bluuebunny/crossref_metadata_2025 huggingface dataset:
Wear Calculation for Toroidal Drive
Authors: Xu Lizhong , Huang Zhen
Published: June 2006

In this paper, by analyzing relative motion relationship of the toroidal drive, the lengths of the sliding arc and the rolling arc of the stator, worm, and planet are given. The formulas of the sliding ratios of the stator, worm, and planet teeth surfaces are introduced. The formulas of the wear values of teeth surfaces of the stator, worm, and planet for the drive are proposed. Using the formulas, distributions of the wear values of the stator, worm, and planet teeth surfaces are calculated and influences of the principal parameters of the drive on the wear values are discussed. Test results are close to calculating the value of the above wear equation.
RANDOM β-TRANSFORMATIONS
Authors: BAHSOUN WAEL , GÓRA PAWEŁ
Published: June 2006

We answer a question posed by Buzzi about the quasi-compactness of the Frobenius–Perron operator of random β-transformations for β∈(1,∞).
Nocturnal Low-Level Jet in a Mountain Basin Complex. Part II: Transport and Diffusion of Tracer under Stable Conditions
Authors: Darby Lisa S. , Allwine K. Jerry , Banta Robert M.
Published: June 2006

Differences in nighttime transport and diffusion of sulfur hexafluoride (SF6) tracer in an urban complex-terrain setting (Salt Lake City, Utah) are investigated using surface and Doppler lidar wind data and large-scale surface pressure differences. Interacting scales of motion, as studied through the URBAN 2000 field program combined with the Vertical Transport and Mixing (VTMX) experiment, explained the differences in the tracer behavior during three separate intensive operating periods. With an emphasis on nighttime stable boundary layer conditions, these field programs were designed to study flow features responsible for the nighttime transport of airborne substances. This transport has implications for air quality, homeland security, and emergency response if the airborne substances are hazardous. The important flow features investigated included thermally forced canyon and slope flows and a low-level jet (LLJ) that dominated the basin-scale winds when the surface pressure gradient was weak. The presence of thermally forced flows contributed to the complexity and hindered the predictability of the tracer motion within and beyond the city. When organized thermally forced flows were present, the tracer tended to stay closer to the city for longer periods of time, even though a strong basin-scale LLJ did develop. When thermally forced flows were short lived or absent, the basin-scale low-level jet dominated the wind field and enhanced the transport of tracer material out of the city.
Protein C concentrations in severe sepsis: an early directional change in plasma levels predicts outcome
Authors: Shorr Andrew F , Bernard Gordon R , Dhainaut Jean-Francois , Russell James R , Macias William L , Nelson David R , Sundin David P
Published: June 2006

Introduction

Protein C, because of its central role in hemostasis, plays an integral role in the host response to infection. Protein C depletion, resulting from increased consumption, degradation, and/or decreased synthesis, is characteristic of sepsis and has been shown to predict morbidity and mortality. The objective of this study was to determine whether early directional changes in protein C levels correlate with outcome.

Methods

Patients in the Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) clinical trial were assessed and categorized by baseline protein C (n = 1574). Deficiency was categorized as: severe deficiency, protein C levels ≤ 40% of normal protein C activity (n = 615, 39% of patients); deficient, protein C levels 41–80% of normal protein C activity (n = 764, 48.5% of patients); and normal, >80% of normal protein C activity (n = 195, 12.4% of patients). Logistic regression analysis of 28-day mortality for placebo patients was used to investigate whether baseline and day 1 protein C levels were independent risk factors for mortality. The impact of treatment with drotrecogin alfa (activated) (DrotAA) was also assessed.

Results

Protein C levels at baseline and day 1 were independent risk factors in placebo patients. If baseline protein C levels of severely deficient placebo patients remained ≤ 40% at day 1 their odds of death increased (odds ratio = 2.75, P < 0.0001), while if levels improved to >40% by day 1 their risk of death decreased (odds ratio = 0.43, P = 0.03). If baseline protein C levels of placebo patients were >40% but decreased by ≥ 10% on day 1, their risk of death increased (odds ratio = 1.87, P = 0.02). DrotAA treatment improved protein C levels by day 1 compared with placebo (P = 0.008) and reduced the risk of death in severely deficient (≤ 40%) patients at baseline. Treatment also decreased the number of severely protein C deficient (= 40%) patients and decreased the number of deficient (41–80%) patients and normal (>80%) patients who had a ≥ 10% decrease in protein C levels by day 1.

Conclusion

Baseline protein C levels were an independent predictor of sepsis outcome. Day 1 changes in protein C, regardless of baseline levels, were also predictive of outcome. The association of DrotAA treatment, increased protein C levels, and improved survival may partially explain the mechanism of action.
High-Risk Neuroblastoma Treated With Tandem Autologous Peripheral-Blood Stem Cell–Supported Transplantation: Long-Term Survival Update
Authors: George Rani E. , Li Shuli , Medeiros-Nancarrow Cheryl , Neuberg Donna , Marcus Karen , Shamberger Robert C. , Pulsipher Michael , Grupp Stephan A. , Diller Lisa
Published: June 2006

Purpose

To provide an update on long-term survival of patients with high-risk neuroblastoma treated with tandem cycles of myeloablative therapy and peripheral-blood stem-cell rescue (PBSCR).

Patients and Methods

Ninety-seven patients with high-risk neuroblastoma were treated between 1994 and 2002. Patients underwent induction therapy with five cycles of standard agents, resection of the primary tumor and local radiation, and two consecutive courses of myeloablative therapy (including total-body irradiation) with PBSCR.

Results

Fifty-one patients have experienced relapse or died. Median follow-up time among the 46 patients who remain alive without progression is 5.6 years (range, 15.1 months to 9.9 years). Progression-free survival (PFS) rate at 5 years from diagnosis was 47% (95% CI, 36% to 56%), and PFS rate at 7 years was 45% (95% CI, 34% to 55%). Overall survival rate was 60% (95% CI, 48% to 69%) and 53% (95% CI, 40% to 64%) at 5 and 7 years, respectively. The 5- and 7- year PFS rates from time of first transplantation for 82 patients who completed both transplants were 54% (95% CI, 42% to 64%) and 52% (95% CI, 40% to 63%), respectively. Five patients died from treatment-related toxicity after tandem transplantation. Relapse occurred in 37 (42%) of 89 patients, mainly within 3 years of transplantation and primarily in diffuse osseous sites. No primary CNS relapse or secondary leukemia was seen. One patient developed synovial cell sarcoma 8 years after therapy.

Conclusion

High-dose therapy with tandem autologous stem-cell rescue is effective for treating high-risk neuroblastoma, with encouraging long-term survival. CNS relapse and secondary malignancies are rare after this therapy.
Polymorphisms associated with apolipoprotein B levels in Greek patients with familial hypercholesterolemia
Authors: Choumerianou Despoina M. , Maumus Sandy , Skoumas John , Pitsavos Christos , Stefanadis Christodoulos , Visvikis-Siest Sophie , Dedoussis George V.Z.
Published: June 2006

Clin Chem Lab Med 2006;44:799–806.
Conceptual and Practical Considerations for Sharing Catastrophic/Systemic Risks
Authors: Skees Jerry R. , Barnett Barry J.
Published: June 2006

Catastrophic or systemic risks are a major challenge for the farm and food system and rural communities. Private sector markets for sharing catastrophic risks are limited, but less so than in the past. This article presents a conceptual base for understanding why markets for sharing catastrophic risks may be incomplete and/or inefficient. Next, federal efforts to address catastrophic risk losses are reviewed. Finally, new capital market developments are presented and an alternative is introduced where the government would write risk options for specific perils.
Sound Policies for Food Security: The Role of Culture and Social Organization
Authors: Molnar Joseph J.
Published: June 2006

Culture conditions the ability to organize to provide food security, but social organization is the immediate source of policies that prevent food insecurity or determine what happens when it does occur. Weather, war, terrorism, conflict, overpopulation, environmental degradation, corruption, and faulty policies have been identified as causes of food insecurity. Perhaps most of the blame for food insecurity should go to faulty policies or poor implementation of sound policy. This article identifies reasons for both kinds of failure that are linked to culture and social organization. The central task of government is to allow the food system to manage its own affairs, but policies must be ready to guide action when market, crop, or policy failures create food insecurity among those with no other means of coping with adversity.
Using Active Learning to Enhance Lectures
Authors: Bonwell Charles C.
Published: June 2006

Eighty percent of college professors lecture more than 80% of the time. Since clarity of information is crucial to rigorous disciplines such as agricultural economics, this research‐based article will examine ways in which student comprehension of lectures can be improved through the use of active learning. Specific strategies are suggested for previewing material, organizing information, assessing student learning, signaling transitions, using multiple examples, stressing, important points, providing pauses, eliminating unexplained content, and reviewing information frequently.
Bigger, Smaller, Richer, Poorer: Trends in Agricultural Economics
Authors: Zepeda Lydia , Marchant Mary
Published: June 2006

The 1996 American Agricultural Economics Association (AAEA) Employment Services Committee (ESC) survey results reveal that although enrollments are declining in both undergraduate and graduate programs, faculty numbers are increasing. These trends belie the fact that the increase in faculty has come among nontenure track faculty and that the number of tenure track assistant professors has declined markedly because of fewer hires, promotions, and attrition. One result is an aging tenure track faculty. Salaries among all faculty have been increasing at over 2% per year; however, a greater proportion of faculty is in the nontenure track at lower salaries. Key strategies to reverse declining enrollments are for departments to improve diversity, to gather information on placement of students at all levels, and especially to learn more about private‐industry placements at the undergraduate and masters levels and about foreign employment at the graduate level.
Shape variation of bilayer membrane daughter vesicles induced by anisotropic membrane inclusions
Authors: Bohinc Klemen , Lombardo Darko , Kraljiglič Veronika , Fošnarič Miha , May Sylvio , Pernuš Franjo , Hägerstrand Henry , Iglič Aleš
Published: June 2006

A theoretical model of a two-component bilayer membrane was used in order to describe the influence of anisotropic membrane inclusions on shapes of membrane daughter micro and nano vesicles. It was shown that for weakly anisotropic inclusions the stable vesicle shapes are only slightly out-of-round. In contrast, for strongly anisotropic inclusions the stable vesicle shapes may significantly differ from spheres, i.e. they have a flattened oblate shape at small numbers of inclusions in the membrane, and an elongated cigar-like prolate shape at high numbers of inclusions in the vesicle membrane.
Serum decreases the size of Metafectene-and Genejammer-DNA complexes but does not affect significantly their transfection activity in SCCVII murine squamous cell carcinoma cells
Authors: Konopka Krystyna , Overlid Nathan , Nagaraj Anitha , Düzgüneş Nejat
Published: June 2006

Cationic liposome-DNA (lipoplexes) or polymer-DNA (polyplexes) complexes have been used to deliver therapeutic genes, both in vitro and in vivo. However, gene transfer by these non-viral vectors is usually inhibited by biological milieu. A relatively high efficiency of transfection could be achieved in human oral cancer cells transfected with the polycationic liposome, Metafectene, and the polyamine reagent, GeneJammer, in the presence of 60% fetal bovine serum (FBS) (Konopka et al., Cell. Mol. Biol. Lett. 10 (2005) 455–470). Here, we examined the efficacy of these vectors to deliver β-galactosidase (β-gal), luciferase and Herpes Simplex Virus thymidine kinase (HSV-tk) genes to SCCVII murine squamous cell carcinoma cells, which are used to generate an orthotopic murine model of oral cancer. We also evaluated the hydrodynamic size and zeta potential of the vectors and the effect of FBS and mouse serum (up to 60%) on the size of Metafectene and GeneJammer complexes with the pCMV.Luc plasmid. Our results indicate that Metafectene and GeneJammer are highly effective in transfecting SCCVII cells. Approximately 60–70% of SCCVII cells transfected with pCMV.lacZ were positive for β-gal staining. The expression of β-galactosidase was essentially not affected by serum. Mouse serum (20–60%) reduced both Metafectene-and GeneJammer-mediated luciferase expression by ∼30–45%, while FBS did not affect transfection efficiency. The delivery of the HSV-tk gene by Metafectene or GeneJammer in the presence of 0% or 60% FBS, followed by GCV treatment for 6 days, resulted in over 90% cytotoxicity. The mean diameters of the DNA complexes of Metafectene and GeneJammer decreased significantly as a function of the serum concentration. The reduction in the size of the lipoplexes and polyplexes by serum was essentially not inhibitory to transfection of SCCVII cells. This is in contrast to previous hypotheses that serum-induced decrease in the size of lipoplexes is the primary cause of serum inhibition of transfection.
Finding limiting flows of batch extractive distillation with interval arithmetic
Authors: Frits Erika R. , Lelkes Zoltán , Fonyó Zsolt , Rév Endre , Markót Mihály Cs. , Csendes Tibor
Published: June 2006

A feasibility study on batch extractive distillation is based on analyzing profile maps. The existence and location of singular points and separatrices in these maps depend on process parameters. The limiting flows of the process are related to those parameter values where the map changes shape. Graphical tools can be used to roughly estimate these values. If a singularity is not found using graphical methods, one cannot guarantee that a singularity does not exist. Reliable computation of all zeroes of a nonlinear multidimensional function can be used to determine these points. This can be accomplished using interval arithmetic. An interval arithmetic–based branch‐and‐bound optimizer is applied to find the singular points and bifurcations. All the singular points of the maps at specified process parameters are found in this way. Limiting flows are determined with the same methodology by finding the bifurcation points and the corresponding parameter values. © 2006 American Institute of Chemical Engineers AIChE J, 2006
Der Weg zur Struktur amorpher Festkörper – eine Studie am Beispiel der Keramik Si3B3N7
Authors: Jansen Martin , Schön J. Christian , van Wüllen Leo
Published: June 2006

Si3B3N7 ist die Basisverbindung einer neuen Klasse amorpher Keramiken aus Si, B, N und C mit einem einzigartigen Eigenschaftsspektrum. Es bildet ein ungeordnetes Netzwerk, in dem die konstituierenden Elemente überwiegend kovalent aneinander gebunden sind. Wie bei Quarzglas ist die Zusammensetzung von a‐Si3B3N7 nahezu stöchiometrisch. Da alle drei konstituierenden Elemente als Aufatome für strukturempfindliche Sonden fungieren können, wurde Si3B3N7 als Grundlage für systematische Strukturuntersuchungen herangezogen, wobei insbesondere die Verfahren für die Strukturbestimmung bei festen Stoffen ohne Translationssymmetrie erprobt und verbessert werden sollten. Allerdings kann aus experimentellen Ergebnissen nicht die komplette amorphe Struktur abgeleitet werden, weshalb sie durch Computersimulationen überprüft und ergänzt werden müssen. Dazu wurden fünf Familien von Strukturmodellen erzeugt und mit den experimentellen Ergebnissen verglichen. Nur solche Modelle korrelierten gut mit dem Experiment, die bei ihrer Generierung so nahe wie möglich dem tatsächlichen Syntheseweg folgten.
Cover Picture: Higher‐Nuclearity Group 14 Metalloid Clusters: [Sn9{Sn(NRR′)}6] (Angew. Chem. Int. Ed. 26/2006)
Authors: Brynda Marcin , Herber Rolfe , Hitchcock Peter B. , Lappert Michael F. , Nowik Israel , Power Philip P. , Protchenko Andrey V. , Růžička Aleš , Steiner Jochen
Published: June 2006

Metalloid Clusters possess more metal–metal than metal–ligand contacts and contain metal atoms that participate only in metal–metal interactions. The metalloid cluster shown features a body‐centered Sn15 core and six amido ligands (Sn blue, N green, Si yellow, C black). In the Communication by M. F. Lappert, P. P. Power, R. Herber, and co‐workers on page 4333 ff., the synthesis and structures of two such clusters are presented along with Mössbauer spectra, which show two distinct Sn environments.
Functional problems in adult rectal prolapse and controversies in surgical treatment
Authors: Eu K-W , Seow-Choen F
Published: June 2006

Background

Rectal prolapse is a condition that has fascinated surgeons for a long time. To date, no single ideal surgical treatment has been identified. The aetiology of rectal prolapse remains highly controversial, but it is recognized that associated functional problems, such as incontinence and constipation, are common. The pathophysiology, and controversies surrounding continence and constipation, remain topics of debate.

Method

All relevant papers derived from Medline and manual searching on rectal prolapse and associated functional problems were reviewed.

Results and Conclusion

The surgical management of rectal prolapse has evolved from historical encirclement procedures to current minimally invasive ones. Successful management must include adequate attention to the associated functional problems in order to eradicate the basic abnormality.
Surgical management of pancreatic necrosis presenting with locoregional complications
Authors: Chaudhary A , Dhar P , Sachdev A , Agarwal A K
Published: June 2006

Background

Local complications of pancreatic necrosis may occur after surgery, but when they occur spontaneously render surgical treatment more hazardous and impair prognosis.

Methods

A retrospective review was carried out of 83 patients who underwent surgery for pancreatic necrosis from 1988 to 1995, to determine the incidence, type, treatment and outcome of locoregional complications caused by pancreatic necrosis associated with acute pancreatitis.

Results

Seventeen patients (20 per cent) were identified to have intra-abdominal complications with pancreatic necrosis either before operation or at the time of surgery. The majority of patients had a delay in intervention (mean 46 days). At presentation ten of the 17 patients had one or more organ system failures. Fourteen patients had gastrointestinal tract involvement, two had involvement of the biliary tract and one patient had a splenic rupture. Six patients died.

Conclusions

In patients with pancreatic necrosis, development of locoregional complications is associated with a high mortality rate. The presence of gastrointestinal bleeding, peritonitis, jaundice or pneumoperitoneum in such patients suggests the presence of a complication of the necrotic process and should prompt early intervention. Early referral of patients with severe acute pancreatitis to specialized units may reduce the risk of locoregional complications.
Melanoma of the nose
Authors: Papadopoulos T , Rasiah K , Thompson J F , Quinn M J , Crotty K A
Published: June 2006

Background

Melanoma of the nose is rare and management guidelines are poorly defined. In the past, excision margins have often been much narrower than for melanoma elsewhere.

Methods

The study was a retrospective clinicopathological study of 34 patients with cutaneous melanoma of the nose treated in a single unit.

Results

Desmoplastic neurotropic melanoma and lentigo maligna melanoma were the most common histological tumour types. Local recurrence occurred in eight patients, and in six cases appeared to be a result of inadequate excision margins. Regional lymph node metastases were associated with a very poor prognosis.

Conclusion

Adequate surgical excision is the mainstay of successful treatment for melanoma of the nose. Excision margins for nasal melanoma should not be any less than for melanoma elsewhere. Careful planning is required, not only to gain local disease control and the best chance of cure, but also to achieve functionally and aesthetically acceptable results. Excision margins need not be compromised in view of the variety of local flaps that can be employed to close the primary defect.
Prospective evaluation of quality of life in patients with localized oesophageal cancer treated by multimodality therapy or surgery alone
Authors: Reynolds J V , McLaughlin R , Moore J , Rowley S , Ravi N , Byrne P J
Published: June 2006

Background

Health-related quality of life (HRQL) outcomes are important in assessing new approaches to the treatment of cancer. Neoadjuvant therapy is being used increasingly before surgery in patients with localized oesophageal cancer. This prospective non-randomized study evaluated HRQL in patients treated by preoperative chemotherapy and radiation therapy followed by surgery (multimodal therapy) or by surgery alone.

Methods

Data from European Organization for Research and Treatment of Cancer quality of life questionnaires QLQ-30 and QLQ-OES24 were collected prospectively. Questionnaires were completed at diagnosis, after chemoradiotherapy where applicable, and at 3, 6 and 12 months after surgery.

Results

The study included 202 consecutive patients with oesophageal cancer considered suitable for curative (R0) resection at the time of staging. Eighty-seven patients received chemotherapy combined with external-beam radiotherapy before surgery. At baseline, 75 (86 per cent) of 87 patients in the multimodal group completed questionnaires, compared with 72 (62·6 per cent) of 115 in the surgery-alone group. There were no significant differences in baseline global HRQL scores between groups. Preoperative chemoradiotherapy significantly reduced physical (P = 0·004) and role (P = 0·007) functioning before surgery, despite a significant (P = 0·043) improvement in the dysphagia score. Oesophageal resection had a negative impact on global, functional and symptom HRQL scores at 3 months in both groups. Most variables had recovered by 6 months in the two groups, but at 12 months physical and role functioning remained impaired in the surgery-alone group, and social functioning and financial worries in the multimodal group.

Conclusion

Although the multimodal regimen had a negative impact on HRQL before surgery, postoperative quality of life in patients who had multimodal therapy was similar to that in those who had surgery alone.
Evolutionary dynamics of knowledge
Authors: Parra Carlos M. , Yano Masakazu
Published: June 2006

This study discusses the evolutionary nature of knowledge acquisition at micro and macro levels, and in particular when the process involves an artificial agent's interpretative devices. In order to accomplish this, we propose using an individual learning model (or inner‐world reconstruction model) that in our view overcomes neoclassic epistemological holdups and may increase the predictive power of computational economics, by letting an artificial agent's knowledge evolve by itself, irrespective of globally specified goals or individual motives of behavior; using simultaneous (or parallel) genetic algorithms (GA) to evolve a single agent's learning strategy, each GA with different general specifications, in a multiagent setting. © 2006 Wiley Periodicals, Inc. Complexity 11: 12–19, 2006
Anemia and cognitive performance in hospitalized older patients: results from the GIFA study
Authors: Zamboni Valentina , Cesari Matteo , Zuccalà Giuseppe , Onder Graziano , Woodman Richard C , Maraldi Cinzia , Ranzini Monica , Volpato Stefano , Pahor Marco , Bernabei Roberto
Published: June 2006

Background

Anemia represents a major risk factor for adverse health‐related events in older persons. The aim of this study was to evaluate the association between hemoglobin levels/anemia and cognitive function in hospitalized older persons.

Method

Data are from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study. Hemoglobin levels (in g/dL) were measured upon admission to hospital; anemia was defined according to the WHO criteria. Cognitive performance was assessed by the Abbreviated Mental Test (AMT) on admission; an AMT score <7 defined cognitive impairment. Logistic regressions and analyses of covariance were performed to evaluate the relationship between cognitive status and hemoglobin levels/anemia.

Results

Mean age of the sample (n = 13,301) was 72.0 years. Participants with cognitive impairment presented a higher prevalence of anemia (47%) compared to those without cognitive impairment (35%, p < 0.001). Adjusted logistic regressions showed that hemoglobin levels/anemia were significantly associated with cognitive impairment (OR = 0.96, 95%CI = 0.94–0.99, p = 0.004, and OR = 1.32, 95%CI = 1.18–1.48, p < 0.001, respectively). Patients with anemia and cognitive impairment at the hospital admission presented a higher number of impaired Activities of Daily Living compared to those with only one or none of the studied conditions (p for trend < 0.001).

Conclusion

Low hemoglobin levels and anemia are independently associated with cognitive performance in older persons admitted to acute care units. Copyright © 2006 John Wiley & Sons, Ltd.
Abuse of vulnerable people with dementia by their carers: can we identify those most at risk?
Authors: Cooney Colm , Howard Robert , Lawlor Brian
Published: June 2006

Objective

We wanted to explore possible associations between characteristics of carers, dementia sufferers and the caring situation and the presence of abuse that was acknowledged by carers.

Methods

Eighty‐two carers of dementia sufferers were interviewed in their homes about three types of abuse (verbal abuse, physical abuse and neglect) using a structured questionnaire.

Results

Fifty‐two percent (n = 43) carers admitted to having carried out some form of abuse. Verbal abuse was the most common form (n = 42, 51%), while 20% (n = 16) of carers admitted to physical abuse and 4% (n = 3) to neglect abuse. Significant associations were found between verbal abuse and psychological ill health in the carer and behavioural problems in the dementia sufferer. Physical abuse was significantly associated with higher levels of self‐reported good health by the carer. High expressed emotion measured in carers was highly correlated with all types of abuse.

Conclusion

It is possible to identify situations where people with dementia may be at high risk of abuse from their carers. Any effective intervention strategy should address psychological health problems in the carer, behavioural problems in the dementia sufferer and a strategy to manage high levels of expressed emotion in these situations. Copyright © 2006 John Wiley & Sons, Ltd.
Psychiatric comorbidity in older adults with bipolar disorder
Authors: Sajatovic Martha , Blow Frederic C. , Ignacio Rosalinda V.
Published: June 2006

Introduction

Comorbidity patterns and correlates among older adults with bipolar disorder (BPD) are not well understood. The aim of this analysis was to examine the prevalence of comorbid PTSD and other anxiety disorders, substance abuse and dementia in a population of 16,330 geriatric patients with BPD in a Veterans Health Administration administrative database.

Methods

Patients were identified from case registry files during Federal Fiscal Year 2001(FY01). Comorbidity groups were compared on selected clinical characteristics, inpatient and outpatient health resource use, and costs of care.

Results

Four thousand six hundred and sixty‐eight geriatric veterans with BPD were comorbid for either substance abuse, PTSD and other anxiety disorder, or dementia (28.6% of all veterans with BPD age 60 or older). Mean age of all veterans in the four comorbidity groups was 70.0 years (±SD 7.2 years). Substance abuse was seen in 1,460 (8.9%) of elderly veterans with BPD, while PTSD was seen in 875 (5.4%), other anxiety disorders in 1592 (9.7%), and dementia in 741 (4.5%) of elderly veterans. Individuals with substance abuse in this elderly bipolar population are more likely to be younger, minority, unmarried and homeless compared to elderly bipolar populations with anxiety disorders or dementia. Inpatient use was greatest among geriatric veterans with BPD and dementia compared to veterans with BPD and other comorbid conditions.

Conclusion

Clinical characteristics, health resource use and healthcare costs differ among geriatric patients with BPD and comorbid anxiety, substance abuse or dementia. Additional research is needed to better understand presentation of illness and modifiable factors that may influence outcomes. Copyright © 2006 John Wiley & Sons, Ltd.
Reliability, validity and factor structure of the GDS‐15 in Iranian elderly
Authors: Malakouti Seyed Kazem , Fatollahi Paridokht , Mirabzadeh Arash , Salavati Mojgan , Zandi Taher
Published: June 2006

Objectives

Depressive disorders are a public health problem even in developing countries. Access to valid and reliable screening instruments is needed for conducting community surveys. The main objective of this study is to provide the Iranian version of the Geriatric Depression Scale‐15 (GDS).

Methods

The GDS‐15 Farsi version was developed by translation and back translation. Two hundred and four subjects aged 59 years or older, who were chosen randomly from residents of the Ekbatan district of Tehran, the capital city of Iran, completed the GDS‐15. The Composite International Diagnostic Interview (CIDI) was used to establish a gold standard diagnosis of major depressive disorders.

Results

The GDS was found to be an internally consistent measure. Alpha, split‐half coefficients and test–retest reliability were 0.9, 0.89 and 0.58 respectively. Two factors were extracted by using factor analysis and the principle component analysis (varimax rotation): ‘depression’ and ‘psychosocial activity’. The Depression factor (omitting items 2, 9, 10, 13), which could be considered as a short form of the scale (α = 0.92), has significant correlation with the main scale (r = 0.58). Using receiver operating curve (ROC) analysis, the optimum cutoff score for GDS‐15 is 7/8, yielding a sensitivity of 0.9 and a specificity of 0.84. The optimum cutoff score for GDS‐11 is 6, yielding a sensitivity of 0.9 and a specificity of 0.83.

Conclusion

The long and short forms of the GDS have excellent properties as screening instruments for major depression in older dwellers in Iran, particularly in urban areas, as presented in our findings. Copyright © 2006 John Wiley & Sons, Ltd.
Mucoepidermoid carcinoma of salivary glands in the pediatric age group: 18 clinical cases, including 11 second malignant neoplasms
Authors: Védrine Pierre Olivier , Coffinet Laurent , Temam Stéphane , Montagne Karine , Lapeyre Michel , Oberlin Odile , Orbach Daniel , Simon Claude , Sommelet Danièle
Published: June 2006

Background.

Salivary gland tumors represent 1% of head and neck tumors, with only 5% of these occurring in patients younger than 20 years. Mucoepidermoid carcinoma (MEC) is one of the most frequent salivary gland cancers among adults and children.

Methods.

This survey was conducted among 34 French pediatric oncology departments. From 1980 to 2000, 18 cases were reported.

Results.

Treatment included surgery or radiotherapy, or both. The 5‐year survival rate was 93.7%. Eleven patients had been previously treated by radiotherapy and/or chemotherapy for a first malignant tumor, specifically, lymphoid leukemia (n = 4), lymphoma (n = 3), brain tumor (n = 2), sarcoma (n = 1), and retinoblastoma (n = 1).

Conclusions.

MEC is very rare in the pediatric age group. Treatment involves surgical removal of the tumor plus radiotherapy, according to histologic staging. MEC has a good prognosis in young patients. The survival rate does not differ in the subgroup of patients with MEC as a secondary tumor. © 2006 Wiley Periodicals, Inc. Head Neck, 2006
Management and control of public hospitals—the use of performance measures in Norwegian hospitals. A case‐study
Authors: Pettersen Inger Johanne , Nyland Kari
Published: June 2006

This paper investigates the use of performance measures in the management control and decision‐making processes in the Norwegian hospital sector. The motivation for the study is to understand the implementation of performance‐based management systems which is an element in the international New Public Management (NPM) reforms waves now affecting the hospital sector. The theoretical framework is based on the description of hospitals as complex and decoupled organizations. The use of benchmarking is discussed, and the focus is put on the information biases that exist in such data. The main finding in the empirical study is that the ambiguous information which exists in the performance measures used at the hospital department level, maintains the decoupling between the clinical activities and the management control practices. This decoupling creates management control problems because it hampers the knowledge on the cause‐effects of actions, which is important in order to undertake strategic decisions and diagnostic action. In order to increase transparency, cost information should be decomposed as to develop practical indicators for interactive control purposes in clinical departments. Copyright © 2006 John Wiley & Sons, Ltd.
Cannabis and neurodevelopment: implications for psychiatric disorders
Authors: Sundram Suresh
Published: June 2006

The developing brain is susceptible to the effects of exogenous cannabinoids both during the perinatal period through maternal cannabis use and in young adolescent users. Emerging data from human and animal perinatal exposure studies demonstrate a subtle rather than gross effect of cannabis upon later functioning including; specific cognitive deficits especially in visuospatial function; impulsivity, inattention and hyperactivity; depressive symptoms; and substance use disorders. From animal studies motor control systems, neuroendocrine function and nociception may additionally be affected. Fetal studies indicate that these outcomes may be through cannabinoid mediated influences on the ontogeny of, especially dopamine and opioid, neurotransmitter systems. The effect of cannabinoids in the adolescent suggest long‐term deleterious outcomes in cognition, depressive symptoms, schizophrenia and substance use disorders. Much of these data support a neurodevelopmental effect, however, predisposing genetic and/or environmental factors cannot be excluded from human studies. Gender specific differences have been observed in both human and animal studies implying sex hormone and related factors may interact with cannabinoids in neurodevelopment. Further understanding how cannabinoids influence neurodevelopment will inform public debate about the health effects of cannabis but also open avenues in discerning how modulation of the endocannabinoid system may assist in the development of therapeutic tools for a variety of neuropsychiatric disorders. Copyright © 2006 John Wiley & Sons, Ltd.
The role of the standard EEG in clinical psychiatry
Authors: O'Sullivan S. S. , Mullins G. M. , Cassidy E. M. , McNamara B.
Published: June 2006

Background

The EEG is a commonly requested test on patients attending psychiatric services, predominantly to investigate for a possible organic brain syndrome causing behavioural changes.

Aims

To assess referrals for EEG from psychiatric services in comparison with those from other sources. We determine which clinical factors were associated with an abnormal EEG in patients referred from psychiatric sources.

Methods

A retrospective review of EEG requests in a 1‐year period was performed. Analysis of referral reasons for psychiatric patients was undertaken, and outcome of patients referred from psychiatric services post‐EEG was reviewed.

Results

One thousand four hundred and seventy EEGs were reviewed, of which 91 (6.2%) were referred from psychiatry. Neurology service referrals had detection rates of abnormal EEGs of 27%, with psychiatric referrals having the lowest abnormality detection rate of 17.6% (p < 0.1). In psychiatric‐referred patients the only significant predictors found of an abnormal EEG were a known history of epilepsy (p < 0.001), being on clozapine (p < 0.05), and a possible convulsive seizure (RR = 6.51). Follow‐up data of 53 patients did not reveal a significant clinical impact of EEG results on patient management.

Conclusions

Many patients are referred for EEG from psychiatric sources despite a relatively low index of suspicion of an organic brain disorders, based on reasons for referral documented, with an unsurprising low clinical yield. Copyright © 2006 John Wiley & Sons, Ltd.
Junctional adhesion molecule‐A regulates cell migration and resistance to shear stress
Authors: Huang Hayden , Cruz Francisco , Bazzoni Gianfranco
Published: June 2006

Junctional adhesion molecule‐A (JAM‐A) is an adhesive protein expressed in endothelial cells, epithelial cells, platelets, and some leukocytes. JAM‐A localizes to the tight junctions between contacting endothelial and epithelial cells, where it contributes to cell–cell adhesion and to the control of paracellular permeability. JAM‐A also regulates cell motility, even though the quantitative biophysical features have not been characterized. In this study, we evaluated the role of JAM‐A in the regulation of cell motility using JAM‐A‐expressing and JAM‐A‐deficient murine endothelial cells. We report that, in the absence of shear stress, JAM‐A absence increases cell motility by increasing directional persistence but not cell speed. In addition, in the presence of shear stress, JAM‐A absence increases protrusion extension in the direction of flow and increased downstream cellular displacement (while, conversely, decreasing upstream displacement). All these effects of JAM‐A absence are mitigated by the microtubule‐stabilizing compound taxol. A motility‐ and microtubule‐related function, integrin‐mediated adhesiveness, was only slightly reduced in JAM‐A‐deficient cells compared with JAM‐A‐expressing cells. However, overexpression of JAM‐A in the JAM‐A‐deficient cells increased integrin adhesiveness to the same levels as those observed in taxol‐treated JAM‐A‐deficient cells. Taken together, these data indicate that JAM‐A regulates cell motility by cooperating with microtubule‐stabilizing pathways. J. Cell. Physiol. 209: 122–130, 2006. © 2006 Wiley‐Liss, Inc.
PhiC31 integrase mediates integration in cultured synovial cells and enhances gene expression in rabbit joints
Authors: Keravala Annahita , Portlock Joylette L. , Nash Joan A. , Vitrant David G. , Robbins Paul D. , Calos Michele P.
Published: June 2006

Background

Gene transfer to synovium in joints has been shown to be an effective approach for treating pathologies associated with rheumatoid arthritis (RA) and related joint disorders. However, the efficiency and duration of gene delivery has been limiting for successful gene therapy for arthritis. The transient gene expression that often accompanies non‐viral gene delivery can be prolonged by integration of vector DNA into the host genome. We report a novel approach for non‐viral gene therapy to joints that utilizes phage ϕC31 integrase to bring about unidirectional genomic integration.

Methods

Rabbit and human synovial cells were co‐transfected with a plasmid expressing ϕC31 integrase and a plasmid containing the transgene and an attB site. Cells were cultured with or without G418 selection and the number of neo‐resistant colonies or eGFP cells determined, respectively. Plasmid rescue, PCR query, and DNA sequence analysis were performed to reveal integration sites in the rabbit and human genomes. For in vivo studies, attB‐reporter gene plasmids and a plasmid expressing ϕC31 integrase were intra‐articularly injected into rabbit knees. Joint sections were used for histological analysis of β‐gal expression, and synovial cells were isolated to measure luciferase expression.

Results

We demonstrated that co‐transfection of a plasmid expressing ϕC31 integrase with a plasmid containing the transgene and attB increased the frequency of transgene expression in rabbit synovial fibroblasts and primary human RA synoviocytes. Plasmid rescue and DNA sequence analysis of plasmid‐chromosome junctions revealed integration at endogenous pseudo attP sequences in the rabbit genome, and PCR query detected integration at previously characterized integration sites in the human genome. Significantly higher levels of transgene expression were detected in vivo in rabbit knees after intra‐articular injection of attB‐reporter gene plasmids and a plasmid expressing ϕC31 integrase.

Conclusion

The ability of ϕC31 integrase to facilitate genomic integration in synovial cells and increase transgene expression in the rabbit synovium suggests that, in combination with more efficient DNA delivery methods, this integrase system could be beneficial for treatment of rheumatoid arthritis and other joint disorders. Copyright © 2006 John Wiley & Sons, Ltd.
Cover Picture: Macromol. Biosci. 6/2006
Authors: Choi Hak Soo , Ooya Tooru , Yui Nobuhiko
Published: June 2006

Cover: The figure shows the formation of a block‐selective polyrotaxane composed of PEI‐b‐PEG‐b‐PEI copolymer by pH‐controlled threading of cyclodextrins (CDs) onto the copolymer. While the CD threads indiscriminately at high pH onto the entire block copolymer, lowering the pH to 4.4 in the presence of 9‐anthraldehyde results in expulsion of the macrocycles from the PEI blocks and capping of the rotaxane by a one‐pot sequence. Further details can be found in the article by H. S. Choi, T. Ooya, and N. Yui* on page 420.
Activation‐induced cytidine deaminase (AID) is expressed in normal spermatogenesis but only infrequently in testicular germ cell tumours
Authors: Schreck S , Buettner M , Kremmer E , Bogdan M , Herbst H , Niedobitek G
Published: June 2006

Activation‐induced cytidine deaminase (AID) is essential for somatic hypermutation (SHM) and class switch recombination (CSR) of immunoglobulin genes in antigen‐dependent B‐cell maturation. SHM is not restricted to immunoglobulin gene loci, raising the possibility of a function for AID in other cell types. In this study, it is shown that AID is expressed in spermatocytes in the human testis. AID was mostly cytoplasmic but nuclear AID was also observed in a proportion of cells, in keeping with the DNA deamination model of AID function. Intratubular germ cell neoplasia unclassified (IGCNU), the precursor lesion of testicular cancers, was AID‐negative. Seminomas also lacked AID expression. Nuclear and cytoplasmic AID expression was observed in three of 32 mixed non‐seminomatous germ cell tumours. The results provide evidence for a physiological role for AID outside the immune system. AID expression in spermatocytes points to a role in meiosis. It remains uncertain whether AID may also contribute to the genetic aberrations characteristically found in testicular germ cell tumours. The consistent absence of detectable AID expression in atypical spermatogonia of IGCNU and its rare expression in germ cell tumours suggest that continued expression of AID is not involved in the pathogenesis of germ cell tumours. Copyright © 2006 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Molecular dynamics study of conformational changes in human serum albumin by binding of fatty acids
Authors: Fujiwara Shin‐ichi , Amisaki Takashi
Published: June 2006

Human serum albumin (HSA) binds with fatty acids under normal physiologic conditions. To date, there is little published information on the tertiary structure of HSA–fatty acid complex in aqueous solution. In the present study, we used molecular dynamics (MD) simulations to elucidate possible structural changes of HSA brought about by the binding of fatty acids. Both unliganded HSA and HSA–fatty acid complex models for MD calculations were constructed based on the X‐ray crystal structures. Five myristates (MYRs) were bound in the HSA–fatty acid complex model. In the present MD study, the motion of domains I and III caused by the binding of MYR molecules increased the radius of gyration of HSA. Root‐mean‐square fluctuations from the MD simulations revealed that the atomic fluctuations of the specific amino acids at drug‐binding site I that can regulate the drug‐binding affinity were increased by the binding of MYR molecules. Primary internal motions, characterized by the first three principal components, were observed mainly at domains I and III in the principal component analysis for trajectory data. The directional motion projected on the first principal component of unliganded HSA was conserved in HSA–MYR complex as the third principal directional motion with higher frequency. However, the third principal directional motion in unliganded HSA turned into the first principal directional motion with lower frequency in the HSA–MYR complex. Thus, the present MD study provides insights into the possible conformational changes of HSA caused by the binding of fatty acids. Proteins 2006. © 2006 Wiley‐Liss, Inc.
Assessing the combined effect of asbestos exposure and smoking on lung cancer: a Bayesian approach
Authors: Wraith D. , Mengersen K.
Published: June 2006

We review the literature on the combined association between lung cancer and two environmental exposures, asbestos exposure and smoking, and explore a Bayesian approach to assess evidence of interaction between the exposures. The meta‐analysis combines separate indices of additive and multiplicative relationships and multivariate relative risk estimates. By making inferences on posterior probabilities we can explore both the form and strength of interaction. This analysis may be more informative than providing evidence to support one relation over another on the basis of statistical significance. Overall, we find evidence for a more than additive and less than multiplicative relation. Copyright © 2006 John Wiley & Sons, Ltd.