bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of an amino acid sequence within GABAA receptor β3 subunits that is important for receptor assembly
Authors: Ehya Noosha , Sarto Isabella , Wabnegger Leila , Klausberger Thomas , Sieghart Werner
Published: March 2003

GABAA receptors are chloride ion channels that can be opened by GABA, the most important inhibitory transmitter in the CNS. In the mammalian brain the majority of these pentameric receptors is composed of two α, two β and one γ subunit. To achieve the correct order of subunits around the pore, each subunit must form specific contacts via its plus (+) and minus (–) side. To identify a sequence on the β3 subunit important for assembly, we generated various full‐length or truncated chimeric β3 constructs and investigated their ability to assemble with α1 and γ2 subunits. It was demonstrated that replacement of the sequence β3(76–89) by the homologous α1 sequence impaired assembly with α1 but not with γ2 subunits in α1β3γ2‐GABAA receptors. Other experiments indicated that assembly was impaired via the β3(–) side of the chimeric subunit. Within the sequence β3(76–89) the sequence β3(85–89) seemed to be of primary importance for assembly with α1 subunits. A comparison with the structure of the acetylcholine‐binding protein supports the conclusion that the sequence β3(85–89) is located at the β3(–) side and indicates that it contains amino acid residues that might directly interact with the (+) side of the neighbouring α1 subunit.
Peptidase activities of the 20/26S proteasome and a novel protease in human brain
Authors: Vigouroux Sophie , Furukawa Yoshiaki , Farout Luc , J. Kish Stephen , Briand Marièle , Briand Yves
Published: March 2003

Many neurodegenerative diseases are characterized by ubiquitin‐positive protein aggregates or inclusion bodies. Ubiquitin‐conjugated proteins are degraded by the 20/26S proteasome, and reduced proteasome peptidase activities in brain homogenates have been reported in pathologic lesions of Parkinson's and Alzheimer's diseases. However, it is unknown whether crude extracts of human brain contain other proteases having peptidase activities. We found a novel protease of molecular weight of approximately 105 kDa in normal human brain, which exhibited trypsin‐like (T‐L) and chymotrypsin‐like (ChT‐L) activities (corresponding to 52% and 21% of the total activities in crude extracts) but not peptidyl glutamyl peptide hydrolase activity. Both T‐L and ChT‐L activities of this protease were partially inhibited by proteasome inhibitors (MG132, lactacystin) and, in contrast to those of the proteasome, also by sodium dodecyl sulfate. A simple method to obtain a brain fraction specific to the 20/26S proteasome was developed. Our human brain data suggest that T‐L and ChT‐L activity levels of the proteasome reported previously may include those of the 105 kDa protease, an enzyme of as yet unknown biological significance, and that it is necessary to separate the proteasome from this protease to evaluate the actual status of the ubiquitin‐proteasome system in neurodegenerative disorders.
Somatostatin receptors (sst2) are coupled to Go and modulate GTPase activity in the rabbit retina
Authors: Vasilaki Anna , Georgoussi Zafiroula , Thermos Kyriaki
Published: March 2003

The role of somatostatin and its mechanism of action in the retina remains an important target for investigation. Biochemical and pharmacological studies were engaged to characterize the somatostatin receptors in the rabbit retina, and their coupling to G‐proteins. The ability of selective ligands to inhibit [125I]Tyr11‐somatostatin‐14 binding to rabbit retinal membranes was examined. The sst2 analogues SMS201–995, MK678, and BIM23014, displayed IC50 values of 0.28 ± 0.12, 0.04 ± 0.01 and 1.57 ± 0.39 nm, respectively. The sst1 analogue CH275 moderately displaced the [125I]Tyr11‐somatostatin‐14 binding, while selective analogues for sst3, sst4 and sst5 had minimal effect. Immunoblotting and/or immunohistochemistry studies revealed the presence of the pertussis toxin sensitive Gi1/2, and Go proteins, as well as Gs. Somatostatin‐14 and MK678 stimulated GTPase activity in a concentration‐dependent manner with EC50 values of 42.8 ± 16.8 and 70.0 ± 16.5 nm, respectively, thus supporting the functional coupling between the receptor and the G‐proteins. CH275 stimulated the GTPase activity moderately, in agreement with its binding profile. The antisera raised against Goα and Gi1/2α inhibited the somatostatin‐induced high‐affinity GTPase activity, but only anti‐Goα inhibited the MK678 stimulation of the enzyme. These results suggest that somatostatin mediates its actions in the rabbit retina by interacting mainly with sst2 receptors that couple to Goα.
Conditions for rehabilitation of older patients with dementia and hip fracture – the perspective of their next of kin
Authors: Hedman Ann‐Marie Rydholm , Grafström Margareta
Published: March 2003

Conditions for rehabilitation of older patients with dementia and hip fracture – the perspective of their next of kin

The aim of this study was to describe the conditions for rehabilitation of older patients with dementia and hip fracture from the perspective of their next of kin. Twenty patients at orthopaedic wards were examined postfracture using a short cognitive test. The same number of next of kin answered four open‐ended questions about rehabilitation as well as about the patient’s physical function. Qualitative content analysis was used to identify categories. The findings indicate that the conditions for rehabilitation of older patients with dementia and hip fracture are related to the patients’ competence, specific needs of support in the light of competence, environmental factors and classification of the rehabilitation activities. The study confirms that the conditions for rehabilitation are related to symptoms of dementia disease and arise from a decline in competence making the patient unable to cope with the environmental pressure and to perform rehabilitation activities. Because of difficulties in assessing competence, patients with dementia are being judged as incapable of managing rehabilitation. A supportive strategy is necessary to encourage the recovery process.
The woven fabric – a metaphor of nursing care: the major subject in nursing education
Authors: Asp Margareta , Fagerberg Ingegerd
Published: March 2003

The woven fabric – a metaphor of nursing care: the major subject in nursing education

Society's future needs regarding health care present challenges to traditional nursing education. Today, the ambition is to create a nursing role that is appropriate to people's health care needs rather than the needs of the health care system. In nursing education, the major subject – nursing care – is central. Accordingly, there is a need for a consistent and clear articulation of this subject as well as the nursing profession. The aim of the present study was to interpret and describe the major subject, its content and structure in the nursing programme at Mälardalen University. With a hermeneutic approach an interpretation and application emerged as a metaphor of nursing care – the woven fabric. In this structure concepts function as bridges linking theory and practice, whereby it is possible to integrate different aspects of knowledge in order to think, feel and act nursing care.
Decision‐making in the treatment of elderly people: a cross‐cultural comparison between Swedish and German physicians and nurses
Authors: Richter Jörg , Eisemann Martin R. , Bauer Barbara , Kreibeck Hannelore , Åström Sture
Published: March 2003

Decision‐making in the treatment of elderly people: a cross‐cultural comparison between Swedish and German physicians and nurses

The aim of the study was to evaluate the comparability of decisions in the treatment of severely ill incompetent elderly patients among physicians and nurses from a cross‐cultural perspective. Convenience samples of 192 doctors and 182 nurses from Germany and 104 doctors and 122 nurses from Sweden have been investigated by a questionnaire in a cross‐sectional study. Between 39 and 58% of the subjects in the various groups have chosen treatment options, which are not consistent with the patient's will. However, nurses showed a significantly higher compliance than doctors. The probability of choosing cardio‐pulmonary resuscitation decreased with increasing information about the patient's wish. Ethical concerns and the patient's wishes appeared as the most important determinants of treatment decisions, whereas the hospital costs as well as the physicians' religion were of minor importance. The inconsistencies concerning decision‐ making within and between the groups reflect differences in underlying values and lack of societal consensus, which represent a prerequisite for the improvement of patient autonomy. To focus more frequently and to a larger extent onto the problems related to the treatment of severely ill elderly patients as well as onto the training of communication skills with an orientation towards informed consent in the medical training seems to be warranted.
Validity and reliability of the Nursing Minimum Data Set for the Netherlands (NMDSN)
Authors: Goossen William , Dassen Theo , Dijkstra Ate , Hasman Arie , Tiesinga Lucas , Van Den Heuvel Wim
Published: March 2003

The Nursing Minimum Data Set for the Netherlands (NMDSN) describes nursing care based on nursing phenomena, interventions and outcomes. The validity and reliability of its data collection has not been tested yet.

Purpose:  To report about the discriminative validity and the interrater reliability of the NMDSN.

Design:  Data were collected in an intensive care ward, in a nursing home and in a residential home. The unit of measurement and analysis is the ‘patient day’. The analysis for validity consisted of ridits calculations, and their graphical representations. Interrater reliability was measured by percentage agreement and Cohen's kappa.

Results:  Graphs illustrate the differences on most nursing phenomena and interventions as expected beforehand. The percentage agreements for the residential home vary from 60.4 to 100%, and the kappa statistics from −0.09 to 0.85, indicating a poor to almost perfect interrater reliability.

Conclusion:  Intensive care patients and patients in the nursing home have more problems and need more nursing interventions compared with general hospital patients, while the patients in the residential home have lesser of both. This illustrates the discriminative validity of the NMDSN. The kappa values for various NMDSN variables are sufficient. A similar test in the general hospital is recommended.
Ambiguity leads to uncertainty: ambiguous demands to blood donors
Authors: Lindstrøm Torill Christine , Røsvik Anne
Published: March 2003

Blood donors must respond to standard control questions and comply to certain demands before donating blood, to exclude possible recent contamination. This study investigates whether donors had adequate knowledge about ‘the immunological window period’, and whether the standard questionnaire in use was understandable and clear. It was found that nearly 40% of the donors had inadequate knowledge about ‘the immunological window period’ and that 10–40% of the donors would respond in various ways to different interpretations of the formulations of the questionnaire, indicating that the questionnaire was ambiguous. It was concluded that these factors could increase the risk of donating on wrong conditions. Demands and control questions posed to donors must be void of ambiguous formulations and take proper account of actual human sexual behaviours and life styles. Finally, it is suggested that blood banks must offer practical solutions (such as a ‘fake donation’) for temporarily rejected donors in order to respect their private integrity.
PCR primers for polymorphic microsatellite loci in the facultatively polygynous plant‐antPetalomyrmex phylax(Formicidae)
Authors: Dalecky A. , Debout G. , Mondor G. , Rasplus J.‐Y. , Estoup A.
Published: March 2003

Fourteen microsatellite loci were isolated and their level of polymorphism characterized in two populations of the facultatively polygynous plant‐antPetalomyrmex phylax(Formicinae). High levels of within‐population variation were observed at most loci, with number of alleles ranging from two to 15, and heterozygosity from 0.050 to 0.925. Cross‐species amplification of these loci was also tested in four plant‐ant species belonging to three other genera,Aphomomyrmex,Cladomyrma (both Formicinae) andCataulacus(Myrmicinae).
Isolation and characterization of polymorphic microsatellite DNA markers in two shrew species, Sorex unguiculatus and S. caecutiens
Authors: Naitoh Y. , Ishibashi Y. , Abe S. , Ohdachi S. D.
Published: March 2003

We isolated six microsatellite markers from the partial genomic libraries of two Sorex shrews, S. unguiculatus and S. caecutiens, and examined their allelic variation. All loci showed high allelic variation ranging from 15 to 19 alleles and all but one locus conformed to Hardy–Weinberg expectations in the species where the loci were isolated. Cross‐species amplifications showed that all primers derived from S. unguiculatus were useful for S. caecutiens, while among primer sets derived from S. caecutiens only one was useful for S. unguiculatus. Accordingly, at least five microsatellite markers were useful in S. caecutiens and three in S. unguiculatus.
Characterization of tetranucleotide microsatellite loci in a Lake Victorian, haplochromine cichlid fish: a Pundamilia pundamilia × Pundamilia nyererei hybrid
Authors: Taylor Martin I. , Meardon Fiona , Turner George , Seehausen Ole , Mrosso Hilary D. J. , Rico Ciro
Published: March 2003

The haplochromine cichlid fishes inhabiting Lake Victoria in East Africa are of great interest to evolutionary biologists. We have isolated and optimized six tetranucleotide and a single dinucleotide locus from a hybrid of the haplochromine cichlid fishes, Pundamilia pundamilia and P. nyererei. Characterization in 18 individuals of P. nyererei from a single wild population revealed between six and 18 alleles per locus, with expected heterozygosity ranging from 0.68 to 0.94. These loci will prove useful for investigations of population structure, and elucidating relationships between closely related species. An additional 26 unoptimized loci have been deposited with GenBank and the MEN database.
Isolation of polymorphic microsatellite loci in the genus Clusia (Clusiaceae)
Authors: Hale Marie L. , Squirrell Jane , Borland Anne M. , Wolff Kirsten
Published: March 2003

Microsatellite flanking region sequences may provide phylogenetically useful information. We isolated 13 polymorphic microsatellite loci from two species, Clusia minor (five loci) and Clusia nemorosa (eight loci), to aid in the determination of phylogenetic relationships within the genus Clusia. Eleven loci amplified across all 17 Clusia species tested, while two loci amplified in 10 out of 17 species. The extensive cross‐species amplification suggests that these loci may be useful for an examination of phylogenetic relationships in this genus.
Characterization of microsatellite loci in Anopheles flavirostris, the principal malaria vector in the Philippines
Authors: Torres E. P. , Fischer K. , Foley D. H. , Kemp D.
Published: March 2003

Microsatellites were isolated and characterized from Anopheles flavirostris, the principal malaria vector in the Philippines. Fifty of the 150 positive clones sequenced contained mostly dinucleotide microsatellites and only 16 had trinucleotide repeats. We designed primers from the unique sequences flanking 18 microsatellite loci. Of these, 11 loci produced successful amplification and revealed high levels of polymorphism; 86 alleles were detected with allele number ranging from 2 to 16 at each locus. The high allelic variability will make these microsatellite loci very useful for taxonomic and population genetic studies.
Isolation and characterization of microsatellite DNA primers in burrowing owl (Athene cunicularia)
Authors: Korfanta N. M. , Schable N. A. , Glenn T. C.
Published: March 2003

We developed polymerase chain reaction (PCR) primers to amplify 22 microsatellite DNA loci in burrowing owls (Strigiformes: Athene cunicularia). The seven most easily amplified and scored polymorphic loci are presented. These show 3−19 alleles per locus and expected heterozygosities of 0.067–0.712. Inheritance at all loci conformed to Mendelian expectations among six owl families, and six loci conform to Hardy–Weinberg expectations.
Development of polymorphic microsatellite markers in Arisaema serratum (Thunb.) Schott, Araceae
Authors: Nishizawa Toru , Kawahara Takayuki , Kinoshita Eiichiro , Ueda Kunihiko , Watano Yasuyuki
Published: March 2003

Arisaema serratum is a perennial herb capable of changing sex expression from year to year. We developed five polymorphic microsatellite markers for A. serratum to estimate male reproductive success. Variability at these loci was examined in two populations, one at Horigane and one at Kanazawa Japan; the number of alleles per locus ranged from five to 35 (the mean 21.4) in Horigane and from three to 36 (22.0) in Kanazawa. This high allelic diversity indicates that our markers are suitable for the study of male reproductive success in A. serratum.
Isolation and characterization of microsatellite loci in hybridizing California and Gambel's quail (Callipepla californica and C. gambelii)
Authors: Gee Jennifer M. , Calkins Jennifer D. , Petren Kenneth
Published: March 2003

Callipepla californica and C. gambelii are sibling species of quail that hybridize throughout Southern California where their ranges overlap. We developed seven highly polymorphic microsatellite markers that will be used to assess introgression between these species. Numbers of alleles ranged in C. californica from seven to 24 and in C. gambelii from five to 18, with high expected levels of heterozygosity in both species. Alleles exclusive to each species are present at most loci.
Isolation and characterization of microsatellite loci in wheat stem sawfly Cephus cinctus and cross‐species amplification in related species
Authors: Hartel K. D. , Frederick B. A. , Shanower T. G.
Published: March 2003

The wheat stem sawfly is an important insect pest of wheat that can cause significant damage to yield and grain quality. Five microsatellite loci were isolated and characterized in wheat stem sawfly, Cephus cinctus, to facilitate future population genetic studies and help delineate their geographical origin. These loci were found to be polymorphic with an expected heterozygosity ranging from 0.304 to 0.937 and an observed heterozygosity ranging from 0.05 to 0.65. Successful cross‐species amplification demonstrates the potential for these markers to provide a valuable tool for future population studies among related Cephus species.
A10. Advantages of electrosurgical resurfacing (24 years’ experience)
Authors: Nikitina Susanna
Published: March 2003

Since 1932, electrosurgical resurfacing for the treatment of scarring disorders and the removal of wrinkles has been successfully carried out on tens of thousands of patients in the Cosmetic and Plastic Surgery Centre in Leningrad . My aim is to share my own work experience of 24 years; I have performed more than 10 000 electrosurgical resurfacing procedures.

Electroresurfacing is essentially a superficial skin resurfacing to the reticular layer. It is performed with special AC/DC apparatus and thermocautery, designed by a dermatologist from Leningrad. The procedure is performed on an outpatient basis, under local (EMLA cream) or intravenous anaesthesia. After the procedure, which takes 5, 10 or 15 min (depending on the area involved), the patient is discharged. It is not recommend that full face resurfacing is performed in one single session. It is better to have one half of face treated during the first session, allow seven days for healing, and then perform the second session. Two to three weeks are therefore needed for a full face resurfacing. The skin is red for up to 10 days following the procedure, however the redness fades after a few weeks. New skin is regenerated, providing a fresher, smoother appearance with total disappearance of mild and moderate wrinkling. In the case of full face resurfacing, there is a significant ‘lifting’ effect. Electrosurgical resurfacing is 80–100% effective for at least 5−10 years. It can be easily performed in any location, if required, as the advantages are obvious. First, there is no possibility of infection. The second advantage is that the equipment is portable, light (0.5–1 kg depending on the transformer), easy to use, and inexpensive. Contraindications are acute inflammatory and contagious skin diseases, as well as severe psychosomatic diseases. Overzealous coagulation may cause depigmentation, edge pigmentation and keloid scars, and therefore it is very important to ensure that coagulation is at the right strength.

Based on the overwhelming experience of myself and my teachers, electrosurgical resurfacing has proved to be an excellent method for removing fine lines and wrinkles and for the correction of scars. Simplicity, a high degree of effectiveness, and a low incidence of complications make this method very attractive.
A14. Laser and IPL treatments of vascular malformations: the pre‐operative and post‐operative role of cosmetics and cosmoceuticals
Authors: Troilius Agneta
Published: March 2003

A sunscreen with a sun protection factor (SPF) of 15 blocks approximately 93% of UVB radiation and a sunscreen with SPF 30 blocks approximately 97% of UVB radiation. Most chemical sunscreens (e.g. benzophenone) block 95% of UVB rays, but not UVA rays. The ideal sunscreen is a physical sunscreen (e.g. titanium dioxide that reflects rays) combined with a chemical sunscreen. Following treatments with lasers and IPL using high fluences, blisters or small erosions and ulcerations may occur. It is necessary first of all to avoid a secondary infection that may cause a scar. If topical antistaphylococcal penicillin (e.g. fucidic acid) is used under occlusion, there is a high risk of developing resistance towards this penicillin. Instead, after cleansing, hydrogen peroxide may be used twice daily. For an ulcerating haemangioma, a hydrocolloid (e.g. Mepilex) that not only absorbs fluid but also diminishes pain can be used. For a capillary malformation with no ulceration and only slight purpura or erythema, a moisturiser applied daily may suffice. A group IV steroid applied locally can prevent scarring. Patients should always be encouraged to come back as soon as there is any problem with healing, and a quality foundation to cover the purpura or the lesion should be recommended.
Nursing in prisons: understanding educational needs through a case study approach
Authors: Willcox Adrienne
Published: March 2003

The health of people in British prisons is subject to scrutiny and comment by several agencies. These include the Home Office – who hold responsibility for services – penal reformers, prisoner representation groups, the media and providers of healthcare within prisons. Nurses make up the largest workforce within the latter group, and are employed outside the NHS. The aim of this research was to explore the educational needs of nurses working in a prison, and to map findings against a nation‐wide scoping study of prison nurses’ role commissioned by the UK Central Council for Nursing, Midwifery and Health Visiting (UKCC). Very little research exists on the educational aspects of healthcare provision in prisons, although the nature of ill‐health presentations is well documented. The UKCC study is unique, and enables comparison between national findings and this research, which took place in a single location. The objectives of the study were to investigate: the clinical and educational background of nurses working within prisons; the tasks and responsibilities of their role and how they were prepared for them; their perceived educational needs, including the content and structure of any proposed programme, and finally to estimate the degree of match between these findings and the UKCC national findings. Using a case study of one group of nurses working in a prison, data collection methods included a biographical timeline exercise and semi‐structured interviews. Content and thematic analysis of transcripts was undertaken, followed by documentary analysis of Nursing in Secure Environments (UKCC 1999). Both sets of findings were then compared for commonalities, anomalies and gaps. Findings revealed that there is no recognized, accredited qualification for a specialist prison nursing role. Induction programmes do not exist in all institutions, and continuing professional development occurs haphazardly according to the individual nurse, with little evidence of strategic planning in order to meet the health needs of people in prison. The implications for practice are diverse, and the opportunities for improvement are enormous. The educational needs of prison nurses are inseparable from the epistemological and ontological assumptions different agencies have about the way in which a society should, or could, treat those who break its rules.
California Condors and DDE: a re‐evaluation
Authors: Snyder Noel F. R. , Meretsky Vicky J.
Published: March 2003

Eggshells of wild California Condors Gymnogyps californianus were much thinner in the 1960s, when DDT was used heavily, than during earlier pre‐DDT and later reduced‐DDT periods. However, eggshell thickness was more strongly linked to egg size (mass) than to measured levels of p,p′DDE (the primary metabolite of DDT). Egg size was consistent within individual females and yielded correlation coefficients with shell thickness ranging from 0.49 to 0.97, depending on the period and the analysis assumptions used. Measured DDE levels, although often substantial, provided only a weak correlation (r = −0.33) with shell thickness. In part, the absence of a strong DDE/thickness correlation may have been an artefact of losses of DDE from fragment membranes over time. Nevertheless, the extreme (28–29%) shell thinning of the 1960s was not linked with clearly increased egg‐breakage or nest‐failure rates, and one female of the 1980s with 25.6% shell thinning was the most productive female of her era. Some eggs with over 30% shell thinning hatched successfully, and broken eggs closely resembled hatched eggs in shell thickness, strongly suggesting that shell thinning was not an important cause of breakage. The apparent absence of harmful effects from the extreme shell thinning of the 1960s may have resulted from (1) the fact that historic pre‐DDT condor eggs were on average 16.7% thicker shelled for their mass than predicted by the overall egg mass/shell thickness curve for birds, and (2) a possible egg‐size decline or sampling bias toward small‐egged females in the 1960s. That DDE was an important cause of the Condor's decline appears unlikely from overall available data.
Local Strain Measurement for Prediction of Fatigue Macrocrack Initiation in Notched Specimens
Authors: Ostash O. P. , Chepil R. V.
Published: March 2003

Abstract: On the basis of direct measurement of the opening displacement of the notch contour the procedure of the evaluation of local elastoplastic strains range, Δɛ*, is developed. The experimental values of Δɛ* are compared with the calculational data using known equations by Neuber, Glinka, etc. It is shown that for Δɛ* < 2% the experimental and calculational values are in good agreement but only in the case when the gradient of strains near the notch tip is taken into account. The proposed experimental method is used for the prediction of period Ni to fatigue macrocrack initiation in specimens of a complicated shape.
A Method for Determining X‐ray Elastic Constants for the Measurement of Residual Stress
Authors: Munsi A. S. M. Y. , Waddell A. J. , Walker C. A.
Published: March 2003

Abstract: The X‐ray diffraction method is arguably the most convenient method of measuring residual stresses in terms of cost, spatial resolution, measurement time and the accuracy of measurement. The normal methods for calibrating X‐ray diffractometers are not conveniently applied to automated scanning systems, however, and so a new approach is required. In this study, a scanning X‐ray diffractometer was calibrated and the X‐ray elastic constant for a steel alloy was determined using a customised four‐point bending rig. The bending rig, in turn, was calibrated by dead loading. This study also described a simple alternative method for determining the X‐ray elastic constant, without the use of specialised software. After calibration, the error band of the diffractometer was found to be less than ±10 MPa. As this is ±5% of the yield stress for a typical steel, this level of accuracy was deemed to be acceptable for the measurement of residual stress.
The influence of high contrast acuity and normalised low contrast acuity upon self‐reported situation avoidance and driving crashes
Authors: Slade S. V. , Dunne M. C. M. , Miles J. N. V.
Published: March 2003

The aim of this study was to determine the cues used to signal avoidance of difficult driving situations and to test the hypothesis that drivers with relatively poor high contrast visual acuity (HCVA) have fewer crashes than drivers with relatively poor normalised low contrast visual acuity (NLCVA). This is because those with poorer HCVA are well aware of their difficulties and avoid dangerous driving situations while those poorer NLCVA are often unaware of the extent of their problem. Age, self‐reported situation avoidance and HCVA were collected during a practice based study of 690 drivers. Screening was also carried out on 7254 drivers at various venues, mainly motorway sites, throughout the UK. Age, self‐reported situation avoidance and prior crash involvement were recorded and Titmus vision screeners were used to measure HCVA and NLCVA. Situation avoidance increased in reduced visibility conditions and was influenced by age and HCVA. Only half of the drivers used visual cues to signal situation avoidance and most of these drivers used high rather than low contrast cues. A statistical model designed to remove confounding interrelationships between variables showed, for drivers that did not report situation avoidance, that crash involvement decreased for drivers with below average HCVA and increased for those with below average NLCVA. These relationships accounted for less than 1% of the crash variance, so the hypothesis was not strongly supported.
Spherical and irregular aberrations are important for the optimal performance of the human eye
Authors: Nio Y. K. , Jansonius N. M. , Fidler V. , Geraghty E. , Norrby S. , Kooijman A. C.
Published: March 2003

Contrast sensitivity measured psychophysically at different levels of defocus can be used to evaluate the eye optics. Possible parameters of spherical and irregular aberrations, e.g. relative modulation transfer (RMT), myopic shift, and depth of focus, can be determined from these measurements. The present paper compares measured results of RMT, myopic shift, and depth of focus with the theoretical results found in the two eye models described by Jansonius and Kooijman (1998). The RMT data in the present study agree with those found in other studies, e.g. Campbell and Green (1965) and Jansonius and Kooijman (1997). A new theoretical eye model using a spherical aberration intermediate between those of the eye models described by Jansonius and Kooijman (1998) and an irregular aberration with a typical S.D. of 0.3–0.5 D could adequately explain the measured RMT, myopic shift, and depth of focus data. Both spherical and irregular aberrations increased the depth of focus, but decreased the modulation transfer (MT) at high spatial frequencies at optimum focus. These aberrations, therefore, play an important role in the balance between acuity and depth of focus.
Central corneal thickness is lower in osteogenesis imperfecta and negatively correlates with the presence of blue sclera
Authors: Evereklioglu Cem , Madenci Ercan , Bayazıt Yıldırım A. , Yılmaz Kutluhan , Balat Ayşe , Bekir Necdet A.
Published: March 2003

Background:  Osteogenesis imperfecta (OI) is a rare, autosomal‐inherited, connective tissue disorder characterised by bone fractures, deafness and blue sclera. Additional ocular findings are decreased ocular rigidity, myopia, glaucoma, keratoconus, corneal opacity, small corneal diameter and congenital Bowman's layer agenesis.

Purpose:  This cross‐sectional, masked, case‐control study aimed to assess whether central corneal thickness (CCT) is affected in patients with OI and to focus on the clinical significance of scleral blueness.

Materials and methods:  Twenty‐three children with OI (13 boys, 10 girls) and 15 age‐, sex‐ and refraction‐matched healthy control subjects (eight boys, seven girls) were assessed for CCT by ultrasound pachymetry. The CCT was compared between two different patient subgroups (type‐I OI with blue sclera, n = 12; type‐IV OI without blue sclera, n = 11). Mann–Whitney U‐test or analysis of variance was used as indicated and only right eyes of each subject were included in statistical analysis. Results were expressed as mean ± S.D. and statistical significance was taken as p < 0.05.

Results:  Mean age and sex distribution was similar between the groups (10.1 ± 2.5 vs 9.8 ± 1.8 years, p > 0.05). Patients with OI had significantly lower CCT (459.5 ± 24.6 μm) than in control subjects (543.6 ± 21.4 μm; p < 0.001). The CCT was below 500 μm in 22 of 23 children (95.6%) with OI, 15 of which (65.2%) were below 450 μm. In contrast, CCT was over 500 μm in all eyes in the control group. Type‐I OI eyes with blue sclera had significantly (p = 0.005) lower CCT readings (446.5 ± 16.3 μm) than type‐IV OI eyes without blue sclera (473.6 ± 25.0 μm). Mean keratometric values were similar between the groups (44.2 ± 1.7 vs 43.8 ± 1.6 dioptre, p > 0.05). Mean cycloplegic refraction was similar between the groups (−0.32 ± 0.5 vs −0.18 ± 0.4 dioptre; p > 0.05), although five of 23 OI patients had myopia, and mean intraocular pressure was lower in OI patients than controls (12.7 ± 1.8 mmHg vs 15.6 ± 1.9 mmHg; p < 0.001).

Conclusions:  The CCT is thinner and negatively correlated with the blueness of the sclera in patients with OI. The CCT readings may therefore be of utmost importance in the diagnosis of OI. An ophthalmologist should be aware of an artificially low intraocular pressure measurement in such patients. In addition, when considering a keratorefractive treatment, CCT must be evaluated carefully to avoid unexpected results or complications. Sturdy protective spectacles should be prescribed to those who are not bed bound. Possible correlation of low CCT with biochemical changes in scleral collagen or systemic parameters awaits further investigation.
Is visual efficiency reduced in myopic eyes?
Authors: Vera‐Díaz F. A. , McGraw P. V. , Strang N. C. , Whitaker D.
Published: March 2003

Purpose:  Myopic eye growth has the potential to modify both optical and neural performance of the human eye. To examine the influence of these factors we measured contrast detection thresholds in the presence of different levels of stimulus noise.

Methods:  Contrast detection thresholds were measured for a 4 c deg−1 sinusoidal grating windowed by a Gaussian contrast envelope using a 2‐Alternative Force Choice method of constant stimuli. The stimulus (Gabor) was embedded in different levels of external noise (from 9.86 × 10−5 secdeg2 to 0 noise). Threshold measures when plotted against noise level produce a linear relationship: the slope provides a measure of sampling efficiency (neural index), and the intercept with the abscissa provides an estimate of internal noise (optical index). Six emmetropes and 15 myopes (≥6.00 D) participated in the study. The data of the emmetropic subjects were used as a baseline for comparison with the myopic group. In addition, biometric data were collected from all subjects.

Results:  All emmetropic subjects showed similar results (p > 0.5) with sampling efficiencies of the order of ∼14% and internal noise measures of ∼2.4 × 10−5 secdeg2. All myopic subjects demonstrated reduced visual efficiency (p < 0.01) which could take the form of a reduced sampling efficiency or increased intrinsic noise levels, although most myopic subjects showed reduced sampling efficiency. Interestingly, reductions in sampling efficiency were compensated by lower levels of internal noise in this group.

Conclusions:  Myopes show reduced visual efficiency in comparison to emmetropes. This can take the form of either increased internal noise or reduced sampling efficiency. However, deficits in sampling efficiency are associated with lower levels of internal noise. This may represent a compensation mechanism in the visual system of myopes to impaired neural sampling.
The development of the Quality of Life Impact of Refractive Correction (QIRC) questionnaire
Authors: Garamendi E. , Pesudovs K. , Elliott D. B. , Gelsthorpe S. , Burr J.
Published: March 2003

Purpose:  To develop an instrument for the comprehensive measurement of the impact of refractive correction on quality of life in the pre‐presbyopic age group. To design the questionnaire to be relevant to refractive correction by spectacles, contact lenses and refractive surgery.

Methods:  Quality of life domains were identified using literature review and professional focus group discussion. Items within these domains were selected from the scientific literature (global, vision‐specific and cosmetic surgery‐specific quality of life instruments) and from suggestions of professionals and lay people. Six focus groups were used for item reduction: Three groups of professionals (psychology and eye care professionals experienced with spectacle, contact lens and refractive surgery patients) and three groups of lay public. The reduced item set was built into a pilot questionnaire. Statistical analysis for item reduction included factor analysis (SPSS) and Rasch modelling (Quest, Rumm 2010).

Results:  Seven domains of quality of life were selected. Within these, 647 items were selected as possibly being relevant. This number was reduced based on the responses of the focus groups to 90 items, which form a pilot questionnaire. The responses of 306 subjects (102 spectacle wearers, contact lens wearers and people who have had refractive surgery) were used to further reduce items using factor analysis and Rasch modelling. This resulted in the final version of the Quality of Life Impact of Refractive Correction (QIRC) questionnaire.

Conclusions:  The methodological approach for item selection, item reduction, question construction and response scaling ensures construct validity of the QIRC questionnaire. The QIRC questionnaire is suitable for measuring quality of life in spectacle, contact lens wearers and refractive surgery patients, for outcome and cross‐sectional research.
Exercise in the Management of Heart Failure
Authors: Roubenoff Ronenn , Forman Daniel
Published: March 2003

Heart failure (HF) is becoming more prevalent as treatment of hypertension and other underlying diseases prolongs survival, while the aging of the population increases the number of people at risk. HF has long been thought to be a disease whose prognosis is driven solely by pump function. However, the correlation between cardiac output and functional status is not strong, and recent data have disclosed a strong effect of HF on skeletal as well as cardiac muscle. This has led to re‐examination of the notion that enforced rest is central to treatment of HF. Recent data indicate that exercise can markedly improve skeletal muscle strength and endurance, as well as overall functional status, without directly affecting cardiac function. Clinicians should incorporate exercise training into the routine care of patients with HF.
ABCs of Dietary Guidelines 2000 for Clinicians
Authors: Dwyer Johanna , Lichtenstein Alice H.
Published: March 2003

The Dietary Guidelines for Americans are the ABCs for good health. They urge that all Americans Aim for fitness, Build a healthy base, and Choose sensibly. Action steps include the following: Aim for fitness: Aim for a healthy weight. Be physically active everyday. Build a healthy base: Let the food pyramid guide your food choices. Choose a variety of grains daily, especially whole grains. Choose a variety of fruits and vegetables daily. Keep food safe to eat. Choose sensibly: Choose a diet that is low in saturated fat and cholesterol and moderate in total fat. Choose beverages and foods to moderate your intake of sugars. Choose and prepare foods with less salt. If you drink alcoholic beverages, do so in moderation.
Unintentional Weight Loss and Its Management in Patients with Parkinson's Disease
Authors: Holden Kathrynne E.
Published: March 2003

Abstract Unintentional weight loss (UWL) is common in patients with Parkinson's disease (PD). Possible causes include increased energy expenditure due to tremor, dyskinesias, and rigidity; reduced energy intake due to PD‐related conditions, including olfactory dysfunction, cognitive impairment, depression, dysphagia, and deterioration in manual dexterity; and/or medication‐related side effects, including dry mouth, nausea/vomiting, appetite loss, anorexia nervosa, insomnia, fatigue, nervousness, and anxiety. In many cases, UWL is probably multifactorial. UWL increases the risk of malnutrition, morbidity and mortality, and the need for hospitalization, home health care, or long‐term care. Weight loss may be accompanied by loss of bone density and skeletal muscle. People with PD often have gait and balance impairment and increased incidence of falls, fractures, and hospitalization, and this loss of bone and muscle mass further increases these risks. Early nutrition intervention could potentially avert pain and trauma to the patient, as well as reduce the burden of health care costs. Management of weight loss should include a multidisciplinary team, including a primary care physician, a neurologist, a registered dietitian, and, when dysphagia or dysarthria is present, a speech‐language pathologist. Specialized interviewing skills and assessment techniques improve patient compliance and provide for successful therapy. Determining etiology of weight loss and individualizing patient education are necessary to guide therapy and improve the chances of success in attaining weight‐management goals. A case history is presented, demonstrating gradual long‐term weight loss, subsequent weight regain and increased ability to exercise, and a decrease in number of daily falls.
Nutritional Management of Individuals with Alzheimer's Disease and Other Progressive Dementias
Authors: Morris Judith , Volicer Ladislav
Published: March 2003

Alzheimer's disease (AD) causes a steady loss of memory and a decline in the ability to care for oneself. Weight loss is an insidious, yet common, problem that requires intervention and supervision during all stages of the disease. In spite of swallowing difficulties, natural feeding techniques can be used to sustain demented individuals without the use of tube feeding. Mealtime independence that supports an adequate nutritional intake can be encouraged by a variety of environmental, behavioral, and physical strategies. Supplements and adjustments in the diet's texture and volume in response to chewing and swallowing difficulties can enhance food and fluid intake and help to maintain an established target weight. Strategies used to maintain nutritional status in AD may also be useful for individuals with other progressive dementias. It is important to consider the individual's comfort and dignity when making any team treatment decisions.
The Use of Probiotics for the Prevention, Management, and Treatment of Gastrointestinal Disease
Authors: Vanderhoof Jon A. , Young Rosemary J.
Published: March 2003

Abstract Bacterial flora acquired at birth remain relatively constant throughout life. Temporary alterations of this flora using probiotic organisms may result in positive therapeutic effects. Precise mechanisms of probiotic action are just beginning to be understood. The function of competitive inhibition, while important, has been found to be augmented by effects on the intestinal and, possibly, the systemic, immune system. A few lactobacillus and bifidobacteria species, along with Saccharomyces boulardii, have been evaluated in clinical settings using appropriate methodology. These are discussed in this review.
Dietary Management of Cardiovascular Disease: A Year 2002 Perspective
Authors: Van Horn Linda , McDonald Arline , Peters Eileen , Gernhofer Niki
Published: March 2003

Never before has so much evidence pointed to the importance of diet and lifestyle behavior as influencing risk for cardiovascular disease. The National Cholesterol Education Program (NCEP) recently released its Third Expert Panel Report on the Detection and Treatment of Cardiovascular Disease in Adults (ATP III). This report, along with policy guidelines related to obesity, hypertension, diabetes, and other chronic diseases, provides strong recommendations for lifestyle interventions—modified diet, physical activity, and weight control—as key factors in the prevention of disease. The current evidence surrounding these recommendations is summarized, and translational examples are presented. The strength of the evidence and the practical significance of the resulting recommendations are discussed.
Role of neuropathy and plasma nitric oxide in recurrent neuropathic and neuroischemic diabetic foot ulcers
Authors: Jude Edward B , Tentolouris Nicholas , Appleton Ian , Anderson Simon , Boulton Andrew J.M
Published: March 2003

Various factors are associated with foot ulceration, including delayed reporting of ulcers, poor glycemic control, and severity of neuropathy. Several studies have looked at the role of nitric oxide in wound healing. However, no studies have examined its role in the occurrence and recurrence of diabetic foot ulceration. In a cross‐sectional study we examined the role of neuropathy, retinopathy, nephropathy, and plasma nitric oxide (estimated from plasma nitrite and nitrate) levels in diabetic patients with recurrent and non‐recurrent neuropathic and neuroischemic foot ulcers. Patients with recurrent foot ulcers had higher vibration perception threshold values compared to patients with non‐recurrent foot ulcers (47.4 ± 5.7 volts versus 39.5 ± 10.3 volts respectively, P < 0.05). In addition, subjects with recurrent foot ulcers had significantly higher plasma nitric oxide compared to subjects with non‐recurrent foot ulcers (46.9 ± 6.3 μm/L versus 30.2 ± 2.4 μm/L respectively, P < 0.01). Multivariate logistic regression analysis adjusted for age, sex, hemoglobin A1c, presence of retinopathy and nephropathy, vibration perception threshold, plasma creatinine, and total nitric oxide, indicated that only vibration perception threshold was independently associated with the presence of an ulcer [odds ratio: 1.26 (1.10‐1.46); P <0.001)] and the recurrence of foot ulcers [odds ratio: 1.13 (1.01‐1.27); P=0.04)]. This study has shown that although plasma nitric oxide is higher in patients with recurrent neuropathic and neuroischemic foot ulcers, severity of neuropathy was the most important factor associated with the development and recurrence of foot ulcers in diabetic patients.
Four moral questions for human embryonic stem cell research
Authors: GREEN RONALD M.
Published: March 2003

Human embryonic stem cell research offers great promise for the treatment of many serious disease conditions in a variety of medical areas, including wound healing. Before this promise can be realized, society and individual researchers, clinicians, and patients will have to answer four ethical questions: 1) Can we ever intentionally destroy a human embryo? 2) Can we benefit from others' destruction of embryos? 3) Can we create an embryo to destroy it? 4) Can we clone human embryos? After outlining the issues raised by each question, the author concludes by indicating his own affirmative answer to each of these questions.