bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Implications of Obesity
Authors: Flancbaum Louis , Choban Patricia S.
Published: July 2002

Obesity is perhaps the most significant public health problem facing the United States today. Obese patients are at increased risk for numerous medical problems, which can adversely affect surgical outcome. However, these risks have not uniformly translated into increased or prohibitive operative morbidity and mortality in this population. With appropriate perioperative precautions and monitoring, the incidence of serious cardiovascular and pulmonary complications can be minimized. Obese patients can be treated as safely and effectively as their normal weight counterparts under most circumstances and should not be denied surgical treatment for any disorder when surgery constitutes the most appropriate therapy. When indicated, surgical treatment should be considered for patients with clinically severe obesity, since currently it appears to offer the best long-term results for weight control and amelioration of comorbidity.
The Graft-Versus-Leukemia Effects of Allogeneic Cell Therapy
Authors: Porter, MD David L. , Antin, MD Joseph H.
Published: July 2002

Until recently, the only cure for relapse after allogeneic bone marrow transplantation (BMT) has been a second BMT. Recently, infusions of leukocytes collected from the original transplant donor have been used to induce a direct graft-versus-leukemia (GVL) reaction in patients with relapsed disease. Adoptive immunotherapy with donor leukocyte infusions (DLI) results in complete remission for 60–80% of patients with relapsed chronic-phase CML; therapy is also effective for relapse of diseases other than CML, although response rates are lower. Adoptive immunotherapy induces remissions for the majority of patients with post-transplantation Epstein-Barr virus-related lymphomas and other viral-associated illnesses. The extraordinary success of DLI demonstrates that it is now possible to harness the GVL potential of the human immune system for clinical benefit. The necessary effector cells and target antigens required for GVL reactivity are poorly defined but are the subject of intensive investigation. Future trials will investigate strategies that retain and enhance the GVL effects while limiting toxicity from this therapy, and they may define methods of successful allogeneic adoptive immunotherapy outside the setting of allogeneic BMT.
STUDY OF TRILINEAR GAUGE-BOSON COUPLINGS AT THE TEVATRON COLLIDER
Authors: Ellison John , Wudka José
Published: July 2002

▪ Abstract  We review studies of the trilinear gauge-boson couplings at the Tevatron proton-antiproton collider from data collected by the CDF and DØ collaborations during the period 1992–1996. The gauge-boson couplings are a fundamental prediction of the standard model, resulting from the non-Abelian nature of the theory. Therefore, experimental tests of the couplings are of foremost importance. We introduce the experimental results by reviewing the effective Lagrangian formalism, the indirect constraints on the couplings from low-energy experiments, and the expected values of the couplings in theories beyond the standard model. Finally, we consider the prospects for future measurements.
Designing Inhibitors of Cyclin-Dependent Kinases
Authors: Hardcastle Ian R. , Golding Bernard T. , Griffin Roger J.
Published: July 2002

Cyclin-dependent kinases (cdks) play a pivotal role in controlling progression through the cell cycle. The complex mechanisms that control cdks have been elucidated and, in the case of cdk2, explained with reference to X-ray crystal structures of the catalytically active and inactive kinase. Deregulation of the cell cycle is commonly observed in cancer, so cdks are potential targets for experimental therapeutic agents. A number of distinct structural classes of cdk inhibitors have been discovered. Good selectivity among these ATP competitive inhibitors for cdks over other kinases has been established, and selectivity between individual cdks is often observed. The crystal structures of a number of key inhibitors bound to cdk2 can be used to explain the observed structure-activity relationships within the compound series and to guide the design of more potent inhibitors.
Molecular Dynamics Simulation of Nucleic Acids
Authors: Cheatham III Thomas E. , Kollman Peter A.
Published: July 2002

We review molecular dynamics simulations of nucleic acids, including those completed from 1995 to 2000, with a focus on the applications and results rather than the methods. After the introduction, which discusses recent advances in the simulation of nucleic acids in solution, we describe force fields for nucleic acids and then provide a detailed summary of the published literature. We emphasize simulations of small nucleic acids (∼6 to 24 mer) in explicit solvent with counterions, using reliable force fields and modern simulation protocols that properly represent the long-range electrostatic interactions. We also provide some limited discussion of simulation in the absence of explicit solvent. Absent from this discussion are results from simulations of protein-nucleic acid complexes and modified DNA analogs. Highlights from the molecular dynamics simulation are the spontaneous observation of A [Formula: see text] B transitions in duplex DNA in response to the environment, specific ion binding and hydration, and reliable representation of protein-nucleic acid interactions. We close by examining major issues and the future promise for these methods.
MOLECULAR MODELING OF MECHANOTRANSDUCTION IN THE NEMATODE CAENORHABDITIS ELEGANS
Authors: Tavernarakis and Nektarios , Driscoll Monica
Published: July 2002

▪ Abstract  Genetic and molecular studies of touch avoidance in the nematode Caenorhabditis elegans have resulted in a molecular model for a mechanotransducing complex. mec-4 and mec-10 encode proteins hypothesized to be subunits of a mechanically gated ion channel that are related to subunits of the vertebrate amiloride-sensitive epithelial Na+ channel. Products of mec-5, a novel collagen, and mec-9, a protein that includes multiple Kunitz-type protease inhibitor repeats and EGF repeats, may interact with the channel in the extracellular matrix. Inside the cell, specialized 15-protofilament microtubules composed of mec-12 α-tubulin and mec-7 β-tubulin may be linked to the mechanosensitive channel by stomatin-homologous MEC-2. MEC-4 and MEC-10 are members of a large family of C. elegans proteins, the degenerins. Two other degenerins, UNC-8 and DEL-1, are candidate components of a stretch-sensitive channel in motor neurons. Implications for advancing understanding of mechanotransduction in other systems are discussed.
The Interdependence of Vital Events: Twentieth-Century Indian Kerala
Authors: Rajan S. I. , James K. S.
Published: July 2002

The parish records of Syrian Catholics and Latin Catholics in twentieth-century Kerala, India, can be used to assess the seasonal fluctuations and interdependence of such vital events as births, deaths, and marriages in the short run. That the effect of seasonality has been more pronounced among the Syrian Catholic community than among the Latin Catholic community is due largely to socioeconomic, cultural, religious, and, more important, occupational differences.
“Not for Ornament”: Patenting Activity by Nineteenth-Century Women Inventors
Authors: Khan B. Zorina
Published: July 2002

Contrary to claims that nineteenth-century women did not contribute to inventive activity and that their work was insulated from technological progress, women inventors pursued profit opportunities and distributed patents in much the same way as their male counterparts whose patent rates responded to market incentives. Women in rural and frontier regions were especially inventive. A random sample of assignment contracts indicates that the rate at which women commercialized inventions kept pace with patenting. The evidence indicates that nineteenth-century women were active participants in the market for technology and suggests that the diffusion of household articles may have been more pervasive than previously thought.
Abbott H. Thayer's Anticipation of a Computer-Based Method of Working
Authors: Behrens Roy R.
Published: July 2002

This article describes the practice of Abbott H. Thayer (1849-1921) of working on several copies of the same painting, taking each to a different conclusion. It compares that method to the cur-rent computer-based practice of using the SAVE AS command to create copies of a digital artwork or design, which can then also be taken to different conclusions.
From Memory Arts to the New Code Paradigm: The Artist as Engineer of Virtual Information Space and Virtual Experience
Authors: Merritt Richard K.
Published: July 2002

This paper examines contemporary developments in the creation and experience of immersive 3D art projects in the context of spatial and information design. It takes into consideration historic forebears, particularly the ancient Greek art of memory, contemporary theorists, and current new media artists who are pushing code and application design to new limits. The essay specifically addresses the role of the artist as “coder” and application engineer and anticipates concerns and possible technological developments in data visualization and virtual spaces. As new media artists write their own code, current boundaries between disciplines and sectors become blurred and new aesthetic judgments become pivotal. Additionally, current management and organizational structures are challenged to confront a world that increasingly visualizes and communicates in 3D.
Life and Death in the Digital World of the Plaintext Players
Authors: Corcoran Marlena
Published: July 2002

This essay analyzes the age-old struggle of Life and Death as it plays out in the new digital medi um. It begins with a consideration of the dramati zations of an on-line improvisational group known as the Plaintext Players. Life and Death are discussed as contestants in a great morality play; as psychological driving force in the performances; as formal textual realm; and as thematic setting. The article goes on to discuss the complex negotiations of subject and object in the intricate interactions of dialogue, action, and spoofing in MOO performances. Finally the author considers “Real Life as Afterlife,” as one of the Players' performances is transposed onto the real-life stage.
Decentralized Control of Construction Behavior in Paper Wasps: An Overview of the Stigmergy Approach
Authors: Karsai István
Published: July 2002

Grassé [26] coined the term stigmergy (previous work directs and triggers new building actions) to describe a mechanism of decentralized pathway of information flow in social insects. In general, all kinds of multi-agent groups require coordination for their effort and it seems that stigmergy is a very powerful means to coordinate activity over great spans of time and space in a wide variety of systems. In a situation in which many individuals contribute to a collective effort, such as building a nest, stimuli provided by the emerging structure itself can provide a rich source of information for the working insects. The current article provides a detailed review of this stigmergic paradigm in the building behavior of paper wasps to show how stigmergy influenced the understanding of mechanisms and evolution of a particular biological system. The most important feature to understand is how local stimuli are organized in space and time to ensure the emergence of a coherent adaptive structure and to explain how workers could act independently yet respond to stimuli provided through the common medium of the environment of the colony.
Norms, Heresthetics, and the End of the Cold War
Authors: Evangelista Matthew
Published: July 2002

The academic debate about the end of the Cold War has reached an impasse. Realists draw on evidence of economic decline and external pressure to explain the Soviet Union's retrenchment. Constructivists emphasize ideational change and Mikhail Gorbachev's “new thinking” as the source of accommodation. Neither approach sufficiently accounts for the fact that many powerful Soviet institutions did not support Gorbachev's approach from early on, well before his decisions contributed to the disintegration of the country. Even so, Gorbachev persuaded influential people who disagreed with him to accept his policy proposals. William Riker's concept of heresthetics—the use of language to manipulate the political agenda—goes a long way toward explaining Gorbachev's success. Heresthetics could be a way to bridge the gap between realist and constructivist approaches to international relations.
Social Class Identification and Class Interest in Taiwan
Authors: Marsh Robert
Published: July 2002

Are social classes perceived as a meaningful source of identity in Taiwan? I explore this issue with data from a 1992 survey (N = 2,377) of the population of Taiwan. Respondents were asked, "If people in our society are divided into upper, upper middle, middle, lower middle, working and lower classes, which class do you think you belong to?" Ninety-eight per cent placed themselves in one or the other of these six classes. The modal responses were "middle class" (41%) and "working class" (29%). Two tests are made of whether these responses are meaningful and consequential. First, I show that subjective class identification is rooted in respondent's position in the objective stratification system, i.e., the higher one's education, occupation, power and income, the higher the social class with which one identifies. The second test is the extent to which, controlling for one's objective position in the stratification system, subjective class identification has significant net effects on attitudes toward class issues (e.g, whether big enterprises have too much economic and political power). Class interest theory predicts that Taiwanese who identify with the "middle" or higher classes have a more conservative ideology concerning class conflict, while those who think of themselves as "working class" or lower are more likely to believe there is class conflict, to favor collective action by employees against their employer, and to think big enterprises have too much power. Multiple regression analysis provides at best weak support for class interest theory. Subjective class identification has a significant net effect on attitudes toward only two of eight class issues. While the Taiwan respondents are not generally conservative on these class issues, class identification appears to have little to do with whether one is conservative or nonconservative. A serendipitous finding concerns education, which more than any other variable had significant net effects on attitudes toward class issues. It is Taiwan's most educated who are the least conservative on class issues. This finding has parallels with what some observers of Europe and the United States have called the New Class. The paper concludes with a discussion of the reasons why class identification is only weakly consequential for class-relevant beliefs in Taiwan.
Truncated thioredoxin (Trx80) induces production of interleukin-12 and enhances CD14 expression in human monocytes
Authors: Pekkari Klas , Avila-Cariño Javier , Bengtsson Åsa , Gurunath Ramanathan , Scheynius Annika , Holmgren Arne
Published: July 2002

Human thioredoxin (Trx) is the major 12-kd cellular disulfide-reductase that on secretion acts as a cocytokine with several interleukins. Truncated Trx with the 80 N-terminal residues (Trx80), also present in plasma, was by itself a mitogenic cytokine for human peripheral blood mononuclear cells (PBMC). This study investigated which cells in PBMC are targets of recombinant Trx80. Purified human CD14+ monocytes, but not B or T cells, in a synthetic medium were activated to differentiation by Trx80 as measured by flow cytometry of surface antigens because exposure to 100 nM Trx80 increased expression of CD14, CD40, CD54, and CD86. Proliferation of the monocytes was increased in a dose-dependent manner by Trx80 in concentrations ranging from 10 nM to 1 μM. Trx or interleukin (IL) 2 did not induce proliferation or expression of surface antigens on monocytes. Trx80 alone induced secretion of IL-12 from CD40+ monocytes in the PBMC cultures and this effect was enhanced by IL-2. Trx80 and IL-2 together were strongly synergistic to induce secretion of interferon-γ in PBMC cultures. The results showed that Trx80 is a potent cytokine for normal human monocytes and directs the immune system in favor of a Th1 response via IL-12 production.
Survival of transfused donor white blood cells in HIV-infected recipients
Authors: Kruskall Margot S. , Lee Tzong-Hae , Assmann Susan F. , Laycock Megan , Kalish Leslie A. , Lederman Michael M. , Busch Michael P.
Published: July 2002

The appearance and expansion of donor white blood cells in a recipient after transfusion has many potential biologic ramifications. Although patients with HIV infection are ostensibly at high risk for microchimerism, transfusion-associated graft-versus-host disease (TA-GVHD) is rare. The purpose of this study was to search for sustained microchimerism in such patients. Blood samples were collected from 93 HIV-infected women (a subset from the Viral Activation Transfusion Study, an NHLBI multicenter randomized trial comparing leukoreduced versus unmodified red blood cell [RBC] transfusions) before and after transfusions from male donors. Donor lymphocytes were detected in posttransfusion specimens using a quantitative Y-chromosome–specific polymerase chain reaction (PCR) assay, and donor-specific human leukocyte antigen (HLA) alleles were identified with allele-specific PCR primers and probes. Five of 47 subjects randomized to receive nonleukoreduced RBCs had detectable male lymphocytes 1 to 2 weeks after transfusion, but no subject had detectable male cells more than 4 weeks after a transfusion. In 4 subjects studied, donor-specific HLA haplotypes were detected in posttransfusion specimens, consistent with one or more donors' cells. None of 46 subjects randomized to receive leukoreduced RBCs had detectable male lymphocytes in the month after transfusion. Development of sustained microchimerism after transfusion in HIV-infected patients is rare; HIV-infected patients do not appear to be at risk for TA-GVHD.
Prognostic significance of minimal residual disease detection and PML/RAR-α isoform type: long-term follow-up in acute promyelocytic leukemia
Authors: Jurcic Joseph G. , Nimer Stephen D. , Scheinberg David A. , DeBlasio Tony , Warrell Raymond P. , Miller Wilson H.
Published: July 2002

The t(15;17) translocation in acute promyelocytic leukemia (APL) yields a PML/RAR-α fusion messenger RNA species that can be detected by reverse transcription–polymerase chain reaction (RT-PCR) amplification. Breakpoints within intron 3 of PML produce a short PML/RAR-α isoform, whereas breakpoints within intron 6 result in a longer form. Using RT-PCR, serial evaluations were performed on the bone marrow of 82 patients with APL (median follow-up, > 63 months) who received retinoic acid (RA) induction followed by postremission treatment with chemotherapy, RA, and biologic agents. Sixty-four patients attained a clinical complete remission and had at least 2 RT-PCR assays performed after completing therapy. Forty of 47 patients (85%) with newly diagnosed APL who were induced using RA had residual disease detectable by RT-PCR before additional therapy. After 3 cycles of consolidation therapy, residual disease was found in only 4 of 40 evaluable patients (10%). Among newly diagnosed patients who had 2 or more negative RT-PCR assays, only 3 of 41 (7%) had a relapse, whereas all 4 patients (100%) who had 2 or more positive results had a relapse. Among 63 newly diagnosed patients, those who expressed the short isoform appeared to have shorter disease-free and overall survival durations than patients who expressed the long isoform. These data indicate that 2 or more negative RT-PCR assays on bone marrow, performed at least 1 month apart after completing therapy, are strongly associated with long-term remissions. Conversely, a confirmed positive test is highly predictive of relapse.
HLA-G protein up-regulation in primary cutaneous lymphomas is associated with interleukin-10 expression in large cell T-cell lymphomas and indolent B-cell lymphomas
Authors: Urosevic Mirjana , Willers Joerg , Mueller Beatrix , Kempf Werner , Burg Guenter , Dummer Reinhard
Published: July 2002

Primary cutaneous lymphomas (CLs) constitute a spectrum of diseases characterized by a clonal accumulation of lymphocytes in the skin. Most CLs display a Th2 cytokine profile, including expression of interleukin-10 (IL-10). Because the up-regulation of HLA-G, a nonclassical class Ib molecule inducible by IL-10, might account for the immunescape of the malignant clone, HLA-G and IL-10 expression has been investigated in 45 cases of primary CL (10 of B-cell and 35 of T-cell origin) with quantitative polymerase chain reaction (PCR) and immunohistochemistry. HLA-G message was present in all cutaneous B-cell (CBCL) and T-cell (CTCL) lymphomas evaluated. Immunohistochemistry revealed HLA-G protein expression in 23 (51%) of 45 cases (7 of 10 CBCL, 16 of 35 CTCL). While in CBCL mostly indolent types displayed HLA-G positivity, in CTCL HLA-G expression was associated with high-grade histology and advanced stage of the disease. Except for neoplastic and infiltrating lymphocytes, other cells such as macrophages and dendritic cells showed HLA-G immunoreactivity. Furthermore, IL-10 protein expression was demonstrated in 16 (73%) of 22 HLA-G+ cases, which correlated with HLA-G protein presence (P < .001). HLA-G up-regulation together with IL-10 expression in CL might additionally contribute to the evasion of immunosurveillance and facilitate the transition from low- to high-grade lymphomas.
The diagnosis and management of polycythemia vera in the era since the Polycythemia Vera Study Group: a survey of American Society of Hematology members' practice patterns
Authors: Streiff Michael B. , Smith Brad , Spivak Jerry L.
Published: July 2002

The Polycythemia Vera Study Group (PVSG) was organized in 1967 to identify the optimal approach to the diagnosis and treatment of polycythemia vera (PV). Nevertheless, a systematic assessment of US physicians' approach to PV has not been performed. To determine practice patterns in the management of PV, a random sample of the US American Society of Hematology (ASH) membership was surveyed. Thirty-three percent of 3000 surveys were returned. Significant variations in diagnostic and therapeutic approach were evident by region, practice type, specialty, and clinical experience. Red cell volume determinations (78% of respondents), serum erythropoietin levels (76%), and arterial blood gases (75%) were the most frequent tests used in the diagnosis of PV. Sixty-nine percent of physicians use phlebotomy as their first choice for erythrocytosis. Phlebotomy plus hydroxyurea (27.8%) and hydroxyurea alone (10%) were used less often. Despite PVSG recommendations, almost 16% of physicians used a target hematocrit of 0.55 (50%) or 0.55 (55%) for phlebotomy therapy. Eighty-two percent of physicians treated thrombocytosis only when platelet counts exceeded 1000 × 109/L (1 000 000/μL) or in the event of symptoms. Hydroxyurea (62.8%) and anagrelide (35.4%) were the primary agents used to treat thrombocytosis. Thus, this national survey of US hematologists and oncologists has identified substantial variation in the approach to the diagnosis and treatment of PV. A significant minority of physicians undertreat erythrocytosis, and little consensus exists regarding the treatment of thrombocytosis.
Requirement for mitogen-activated protein kinase activation in the response of embryonic stem cell–derived hematopoietic cells to thrombopoietin in vitro
Authors: Filippi Marie-Dominique , Porteu Françoise , Pesteur Françoise Le , Schiavon Valérie , Millot Gaël A. , Vainchenker William , de Sauvage Frédéric J. , Dubart Kupperschmitt Anne , Sainteny Francoise
Published: July 2002

Enforced expression of c-mpl in embryonic stem (ES) cells inactivated for this gene results in protein expression in all the ES cell progeny, producing cells that do not belong to the megakaryocytic lineage and are responsive to PEG-rhuMGDF, a truncated form of human thrombopoietin (TPO) conjugated to polyethylene glycol. These include a primitive cell called BL-CFC, thought to represent the equivalent of the hemangioblast, and all myeloid progenitor cells. In this model, PEG-rhuMGDF was able to potentiate the stimulating effects of other growth factors, including vascular endothelial growth factor, on BL-CFC and a combination of cytokines on the growth of granulocyte macrophage–colony-forming units. The importance of the C-terminal domain of Mpl and of mitogen-activated protein kinase (MAPK) activation in TPO-dependent megakaryocytic differentiation has been well studied in vitro. Here, the role of this domain and the involvement of MAPK in upstream and nonmegakaryocytic cells are examined by using 2 truncated mutants of Mpl (Δ34, deletion of residues 71 to 121 in the C-terminal domain; and Δ3, deletion of residues 71-94) and specific inhibitors of the MAPK pathway. The 2 deleted regions support different functions, mediated by different signals. Residues 71 to 121 were required for PEG-rhuMGDF–dependent growth of BL-CFC, for megakaryocytic and other myeloid progenitors, and for megakaryocyte polyploidization. These responses were mediated by the ERK1–ERK2 MAPK pathway. In contrast, the only function of the sequence comprising residues 71 to 94 was to mediate the synergistic effects of PEG-rhuMGDF with other hematopoietic growth factors. This function is not mediated by MAPK activation.
Multiple inhalers confuse asthma patients
Authors: van der Palen J , Klein JJ , van Herwaarden CL , Zielhuis GA , Seydel ER
Published: July 2002

This study investigated the influence of the use of different types of inhalers on the adequacy of inhalation technique among adult asthmatics. Three hypotheses were tested: first, patients using only one type of inhaler will demonstrate adequate inhalation technique more often than those with two or more types. Secondly, patients using a combination of dry powder inhalers (DPIs) will demonstrate correct inhalation technique more often than those using the combination of a metered dose inhaler (MDI) and a DPI. Thirdly, some inhalers or combinations of inhalers are more prone to erroneous inhalation technique than others. Adult outpatients with asthma who regularly used inhaled steroid therapy (n=321) participated in the study. The inhalers investigated were MDIs on the one hand, and the DPIs Turbuhaler, Diskhaler, Cyclohaler, Inhaler Ingelheim and Rotahaler on the other. Of 208 adult asthmatics with only one inhaler, 71% made no inhalation errors versus 61% of 113 patients with two or more different inhalers. Of patients with a combination of DPIs 68% performed all essential checklist items correctly, versus 54% of patients with the combination of "regular" MDI and DPI. Patients using only the Diskhaler made fewest errors. Whenever possible, only one type of inhaler should be prescribed. If a combination is unavoidable, combinations of DPIs are preferable to MDI and DPI. The Diskhaler seems to be the most foolproof device.
Methacholine challenge in preschool children: methacholine-induced wheeze versus transcutaneous oximetry
Authors: Yong SC , Smith CM , Wach R , Kurian M , Primhak RA
Published: July 2002

Tracheal/chest auscultation for wheeze and transcutaneous oximetry have both been suggested as measures of outcome in bronchial provocation tests in young children. This study aimed to compare the sensitivity and safety of these two techniques as end-points for methacholine challenge in children aged <4 yrs. Seventy-two methacholine challenges were performed in 39 children aged <4 yrs with recurrent wheeze. Arterial oxygen saturation (Sa,O2) and transcutaneous oxygen pressure tcPO2 continuously, and the test was terminated when wheeze was heard or at Sa,O2 <91%. tcPO2 was not used as an end-point. Wheeze or desaturation occurred at < or =8 mg x mL(-1) methacholine in every test. One child had transient clinical cyanosis, but no other ill-effects were seen. Fifty-six tests (78%) were terminated for wheeze, seven (10%) for fall in Sa,O2 and nine (12%) showed simultaneous responses in both parameters. Twenty-eight tests (39%) contained a fall in tcPO2 >3 kPa but six of these also showed a significant rise. Fifty-three tests (75%) contained a fall in tcPO2 >15%, but 20 of these also showed a significant rise. Tracheal/chest auscultation with Sa,O2 monitoring is a sensitive and relatively safe end-point for bronchial challenges in preschool children. The erratic pattern of transcutaneous oxygen pressure response in some children casts doubt on its reliability as a proxy measure of bronchial obstruction.
Prediction of long-term functional outcome after stroke rehabilitation
Authors: Pettersen Renate , Dahl Trond , Wyller Torgeir Bruun
Published: July 2002

Objective: To ”nd patient characteristics in the early post stroke phase that could predict three years functional outcome.

Design: Prospective study.

Setting: In-hospital rehabilitation department (admission and discharge). Outpatient department one and three years post stroke.

Subjects: One hundred and forty-two stroke patients (56% women), median age 75 years.

Main outcome measures: Barthel Index (BI) score; BI score change; accommodation status; Rankin scale score; and Frenchay Activities Index (FAI) score, all registered three years post stroke.

Results: The percentages of patients still living at home after one and three years were 88% and 83%, respectively. Twenty per cent of the patients had deteriorated according to the BI after three years, mostly due to recurrent strokes (odds ratio (OR) 10.3; 95% con”dence interval (CI) 3.0–35.5) and co-morbidity with other disabling disorders (OR 3.9; CI 1.1–13.5). Co-morbidity also emerged as an important risk factor for dependency according to BI score (OR 8.8; CI 2.4–32.1) as well as for a poor FAI score (OR 4.9; CI 1.9–13.0). BI in the early phase was the strongest predictor for long-term functional outcome. Urinary incontinence emerged as a risk factor for nursing home placement after three years (OR 3.2; CI 0.9–11.3). Cognitive dysfunction was a risk factor for poor FAI scoring (OR 2.7; CI 1.0–7.0).

Conclusions: After stroke rehabilitation, concomitant chronic disabling disorders and recurrent strokes seem to play an important role regarding dependency, handicap and long-term functional decline.
A prospective, within-patient comparison between metal butterfly needles and Teflon cannulae in subcutaneous infusion of drugs to terminally ill hospice patients
Authors: Ross J R , Saunders Y , Cochrane M , Zeppetella G
Published: July 2002

We performed a prospective study of hospice in-patients requiring a syringe driver (SD), to determine the site duration and tolerability of metal butterfly needles compared to Teflon cannulae. Using patients as their own control, prescribed medications were divided equally between two SDs (Graseby MS16a), for delivery over 24 h. A butterfly infusion (Flo-safer™, 25 gauge) was connected to one SD and a Teflon cannula (Abbocath® -T, 24 gauge), to the second. These were inserted subcutaneously (sc) on opposite sides of the body at comparable sites; oedematous, broken or painful sites were excluded. SD sites were examined at 4-hourly intervals. The study was terminated when both devices had required resiting. Needle and cannula times were compared using the Wilcoxon signed rank test. Thirty patients entered the study, 13 males and 17 females, mean age (standard deviation): 70 (11) years. Thirteen patients completed the study. Nine patients died and eight patients discontinued the study before both needle and cannula had been resited. All 30 patients are included in the analysis. The time from insertion to resiting of the cannula was significantly longer than the needle: P<0.0002, median (range) 93.5 (22.8-263.5) h versus 42.8 (7.5-162.3) h, respectively. The cost of the needle versus cannula is £1.93 versus £2.51, respectively. Teflon cannulae have a median life span twice that of metal butterfly needles and are a cost-effective alternative for administration of medications by sc infusion in terminally ill patients.
The essence of spiritual care: a phenomenological enquiry
Authors: Wright M C
Published: July 2002

This study used a phenomenological approach, founded on the Husserlian tradition, to discover the spiritual essence of palliative care in the lived experience of stakeholders. Semistructured interviews were conducted with 16 participants who held a variety of roles linked to palliative care, and were of different religions and none. Amongst these participants, spiritual care is based on the assumption that all people are spiritual beings. It recognizes the relationship between illness and the spiritual domain and acknowledges the possibility of a search for meaning in the big questions of life and death. It responds to religious and humanistic needs by meeting both the requirements of faith and the desire for another human being to ‘be there’. Fundamentally, spiritual care seeks to affirm the value of each and every person based on nonjudgemental love.
Remote sensing methods in medium spatial resolution satellite data land cover classification of large areas
Authors: Franklin S. E. , Wulder M. A.
Published: July 2002

Numerous large-area, multiple image-based, multiple sensor land cover mapping programs exist or have been proposed, often within the context of national forest monitoring, mapping and modelling initiatives, worldwide. Common methodological steps have been identified that include data acquisition and preprocessing, map legend development, classification approach, stratification, incorporation of ancillary data and accuracy assessment. In general, procedures used in any large-area land cover classification must be robust and repeatable; because of data acquisition parameters, it is likely that compilation of the maps based on the classification will occur with original image acquisitions of different seasonality and perhaps acquired in different years and by different sensors. This situation poses some new challenges beyond those encountered in large-area single image classifications. The objective of this paper is to review and assess general medium spatial resolution satellite remote sensing land cover classification approaches with the goal of identifying the outstanding issues that must be overcome in order to implement a large-area, land cover classification protocol.
Holocene raised-beach ridges and sea-ice-pushed boulders on the Kola Peninsula, northwest Russia: indicators of climatic change
Authors: Møller Jakob J. , Yevzerov Vladimir Y. , Kolka Vasili V. , Corner Geoffrey D.
Published: July 2002

The primary aim of this paper is to describe and discuss the palaeoclimatic significance of mid-to late-Holocene fields of raised-beach ridges at Matalaniemi and sea-ice-pushed boulders at Kutovaya Bay on the Kola Peninsula. These beach features are interpreted as indicating at least 12 periods of stormy conditions alternating with calmer periods of relatively low sea-surface temperature since about 8000 cal. BP. A consistent chronology of climate change is difficult to establish due to considerable uncertainties attributed to local beach processes and relative sea-level displacements. A tentative interpolated chronology is suggested. At present, terrace formation at Matalaniemi and the absence of sea ice at Kutovaya Bay indicate an intermediate windy and mild type of winter climate.
Redox-modulated xenobiotic action and ROS formation: a mirror or a window?
Authors: Pagano G
Published: July 2002

A number of xenobiotics require redox reactions to form the reactive intermediates involved in the ultimate toxic events (e.g., adduct formation). The same mechanisms lead to the formation of reactive oxygen species (ROS), which can themselves exert direct toxicity including, e.g., DNA oxidative damage or glutathione depletion. The occurence of both mechanistic features in xenobiotic activation and toxicity may raise some difficulties in ascertaining the respective roles of reactive intermediates versus ROS-related mechnisms. An example is provided by the toxicity mechanisms of mitomycin C (MMC) and diepoxybutane (DEB), which are commonly referred to as ‘cross-linkers’. Their toxic actions, however, are well-known to be modulated via redox parameters, such as oxygen tension, antioxidants levels, or thioredoxin overexpression. The diagnostic assessment of Fanconi's anaemia (FA) relies on MMC and DEB sensitivity, which is usually referred to as ‘cross-linker sensitivity’; thus the redox-dependent toxicities of MMC and DEB may have direct implications for the definition of FA phenotype. Another major aspect in ROS formation relies on the extensive evidence pointing to the requirement for oxidative, as well as nitrosative activities in triggering a number of key events in cell division and differentiation, and in early embryogenesis. In turn, anti-oxidants that may prevent ROS-associated cellular damage in adult cells may prove to exert adverse or fatal outcomes when administered in early life stages. The overall information available on xenobiotic redox biotransformation and on the physiopathological roles of ROS points to the need of addressing ad hoc studies that should take into account the multiplicity of mechanistic events involved.
Human carcinogens: an evaluation study via the COMPACT and HazardExpert procedures
Authors: Lewis D FV , Bird M G , Jacobs M N
Published: July 2002

The results of computer-optimized molecular parametric analysis of chemical toxicity (COMPACT) and Hazard Expert evaluations on 14 established human carcinogens are reported. The concordances between COMPACT and carcinogenicity (71%%) and between HazardExpert and carcinogenicity (57%%) are significantly improved when taken in combination, where all 14 carcinogens are correctly identified by the two systems used in conjunction. However, if a negative energy of the highest occupied molecular orbital (EHOMO) value is regarded as evidence of electrophilic reactivity likely to give rise to mutagenicity and carcinogenicity, then 13//14 (93%%) of the carcinogens are correctly identified by combination with the COMPACT procedure alone. It is possible, therefore, to establish likely carcinogenicity arising from either P450 mediation (CYP1 and CYP2E) or compound electrophilicity via the employment of a straightforward approach to molecular and electronic structure calculation, a process that can be performed in a relatively short time frame (i.e., less than 1 hour per chemical) and at a low cost.
Contribution of cervical cord MRI and brain magnetization transfer imaging to the assessment of individual patients with multiple sclerosis: a preliminary study
Authors: Rovaris M , Holtmannspötter M , Rocca M A , Iannucci G , Codella M , Viti B , Campi A , Comi G , Yousry T A , Filippi M
Published: July 2002

This study was performed to assess how established diagnostic criteria for brain magnetic resonance imaging (MRI) interpretation in cases of suspected multiple sclerosis (MS) (Barkhof’s criteria) would perform in the distinction of MS from other diseases and whether other MR techniques (cervical cord imaging and brain magnetization transfer imaging [MTI]), might help in the diagnostic work-up of these patients. We retrospectively identified 64 MS and 59 non-MS patients. The latter group included patients with systemic immune-mediated disorders (SID; n=44) and migraine (n=15). All patients had undergone MRI scans of the brain (dual echo and MTI) and of the cervical cord (fast short-tau inversion recovery). The number and location of brain T2-hyperintense lesions and the number and size of cervical cord lesions were assessed. Brain images were also postprocessed to quantify the total lesion volumes (TLV) and to create histograms of magnetization transfer ratio (MTR) values from the whole of the brain tissue. Barkhof’s criteria correctly classified 108/123 patients, thus showing an accuracy of 87.8%. “False negative” MS patients were 13, while 2 patients with systemic lupus erythematosus (SLE) were considered as “false positives”. Using brain T2 TLV, nine of the“false negative” patients were correctly classified. Correct classification of 10 MS patients and both the SLE patients was possible based upon the presence or absence of one cervical cord lesion. Two MS patients with negative Barkhof’s criteria and no cervical cord lesions were correctly classified based on their brain MTR values. Overall, only one MS patient could not be correctly classified by any of the assessed MR quantities. These preliminary data support a more extensive use of cervical cord MRI and brain MTI to differentiate between MS and other disorders in case of inconclusive findings on T2-weighted MRI scans of the brain.
Comparison of two brief neuropsychological batteries in people with multiple sclerosis
Authors: Solari A , Mancuso L , Motta A , Mendozzi L , Serrati C
Published: July 2002

Background: We compared two brief neuropsychological batteries devised to assess people with multiple sclerosis (MS) and used them to assess the relationship between cognitive impairment and clinical characteristics. Methods: We administered either the Brief Repeatable Battery of Neuropsychological Tests (BRBNT) or the Screening Examination for Cognitive Impairment (SEFCI) to 213 consecutive MS outpatients and 213 individually matched controls. Results: Administration times were longer for BRBNT than SEFCI, for MS and controls (p=0.001). People with MS had lower scores in all individual tests than controls (p<0.001, BRBNT and SEFCI). By the criterion of poor performance on one or more tests, the sensitivity of BRBNT was 41.9% and that of SEFCI 31.5%. The corresponding figures by poor performance on two or more tests were 16.2% for BRBNT and 18.5% for SEFCI. The Buschke Selective Reminding and Paced Auditory Serial Addition were the tests best discriminating between people with MS and controls for BRBNT, and the Symbol Digit Modalities test for SEFCI. The only clinical variable independently associated with impaired performance on these batteries was EDSS. Conclusions: Both cognitive batteries were well accepted and easy to administer. Administration time for SEFCI was significantly shorter than for BRBNT; however, alternative forms for serial evaluation are available only for BRBNT. The BRBNT was slightly more sensitive in detecting impairment by the criterion of poor performance on one or more tests. EDSS score was the only clinical variable independently associated with cognitive impairment.
Interferon-β-1b and interferon-γ have similar inhibitory effects on apolipoprotein-E production in the monocyte/macrophage
Authors: O'Toole D , Love W C
Published: July 2002

Apolipoprotein-E (Apo-E) is the major lipid carrier in the brain, and is therefore important in the recycling of lipids and cholesterol to regenerating neurons during the remission phase of multiple sclerosis (MS). Interferon (IFN)-γ has been shown to inhibit Apo-E production by a mainly post-transcriptional method in a macrophage cell line, and reduced Apo-E in cerebrospinal fluid is noted during the remission phase in patients. IFN-β-1b is a recombinantly produced, anti-inflammatory cytokine, which has been shown to reduce the severity of MS relapses and reduce relapse rate. We have examined the effects of IFN-γ and IFN-β-1b on the production of Apo-E mRNA, cellular protein and secreted protein in primary monocytes derived from donor blood. IFN-β-1b does not relieve the dose-dependent inhibition of Apo-E seen with IFN-γ at up to 100 U/ml in these cells, and when used alone inhibits Apo-E production in a dose-dependent manner. This inhibition by IFN- β-1b was seen to be at a transcriptional level, and dose dependent up to 100 U/ml. Apo-E genotype, which has also been linked to failure to recover from MS relapses, did not affect this inhibition. The mode of action of IFN-β-1b in MS is therefore not thought to be through modification of Apo-E production.
Daylight linked dimming: effect on fluorescent lamp performance
Authors: Tetri Eino
Published: July 2002

Using automatic lighting control it is possible to utilize daylight and thus reduce the use of artificial lighting energy. However, a control system based on daylight makes great demands on lamps and ballasts. A lamp life test was used to study the effect of dimming on lamp life and the lumen maintenance of fluorescent lamps. Lamps were dimmed statically to a 1%, 5% or 15% luminous flux level or dimmed dynamically up and down thus simulating dimming according to the daylight illuminance. The results show that with electronic ballasts, lamps will reach the nominal lamp life even if the lamps are dimmed according to the daylight illuminance. When lamps burn continuously at low dimming levels, the lumen maintenance factor is larger than when lamps burn undimmed. The effect of dimming on lamp life and lumen maintenance factor is thus not an obstacle to the combined use of daylight and artificial lighting.
Summertime performance of an automated lighting and blinds control system
Authors: Roche L
Published: July 2002

An innovative automated blind and lighting control system was developed to eliminate direct solar penetration and keep working plane illuminances within an optimal range, while making maximum use of daylight, and minimizing blind movement. Data collected from a controlled experiment indicate that the system eliminated direct solar glare and kept the working plane illuminance within the target range, while providing only 30% more electric lighting than a theoretical system with no blinds and perfect knowledge of the working plane illuminance. The system needed to provide 60% less electric lighting than a similar system with switchable rather than dimmable luminaires. Total blind movement varied from less than 1 min to over 6 min in one day depending on the weather, with an average of 190 s. Similar integrated systems have the potential to save a large fraction of the electricity used for lighting, while providing an amenable visual environment.
Contentious development: peri-urban studies in sub-Saharan Africa
Authors: Mbiba Beacon , Huchzermeyer Marie
Published: July 2002

This paper reviews the current state of literature on peri-urban research in sub-Saharan Africa. This research has been led by multi-lateral and bilateral development agencies that have sought to find a role in urban development. The review finds that the donor-driven research has remained largely descriptive. It has neither emphasized nor theorized the rapid and contentious peri-urban transformations associated with globalization. The paper identifies these contradictory transformations and then reviews a range of social development theories, suggesting to what extent they are useful to a meaningful engagement with these contradictions. It highlights in particular the potential role of structuration theory.