bluuebunny/crossref_metadata_2025 huggingface dataset:
The Tacit Media Pedagogy as Praxial Critique: A Critique of Postmodern Theory for Higher Education Curriculum
Authors: Tatusko Andrew M.
Published: December 2004

Employing Calvin O. Schrag's response to postmodernism—transversal rationality engaged through praxial critique—the constructive side of postmodern theories can be highlighted in higher education while at the same time answering the pundits who see little to no constructive side to postmodern theories. Using praxial critique through media literacy is a proposed way to construct a curriculum that is centered around transversal rationality as a way to answer the challenges of postmodernism in a constructive way that neither dimisses nor blindly accepts its conclusions. In this way the limits of postmodern theory are critiqued. Some shortcomings of key postmodern theories are drawn out in relation to educational theory while aspects of some of these theories for a constructive employment in higher education are affirmed.
“How to be Thankful for Being Free”: Searching for a Convergence of Discourses on Teaching Patriotism, Citizenship, and United States History
Authors: Nash Margaret A.
Published: December 2004

Immediately after the events of September 11, 2001, there was a dramatic upsurge in exhibitions of patriotism, most generally in the form of flags prominently displayed on houses, storefronts, and automobiles. There also was a renewed zeal for inculcating patriotic feelings in children at public schools across the country. This paper, based on a study of teacher credential candidates at a large urban midwestern university, suggests that there may be a need to create a new discourse of patriotism. Such a project might integrate patriotism, the discourse on citizenship education, and the discourse of multicultural education, into a coherent whole. This new discourse on patriotism might, then, ground the emotionalism of patriotism in the responsibility of citizenship, employing the critical thought generated in discourses of multiculturalism.
OPTIMAL TAXATION ON MIXED DIAMOND GOODS: IMPLICATIONS FOR PRIVATE CAR OWNERSHIP IN CHINA
Authors: Deng Xin , Ng Yew‐Kwang
Published: December 2004

Abstract.  The ‘diamond effect’ exists when a consumer's utility depends on the exchange value, not just on the intrinsic consumption effects of the good. Yew‐Kwang Ng has discussed the optimal tax on a pure ‘diamond’ good. This paper extends Ng's model to cover mixed diamond goods. It uses three mathematical models to show that the optimal tax on a mixed diamond good with both intrinsic and diamond effects depends on the proportion of the diamond effect. The result may explain the violation of the Ramsey Rule in practice, and may be used to formulate private car taxes in China.
ARE OUTPUT FLUCTUATIONS TRANSITORY? NEW EVIDENCE FROM 24 CHINESE PROVINCES
Authors: Narayan Paresh Kumar
Published: December 2004

Abstract.  The fact that an occurrence of a unit root in real output is inconsistent with the notion that business cycles are stationary fluctuations around a deterministic trend makes this an important topic for empirical investigation. We examine this issue for 24 Chinese provinces using the recently developed Lagrange multiplier panel unit root test which allows for a structural break. Our main finding is that real gross domestic product (GDP) and real GDP per capita for Chinese provinces are stationary fluctuations around a deterministic trend.
IMPERFECT INFORMATION AND DIFFERENCES IN HOME OWNERSHIP INVESTMENT
Authors: Hirono Keiko Nosse
Published: December 2004

Abstract.  We study the extent to which differences in home ownership investment are caused by differences in information known about the property. We study the advantages accruing to buyers who have complete information and who can pay less than the equilibrium price if sellers undervalue their properties. The reduction in home ownership investment can increase consumption or investment in other assets. We develop an empirical model to capture the gain to such buyers. We estimate this to have been 12.6%−27.6% of the equilibrium price of houses at maximum in the Tokyo metropolitan area during the 1980s.
PRIVATE EDUCATION AND‘EDUCATION FOR ALL’‐ OR HOW NOT TO CONSTRUCT AN EVIDENCE‐BASED ARGUMENT: A REPLY TO TOOLEY
Authors: Watkins Kevin
Published: December 2004

The poor cannot afford education if they are left to pay for it themselves. Furthermore, given the right political structures government schools can deliver accountability and a good quality of education.
BASIC EDUCATION AS A HUMAN RIGHT
Authors: Willmore Larry
Published: December 2004

The Universal Declaration of Human Rights promises free elementary education and free choice of the type of education. International fora emphasise the first right while neglecting the second. This is unfortunate, since school choice can reduce costs and increase the attractiveness of an educational system. This essay examines arguments for limiting choice of free education, often to schools owned and operated by the state. It finds each of them to be unconvincing.
SHARING THE BURDEN OF FINANCING: GOVERNMENT AND HOUSEHOLD PARTNERSHIPS FOR BASIC EDUCATION1
Authors: Bray Mark
Published: December 2004

If the goal of achieving education for all is to be met consideration has to be given to how it is financed. States in which there is least primary education are often those with unstable governments and poor tax collection systems. In such circumstances, education for all is often best achieved by partnerships between governments, families and other bodies in both the provision and funding of education.
THE REGULATION OF PRIVATE SCHOOLS SERVING LOW‐INCOME FAMILIES IN HYDERABAD, INDIA: AN AUSTRIAN ECONOMIC PERSPECTIVE1
Authors: Dixon Pauline
Published: December 2004

It is the intention of government that private schools in Hyderabad are prevented by regulation from exhibiting the basic manifestations of competitive markets ‐ low prices, innovation, good service and so on. However, private schools do, in practice, manifest these features. This paradox is resolved because regulations are not enforced in practice, with the acceptance of bribes by government officials being common. As a result of ‘extra‐legal’ activity, private schools are able to offer a better service to the poor than if regulations had been enforced.
CHALLENGES FOR FINANCIAL STABILITY POLICY1
Authors: Clark Alastair
Published: December 2004

Financial stability issues have attracted increasing attention as the global financial system has become more complex and more integrated. This article discusses some challenges posed by this environment for financial stability policy‐makers. The challenges identified are: how to assess the relative merits of different policy measures and calibrate their effects; how to design regulatory capital requirements that are not too prescriptive or detailed; how incentive structures for individuals within firms can be better aligned with a firm's objectives for both return and risk; how‘the authorities’ should relate to large, complex financial institutions; and how to improve the handling of sovereign debt crises. The article gives a flavour of the official debate in each of these areas.
MUST GOVERNMENT GO FISHING?
Authors: Elliot Gerald
Published: December 2004

The depletion of fish stocks around the UK presents serious problems for the UK, and in particular the Scottish, fishing industry. This is a classic ‘tragedy of the commons’, repeatedly occurring in fisheries, where open access to a limited resource leads to serious depletion and may ultimately wipe out that resource. A recent report by the Royal Society of Edinburgh endorses the scientific basis for drastic cuts in fishing quotas under the Common Fisheries Policy to conserve stocks, and the necessary regulation and restriction of fishing effort in the UK. But it further recommends government‐led initiatives to reorganise and finance the industry. Fishing in the UK is a successful entrepreneurial business and no such intervention by government is required. Government must concentrate on devising methods of regulation which, through the extension of tradable property rights in fishing, would encourage the best economic return from this important public resource.
THE CONSTITUTIONAL PROPOSAL OF THE EUROPEAN CONVENTION: AN APPRAISAL AND EXPLANATION
Authors:   The European Constitutional Group
Published: December 2004

The recent European Convention was constructed so that the median voter on the convention had a bias in favour of centralisation. The conclusions of the Convention were therefore not surprising. The European Constitutional Group has made a number of suggestions for change to the Convention that could reverse its centralising approach.
The levels of chemokines CXCL8, CCL2 and CCL5 in multiple sclerosis patients are linked to the activity of the disease
Authors: Bartosik‐Psujek H. , Stelmasiak Z.
Published: December 2004

Chemokines are small cytokines with selective chemoattractant properties. They contribute to the T‐cell‐mediated pathogenesis of multiple sclerosis (MS). In order to ascertain whether different types and stage of disease correlate with a varying level of chemokines, the levels of CXCL8, CCL2 and CCL5 were measured in serum and the cerebrospinal fluid (CSF) of the MS patients. ELISA method was used to examine 56 patients with different types of MS alongside the 29 patients of the control group. The levels of CXCL8 and CCL2 in both groups were higher in CFS than in serum whilst the level of CCL5 measured higher in serum than in CSF. A significant rise in the levels of CXCL8 and CCL5 was observed during relapse, as against the level of CCL2 which was lower when compared with the control and other MS groups. No significant differences were observed in the levels of chemokines between the stable relapsing–remitting MS and progressive MS. The different levels of chemokines are linked to relapse of the disease. No separate, specific pattern of chemokine production dependent on the type of MS could be ascertained.
Focal status epilepticus as the first manifestation of paracoccidioidomycosis
Authors: França M. C. , de Castro R. , Balthazar M. L. F. , Faria A. V. , Cendes F.
Published: December 2004

We report a 56‐year old man with prolonged focal motor status epilepticus as the first clinical manifestation of paracoccidioidomycosis (PCM) and discuss this unusual presentation. We emphasize the need for a comprehensive work‐up and increased awareness for central nervous system involvement in PCM, particularly in endemic areas.
Chronic inflammatory demyelinating polyneuropathy, phrenic nerve and respiratory symptoms
Authors: Costa J. , de Carvalho M.
Published: December 2004

Respiratory involvement in chronic inflammatory demyelinating polyneuropathy (CIDP) has been very recently described. Phrenic nerve conduction studies have been described as useful to detect respiratory impairment in these patients. This study describes two patients with CIDP, in whom neurophysiological studies of the respiratory muscles were performed. The first patient had severe respiratory insufficiency, and phrenic nerve studies disclosed no motor responses and electromyography (EMG) of the diaphragm confirmed severe loss of motor units, bilaterally. On treatment, we documented clinical and neurophysiological improvement. In the second patient, phrenic nerve studies showed abnormal results; however, EMG of the diaphragm ruled out loss of motor units. The first case represents the risk of phrenic nerve involvement in this disorder, and the potential recovery on treatment. The second case illustrates that the temporal dispersion of the motor responses can be misleading, and EMG of diaphragm should be performed to confirm the loss of motor units.
Hypocretin deficiency in Prader–Willi syndrome
Authors: Nevsimalova S. , Vankova J. , Stepanova I. , Seemanova E. , Mignot E. , Nishino S.
Published: December 2004

Four patients with clinically and genetically confirmed Prader–Willi syndrome (PWS) underwent nocturnal polysomnograpy (PSG), multiple sleep latency test (MSLT), human leukocyte antigens (HLA) typing and estimation of cerebrospinal fluid (CSF) hypocretin‐1 (Hcrt‐1) level to investigate if a role of hypothalamic dysfunction and sleep disturbance might be functionally connected through the hypocretin (orexin) system. In all four patients physical examination confirmed extreme obesity (increasing with age) with dysmorphogenetic features. Excessive daytime sleepiness (EDS) was manifested in only two subjects without any imperative feature. None of the patients under study suffered from cataplexy. Nocturnal PSG revealed fragmented sleep with low efficiency, the hypopnea and apnea indexes increasing from borderline up to very high values in direct proportion to the patients’ age. MSLT latency was shortened in two patients with clinically expressed EDS, only one sleep onset rapid eye movements (REM) period (SOREM) was found. HLA typing showed DQB1*0602 positivity in two patients; the further two were negative. Mean value of CSF Hcrt‐1 in the patients group was down to 164 ± 46.8 pg/ml (in comparison with 265.8 ± 48.8 pg/ml in 10 young healthy subjects, P = 0.02). The deficiency of CSF Hcrt‐1 level correlated in PWS patients with their EDS severity.
A randomly assigned double‐blind cross‐over study examining the relative anti‐parkinsonian tremor effects of pramipexole and pergolide
Authors: Navan P. , Findley L. J. , Undy M. B. , Pearce R. K. B. , Bain P. G.
Published: December 2004

This study examined the relative anti‐Parkinson's disease (PD) tremor potencies of pergolide and pramipexole in people with PD, using a 3‐month double‐blind cross‐over design. Patients were randomly assigned to receive either pergolide and then pramipexole (n = 9) or vice versa (n = 8). The dose of the respective dopamine agonist was increased according to a titration schedule up to a maximum 1.5 mg t.d.s., with cross‐over at 10 weeks. Assessments were performed at baseline, 4, 8 and 12 weeks. The primary outcome measures were the differences in the clinical (rest and postural) tremor scores on pergolide versus pramipexole. Seventeen PD patients (11 females and six males) with a mean age 68.4 years (range: 55–84 years) and a mean disease duration of 3.9 years (range: 2 months to 13 years) participated in the study. Twelve of the patients were taking other anti‐parkinsonian medications. Two patients dropped out of the study whilst on pergolide. Fifteen of 16 patients were able to cross‐over from one dopamine agonist to the other, without major retitration. There were no significant differences between the effects of the two drugs on the primary outcome measures, suggesting that the anti‐PD tremor efficacies of dopaminergic medications are not dependent on differential affinities for dopamine receptor types.
The Elements of Rationality and Chance in the Choice of Human Action
Authors: KRAUSZ ERNEST
Published: December 2004

The focus in this paper is on deliberate human action. The central questions addressed are: whether purely rational choice is possible; whether choices may be induced by chance alone; or whether there is always a mixture of rationality and chance, as well as other factors such as habit, emotion, imitation and irrationality. The approach is a factualist one, upholding the view that, although human action can be explained by its antecedents, this is not incompatible with the notion of "free choice". It is the actual choosing process that determines the final choice of action. Whatever the sources of the elements involved in the choosing process, the choice of action is a specific outcome created by the acting agent. It is in this choosing process and decision making that both rationality and chance enter. The conclusion is that rationality is the element which links intentionality with goal seeking and attainment, but that the actual choice is determined by a complex interactive process in which both logic and chance play a part.
Constraints on the Internal Conversation: Margaret Archer and the Structural Shaping of Thought
Authors: MUTCH ALISTAIR
Published: December 2004

Margaret Archer has recently provided a persuasive account of the importance of the internal conversation to reflexivity. This raises questions about the shaping of such conversations by involuntary agential positioning. The work of Bourdieu and Bernstein is reviewed to suggest that structural influences can operate by condi‐tioning the resources available for the conducting of the internal conversation. Particular emphasis is placed on the transfer of taken for granted ideas from one domain of practice to another.
Petrogenesis of a high‐temperature metamorphic terrane: a new tectonic interpretation for the north Dabieshan, central China
Authors: ZHANG R. Y. , LIOU J. G. , TSAI C. H.
Published: December 2004

ABSTRACT The northern Dabie terrane consists of a variety of metamorphic rocks with minor mafic‐ultramafic blocks, and abundant Jurassic‐Cretaceous granitic plutons. The metamorphic rocks include orthogneisses, amphibolite, migmatitic gneiss with minor granulite and metasediments; no eclogite or other high‐pressure metamorphic rocks have been found. Granulites of various compositions occur either as lenses, blocks or layers within clinopyroxene‐bearing amphibolite or gneiss. The palaeosomes of most migmatitic gneisses contain clinopyroxene; melanosomes and leucosomes are intimately intermingled, tightly folded and may have formed in situ. The granulites formed at about 800–830 °C and 10–14 kbar and display near‐isothermal decompression P–T paths that may have resulted from crust thickened by collision. Plagioclase‐amphibole coronae around garnets and matrix PI + Hbl assemblages from mafic and ultramafic granulites formed at about 750–800 °C. Partial replacement of clinopyroxene by amphibole in gneiss marks amphibolite facies retrograde metamorphism. Amphibolite facies orthogneisses and interlayered amphibolites formed at 680–750 °C and c. 6 kbar. Formation of oligoclase + orthoclase antiperthite after plagioclase took place in migmatitic gneisses at T ≤ 490°C in response to a final stage of retrograde recrystallization. These P–T estimates indicate that the northern Dabie metamorphic granulite‐amphibolite facies terrane formed in a metamorphic field gradient of 20–35 °C km‐1 at intermediate to low pressures, and may represent the Sino‐Korean hangingwall during Triassic subduction for formation of the ultrahigh‐ and high‐P units to the south. Post‐collisional intrusion of a mafic‐ultramafic cumulate complex occurred due to breakoff of the subducting slab.
SHRIMP II dating of zircons and monazites: reassessing the timing of high‐grade metamorphism and fluid flow in the Reynolds Range, northern Arunta Block, Australia
Authors: VRY J. , COMPSTON W. , CARTWRIGHT I.
Published: December 2004

ABSTRACT Key insights into the timing of tectonometamorphic events in a complex high‐grade metamorphic terrane can be obtained by combining results from SHRIMP II ion microprobe studies of individual monazite grains with SHRIMP II studies and scanning electron microscope (SEM)‐based cathodoluminescence (CL) imaging of zircons. Results from the Reynolds Range region, Arunta Block, Northern Territory, Australia, show that the final episode of regional metamorphism to high‐T and low‐P granulite facies conditions is most likely to have occurred at c. 1580 Ma, not at 1785–1775 Ma, as previously accepted. The previous interpretation was based on zircon studies of structurally controlled granitoids, without SEM‐based CL imaging. Monazites in a 1806± 6 Ma megacrystic granitoid preserve rare cores that are interpreted to be inherited magmatic monazite, but record no evidence of another high‐T event prior to 1580 Ma. Most monazites from the region record only a single high‐T metamorphic event at c. 1580 Ma. Zircon inheritance is very common. Zircons or narrow overgrowths of zircon dated at c. 1580 Ma have only been found in two types of rocks: rocks produced by metasomatic fluid flow at high temperatures (≤750°C), and rocks that have undergone local partial melting. Previous explanations that attributed these 1580 Ma zircon ages to widespread hydrothermal fluid fluxing associated with post‐tectonic pegmatite emplacement at amphibolite facies conditions are not supported by the available evidence including oxygen isotope data.

The observed high regional metamorphic temperatures require the involvement of advective heating. However, contrary to a previous tectonic model for the formation of this and other low‐P, high‐T metamorphic belts, the granites that are exposed at the present structural level do not appear to be the source of that heat, unless some of the granites were emplaced at c. 1580 Ma.
Rapid Variscan exhumation and the role of magma in core complex formation: southern Brittany metamorphic belt, France
Authors: BROWN MICHAEL , DALLMEYER R. DAVID
Published: December 2004

ABSTRACT The high‐grade migmatitic core to the southern Brittany metamorphic belt has mineralogical and textural features that suggest high‐temperature decompression. The chronology of this decompression and subsequent cooling history have been constrained with 40Ar/39 Ar ages determined for multigrain concentrates of hornblende and muscovite prepared from amphibolite and late‐orogenic granite sheets within the migmatitic core, and from amphibolite of the structurally overlying unit. Three hornblende concentrates yield plateau isotope correlation ages of c. 303–298 Ma. Two muscovite concentrates record well‐defined plateau ages of c. 306–305 Ma. These ages are geologically significant and date the last cooling through temperatures required for intracrystalline retention of radiogenic argon. The concordancy of the hornblende and muscovite ages suggest rapid post‐metamorphic cooling. Extant geochronology and the new 40Ar/39Ar data suggest a minimum time‐integrated average cooling rate between c. 725 °C and c. 125 °C of c. 14 ± 4°C Ma‐1, although below 600 °C the data permit an infinitely fast rate of cooling. Mineral assemblages and reaction textures in diatexite migmatites suggest c. 4 kbar decompression at 800–750 °C. This must have pre‐dated the rapid cooling.

Emplacement of two‐mica granites into the metamorphic belt occurred between 345 and 300 Ma. The youngest plutons were emplaced synkinematically along shallow‐dipping normal faults interpreted to be reactivated Eo‐Variscan thrusts. A penetrative, west‐plunging stretching lineation developed in these granites suggests that extension was orogen‐parallel. Extension was probably related to regional uplift and gravitational collapse of thermally weakened crust during constrictional (escape) tectonics in this narrow part of the Variscan orogen. This followed slab breakoff during the terminal stages of convergence between Gondwana and Laurasia; detachment may have been consequent upon a change in kinematics leading to dextral displacement within the orogen. Dextral ductile strike‐slip displacement was concentrated in granites emplaced synkinematically along the South Armorican Shear Zone. Rapid cooling is interpreted to have resulted from tectonic unroofing with emplacement of granite along decollement surfaces. The high‐grade migmatitic core of the southern Brittany metamorphic belt represents a type of metamorphic core complex formed during orogen‐parallel extensional unroofing and regional‐scale ductile flow.
Low Income and Education Levels May Cause Medication Overuse and Chronicity in Migraine Patients
Authors: Atasoy Huseyin Tugrul , Unal Aysun Eroglu , Atasoy Nuray , Emre Ufuk , Sumer Murat
Published: December 2004

Background.—Frequent analgesic drug intake, especially in migraine patients, may induce the risk of medication overuse headache (MOH). The various conditions that may affect the development and the features of MOH have not been determined yet.

Aim.—To compare MOH patients with migraine as pre‐existing headache and episodic migraine patients according to socioeconomic and educational variables.

Methods.—Forty‐six MOH patients with migraine as pre‐existing headache and 61 migraine patients were included into study. The headache characteristics, socioeconomic and educational variables of MOH and migraine groups and subgroups divided according to the education (low/high education subgroups), and income (low/high income subgroups) levels were evaluated.

Results.—We found that mean duration of education was shorter in MOH patients than migraine patients. There was a negative correlation between duration of education and duration of MOH. The mean duration of MOH was longer and rate of low‐income level was higher in patients with low‐education level. The duration of education was lower in MOH patients with low income. The frequency of migraine attacks and low‐income rate was also higher in low‐educated migraine patients. The duration of education was shorter in migraine patients with low income.

Conclusion.—We report that migraineurs with low socioeconomic status may have risk of developing MOH. A better identification of patients at risk of drug‐associated headache may contribute to improved health in a group of patients with MOH.
Peripheral Postganglionic Sympathicoplegia Mimicking Cluster Headache Attacks
Authors: Hannerz Jan , Arnardottir Snjólaug , Bro Skejø Hanne Pernille , Lilja Jan Anders , Ericson Kaj
Published: December 2004

After dissection with complete occlusion of the internal carotid artery, a 58‐year‐old man started to suffer from intense cluster headache‐like attacks. Magnetic imaging showed signs of nonsymptomatic cerebral emboli, which could be dated to have occurred in temporal relation to the start of the attacks, all on the right side. This case and two similar ones indicate that peripheral postganglionic sympathicoplegia can cause attacks with similar pain characteristics, accompanying symptoms, duration, and regularity as in cluster headache.
The Influence of Anxiety on the Progression of Disability
Authors: Brenes Gretchen A. , Guralnik Jack M. , Williamson Jeff D. , Fried Linda P. , Simpson Crystal , Simonsick Eleanor M. , Penninx Brenda W. J. H.
Published: December 2004

Objectives: To determine the influence of anxiety on the progression of disability and examine possible mediators of the relationship.

Design: Community‐based observational study.

Setting: Women's Health and Aging Study I, a prospective observational study with assessments every 6 months for 3 years.

Participants: One thousand two functionally limited women aged 65 and older.

Measurements: Anxiety symptoms were assessed using four questions from the Hopkins Symptom Checklist (nervous or shaky, avoidance of certain things, tense or keyed up, fearful). Participants who reported experiencing two or more of these symptoms at baseline were considered anxious. Anxiety as a predictor of the onset of four types of disability was examined using Cox proportional hazards models. Three models were tested: an unadjusted model, a model adjusted for confounding variables (age, race, vision, number of diseases, physical performance, depressive symptoms), and a mediational model (benzodiazepine and psychotropic medication use, physical activity, emotional support).

Results: Nineteen percent of women reported two or more symptoms of anxiety at baseline. Unadjusted models indicate that anxiety was associated with a greater risk of worsening disability: activity of daily living (ADL) disability (relative risk (RR)=1.40, 95% confidence interval (CI)=1.10–1.79), mobility disability (RR=1.41, 95% CI=1.06–1.86), lifting disability (RR=1.54, 95% CI=1.20–1.97), and light housework disability (RR=1.77, 95% CI=1.32–2.37). After adjusting for confounding variables, anxiety continued to predict the development of two types of disability: ADL disability (RR=1.41, 95% CI=1.08–1.84) and light housework disability (RR=1.56, 95% CI=1.14–2.14). Finally, benzodiazepine and psychotropic medication use, physical activity, and emotional support were not significant mediators of the effect of anxiety on the development of a disability.

Conclusion: Anxiety is a significant risk factor for the progression of disability in older women. Studies are needed to determine whether treatment of anxiety delays or prevents disability.
Sex Differences in the Risk of Frailty for Mortality Independent of Disability and Chronic Diseases
Authors: Puts Martine T. E. , Lips Paul , Deeg Dorly J. H.
Published: December 2004

Objectives: To determine the effect of static and dynamic frailty on mortality in older men and women.

Design: A prospective cohort study with three 3‐year measurement cycles.

Setting: Population based.

Participants: The sample was derived from the Longitudinal Aging Study Amsterdam and consisted of respondents who participated in two cycles (T1: 1992/1993 and T2: 1995/1996) and for whom there was complete data on disability and chronic diseases (N=2,257).

Measurements: Nine frailty markers were assessed at T1 and T2. The frailty markers were defined in two ways: low functioning at T2 (static frailty) and change in functioning between T1 and T2 (dynamic frailty). Survival time, calculated in days from T2 to January 1, 2000, was used as the outcome variable. Predictive ability was examined using Cox proportional hazards analyses separately for men and women.

Results: Women were frailer than men. Static frailty was significantly associated with mortality in men (relative risk (RR)=2.4) and in women (RR=2.6). Dynamic frailty was also associated with mortality in women (RR=2.6), but it was not significantly associated with mortality in men (RR=1.3). When disability and chronic diseases were included in the model as possible mediators, these RRs dropped to 1.6, 2.0, 2.1, and 1.2, respectively, of which the first three were still significant.

Conclusion: Frailty was associated with mortality to a greater extent in women than in men, and this effect was independent of disability and chronic disease. In men, the static definition of frailty was more predictive of mortality than the dynamic definition.
Alteration of a Clinically Meaningful Outcome in the Natural History of Alzheimer's Disease by Cholinesterase Inhibition
Authors: Lopez Oscar L. , Becker James T. , Saxton Judith , Sweet Robert A. , Klunk William , DeKosky Steven T.
Published: December 2004

Objectives: To describe the effect of cholinesterase inhibitors (CEIs) on the natural course of Alzheimer's disease (AD) using clinically meaningful outcomes.

Design: Cross‐sectional and longitudinal study.

Setting: Referral dementia clinic.

Participants: One hundred thirty‐five matched pairs of patients with probable AD.

Measurements: The risk of AD patients being classified as slow progressors (Mini‐Mental State Examination (MMSE) score change ≤2 at 1‐year follow‐up) was examined as a function of treatment with CEIs. A logistic regression analysis, controlling for age, sex, education level, MMSE score, Blessed Dementia Rating Scale (BDRS) for activities of daily living (ADLs), extrapyramidal signs, psychosis, major depression, and use of antidepressants, antipsychotics, and sedative/hypnotics determined the factors that best predict slow progression and nursing home admission.

Results: Eighty‐one (60%) of the patients on CEIs and 53 (39%) of the patients who never used CEIs were considered slow progressors (P=.001) at 1‐year follow‐up. Slow progression was associated only with CEI use (relative risk (RR)=2.45, 95% confidence interval (CI)=1.45–4.16), and sedative/hypnotics use was associated with a MMSE change of 3 points or more (RR=0.35, 95% CI=0.13–0.93). CEI use had a protective effect on nursing home admission (RR=0.095, 95% CI=0.03–0.30), whereas higher scores on the BDRS for ADLs increased risk of admission at 24‐ and 36‐month follow‐up.

Conclusion: CEI use had a clinically meaningful effect on the natural history of AD. Patients taking CEIs were 2.5 times more likely to progress slowly and had a lower risk of nursing home admission after 2 years, even after controlling for multiple factors that can alter the course of the disease, and a slower rate of decline during the first year of follow‐up.
Knowledge and Attitudes About Geriatrics of Medical Students, Internal Medicine Residents, and Geriatric Medicine Fellows
Authors: Kishimoto Mitsumasa , Nagoshi Michael , Williams Shellie , Masaki Kamal H. , Blanchette Patricia Lanoie
Published: December 2004

Objectives: To evaluate the attitudes and knowledge of medical students (MS1–3), internal medicine residents (postgraduate years 1 to 3 (PGY1–3)), and geriatric medicine fellows about elderly patients before implementation of a new geriatrics curriculum.

Design: Cross‐sectional study.

Setting: An academic medical center.

Participants: Two hundred eleven people participated: 54 MS1, 52 MS2, 50 MS3, 20 PGY1, 12 PGY2, 12 PGY3, and 11 geriatric medicine fellows.

Measurements: Each participant completed a questionnaire, including a 16‐item geriatrics attitude scale, and a 23‐item knowledge test (both revised versions of the University of California at Los Angeles (UCLA) Geriatrics Survey). Pearson correlation coefficients and t tests were used for statistical analyses.

Results: Both surveys demonstrated high internal consistency (α=0.70 and 0.71, respectively). Knowledge test scores increased with advancing level of training. MS1 and MS2 scored significantly lower and fellows scored significantly higher than others. PGY3 scored significantly higher than PGY1 on the knowledge test. All groups demonstrated positive attitudes toward geriatric patients (score>3.5). MS1 and fellows had significantly more favorable attitudes scores than more advanced students and residents.

Conclusion: The results suggest that the UCLA Attitudes Scale and Knowledge Test can be used reliably to assess attitudes and knowledge level across all levels of medical education and training. The information from this study will be used to implement a more structured and comprehensive geriatrics curriculum across all trainee levels to improve attitudes and knowledge in the care of the geriatric patient.
Differences in Amount of Informal Care Received by Non‐Hispanic Whites and Latinos in a Nationally Representative Sample of Older Americans
Authors: Weiss Carlos O. , González Hector M. , Kabeto Mohammed U. , Langa Kenneth M.
Published: December 2004

The objective of this study was to evaluate informal (unpaid) care and its broad determinants for Latinos in a nationally representative sample. A cross‐sectional analysis of the 1993 Asset and Health Dynamics Study, a national probability sample of 7,443 older adults aged 70 and older, was performed to determine the independent effect of Latino ethnicity on the receipt of informal care by disabled older individuals. Self‐reported race/ethnicity was used to predict the mean daily hours of informal care received for activity of daily living (ADL) or instrumental activity of daily living (IADL) assistance after adjustment for predisposing, need, and enabling variables. There was a significant association between informal home care and ethnic group, with 44.3% of Latinos receiving informal care, compared with 33.9% of African Americans and 24.6% of non‐Hispanic whites (P<.001). After adjustment, Latinos received 11.0 weekly hours of informal care, compared with 7.5 hours for non‐Hispanic whites and 6.3 hours for African Americans (P<.001). The results from this nationally representative sample indicate that Latinos receive significantly more hours of informal care on average than African Americans or non‐Hispanic whites for ADL and IADL disability. Clinicians should be alert to the significant amount of informal care and possible associated strain in caregivers of older Latinos.
Second donation of granulocyte–colony‐stimulating factor–mobilized peripheral blood progenitor cells: risk factors associated with a low yield of CD34+ cells
Authors: Platzbecker Uwe , Bornhäuser Martin , Zimmer Kristin , Lerche Linda , Rutt Claudia , Ehninger Gerhard , Hölig Kristina
Published: December 2004

BACKGROUND:  There are still limited data on the efficacy and safety of repeated donations of granulocyte–colony‐stimulating factor (G–CSF)‐mobilized peripheral blood progenitor cells (PBPCs) for allogeneic transplantation.

STUDY DESIGN AND METHODS:  Sixty‐seven healthy donors undergoing two consecutive mobilizations of PBPCs within a median interval of 5 months (range, 0.1‐47 months) were investigated. For both first mobilization (FM) and second mobilization (SM), G–CSF (lenograstim) at 7.5 µg per kg per day was administered.

RESULTS:  The nonhematologic side effects were comparable between both mobilizations. A significantly lower yield of CD34+ cells × 106 per kg of donor weight was obtained on Day 5 of SM in female (n = 31; FM, 5.0; SM, 3.23; p = 0.008) but not in male (n = 36; FM, 5.96; SM, 5.36; p = 0.24) donors. Multivariate analysis identified a lower CD34+ blood concentration on Day 5 of FM (p < 0.001) as well as female sex (p = 0.015) as independent risk factors for a lower yield of progenitor cells, whereas donor age and body mass index, interval between donations, and schedule of G–CSF application showed no significant impact.

CONCLUSION:  The identified risk factors allow the estimation of the efficacy of a SM in an individual donor before G–CSF administration, thus avoiding distress to both the donor and the recipient.
A novel A allele with 664G>A mutation identified in a family with the Am phenotype
Authors: Lin Marie , Hou Min‐Ju , Twu Yuh‐Ching , Yu Lung‐Chih
Published: December 2004

BACKGROUND:  The Am phenotype has been characterized as a weak expression of the A antigen on red blood cells but the presence of a normal quantity of the A antigen in saliva. This study describes a molecular genetic analysis of members of an Am family.

STUDY DESIGN AND METHODS:  The eight exon regions of the ABO genes of the Am proposita were amplified by polymerase chain reaction and cloned, and their sequences were analyzed. The α‐1,3‐N‐acetylgalactosaminyltransferase (A‐transferase) activities of the Am serum and the expressed Am transferase were analyzed.

RESULTS:  An A gene with a 664G>A mutation, which predicts an amino acid alteration of Val222Met, was identified in the Am proposita. This Am664A allele was demonstrated in other three family members with the Am phenotype. The A‐transferase activity was virtually undetectable in the Am sera, and the expressed Am transferase showed weak A‐transferase activity, when compared with the expressed A1 transferase, in assays that use acceptor substrates mimicking the Type 2 H structure and Type 1 H structure.

CONCLUSION:  A novel A allele with 664G>A mutation was demonstrated in a pedigree with the Am phenotype. The mechanism leading to the formation of the Am phenotype still awaits elucidation.
Rapid identification of iron deficiency in blood donors with red cell indexes provided by Advia 120
Authors: Radtke Hartmut , Meyer Tina , Kalus Ulrich , Röcker Lothar , Salama Abdulgabar , Kiesewetter Holger , Latza Reinhard
Published: December 2004

BACKGROUND:  A new generation of automated hematology analyzers allows the rapid determination of various red cell (RBC) indexes, including the percentage of hypochromic mature RBCs (HYPOm) and the hemoglobin (Hb) content of reticulocytes (CHr). These indexes have not yet been validated as measures for the detection of iron deficiency in blood donors.

STUDY DESIGN AND METHODS:  Iron status was evaluated in a total of 1142 unselected prospective blood donors based on measurement of serum ferritin, soluble transferrin receptor, and Hb compared to RBC indexes provided by an automated hematology analyzer (Advia 120, Bayer HealthCare) including HYPOm and CHr.

RESULTS:  Assuming that the most precise measure for body iron storage is related to the logarithm of the ratio of soluble transferrin receptor to ferritin, the sensitivity of ferritin for the diagnosis of iron depletion was 89 percent compared to 57 percent for HYPOm and CHr, respectively, to 69 percent for the combination of both RBC indexes, and to 26 percent for Hb concentration.

CONCLUSION:  The RBC indexes HYPOm und CHr are significantly better screening measures for identification of iron depletion in blood donors than Hb.
Diagnostic PCR: validation and sample preparation are two sides of the same coin
Authors: HOORFAR JEFFREY , WOLFFS PETRA , RÅDSTRÖM PETER
Published: December 2004

Increased use of powerful PCR technology for the routine detection of pathogens has focused attention on the need for international validation and preparation of official non‐commercial guidelines. Bacteria of epidemiological importance should be the prime focus, although a “validation infrastructure” once established could easily be adapted for PCR‐based detection of viruses and parasites. The aim of standardization should be the widespread adoption of diagnostic PCR for routine pathogen testing. European experience provides the impetus for realization of this vision through preparation of quantitative reference DNA material and reagents, production of stringent protocols and tools for thermal cycler performance testing, uncomplicated sample preparation techniques, and extensive ring trials for assessment of the efficacy of selected matrix/pathogen detection protocols.
rhBMP‐2 significantly enhances guided bone regeneration
Authors: Wikesjö Ulf M. E. , Qahash Mohammed , Thomson Robert C. , Cook Alonzo D. , Rohrer Michael D. , Wozney John M. , Hardwick W. Ross
Published: December 2004

Abstract
Background: Previous studies have shown a limited potential for bone augmentation following guided bone regeneration (GBR) in horizontal alveolar defects. Surgical implantation of recombinant human bone morphogenetic protein‐2 (rhBMP‐2) in an absorbable collagen sponge carrier (ACS) significantly enhances bone regeneration in such defects; however, sufficient quantities of bone for implant dentistry are not routinely obtained. The objective of this study was to evaluate the potential of rhBMP‐2/ACS to enhance GBR using a space‐providing, macro‐porous expanded polytetrafluoroethylene (ePTFE) device.

Methods: Bilateral, critical size, supra‐alveolar, peri‐implant defects were surgically created in four Hound Labrador mongrel dogs. Two turned and one surface‐etched 10‐mm titanium dental implant were placed 5 mm into the surgically reduced alveolar ridge creating 5‐mm supra‐alveolar defects. rhBMP‐2/ACS (rhBMP‐2 at 0.2 mg/ml) or buffer/ACS was randomly assigned to left and right jaw quadrants in subsequent animals. The space‐providing, macro‐porous ePTFE device was placed to cover rhBMP‐2/ACS and control constructs and dental implants. Gingival flaps were advanced for primary wound closure. The animals were euthanized at 8 weeks postsurgery for histologic and histometric analysis.

Results: Bone formation was significantly enhanced in defects receiving rhBMP‐2/ACS compared to control. Vertical bone gain averaged (±SD) 4.7±0.3 and 4.8±0.1 mm, and new bone area 10.3±2.0 and 8.0±2.5 mm2 at turned and surface‐etched dental implants, respectively. Corresponding values for the control were 1.8±2.0 and 1.3±1.3 mm, and 1.8±1.3 and 1.2±0.6  mm2. Bone–implant contact in rhBMP‐2‐induced bone averaged 6.4±1.4% and 9.6±7.5% for turned and surface‐etched dental implants, respectively (P=0.399). Corresponding values for the control were 14.6±19.4% and 23.7±9.7% (P=0.473). Bone–implant contact in resident bone ranged between 43% and 58% without significant differences between dental implant surfaces.

Conclusions: rhBMP‐2/ACS significantly enhances GBR at turned and surface‐etched dental implants. The dental implant surface technology does not appear to substantially influence bone formation.
A 7‐year life table analysis from a prospective study on ITI implants with special emphasis on the use of short implants
Authors: Nedir Rabah , Bischof Mark , Briaux Jean‐Marie , Beyer Stephan , Szmukler‐Moncler Serge , Bernard Jean‐Pierre
Published: December 2004

Abstract: This paper reports on a 7‐year life table analysis on ITI titanium plasma‐sprayed (TPS) and sandblasted and etched (SLA) implants placed in a private practice and loaded for at least 1 year. In 236 patients, 528 (264 TPS and 264 SLA) implants were placed, 351 (66.5%) implants rehabilitated the posterior region and 71.1% implants were ≤11 mm. In the posterior mandible and maxilla, the mean implant length was 9.90 and 9.74 mm respectively. Implant length was determined through standard radiographs only. Increase of the number of implants or reduction of the width or the length of the rehabilitations was not specifically sought for the shorter implants. One hundred and twenty‐two SLA implants were loaded within 63 days. All early loaded SLA implants resisted the applied 35 N cm without rotation or pain. Three implants failed, one early and two late failures, all were SLA implants placed in the mandible. Shorter implants did not fail more than longer ones. The cumulative success rate was 99.40%. The predictable use of short implants supporting single crowns and small fixed partial dentures of 2–4 units supported by two to three implants permitted (1) restricting the need for sophisticated and expensive presurgical procedures aimed to determine precisely the available bone height by computerized radiographic methods, (2) the placement of prosthetically driven restoration instead of surgically driven ones, (3) reducing the indications span for complex invasive procedures like sinus lift and bone grafting procedures, (4) facilitating the surgery, without attempting to place the longest implant and (5) avoiding the occurrence of sensation disturbance. The safe use of short implants in a private practice should make implant therapy simpler and accessible to a higher number of patients and practitioners.
Effects of platelet‐rich plasma on bone healing in combination with autogenous bone and bone substitutes in critical‐size defects
Authors: Wiltfang Joerg , Kloss Frank Rudolf , Kessler Peter , Nkenke Emeka , Schultze‐mosgau Stefan , Zimmermann Robert , Schlegel Karl Andreas
Published: December 2004

Abstract Objectives: An animal study was carried out to investigate the influence of platelet‐rich plasma (PRP) on the regeneration of bony defects.

Material and methods: Critical‐size defects in the forehead region of a mini‐pig were filled with randomly distributed combinations of autogenous bone, tricalcium‐phosphate granules (CeraSorb™), bovine spongious blocks (BioOss™) and a bovine bone inducing collagenous sponge (Colloss™) with and without PRP in two preparations (Cusasan, 3i). The animals were killed after 2, 4 and 12 weeks. The specimens were evaluated microradiographically and immunohistologically.

Results: Autologous bone (38±9.9%) and Colloss (52.6±4.0%) showed the highest remineralization rates at 2 weeks. The initial high expression of BMP‐2 in the Colloss®‐group gives evidence of an early initiation of bony regeneration. At 2 weeks PRP ad modum 3i was able to enhance bone healing significantly (P=0.028) only when applied in combination with autogenous bone (62.8±1.6%). Four weeks after surgery, both PRP preparations did no longer increase bony regeneration in the autogenous groups. The osteoconductive effect of Bio‐Oss™ (38.7±5.5%) and CeraSorb™ (41±4.9%) was remarkable as well 4 weeks after surgery. Nevertheless, the addition of PRP hardly influenced bony regeneration, ceramic degradation or cytokine expression when bone substitutes were applied. At 12 weeks, the level of reossification had adjusted similarly in all groups.

Conclusion: PRP did not add additional benefit when xenogenic bone substitutes were used. However, a significant effect on bone regeneration was found in the autogenous group initially when PRP is added.