bluuebunny/crossref_metadata_2025 huggingface dataset:
Sporadic and epidemic community legionellosis: two faces of the same illness
Authors: Sopena N. , Force L. , Pedro-Botet M. L. , Barrufet P. , Sauca G. , García-Núñez M. , Tolchinsky G. , Capdevila J. A. , Sabrià M.
Published: September 2006

The present study compares the risk factors, presentation and outcome of community-acquiredLegionella pneumophilapneumonia in 138 sporadic-case patients (1994–2004) and 113 outbreak-case patients (2002) treated in two hospitals in Catalonia (Spain) since urinary antigen assays were adopted.

Univariate and multivariate analysis were performed to compare epidemiological and clinical features, blood chemistry values, radiological findings and outcome of sporadic and epidemic legionnaires' disease.

Univariate analysis showed that male sex, chronic lung disease, HIV infection and immunosuppressive therapy prevailed in sporadic cases. Presentation with respiratory symptoms, confusion and blood chemistry alterations, such as hyponatraemia, aspartate aminotransferase and blood urea nitrogen elevation, and partial pressure of oxygenPO2<7.98 KPa (60 mmHg) were also more frequent in sporadic cases, while headache prevailed in outbreak cases. Sporadic cases had a greater delay in treatment, were more severe and had a worse outcome than epidemic cases. Multivariate analysis showed significant differences in sex, chronic lung disease, HIV infection and headache.

The clinical and outcome differences between the two groups may be explained by the detection of milder forms of legionnaires' disease, the earlier treatment and the lower severity of underlying disease in the outbreak cases.
Sarcoidosis and MIF gene polymorphism: a case–control study in an Irish population
Authors: Plant B. J. , Ghani S. , O'Mahony M. J. , Morgan L. , O'Connor C. M. , Morgan K. , Baugh J. A. , Donnelly S. C.
Published: September 2006

Macrophage migration inhibitory factor is a key pro-inflammatory mediator. A 5-CATT repeat functional polymorphism within the promoter of the gene was previously associated with the lowest promoter activity. It was hypothesised that patients exhibiting a 5-CATT allele would have a less aggressive inflammatory response with an associated less severe clinical phenotype in sarcoidosis.

Irish Caucasian sarcoidosis patients (n = 173) followed up for 1–39 yrs and a control group (n = 166) were genotyped for the CATT repeat polymorphism. Disease severity at the time of diagnosis and at the time of elaboration of the present study was assessed by the presence of thoracic and extrathoracic symptoms, erythema nodosum, radiographic interstitial changes (chest radiograph score equal to stage II or greater, or high-resolution computed tomography confirmed), pulmonary function tests, steroid use, erythrocyte sedimentation rate, C-reactive protein and angiotensin-converting enzyme levels.

In the Irish population studied, no evidence was found of a significant association between either sarcoidosis susceptibility and disease severity and the 5-CATT repeat functional polymorphism in the macrophage migration inhibitory gene.

The present study found no significant association between the 5-CATT repeat macrophage migration inhibitory factor gene polymorphism and sarcoidosis, and did not support the overriding role for macrophage migration inhibitory factor in driving sarcoidosis pathogenesis.
Apolipoprotein E isoform-dependent dendritic recovery of hippocampal neurons following activation of innate immunity
Authors: Maezawa Izumi , Zaja-Milatovic Snjezana , Milatovic Dejan , Stephen Christina , Sokal Izabela , Maeda Nobuyo , Montine Thomas J , Montine Kathleen S
Published: September 2006

Background

Innate immune activation, including a role for cluster of differentiation 14/toll-like receptor 4 co-receptors (CD14/TLR-4) co-receptors, has been implicated in paracrine damage to neurons in several neurodegenerative diseases that also display stratification of risk or clinical outcome with the common alleles of the apolipoprotein E gene (APOE):APOE2, APOE3, andAPOE4. Previously, we have shown that specific stimulation of CD14/TLR-4 with lipopolysaccharide (LPS) leads to greatest innate immune response by primary microglial cultures from targeted replacement (TR) APOE4 mice and greatest p38MAPK-dependent paracrine damage to neurons in mixed primary cultures and hippocampal slice cultures derived from TR APOE4 mice. In contrast, TR APOE2 astrocytes had the highest NF-kappaB activity and no neurotoxicity. Here we tested the hypothesis that direct activation of CD14/TLR-4in vivowould yield different amounts of paracrine damage to hippocampal sector CA1 pyramidal neurons in TR APOE mice.

Methods

We measuredin vivochanges in dendrite length in hippocampal CA1 neurons using Golgi staining and determined hippocampal apoE levels by Western blot. Neurite outgrowth of cultured primary neurons in response to astrocyte conditioned medium was assessed by measuring neuron length and branch number.

Results

Our results showed that TR APOE4 mice had slightly but significantly shorter dendrites at 6 weeks of age. Following exposure to intracerebroventricular LPS, there was comparable loss of dendrite length at 24 hr among the three TR APOE mice. Recovery of dendrite length over the next 48 hr was greater in TR APOE2 than TR APOE3 mice, while TR APOE4 mice had failure of dendrite regeneration. Cell culture experiments indicated that the enhanced neurotrophic effect of TR APOE2 was LDL related protein-dependent.

Conclusion

The data indicate that the environment within TR APOE2 mouse hippocampus was most supportive of dendrite regeneration while that within TR APOE4 hippocampus failed to support dendrite regeneration in this model of reversible paracrine damage to neurons from innate immune activation, and suggest an explanation for the stratification of clinical outcome withAPOEseen in several degenerative diseases or brain that are associated with activated innate immune response.
The automatic recognition and counting of cough
Authors: Barry Samantha J , Dane Adrie D , Morice Alyn H , Walmsley Anthony D
Published: September 2006

Background

Cough recordings have been undertaken for many years but the analysis of cough frequency and the temporal relation to trigger factors have proven problematic. Because cough is episodic, data collection over many hours is required, along with real-time aural analysis which is equally time-consuming.

A method has been developed for the automatic recognition and counting of coughs in sound recordings.

Methods

The Hull Automatic Cough Counter (HACC) is a program developed for the analysis of digital audio recordings. HACC uses digital signal processing (DSP) to calculate characteristic spectral coefficients of sound events, which are then classified into cough and non-cough events by the use of a probabilistic neural network (PNN). Parameters such as the total number of coughs and cough frequency as a function of time can be calculated from the results of the audio processing.

Thirty three smoking subjects, 20 male and 13 female aged between 20 and 54 with a chronic troublesome cough were studied in the hour after rising using audio recordings.

Results

Using the graphical user interface (GUI), counting the number of coughs identified by HACC in an hour long recording, took an average of 1 minute 35 seconds, a 97.5% reduction in counting time. HACC achieved a sensitivity of 80% and a specificity of 96%. Reproducibility of repeated HACC analysis is 100%.

Conclusion

An automated system for the analysis of sound files containing coughs and other non-cough events has been developed, with a high robustness and good degree of accuracy towards the number of actual coughs in the audio recording.
Ubiquitin crosstalk connecting cellular processes
Authors: Groothuis Tom AM , Dantuma Nico P , Neefjes Jacques , Salomons Florian A
Published: September 2006

The polypeptide ubiquitin is used in many processes as different as endocytosis, multivesicular body formation, and regulation of gene transcription. Conjugation of a single ubiquitin moiety is typically used in these processes. A polymer of ubiquitin moieties is required for tagging proteins for proteasomal degradation. Besides its role in protein degradation, ubiquitin is also engaged as mono- or polymer in intracellular signalling and DNA repair. Since free ubiquitin is present in limiting amounts in cells, changes in the demands for ubiquitin in any of these processes is likely to indirectly affect other ubiquitin modifications. For example, proteotoxic stress strongly increases poly-ubiquitylated proteins at the cost of mono-ubiquitylated histones resulting in chromatin remodelling and altered transcription. Here we discuss the interconnection between ubiquitin-dependent processes and speculate on the functional significance of the ubiquitin equilibrium as a signalling route translating cellular stress into molecular responses.
Invisible Barriers to Clinical Trials: The Impact of Structural, Infrastructural, and Procedural Barriers to Opening Oncology Clinical Trials
Authors: Dilts David M. , Sandler Alan B.
Published: September 2006

Purpose

To investigate the administrative barriers that impact the opening of clinical trials at the Vanderbilt-Ingram Cancer Center (VICC) and at VICC Affiliate Network (VICCAN) sites.

Methods

VICC, a National Cancer Institute–designated comprehensive cancer center, and three VICCAN community practice sites were studied. Methodology used was identification and mapping of existing processes and analysis of historical timing data.

Results

At course granularity, the process steps required at VICC and VICCAN main office plus local sites are 20 v 17 to 30 steps, respectively; this gap widens with finer granularity, with more than 110 v less than 60 steps, respectively. Approximately 50% of the steps are nonvalue added. For example, in the institutional review board (IRB) process, less than one third of the steps add value to the final protocol. The numbers of groups involved in the approval processes are 27 (VICC) and 6 to 14 (VICCAN home office and local sites). The median times to open a trial are 171 days (95% CI, 158 to 182 days) for VICC and 191 days (95% CI, 119 to 269 days) for the VICCAN sites. Contrary to expectations, the time for IRB review and approval (median, 47 days) is the fastest process compared with the scientific review committee review and approval (median, 70 days) and contracts and grants review (median, 78.5 days). Opening a cooperative group clinical trial is significantly (P = .05) more rapid because they require fewer review steps.

Conclusion

There are numerous opportunities to remove nonvalue-added steps and save time in opening clinical trials. With increasing numbers of new agents, fewer domestic principal investigators, and more companies off-shoring clinical trials, overcoming such barriers is of critical importance for maintenance of core oncology research capabilities in the United States.
Catheter-Related Deep Venous Thrombosis and Other Catheter Complications in Children With Cancer
Authors: Journeycake Janna M. , Buchanan George R.
Published: September 2006

Purpose

Asymptomatic deep vein thrombosis (DVT) is a complication of central venous catheter (CVC) use in children with cancer, but its clinical significance is not well defined. Children with CVCs commonly experience two other CVC-related complications: occlusion and infection. The aim of this study was to determine the frequency of these two complications and their association with DVT.

Patients and Methods

We conducted a retrospective cohort study of patients who were diagnosed with cancer. Data collected included number and type of catheter insertions, duration of use, reason for removal, associated catheter complications, and demographic information.

Results

Catheters were placed in 287 patients for a total of 128,403 days (mean, 290 ± 269 days/catheter). Of 21 patients (7%) diagnosed with CVC-related DVT, only five had specific signs or symptoms. Nineteen (90%) of these 21 children had prior history of catheter occlusion, and 10 of the 19 also experienced infection. Ten children (48%) were not identified as having DVT until they had had multiple catheters with recurrent complications. Odds of having DVT were higher in patients who had a single catheter complicated by repeated occlusions (odds ratio [OR], 3.7; P = .001) or infection (OR, 2.2; P = .016). Patients experiencing both infection and occlusion were at 6.4 times (P < .0001) higher risk of developing DVT.

Conclusion

Children with CVC-related DVT frequently have recurrent catheter complications. Unrecognized thrombosis may therefore be clinically important. Prospective studies are needed to determine if identification and treatment of occult DVT will prevent additional CVC-related complications and prolong the duration of catheter use.
The HOXB13:IL17BR Expression Index Is a Prognostic Factor in Early-Stage Breast Cancer
Authors: Ma Xiao-Jun , Hilsenbeck Susan G. , Wang Wilson , Ding Li , Sgroi Dennis C. , Bender Richard A. , Osborne C. Kent , Allred D. Craig , Erlander Mark G.
Published: September 2006

Purpose

We previously identified three genes, HOXB13, IL17BR and CHDH, and the HOXB13:IL17BR ratio index in particular, that strongly predicted clinical outcome in breast cancer patients receiving tamoxifen monotherapy. Confirmation in larger independent patient cohorts was needed to fully validate their clinical utility.

Patients and Methods

Expression of HOXB13, IL17BR, CHDH, estrogen receptor (ER) and progesterone receptor (PR) were quantified by real-time polymerase chain reaction in 852 formalin-fixed, paraffin-embedded primary breast cancers from 566 untreated and 286 tamoxifen-treated breast cancer patients. Gene expression and clinical variables were analyzed for association with relapse-free survival (RFS) by Cox proportional hazards regression models.

Results

ER and PR mRNA measurements were in close agreement with immunohistochemistry. In the entire cohort, expression of HOXB13 was associated with shorter RFS (P = .008), and expression of IL17BR and CHDH was associated with longer RFS (P < .0001 for IL17BR and P = .0002 for CHDH). In ER+ patients, the HOXB13:IL17BR index predicted clinical outcome independently of treatment, but more strongly in node-negative patients. In multivariate analysis of the ER+ node-negative subgroup including age, PR status, tumor size, S phase fraction, and tamoxifen treatment, the two-gene index remained a significant predictor of RFS (hazard ratio = 3.9; 95% CI, 1.5 to 10.3; P = .007).

Conclusion

This tumor bank study demonstrated HOXB13:IL17BR index is a strong independent prognostic factor for ER+ node-negative patients irrespective of tamoxifen therapy.
Processes to Activate Phase III Clinical Trials in a Cooperative Oncology Group: The Case of Cancer and Leukemia Group B
Authors: Dilts David M. , Sandler Alan B. , Baker Matthew , Cheng Steven K. , George Stephen L. , Karas Kathleen S. , McGuire Stephen , Menon Gourija S. , Reusch Jason , Sawyer Debbie , Scoggins Maren , Wu Amy , Zhou Kai , Schilsky Richard L.
Published: September 2006

Purpose

National Cancer Institute–sponsored cooperative oncology groups are major sponsors of phase III clinical trials, yet the time and steps required to design and activate such studies has not been well studied. We examine the processes and document the calendar time required to activate such studies opened by the Cancer and Leukemia Group B (CALGB).

Methods

Setup steps were documented by (1) interviewing CALGB headquarters and statistical center staff and committee chairs to discover the steps required to transit from concept development to final study activation, (2) reviewing procedure manuals, and (3) inspecting all study records, documents, and e-mails to identify any additional steps. Calendar time was collected for each major process.

Results

Thirteen phase III studies were activated by CALGB during the study period of May 2002 to May 2005. More than 370 distinct processes were required for study activation: 317 work steps, 42 decision points, and 29 processing loops. Sixty-three percent of the decision points were outside CALGB. The complete process map measures 243.5” × 41” in 8-point font. Median calendar days to activate a phase III study at CALGB was 580 days (range, 295 to 1,248 days) from concept approval and 784 days (range, 537 to 1,130 days) from initial conception of the study.

Conclusion

Setup of a phase III study at a major cooperative oncology group is a complex and lengthy process, with the majority of decision points external to the cooperative group. To improve the activation process, research should to be directed toward both internal and external groups and processes.
Schnurri transcription factors fromDrosophilaand vertebrates can mediate Bmp signaling through a phylogenetically conserved mechanism
Authors: Yao Li-Chin , Blitz Ira L. , Peiffer Daniel A. , Phin Sopheap , Wang Ying , Ogata Souichi , Cho Ken W. Y. , Arora Kavita , Warrior Rahul
Published: September 2006

Bone Morphogenetic Proteins (Bmps) are secreted growth factors that play crucial roles in animal development across the phylogenetic spectrum. Bmp signaling results in the phosphorylation and nuclear translocation of Smads,downstream signal transducers that bind DNA. In Drosophila, the zinc finger protein Schnurri (Shn) plays a key role in signaling by the Bmp2/Bmp4 homolog Decapentaplegic (Dpp), by forming a Shn/Smad repression complex on defined promoter elements in the brinker (brk) gene. Brk is a transcriptional repressor that downregulates Dpp target genes. Thus, brk inhibition by Shn results in the upregulation of Dpp-responsive genes. We present evidence that vertebrate Shn homologs can also mediate Bmp responsiveness through a mechanism similar to Drosophila Shn. We find that a Bmp response element (BRE) from the Xenopus Vent2 promoter drives Dpp-dependent expression in Drosophila. However, in sharp contrast to its activating role in vertebrates, the frog BRE mediates repression in Drosophila. Remarkably, despite these opposite transcriptional polarities, sequence changes that abolish cis-element activity in Drosophila also affect BRE function in Xenopus. These similar cis requirements reflect conservation of trans-acting factors, as human Shn1 (hShn1; HIVEP1) can interact with Smad1/Smad4 and assemble an hShn1/Smad complex on the BRE. Furthermore, both Shn and hShn1 activate the BRE in Xenopus embryos, and both repress brk and rescue embryonic patterning defects in shn mutants. Our results suggest that vertebrate Shn proteins function in Bmp signal transduction, and that Shn proteins recruit coactivators and co-repressors in a context-dependent manner,rather than acting as dedicated activators or repressors.
The yolk syncytial layer regulates myocardial migration by influencing extracellular matrix assembly in zebrafish
Authors: Sakaguchi Takuya , Kikuchi Yutaka , Kuroiwa Atsushi , Takeda Hiroyuki , Stainier Didier Y. R.
Published: September 2006

The roles of extra-embryonic tissues in early vertebrate body patterning have been extensively studied, yet we know little about their function during later developmental events. Here, we analyze the function of the zebrafish extra-embryonic yolk syncytial layer (YSL) specific transcription factor,Mtx1, and find that it plays an essential role in myocardial migration. Downregulating the function of Mtx1 in the YSL leads to cardia bifida, a phenotype in which the myocardial cells fail to migrate to the midline. Mtx1 in the extra-embryonic YSL appears to regulate the embryonic expression of fibronectin, a gene previously implicated in myocardial migration. We further show dosage-sensitive genetic interactions between mtx1 and fibronectin. Based on these data, we propose that the extra-embryonic YSL regulates myocardial migration, at least in part by influencing fibronectin expression and subsequent assembly of the extracellular matrix in embryonic tissues.
Influence of Adsorbate Interaction on Transport in Confined Spaces
Authors: Bhatia Suresh K.
Published: September 2006

This article provides a review of the recent theory of transport in nanopores developed in the author's laboratory. In particular the influence of fluid–solid interactions on the transport coefficient is examined, showing that such interactions reduce the value of the coefficient by almost an order of magnitude in comparison to the Knudsen theory for non-interacting systems. The activation energy and potential energy barriers for diffusion in smooth pores with a one-dimensional potential energy profile are also discussed, indicating the inadequacy of the commonly used assumption of proportionality between the activation energy and heat of adsorption or the minimum pore potential energy. A further feature affected by fluid–solid interactions is the nature of the reflection of fluid molecules colliding with a pore wall surface, varying from being nearly specular — such as in carbon nanotubes — to nearly diffuse for amorphous solids. Diffuse reflection leads to momentum loss and reduced transport coefficients. However, fluid–solid interactions do not affect the transport coefficient in the single-file diffusion regime when the surface reflection is diffuse, and the transport coefficient in this case is largely independent of the adsorbed density.
Thermostable RNase P RNAs lacking P18 identified in the Aquificales
Authors: Marszalkowski Michal , Teune Jan-Hendrik , Steger Gerhard , Hartmann Roland K. , Willkomm Dagmar K.
Published: September 2006

The RNase P RNA (rnpB) and protein (rnpA) genes were identified in the two Aquificales Sulfurihydrogenibium azorense and Persephonella marina. In contrast, neither of the two genes has been found in the sequenced genome of their close relative, Aquifex aeolicus. As in most bacteria, the rnpA genes of S. azorense and P. marina are preceded by the rpmH gene coding for ribosomal protein L34. This genetic region, including several genes up- and downstream of rpmH, is uniquely conserved among all three Aquificales strains, except that rnpA is missing in A. aeolicus. The RNase P RNAs (P RNAs) of S. azorense and P. marina are active catalysts that can be activated by heterologous bacterial P proteins at low salt. Although the two P RNAs lack helix P18 and thus one of the three major interdomain tertiary contacts, they are more thermostable than Escherichia coli P RNA and require higher temperatures for proper folding. Related to their thermostability, both RNAs include a subset of structural idiosyncrasies in their S domains, which were recently demonstrated to determine the folding properties of the thermostable S domain of Thermus thermophilus P RNA. Unlike 16S rRNA phylogeny that has placed the Aquificales as the deepest lineage of the bacterial phylogenetic tree, RNase P RNA-based phylogeny groups S. azorense and P. marina with the green sulfur, cyanobacterial, and δ/ε proteobacterial branches.
Changing concepts of sinusitis
Authors: Putney F. Johnson
Published: September 2006

Realization of the importance of proper nasal and sinus physiology alters the approach to the problem of sinusitis, while the antibiotic and chemotherapeutic agents afford valuable weapons in treatment. Restoration rather than destruction of diseased tissue is the cardinal aim. When the pathologic change in the membrane is irreversible surgery is required, conservative operations being preferred. In longstanding suppurative sinusitis the membrane becomes fibrotic and little benefit results from the sulfonamides or penicillin. Sinusitis is classified as follows: 1. allergic, 2. mechanical, 3. bacterial. In general, allergic cases require primary attention to the allergic diathesis, those due to mechanical blockage are relieved by simple surgical procedures, and early bacterial sinusitis responds to penicillin. Penicillin is equally valuable in treating the complications of orbital cellulitis and osteomyelitis of the skull. When given early surgery can often be avoided, but in chronic osteomyelitis surgical drainage is usually needed in addition.
The progression of impaired hearing for high tones during childhood
Authors: Guild Stacy R.
Published: September 2006

SUMMARY. The “abrupt” type of high‐tone loss is discussed from the standpoint, primarily, of remote or true causes of the lesion of the basal turn of the cochlea usually regarded as the immediate cause of the functional impairment

Four cases are reported, in considerable detail, of children who while under observation either developed an “abrupt” type of high‐tone loss or had a marked degree of progression of an already existing impairment of this type. In all four instances, the impairments progressed gradually

The cause of the impairments, had the last examinations of these children been their first, would have been regarded by most otologists as either an exposure to acoustic trauma of the blast type or a congenital cochlear lesion. The reported observations show that neither diagnosis would be correct for any of these four cases

Other hypothetical, or even plausible, causes are discussed in the light of the evidence from the reported cases. All are ruled out of consideration, more or less completely, and the conclusion is reached that the remote or true cause of many instances of “abrupt” type high‐tone loss is as yet unknown, or unrecognized

The suggestion is made that a follow‐up study of a large number of persons from childhood until they reach mid‐adult age would provide basic information about the most common type of impaired hearing that occurs in man, and that such a study would also furnish a better basis than now exists for clinical prognosis and advice
On the chemical composition of the human perilymph and endolymph
Authors: Waltner Jules G. , Raymond Samuel
Published: September 2006

SUMMARY. 1. Five specimens of perilymph were obtained from the lateral semicircular canal of humans while performing Day operations for Ménière's disease

2. One specimen of endolymph was collected from a patient with Ménière's disease during a Portmann operation

3. Measurements of the ultraviolet absorption and total nitrogen were made on these fluids

4. The protein content of the inner ear fluids as indicated by the above measurements was more than twice that of the cerebrospinal fluid of the same patients

5. These figures corroborate the existence of a barrier between perilymph and spinal fluid, probably of semipermeable nature.
Aureomycin in treatment of otitic and ophthalmic herpes zoster
Authors: Gans Edward W.
Published: September 2006

SUMMARY. I have given a short resumé of the treatments of herpes zoster and considered the probable etiology of the disease. The gravity of this disease when affecting areas about the head and face is not to be denied. Any drug, therefore, that shortens the duration, relieves the pain and decreases complications is an important therapeutic addition. Six cases treated with aureomycin in the department of Ophthalmology and Otolaryngology of Permanente Foundation Hospital are presented. In all six cases there was rapid control of pain, early healing of lesions and a minimum of complications; only one case showing any residuum when last seen

It is concluded, therefore, from these cases and others presented in the literature that aureomycin has a specific effect on herpes zoster infection
Granulomatous complications of oval window fat grafts
Authors: Harris Irwin , Weiss Leo
Published: September 2006

In a series of 119 surgical cases of total stapedectomy utilizing adipose tissue, six cases of granulomatous complication occurred. In five of the six cases the hearing was impaired to below the preoperative level, and in four of the six cases the discrimination score was markedly impaired by the complication.

A satisfactory explanation for this development has been noted in only two of the six cases.
A Comparison of Costs in Providing Dental Care for Special Needs Patients under Sedation or General Anaesthesia in the North East of England
Authors: Prabhu Neeta T , Nunn June H , Evans David J
Published: September 2006

Objective

To compare the costs of providing dental treatment under general anaesthesia or sedation for special needs patients.

Methods

After a Delphi exercise, a questionnaire was designed, piloted and then sent to nine NHS Trust dental service managers, within the Salaried Dental Services in the North East of England, to obtain information on the costs incurred during the treatment of special needs patients using sedation or general anaesthesia. The questionnaire related to the average number of such patients treated per session, staff costs, depreciation cost for buildings and equipment, and overhead costs including consumables and drugs.

Results

All nine dental service managers returned completed questionnaires. The all-inclusive cost for treatment per patient under general anaesthesia ranged from £203.65–£479.50 (mean cost: £285.79) and for sedation from £57.60–£153.50 (mean cost: £90.81). On average three special needs patients were treated per session. The greatest variation in the costs for general anaesthesia was due to staffing costs, which ranged from £1064.10 to £350.00 per session across the Trusts.

Conclusions

In the small number of centres sampled, the cost of delivering dental care under sedation or general anaesthesia was shown to vary widely. Overall, the mean cost of sedation was one-third that of general anaesthesia. However, the cost of both was substantial and cognisance needs to be taken of the costs of such services.
Evidence for Up-to-Date Clinical Dental Practice. Ten Years of the Cochrane Oral Health Group
Authors: Eaton Kenneth A , Fernandez Luisa
Published: September 2006

On 30–31 May 2006, a conference was held in Manchester to celebrate the tenth anniversary of the Cochrane Oral Health Group. This international group has coordinated well over 100 systematic reviews on a wide range of oral health topics. The first day of the conference reviewed what has been achieved. The second day looked to the future and assessed gaps, barriers to progress and opportunities for overcoming them.
Effect of Prolonged Thermal Cycling on Microleakage around Class V Cavities Restored with Glass-Ceramic Inserts with Different Coefficients of Thermal Expansion. An In Vitro Study
Authors: Santini Ario , Ivanovic Vladimir , Tan Chuei Luan , Ibbetson Richard
Published: September 2006

Purpose

The purpose of this in vitro study was to evaluate microleakage around Class V glass-ceramic restorations of different coefficients of thermal expansion after prolonged thermal cycling.

Materials and Methods

One hundred and twenty non-carious extracted human premolars (patient age range 12–20 years) were randomly assigned to three groups. Standard Class V preparations were cut in the buccal surface using customised Cerana burs, size no. 3. Glass-ceramic inserts from two manufacturers (Cerana, Nordiska Dental AB, Helsingborg, Sweden; Beta-Quartz, Hager & Werken GmbH, Duisburg, Germany) were used to restore the cavities and were luted with a hybrid, high-viscous composite (Tetric Ceram, Ivoclar Vivadent, Schaan, Liechtenstein) and a bonding agent (Excite, Ivoclar Vivadent, Schaan, Liechtenstein). A control group, without inserts, was bulk-filled with the same composite used as the luting agent. In accordance with American Dental Association guidelines, half of the preparation was in enamel, half in dentine/cementum and had a mesio-distal width of 3 mm, an occluso-gingival height of 3 mm, and a depth of 2 mm. All margins had butt joints. Sixty teeth, selected at random, were not thermal cycled; the remaining 60 teeth were thermal cycled 4000 times between water baths held at 5°C and 55°C and the specimens prepared and examined for microleakage using 2.0% Procion Red® (ICI, Slough, UK) dye, buffered at pH7, as a marker. The results were analysed using the Kruskal-Wallis test (ANOVA) at a 95% significance level.

Results

At the occlusal margins there was no significant difference in microleakage between the three groups (P>0.5) without thermal cycling. After thermal cycling, microleakage at the occlusal margins was significantly less around cavities restored with Cerana glass-ceramic inserts versus Beta-Quartz and Tetric Ceram (P<0.05 in both cases). At the gingival margins, there was no significant difference in microleakge between the groups before thermal cycling (P>0.5). After thermal cycling, there was significantly less microleakage between Cerana inserts and Tetric Ceram (P<0.05). Comparisons between non-thermal cycled and thermal cycled groups showed there was no significant difference with the Cerana inserts (P=0.5590).

Clinical Implications

The results indicate that, after thermal cycling, restorations restored with Cerana glass-ceramic inserts, which have a coefficient of thermal expansion approximating to that of enamel, show a decrease in marginal microleakage, compared with Beta-Quartz glass-ceramic inserts and Tetric Ceram resin-based composite material. Restorative materials, which have a coefficient of thermal expansion approximating to that of enamel, would seem to be the materials of choice in reducing the problem of marginal microleakege.
The Use of an Evidence-Based Portfolio in the Management of Change in Dental Practice
Authors: Hall John
Published: September 2006

In this paper the author gives his opinion about the problems of getting practices to change systems in order to institute clinical governance. There are many reasons why practices need to change and for this change to be monitored. This paper explains the need for change and the use of the evidence-based portfolio, which is produced by candidates for the Membership of the Faculty of General Dental Practice (UK) [MFGDP(UK)] examination. It can also be produced by individuals who are not taking the MFGDP(UK) examination in conjunction with the Faculty of General Dental Practice (UK)'s key skills programme. It provides a mechanism for demonstrating change and for assessing the quality of care provided by a general dental practice. The author concludes that the evidence-based portfolio will enable a practitioner to apply clinical governance in a practical way.
The Strain of Sympathy: A. Mary F. Robinson, The New Arcadia, and Vernon Lee
Authors: HARRINGTON EMILY
Published: September 2006

This article investigates how A. Mary F. Robinson, a rising poetic star in 1884 at the center of aestheticist literary circles, attempted to establish an ethical aesthetics in The New Arcadia, her collection of poems about rural poverty. Robinson's poetics disrupts her readers' expectations for mellifluous verse, aiming to elicit their sympathy with strained, discordant lyrics, both for the poet as an observer of suffering as well as for the hardships of poverty. The New Arcadia is dedicated to and responds to Robinson's intimate friend Vernon Lee, whose collection of essays Belcaro (1881) argues that the production of aesthetic pleasure is a moral good in itself. Jointly, Lee and Robinson aimed to establish an alternative to the sort of Paterian aestheticism that was often accused of solipsism. For Robinson, however, this approach was not enough, and she sought to question how poetry might engender a sympathy that required the fullest possible understanding of the other and that avoided the often paternalistic, controlling attitudes that underwrote many attempts to bring beauty to the people.
Expression of stathmin in human uterus and decidualizing endometrial stromal cells
Authors: Tamura Kazuhiro , Yoshie Mikihiro , Nishi Hirotaka , Osakabe Yumi , Isaka Keiichi , Hara Takahiko , Kogo Hiroshi
Published: September 2006

The cytosolic phosphoprotein stathmin is upregulated at the site of embryo implantation in the rodents. However, stathmin expression in the human uterus has not yet been investigated. The distribution of uterine and placental stathmin was analyzed by immunohistochemistry, while stathmin mRNA expression was detected in endometrial tissues by the reverse transcriptase-PCR. Cultured endometrial stromal cells were used to investigate whether stathmin plays a role in decidualization. Stathmin is expressed specifically in the glandular epithelium and the stromal cells of human endometrial tissue. It is also expressed by cytotrophoblasts and extravillous trophoblasts, but not by syncytiotrophoblasts or decidual tissues during the first trimester of pregnancy. When stromal cells isolated from normal endometrial tissues were cultured and stimulated to decidualize by progesterone (P4) plus estrogen or dibutyryl cyclic 3′,5′-AMP, their total and phosphorylated stathmin levels decreased. Knocking down stathmin expression in the cultured stromal cells using small interfering RNA, before the cells were exposed to the decidualizing agents, significantly suppressed decidualization, as indicated by the decreased expression of IGF-binding protein-1 and prolactin. Stathmin is differently expressed in human endometrial and placental cells and may participate in the decidualization of endometrial stromal cells.
Spermatogenesis does not require the local production of follistatin
Authors: Lin S-Y , Morrison J R , Matzuk M M , de Kretser D M
Published: September 2006

It has been proposed that follistatin can modulate the actions of activins and/or other members of the transforming growth factor-β superfamily of proteins on testicular function, since mice overexpressing follistatin showed spermatogenic disruption. However, since mice with targeted disruption of the follistatin gene die soon after birth, it is not feasible to determine the effect of the absence of follistatin on testicular function using this model. To further understand the role of follistatin on the development and maintenance of spermatogenesis, fetal testes, collected by Caesarean section at day 18 of gestation from follistatin null mice, were transplanted to the external ear of castrated recombination activating gene 1 immunocompromised male mice. The testicular grafts were then analysed 7–8 weeks after transplantation and showed that full spermatogenesis developed in both the testes of wild-type and follistatin null mice. This study indicates that, if follistatin is required to modulate spermatogenic development, it is not supplied by local testicular production but by circulating follistatin from the host mouse.
Estrogen effects on fetal and neonatal testicular development
Authors: Delbès Géraldine , Levacher Christine , Habert René
Published: September 2006

In recent years, evidences have accumulated that exposure to environmental components with estrogenic activity causes reproductive disorders in human populations. Studies conducted over the past 50 years have clearly shown a continual decline in semen quality accompanied by an increase in male reproductive disorders during this period in industrial countries. As healthy gametes are a prerequisite for healthy children, such disorders are a significant problem not only for the current society, but also for future generations. These male reproductive disorders have been attributed to xenobiotics, and particularly to xenoestrogens, which have steadily increased in diversity and concentration in the environment and food. Epidemiological, clinical, and experimental studies have suggested that excessive exposure to estrogens and xenoestrogens during fetal and neonatal development may induce testicular developmental disorders, leading to alterations in the adult male fertility. Recently, we have clearly demonstrated that fetal and neonatal testes are very sensitive to estrogens, as the inactivation of estrogen receptor α increases steroidogenesis and the inactivation of estrogen receptor β enhances development of the germ cell lineage in the male.
Coho Salmon Smolt Production from Constructed and Natural Floodplain Habitats
Authors: Roni Phil , Morley Sarah A. , Garcia Patsy , Detrick Chris , King Dave , Beamer Eric
Published: September 2006

We examined existing smolt trapping data from 30 constructed and natural floodplain habitats to determine whether the number (production), density, and length of coho salmon Oncorhynchus kisutch smolts varied by project type and area. At 13 of the 30 sites we conducted detailed physical surveys to examine how morphology (shoreline irregularity), depth, and cover influenced smolt density and length. Mean smolt production for all sites averaged 2,492, density 0.37 smolts/m2, and length 98.9 mm. We found no significant difference in smolt production or density between natural and constructed sites or among project types. Smolt length differed by project type and morphology, excavated ponds (gravel pits and mill ponds) producing significantly larger smolts than constructed groundwater or natural channels. Smolt production was positively correlated with wetted area. Smolt length was negatively correlated with density and distance from salt water, suggesting that sites further inland with cooler water temperatures had higher densities and smaller fish. Site perimeter, shoreline irregularity, depth, and percent cover were not significantly different among habitat types at intensively sampled sites, nor were they correlated with smolt production or smolt density. However, multiple regression analysis indicated that shoreline irregularity and percent cover explained 70% of the variation in smolt length.
Size‐Related Variation in the Diet of Juvenile Tautogs from Long Island Sound
Authors: Clark Paul E. , Pereira Jose J. , Auker Linda A. , Parkins Christopher J. , Vinokur Lauren M.
Published: September 2006

Juvenile tautogs Tautoga onitis were collected from shallow‐water nursery areas along the Connecticut coast of Long Island Sound from June through September of 2000, 2001, and 2003. A total of 164 juveniles (8.9–165 mm standard length) were collected using several different methods. The digestive tracts of 152 (92.68%) juveniles each contained at least one identifiable prey item; 12 (7.32%) stomachs were empty. The number of different identifiable prey taxa in the digestive tracts ranged from one to four. Juvenile tautogs from the study area consumed 21 mutually exclusive prey taxa. Over all size‐classes, crustacean prey constituted a major component of the diet. Gammarid amphipods (present in 45.39% of the fish with food in their digestive tracts) and calanoid copepods (16.45%) were the predominant prey. Less commonly consumed prey included hermit crabs Pagurus spp., lady crabs Ovalipes ocellatus, mud crabs (Xanthidae), Asian shore crabs Hemigrapsus sanguineus, eggs of horseshoe crabs Limulus polyphemus, sevenspine bay shrimp Crangon septemspinosa, shore shrimp Palaemonetes spp., polychaete worms (Polychaeta), milky ribbon worms Cerebratulus lacteus, common Atlantic slipper shells Crepidula fornicata, eastern oysters Crassostrea virginica, and blue mussels Mytilus edulis. Hierarchical cluster analysis of prey consumed by young tautogs revealed three distinct size‐related feeding groups: (1) small fish (9–30 mm) that consumed calanoid copepods and gammarid amphipods, (2) midsized fish (31–70 mm) that were generalist feeders, concentrating on polychaete worms and crustaceans, and (3) large fish (81–165 mm) that preyed on mollusks, shrimps, and crabs.
Mr. Hobbs's Extraordinary Approach to Teaching Reading
Authors: Brassell Danny
Published: September 2006

Author Danny Brassell's seventh‐grade reading teacher, Will Hobbs, positively affected his reading attitude with a simple, straightforward approach that motivated students to want to read for pleasure. The teacher

Provided a huge variety of high‐interest books in his classroom

Led book discussions that encouraged students to talk about what they were reading

Allowed students to choose books to read on their own while he read

Discouraged book reports in favor of student oral reviews

Developed a point system to reward students for the number of books they read

Encouraged students to always try to read more by posting the names of the five top readers on the chalkboard

This reading teacher went on to become a best‐selling children's book author whose stories inspire countless reluctant readers to pick up books for fun. The author credits this former reading teacher for providing him with the motivational approach he uses to get his students to read today.
Metamorphosis Hurts: Resistant Students and Myths of Transformation
Authors: Williams Bronwyn T.
Published: September 2006

In labeling students who seem unengaged or defiant in class as “resistant,” teachers may not always be imaginative or thorough enough in thinking about the reasons for this student stance. Though resistance may be a useful concept for such students because teachers see it as something that can be both active and passive, one problem with the label of “resistant student” is that it often implies a binary relationship with the teacher. Yet the roots of student resistance may not be in the teacher but in anxieties and fears that are often inherent in the literacy classroom. If teachers cannot envision what students may be resisting and why, it is impossible to move beyond a classroom tug‐of‐war to actually engage such students in learning.
Prisons and Health Reforms in England and Wales
Authors: Hayton Paul , Boyington John
Published: September 2006

Prison health in England and Wales has seen rapid reform and modernization. Previously it was characterized by over-medicalization, difficulties in staff recruitment, and a lack of professional development for staff. The Department of Health assumed responsibility from Her Majesty’s Prison Service for health policymaking in 2000, and full budgetary and health care administration control were transferred by April 2006. As a result of this reorganization, funding has improved and services now relate more to assessed health need.

There is early but limited evidence that some standards of care and patient outcomes have improved. The reforms address a human rights issue: that prisoners have a right to expect their health needs to be met by services that are broadly equivalent to services available to the community at large. We consider learning points for other countries which may be contemplating prison health reform, particularly those with a universal health care system.
Concordance Between Self-Reported Maltreatment and Court Records of Abuse or Neglect Among High-Risk Youths
Authors: Swahn Monica H. , Whitaker Daniel J. , Pippen Courtney B. , Leeb Rebecca T. , Teplin Linda A. , Abram Karen M. , McClelland Gary M.
Published: September 2006

Objectives. We examined the concordance between measures of self-reported maltreatment and court records of abuse or neglect in a sample of detained youths.

Methods. Data were collected by the Northwestern Juvenile Project and include interviews from 1829 youths aged 10–18 years. Participants were newly detained youths in the Cook County Juvenile Temporary Detention Center in Illinois between 1995 and 1998. Self-reported cases of child maltreatment were compared with court records of abuse or neglect in the Cook County judicial system.

Results. We found that among detained youths, 16.6% of those who reported any maltreatment, 22.2% of those who reported the highest level of maltreatment, and 25.1% of those who reported that they required medical treatment as a result of maltreatment had a court record of abuse or neglect. Among those with any self-reported maltreatment, girls (vs boys) and African Americans (vs Whites) were more likely to have a court record (adjusted odds ratio [AOR]=2.18; 95% confidence interval [CI]=1.53, 3.09; and AOR=2.12; 95% CI=1.23, 3.63, respectively).

Conclusions. Official records seriously underestimate the prevalence of maltreatment, which indicates that multiple data sources are needed to document the true prevalence of maltreatment.