clinician preferences, and scope future practice possibilities. The findings suggest that CC need assistance in dealing with the negative feelings evoked by seclusion. MHN use a range of approaches for debriefing; however, these sometimes do not meet consumer preferences. MHN focus on explaining why seclusion happened and how to avoid it. While mitigation is a critical issue, CC want more emotional support from debriefing. MHN saw the possibility of using the debriefing to support consumers' transit from seclusion to high‐dependency status and then to low‐dependency status. Opinions raised regarding the potential for CC to have a role in debriefing were divided. The findings will be used to inform the development of a consumer debriefing training program for MHN and CC.
Interhemispheric balance of overt attention: a theta burst stimulation study
Authors: Cazzoli Dario , Wurtz Pascal , Müri René M. , Hess Christian W. , Nyffeler Thomas
Published: March 2009

Interhemispheric imbalance is discussed as a pathophysiological mechanism in visuospatial neglect. It is suggested that after a lesion of the right hemisphere the mutual transcallosal inhibition is impaired, resulting in an increased activity of the left hemisphere. We investigated the interhemispheric balance of attention in healthy subjects by using a free visual exploration task and by interfering with the neural activity of the posterior parietal cortex (PPC) of either hemisphere using an inhibitory transcranial magnetic stimulation routine with theta burst stimulation (TBS). Subjects explored colour photographs of real‐life scenes presented on a computer screen under four conditions: (i) without TBS; (ii) after TBS over the right PPC; (iii) after TBS over the left PPC; and (iv) after TBS over the right PPC and, after the first half of the task, over the left PPC. Eye movements were measured, and distribution of mean cumulative fixation duration over screen halves was analyzed. TBS over the right PPC resulted in a significant rightward shift of mean cumulative fixation duration of ∼30 min. The shift could be reversed when a subsequent train of TBS was applied over the left PPC. However, left PPC stimulation alone had no significant effect on visual exploration behaviour. The present study shows that the effect of TBS on the PPC depends on which hemisphere is stimulated and on the state of the contralateral homologue area. These findings are in accordance with the predictions of the interhemispheric rivalry model in neglect.
The neuroanatomy of grapheme–color synesthesia
Authors: Jäncke Lutz , Beeli Gian , Eulig Cornelia , Hänggi Jürgen
Published: March 2009

Grapheme–color synesthetes perceive particular colors when seeing a letter, word or number (grapheme). Functional neuroimaging studies have provided some evidence in favor of a neural basis for this type of synesthesia. Most of these studies have reported extra activations in the fusiform gyrus, which is known to be involved in color, letter and word processing. The present study examined different neuroanatomical features (i.e. cortical thickness, cortical volume and cortical surface area) in a sample of 48 subjects (24 grapheme–color synesthetes and 24 control subjects), and revealed increased cortical thickness, volume and surface area in the right and left fusiform gyrus and in adjacent regions, such as the lingual gyrus and the calcarine cortex, in grapheme–color synesthetes. In addition, we set out to analyze structural connectivity based on fractional anisotropy (FA) measurements in a subsample of 28 subjects (14 synesthetes and 14 control subjects). In contrast to the findings of a recent neuroanatomical study using modern diffusion tensor imaging measurement techniques, we did not detect any statistically significant difference in FA between synesthetes and non‐synesthetes in the fusiform gyri. Our study thus supports the hypothesis of local anatomical differences in cortical characteristics in the vicinity of the V4 complex. The observed altered brain anatomy in grapheme–color synesthetes might be the anatomical basis for this particular form of synesthesia but it is also possible that the detected effects are a consequence (rather than the primary cause) of the life‐long experience of grapheme–color synesthesia.
Partial compensation for N‐type Ca2+ channel loss by P/Q‐type Ca2+ channels underlines the differential release properties supported by these channels at cerebrocortical nerve terminals
Authors: Ladera Carolina , Martín Ricardo , Bartolomé‐Martín David , Torres Magdalena , Sánchez‐Prieto José
Published: March 2009

N‐type and P/Q‐type Ca2+ channels support glutamate release at central synapses. To determine whether the glutamate release mediated by these channels exhibits distinct properties, we have isolated each release component in cerebrocortical nerve terminals from wild‐type mice by specifically blocking N‐type Ca2+ channels with ω‐conotoxin‐GVIA and P/Q‐type Ca2+ channels with ω‐agatoxin‐IVA. In addition, we have determined the release properties at terminals from mice lacking the α1B subunit of N‐type channels (Cav 2.2) to test the possibility that P/Q‐type channels can compensate for the loss of N‐type Ca2+ channels. We recently demonstrated that, while evoked glutamate release depends on P/Q‐ and N‐type channels in wild‐type nerve terminals, only P/Q‐type channels participate in these knockout mice. Moreover, in nerve terminals expressing solely P/Q‐type channels, metabotropic glutamate receptor 7 (mGluR7) fails to inhibit the evoked Ca2+ influx and glutamate release. Here, we show that the failure of mGluR7 to modulate evoked glutamate release is not due to a lack of receptors, as nerve terminals from mice lacking N‐type Ca2+ channels express mGluR7. Indeed, we show that other receptor responses, such as the inhibition of forskolin‐induced release, are preserved in these knockout mice. N‐type channels are more loosely coupled to release than P/Q‐type channels in nerve terminals from wild‐type mice, as reflected by the tighter coupling of release in knockout nerve terminals. We conclude that the glutamate release supported by N‐ and P/Q‐type channels exhibits distinct properties, and that P/Q‐type channels cannot fully compensate for the loss of N‐type channels.
Induction and expression of GluA1 (GluR‐A)‐independent LTP in the hippocampus
Authors: Romberg Carola , Raffel Joel , Martin Lucy , Sprengel Rolf , Seeburg Peter H. , Rawlins J. Nicholas P. , Bannerman David M. , Paulsen Ole
Published: March 2009

Long‐term potentiation (LTP) at hippocampal CA3–CA1 synapses is thought to be mediated, at least in part, by an increase in the postsynaptic surface expression of α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazole proprionic acid (AMPA) receptors induced byN‐methyl‐d‐aspartate (NMDA) receptor activation. While this process was originally attributed to the regulated synaptic insertion of GluA1 (GluR‐A) subunit‐containing AMPA receptors, recent evidence suggests that regulated synaptic trafficking of GluA2 subunits might also contribute to one or several phases of potentiation. However, it has so far been difficult to separate these two mechanisms experimentally. Here we used genetically modified mice lacking the GluA1 subunit (Gria1−/−mice) to investigate GluA1‐independent mechanisms of LTP at CA3–CA1 synapses in transverse hippocampal slices. An extracellular, paired theta‐burst stimulation paradigm induced a robust GluA1‐independent form of LTP lacking the early, rapidly decaying component characteristic of LTP in wild‐type mice. This GluA1‐independent form of LTP was attenuated by inhibitors of neuronal nitric oxide synthase and protein kinase C (PKC), two enzymes known to regulate GluA2 surface expression. Furthermore, the induction of GluA1‐independent potentiation required the activation of GluN2B (NR2B) subunit‐containing NMDA receptors. Our findings support and extend the evidence that LTP at hippocampal CA3–CA1 synapses comprises a rapidly decaying, GluA1‐dependent component and a more sustained, GluA1‐independent component, induced and expressed via a separate mechanism involving GluN2B‐containing NMDA receptors, neuronal nitric oxide synthase and PKC.
Inhibition of thalamic excitability by 4,5,6,7‐tetrahydroisoxazolo[4,5‐c]pyridine‐3‐ol: a selective role for δ‐GABAAreceptors
Authors: Herd Murray B. , Foister Nicola , Chandra Dev , Peden Dianne R. , Homanics Gregg E. , Brown Verity J. , Balfour David J.K. , Lambert Jeremy J. , Belelli Delia
Published: March 2009

The sedative and hypnotic agent 4,5,6,7‐tetrahydroisoxazolo[4,5‐c]pyridine‐3‐ol (THIP) is a GABAAreceptor (GABAAR) agonist that preferentially activates δ‐subunit‐containing GABAARs (δ‐GABAARs). To clarify the role of δ‐GABAARs in mediating the sedative actions of THIP, we utilized mice lacking the α1‐ or δ‐subunit in a combined electrophysiological and behavioural analysis. Whole‐cell patch‐clamp recordings were obtained from ventrobasal thalamic nucleus (VB) neurones at a holding potential of −60 mV. Application of bicuculline to wild‐type (WT) VB neurones revealed a GABAAR‐mediated tonic current of 92 ± 19 pA, which was greatly reduced (13 ± 5 pA) for VB neurones of δ0/0mice. Deletion of the δ‐ but not the α1‐subunit dramatically reduced the THIP (1 μm)‐induced inward current in these neurones (WT, −309 ± 23 pA; δ0/0, −18 ± 3 pA; α10/0, −377 ± 45 pA). Furthermore, THIP selectively decreased the excitability of WT and α10/0but not δ0/0VB neurones. THIP did not affect the properties of miniature inhibitory post‐synaptic currents in any of the genotypes. No differences in rotarod performance and locomotor activity were observed across the three genotypes. In WT mice, performance of these behaviours was impaired by THIP in a dose‐dependent manner. The effect of THIP on rotarod performance was blunted for δ0/0but not α10/0mice. We previously reported that deletion of the α1‐subunit abolished synaptic GABAAresponses of VB neurones. Therefore, collectively, these findings suggest that extrasynaptic δ‐GABAARs vs. synaptic α1‐subunit‐containing GABAARs of thalamocortical neurones represent an important molecular target underpinning the sedative actions of THIP.
GABAAreceptors mediate the opposing roles of dopamine and the tegmental pedunculopontine nucleus in the motivational effects of ethanol
Authors: Ting‐A‐Kee Ryan , Dockstader Colleen , Heinmiller Andrew , Grieder Taryn , Van Der Kooy Derek
Published: March 2009

Recent work has demonstrated that changes in ventral tegmental area (VTA) GABAAreceptor ion conductance properties are responsible for switching morphine’s positive reinforcing properties from a dopamine‐independent to a dopamine‐dependent pathway when an animal transitions from a non‐deprived (minimal drug exposure) to a dependent (chronic drug exposure) and withdrawn state. Here we show that a double dissociation of ethanol’s positive reinforcing properties is exactly opposite to that seen with morphine. In C57BL/6 mice, ethanol‐conditioned place preferences were blocked in dopamine D2 receptor knockout non‐deprived mice, but not by a lesion of the tegmental pedunculopontine nucleus (TPP). On the other hand, TPP lesions, but not a D2 receptor mutation, blocked ethanol‐conditioned place preferences in ethanol‐dependent and withdrawn mice. The opposite effects of ethanol and opiates can be explained by their proposed actions through a common VTA GABAAreceptor switching mechanism.
The Effect of sacral nerve stimulation on uterine activity: a pilot study
Authors: Govaert B. , Melenhorst J. , Link G. , Hoogland H. , Van Gemert W. , Baeten C.
Published: March 2009

Introduction  Sacral nerve stimulation (SNS) is a treatment for consecutive therapy resistant faecal incontinence or constipation. Little is known about the effects of SNS on uterocervical function. Therefore, it is advised to turn off the stimulator during pregnancy or to wait with permanent implantation of the stimulator until family completion. Diagnostic ultrasound provides an, non‐invasive, opportunity to study various aspects of uterine activity. The purpose of this pilot study was to assess the influence of SNS on endometrial waves of the nonpregnant uterus by ultrasound recordings.

Method  Six patients with an implanted SNS were included. Ultrasound recordings were performed with the stimulator turned off and in three stimulation frequencies. Uterine activity is described as wave frequency and wave direction.

Results  All three premenopausal patients showed endometrial activity with the stimulator turned off. This activity was maintained with the stimulator turned on in two patients, but disappeared in one patient. All three postmenopausal patients had no endometrial activity with the stimulator turned off. In one patient there was activity with the stimulator turned on at a frequency of 21 Hz.

Conclusion  We have shown some effect of SNS on uterine activity. In premenopausal women we discovered that SNS seems to exhibit no effect or an inhibitory effect rather than an excitatory effect on uterine activity. Based on the preliminary results of this study, we can not recommend any guidelines for SNS usage during conception and pregnancy. A larger study in premenopausal women with SNS is needed to investigate the significance of these changes.
Systematic review on the efficacy and safety of injectable bulking agents for passive faecal incontinence
Authors: Luo C. , Samaranayake C. B. , Plank L. D. , Bissett I. P.
Published: March 2009

Objective  The aim of this study was to systematically review all published evidence to determine the efficacy and safety of injectable bulking agents for passive faecal incontinence (FI) in adults.

Method  Electronic searches were performed for MEDLINE, EMBASE, ISI Web of Knowledge and other relevant databases. Hand searching of relevant conference proceedings was undertaken. Studies were considered if they met the predefined inclusion criteria of more than ten adult patients and receiving an injectable bulking agent for passive FI with a validated means of assessing preoperative and postoperative incontinence.

Results  Thirteen case series studies and one randomized placebo‐controlled trial (RCT) were included with a total of 420 patients. Two completed RCTs with placebo control were identified but results were unobtainable. Coaptite, Contigen, Durasphere, EVOH and PTQ injections were assessed with 24, 73, 83, 21 and 208 patients respectively. Most studies reported a statistically significant improvement in incontinence scores and quality of life. No statistically significant difference was found between the treatment and placebo arms in the RCT. No serious adverse events were reported.

Conclusions  Currently there is little evidence for the effectiveness of injectable bulking agents in managing passive FI. The inability to obtain results from two further RCTs concerned the reviewers and hindered their ability to make strong recommendations. The identified injectable bulking agents appear to be safe with only minor complications reported.
Exposure to Agent Orange is a significant predictor of prostate‐specific antigen (PSA)‐based recurrence and a rapid PSA doubling time after radical prostatectomy
Authors: Shah Sagar R. , Freedland Stephen J. , Aronson William J. , Kane Christopher J. , Presti Jr Joseph C. , Amling Christopher L. , Terris Martha K.
Published: March 2009

OBJECTIVE

To investigate and report the clinicopathological characteristics and outcomes after radical prostatectomy (RP) in patients with prostate cancer and previous exposure to Agent Orange (AO), particularly in relationship to race.

PATIENTS AND METHODS

In 1495 veterans who had undergone RP the clinicopathological characteristics, biochemical progression rates, and prostate‐specific antigen (PSA) doubling time (DT) after recurrence between AO‐exposed and unexposed men were compared using logistic and linear regression and Cox proportional hazards analyses, and stratified by race.

RESULTS

The 206 (14%) men with AO exposure were more likely to be black (P = 0.001), younger (P < 0.001), treated more recently (P < 0.001), have a higher body mass index (P = 0.001), have clinical stage T1 disease (P < 0.001), and have lower preoperative PSA levels (P = 0.001). After adjusting for several clinical characteristics, AO exposure was not significantly related to adverse pathological features but was significantly associated with biochemical progression risk (relative risk 1.55, 95% confidence interval 1.15–2.09, P = 0.004) and shorter PSADT (P < 0.001) after recurrence (8.2 vs 18.6 months). When stratified by race, these associations were present and similar in both races, with no significant interaction between race and AO exposure for predicting biochemical recurrence or mean adjusted PSADT (P interaction >0.20).

CONCLUSIONS

Patients with AO exposure and treated with RP were more likely to be black, present with lower risk features, have an increased risk of biochemical progression, and shorter PSADT after recurrence. When stratified by race, the association between AO exposure and poor outcomes was present in both races. These findings suggest that among selected men who choose RP, AO exposure might be associated with more aggressive prostate cancer.
Developments in technique and technology: the effect on the results of percutaneous nephrolithotomy for staghorn calculi
Authors: Desai Mahesh , Jain Prashant , Ganpule Arvind , Sabnis Ravindra , Patel Snehal , Shrivastav Prajay
Published: March 2009

OBJECTIVE

To review the development of the technique of percutaneous nephrolithotomy (PCNL), for ease of learning and development of instrumentation for staghorn calculi at our centre since 1991, and to assess the results and outcomes.

PATIENTS AND METHODS

We retrospectively analysed the hospital records of 773 patients (632 males and 141 females, 834 renal units) who underwent PCNL for staghorn calculi at our centre from January 1991 to August 2008. We divided the patients into three groups depending on the changes in treatment policy, global trends and advances in equipment as follows: the first 200 cases (group I) from January 1991 to December 1996 (216 renal units); the next 200 (group II) from January 1997 to December 2001 (212 renal units); and the last 373 (group III) from January 2002 to August 2008 (406 renal units).

RESULTS

The mean (sd, range) operative duration in groups I, II and III, respectively, were 138.2 (52.7, 60–310), 121.4 (42.8, 70–250) and 112.5 (51.5, 55–310) min; the decrease in haemoglobin level was 3.2, 2.6 and 1.6 g/dL, respectively, and continued to decrease with improvements in technique. With increasing experience, the number of stages required for stone clearance and the number of tracts required decreased exponentially. Most of the severe complications occurred early in our experience. The stone clearance rate in groups I, II and III was 81%, 86% and 93%, respectively, after completing the procedure; the overall clearance rate with observation/auxiliary procedures was 86%, 89% and 96%, respectively. The mean hospital stay for groups I, II and III was 11.1 (3.9, 7–25), 9.5 (3.4, 5–22) and 7.1 (3.6, 4–28) days, respectively.

CONCLUSION

The percutaneous management of staghorn calculi requires considerable expertise. Our data suggest that ‘multiperc’ PCNL is difficult to learn and requires experience. Although over the years our results improved, complete clearance remains a challenge. A constant review and application of newer techniques and results will improve the overall clearance rates further.
Prospective comparison of five mediators of the systemic response after high‐intensity focused ultrasound and targeted cryoablation for localized prostate cancer
Authors: Li Liao‐Yuan , Yang Ming , Gao Xin , Zhang Hai‐Bin , Li Jie‐Fang , Xu Wen‐Feng , Lin Zhe , Zhou Xie‐Lai
Published: March 2009

OBJECTIVE

To evaluate whether high‐intensity focused ultrasound (HIFU) is less invasive than targeted cryoablation of the prostate (TCAP), as experimental studies suggest that the acute‐phase reaction is proportional to surgery‐induced tissue damage.

PATIENTS AND METHODS

Between May 2004 and December 2007, 127 consecutive patients undergoing HIFU (71) or TCAP (56) in our departments were assessed prospectively. Blood samples were collected 24 h before (T0), during surgery (T1), at the end of anaesthesia (T2), and at 12 (T3), 24 (T4) and 36 h after surgery (T5). The extent of the systemic response to surgery‐induced tissue trauma was measured by assessing the levels of acute‐phase markers tumour necrosis factor‐α (TNF‐α), interleukin‐6 (IL‐6), IL‐10, C‐reactive protein (CRP) and serum amyloid A (SAA), at all sampling times in all patients.

RESULTS

The median (interquartile range) age in the HIFU and TCAP groups was 70 (62–77) and 68 (59–75) years, respectively (P = 0.4). Baseline levels (T0) of TNF‐α, IL‐6, IL‐10, CRP and SAA were comparable in both groups. The levels of all four markers increased during both procedures; the median values were higher for TCAP at T2 (P = 0.02, 0.001, <0.001 and 0.06), T3 (P < 0.001, 0.009, 0.003 and 0.001), T4 (P = 0.007, <0.001, 0.005 and <0.001) and T5 (P < 0.001, 0.004, <0.001 and 0.02), respectively. IL‐6 was also higher for TCAP at T1 (P = 0.03). IL‐10 did not change at the different sampling times.

CONCLUSION

The tissue trauma and associated invasiveness of HIFU is less than that of TCAP, based on the variables objectively measured in this study.
Attrition from randomized controlled trials of pharmacological weight loss agents: a systematic review and analysis
Authors: Fabricatore A. N. , Wadden T. A. , Moore R. H. , Butryn M. L. , Gravallese E. A. , Erondu N. E. , Heymsfield S. B. , Nguyen A. M.
Published: March 2009

Clinical trials of obesity treatments have been limited by substantial dropout. Participant‐level variables do not reliably predict attrition, and study‐level variables have not yet been examined. We searched MEDLINE and identified 24 large randomized controlled trials of weight loss medications. These trials were comprised of 23 placebo and 32 drug groups. Two authors independently extracted the following for each treatment group: (i) treatment received; (ii) design characteristics (inclusion of a lead‐in period, selection of participants with weight‐related comorbidities, study location and number of study visits); (iii) sample characteristics (sample size, % female, and mean baseline age and body mass index); and (iv) attrition (total, adverse event [AE]‐related and non‐AE‐related) at 1 year. The primary outcome was total attrition, which was significantly related to treatment (i.e. 34.9%, 28.6%, 28.3% and 35.1% in placebo, orlistat, sibutramine and rimonabant groups, respectively, P < 0.0001). In adjusted multivariable models, total attrition was significantly lower in groups that completed a pre‐randomization lead‐in period than in those that did not (29.1% vs. 39.9%, P < 0.01). Gender also was significantly related to total attrition; groups with more women had higher dropout (P < 0.01). The pattern was similar for predicting non‐AE‐related attrition. Findings suggest ways to design studies that maximize retention.
Physical environmental correlates of childhood obesity: a systematic review
Authors: Dunton G. F. , Kaplan J. , Wolch J. , Jerrett M. , Reynolds K. D.
Published: March 2009

Increasing rates of childhood obesity in the USA and other Western countries are a cause for serious public health concern. Neighborhood and community environments are thought to play a contributing role in the development of obesity among youth, but it is not well understood which types of physical environmental characteristics have the most potential to influence obesity outcomes. This paper reports the results of a systematic review of quantitative research examining built and biophysical environmental variables associated with obesity in children and adolescents through physical activity. Literature searches in PubMed, PsychInfo and Geobase were conducted. Fifteen quantitative studies met the inclusion criteria for this systematic review. The majority of studies were cross‐sectional and published after 2005. Overall, few consistent findings emerged. For children, associations between physical environmental variables and obesity differed by gender, age, socioeconomic status, population density and whether reports were made by the parent or child. Access to equipment and facilities, neighborhood pattern (e.g. rural, exurban, suburban) and urban sprawl were associated with obesity outcomes in adolescents. For most environmental variables considered, strong empirical evidence is not yet available. Conceptual gaps, methodological limitations and future research directions are discussed.
Defining Access to Health Care: Evidence on the Importance of Quality and Distance in Rural Tanzania
Authors: Klemick Heather , Leonard Kenneth L. , Masatu Melkiory C.
Published: March 2009

We examine the implications of health‐seeking behavior on access to quality health care using a unique dataset that combines a household survey from rural Tanzania with the location and quality of all health facilities available to households. Patients do not always visit the nearest facility, but choose from among multiple facilities, improving the quality of care they receive by bypassing low quality facilities. Recognizing this behavior alters the projected benefits to health interventions, reducing the value of focusing on the staff qualifications and increasing the value of focusing on travel time and the motivation of current staff.
An Empirical Investigation into the Excessive‐Choice Effect
Authors: Arunachalam Bharath , Henneberry Shida R. , Lusk Jayson L. , Norwood F. Bailey
Published: March 2009

Recent marketing and psychological studies have shown that more choice does not always benefit consumers. This excessive‐choice effect (ECE) is examined empirically using food items in four experiments. The first experiment investigates whether people would voluntarily reduce their choice‐set size. The second seeks to replicate previous experimental results. The third and fourth experiments employ nonhypothetical Becker‐DeGroot‐Marschak (BDM) soda auctions and hypothetical ground beef choice experiments to further detect the prevalence of the ECE in alternative settings and explore the role of personality in decision tasks. Results suggest the ECE exists, but is less prevalent than previous studies suggest.
Treasonous Conduct: Assessing the Wartime Activities, Post‐War Trials and Tribulations of Australian Collaborators in the Second World War*
Authors: Loeffel Robert
Published: March 2009

There has been very little written about the activities of Australian citizens collaborating with the Germans during the Second World War. There are, however, a few instances where Australian citizens were involved in activities in Germany which could be considered treasonous. A number of these were individuals involved in an ill‐conceived military unit created by the Germans from British prisoners of war while there is at least one example of an Australian who allegedly carried out propaganda broadcasts for the Germans. The activities of these individuals and the way the authorities dealt with these cases after the war will be the focus of this article.
A Mace to Swat Two Blow‐Flies: Interpreting the Fitzpatrick and Browne Privilege Case
Authors: Moore Andrew
Published: March 2009

It is not widely remembered that on 10 June 1955 two men, Raymond Edward Fitzpatrick and Frank Courtenay Browne, were sentenced to gaol for three months on a vote of the Commonwealth House of Representatives for contempt of parliament. Two parliamentary officials, Frank Green and Harry Evans, have dominated scholarly attempts to explain this unusual event. To the former, the privilege case largely reflected the animus of Prime Minister Menzies towards Browne and his desire for revenge. To the latter the matter was a genuine case of contempt. This article revisits the 1955 Bankstown Observer privilege case with the benefit of recently released archival material. It seeks to understand why two citizens were deprived of their liberty without legal representation or redress and to find some compromise between the divergent interpretations proffered by Green and Evans.
Konfrontasi and Australia's Aid to Indonesia during the 1960s
Authors: Van Der Eng Pierre
Published: March 2009

This article examines Australia's aid program in Indonesia in the 1960s. With the transfer by the Dutch of West New Guinea to Indonesia in May 1963, the Australian government looked to expand aid to its northern neighbour beyond the Colombo Plan in an effort to cement friendly relations. The events associated with konfrontasi threatened this policy objective. Yet despite Indonesia's belligerent stance, Australia was able to continue its aid program (by supporting the Aeronautical Fixed Telecommunication Network) and to keep the lines of communication with Jakarta open. When konfrontasi ended in August 1966 after regime change in Indonesia, Australia was able to rapidly expand its aid program. This article argues that konfrontasi changed the ways in which Australia's aid program in Indonesia was construed, which in turn contributed to a re‐consideration of the role of aid in Australia's foreign policy more broadly.
A Reconsideration of the Political Significance of Shared Responsibility Agreements
Authors: Strakosch Elizabeth
Published: March 2009

The 1996–2007 Howard Coalition government introduced Shared Responsibility Agreements in 2005 to allocate discretionary funding to indigenous communities in a “mutually responsible” way. The policy was widely criticized as an ineffective and ideologically driven “showpiece”. Its significant governance‐building dimensions went without comment. Through the deployment of the conceptual tools of contract and governance, SRAs established new and depoliticised relationships between government and indigenous peoples, replacing the centralized political structure of the Aboriginal and Torres Strait Islander Commission. The future of the policy under the Rudd Government is uncertain, but understanding the impacts and implications of SRAs remains important.
John Howard's “Nation”: Multiculturalism, Citizenship, and Identity
Authors: Tate John William
Published: March 2009

This article identifies the specific concept of “nation” that informed John Howard's politics from his time as Liberal Party leader in the second half of the 1980s to the final years of his 1996–2007 prime ministership. It compares and contrasts the constitutive, procedural and multicultural models of nation to show Howard's continuing commitment to a constitutive understanding of the Australian nation. He endeavoured to give this understanding expression at the policy level by explicitly moving against the multicultural concept of nation that had informed Australian policy from the late 1970s. The Citizenship Test, introduced in his final year of office, is presented as the final move in this departure from multiculturalism.
Co‐Production and Health System Reform – From Re‐Imagining To Re‐Making
Authors: Dunston Roger , Lee Alison , Boud David , Brodie Pat , Chiarella Mary
Published: March 2009

There is growing interest in the application of citizen participation within all areas of public sector service development, where it is increasingly promoted as a significant strand of post‐neoliberal policy concerned with re‐imagining citizenship and more participatory forms of citizen/consumer engagement. The application of such a perspective within health services, via co‐production, has both beneficial, but also problematic implications for the organisation of such services, for professional practice and education. Given the disappointing results in increasing consumer involvement in health services via ‘choice’ and ‘voice’ participation strategies, the question of how the more challenging approach of co‐production will fare needs to be addressed. The article discusses the possibilities and challenges of system‐wide co‐production for health. It identifies the discourse and practice contours of co‐production, differentiating co‐production from other health consumer‐led approaches. Finally, it identifies issues critically related to the successful implementation of co‐production where additional theorisation and research are required.
Audit for Accountability in China: An Incomplete Mission
Authors: Gong Ting
Published: March 2009

This article argues against the conventional wisdom that accountability is the raison d'être of auditing activities. Audit, admittedly, is a part of the accountability architecture as it contributes to the financial health of a government and the effective management of public money. This does not mean, however, that audit necessarily generates accountability. China's experience with establishing a power audit regime shows that without enabling goals, impartial structural arrangements, and effective procedures, auditing for accountability only remains an incomplete mission.
Regulatory Competition and Accountability: Comparing Universal Service in Telecommunications in Australia and Taiwan*
Authors: Tso Chen‐Dong
Published: March 2009

The recent trend of transforming regulatory bureaus into independent agencies has raised concerns over accountability once the regulator is cut loose from political control. There is also concern that the promotion of public values may be at risk when the regulatory function is outsourced to a mission‐limited independent agency. To find possible solutions to these problems, this study compares the provision of telecommunications universal service in Australia with that in Taiwan to determine how different accountability designs lead to different means of ensuring universal service provision. Following a detailed investigation, this article finds that the consumer sovereignty model used in Australia performs better than the fiduciary trusteeship model in Taiwan in constraining the capture of the regulator by the dominant carrier. Overall, the author argues that, as a social goal, ensuring universal service should rely on both a politically mandated institution and competing regulatory agencies that accommodate different value groups so that a line is drawn between the social and commercial spheres.
Political Accountability in Hong Kong: Myth or Reality?
Authors: Lam Jermain T.M.
Published: March 2009

This article assesses the practice of political accountability in Hong Kong: whether it has largely been realised in practice, or whether it is merely a political slogan for the government to justify its executive‐led governance. The analysis begins with a review of the theoretical concepts of political accountability and ministerial accountability, and then establishes an operational framework to analyse the current practice of political accountability in Hong Kong's political system. It concludes by addressing the degree of political accountability overall.
In Search of Public Accountability: The ‘Wenling Model’ in China
Authors: Hsu S. Philip
Published: March 2009

This article specifically attempts to answer two interrelated research questions: firstly, how do democratic consultation assemblies (DCAs) heighten public accountability in the current institutional setting of China's sub‐provincial localities?; and secondly, what can be learned, from the Chinese case, in relation to achieving public accountability elsewhere? To address the first question, this article will explore two particular variations of the DCAs, and will focus on the interplay between the managerial and democratic accountability orientations to address the second question.
Is CEO Duality Always Negative? An Exploration of CEO Duality and Ownership Structure in the Arab IPO Context
Authors: Chahine Salim , Tohmé Nicholas S.
Published: March 2009

Manuscript type: Empirical

Research Question/Issue: This paper examines the relationships between initial public offering (IPO) underpricing, CEO duality, and strategic ownership in 12 Arab countries of the Middle East and North Africa (MENA) region.

Research Findings/Results: Using all IPOs from January 2000 until the end of July 2007, we document an average IPO underpricing of 184.1 per cent. Underpricing is higher in IPO firms that have CEO duality. However, strategic shareholders, such as corporations and other industry‐related investors, are likely to play a monitoring role whereas underpricing is found to be lower in firms with both CEO duality and strategic shareholder ownership. Moreover, the negative relation between underpricing and strategic blockholding is greater for foreign strategic ownership than it is for domestic strategic ownership.

Theoretical Implications: This paper examines the level and determinants of IPO underpricing in the MENA region. It provides evidence on the role played by foreign strategic owners in reducing agency conflicts and information asymmetries within an environment where firms may be affected by the cultural issues related to political ties and family involvement.

Practical Implications: Our results contribute to the existing debate on the appropriate regulations for an effective and stable financial system in Arab countries. They offer policy‐makers additional evidence on the positive impact of market openness to foreign shareholders.
The Diffusion of Equity Incentive Plans in Italian Listed Companies: What is the Trigger?
Authors: Zattoni Alessandro , Minichilli Alessandro
Published: March 2009

Manuscript Type: Empirical

Research Question/Issue: Recent dynamics in the institutional and market environment facilitated the propagation of equity incentive plans outside the US and the UK. This study sheds light on the reasons behind the diffusion of these plans in Italy, a country where companies are usually controlled by a blockholder and these instruments were almost absent.

Research Findings/Results: To gain a deep understanding of the phenomenon, we collected data on both the diffusion and the technical aspects of equity incentive plans adopted by Italian listed companies in 1999 and 2005. The results show that 1) the determinant of their adoption is the firm size, rather than the absence of a controlling shareholder; 2) these plans are not extensively used to extract company value, although few cases suggest this possibility; and 3) plans' characteristics generally comply with the requirements in tax law, so that fiscal benefits can be accessed.

Theoretical Implications: Our findings contribute to the expansion of the traditional knowledge about reasons behind the adoption of equity incentive plans outside Anglo‐Saxon countries. Further, they provide support for a symbolic perspective of corporate governance, according to which the introduction of new governance practices may not imply substantive governance reforms.

Practical Implications: Our study recommends that policymakers improve the disclosure rules about these plans and avoid the introduction of fiscal benefits that provide an incentive to promote some compensation schemes over others. Moreover, our results encourage members of remuneration committees to pay attention to specific characteristics of the plans.
Group Threat, Collective Angst, and Ingroup Forgiveness for the War in Iraq
Authors: Wohl Michael J. A. , Branscombe Nyla R.
Published: March 2009

We examine the consequences of threat to the ingroup for emotional reactions to ingroup harm doing. It was hypothesized that reminders of a past threat to the ingroup would induce collective angst, and this emotional reaction would increase forgiveness of the ingroup for its harmful actions toward another group. In Experiment 1, Americans read an article about the war in Iraq that implied Americans would soon experience another attack or one where such implied future threat to the ingroup was absent. When the ingroup's future was threatened, forgiveness for the harm Americans have committed in Iraq was increased, to the extent that collective angst was induced. In Experiment 2, Americans experienced more collective angst and were more willing to forgive their ingroup for their group's present harm doing in Iraq following reminders of either the terrorist attacks on September 11, 2001, or the 1941 Japanese attack on Pearl Harbor compared to when the victimization reminder was irrelevant to the ingroup. We discuss why ingroup threat encourages ingroup forgiveness for current harm doing.