bluuebunny/crossref_metadata_2025 huggingface dataset:
Alterations in cerebral dynamics at high altitude following partial acclimatization in humans: wakefulness and sleep
Authors: Ainslie Philip N. , Burgess Katie , Subedi Prajan , Burgess Keith R.
Published: October 2006

We tested the hypothesis that, following exposure to high altitude, cerebrovascular reactivity to CO2 and cerebral autoregulation would be attenuated. Such alterations may predispose to central sleep apnea at high altitude by promoting changes in brain Pco2 and thus breathing stability. We measured middle cerebral artery blood flow velocity (MCAv; transcranial Doppler ultrasound) and arterial blood pressure during wakefulness in conditions of eucapnia (room air), hypocapnia (voluntary hyperventilation), and hypercapnia (isooxic rebeathing), and also during non-rapid eye movement (stage 2) sleep at low altitude (1,400 m) and at high altitude (3,840 m) in five individuals. At each altitude, sleep was studied using full polysomnography, and resting arterial blood gases were obtained. During wakefulness and polysomnographic-monitored sleep, dynamic cerebral autoregulation and steady-state changes in MCAv in relation to changes in blood pressure were evaluated using transfer function analysis. High altitude was associated with an increase in central sleep apnea index (0.2 ± 0.4 to 20.7 ± 23.2 per hour) and an increase in mean blood pressure and cerebrovascular resistance during wakefulness and sleep. MCAv was unchanged during wakefulness, whereas there was a greater decrease during sleep at high altitude compared with low altitude (−9.1 ± 1.7 vs. −4.8 ± 0.7 cm/s; P < 0.05). At high altitude, compared with low altitude, the cerebrovascular reactivity to CO2 in the hypercapnic range was unchanged (5.5 ± 0.7 vs. 5.3 ± 0.7%/mmHg; P = 0.06), while it was lowered in the hypocapnic range (3.1 ± 0.7 vs. 1.9 ± 0.6%/mmHg; P < 0.05). Dynamic cerebral autoregulation was further reduced during sleep ( P < 0.05 vs. low altitude). Lowered cerebrovascular reactivity to CO2 and reduction in both dynamic cerebral autoregulation and MCAv during sleep at high altitude may be factors in the pathogenesis of breathing instability.
Fluoride Intake from Food and Liquid in Japanese Children Living in Two Areas with Different Fluoride Concentrations in the Water Supply
Authors: Nohno K. , Sakuma S. , Koga H. , Nishimuta M. , Yagi M. , Miyazaki H.
Published: October 2006

The purpose of this study was to estimate the average daily amount of fluoride from the diet ingested by Japanese children of ages susceptible to dental fluorosis in two areas with different fluoride concentrations in the water supply. Thirty-eight children aged 2–8 years participated in a survey of fluoride intake. Twenty-one out of 38 children lived in an area in which the community water fluoride concentration was an average of 0.555 ppm (moderate fluoride area: MFA), and 17 lived in a low fluoride area (LFA), which ranged between 0.040 and 0.131 ppm. To measure the fluoride intake, diets were collected with a duplicate-diet technique. The fluoride concentrations in each sample were measured using the diffusion technique of Taves and the electrode technique. Meanwhile, after clinical examinations for dental caries and fluorosis, 228 subjects aged 13–15 years were selected for analysis from the same communities. The mean DMFT in the MFA was significantly lower than that in the LFA. The severest grade of dental fluorosis observed was ‘very mild’ according to Dean’s fluorosis index in both areas. The total daily fluoride intakes were 0.0252–0.0254 mg F/kg/day in the MFA and 0.0126–0.0144 mg F/kg/day in the LFA. Differences in the fluoride concentration of drinking water in this study were reflected in the fluoride intake from the diet in a typical Japanese diet.
Fluoride Intake Levels in Relation to Fluorosis Development in Permanent Maxillary Central Incisors and First Molars
Authors: Hong Liang , Levy Steven M. , Warren John J. , Broffitt Barbara , Cavanaugh Joseph
Published: October 2006

Gaps remain in our knowledge about the levels of fluoride intake that cause dental fluorosis. The purpose of this study was to report the fluorosis prevalence by levels of estimated fluoride intake in an effort to understand the importance of different levels of daily fluoride intake. As part of the longitudinal Iowa Fluoride Study, subjects were followed from birth to 36 months with questionnaires every 3–4 months to gather information on fluoride intake from various sources. Daily fluoride intake in mg per kg body weight (BW) was estimated from water, beverages and selected foods, fluoride supplements and dentifrice. Six hundred and twenty-eight subjects were examined for fluorosis on permanent incisors and first molars at about age 9 by two calibrated examiners using the Fluorosis Risk Index categories. Fluorosis prevalence rates were determined separately for maxillary central incisors and first molars by levels of estimated fluoride intake. There were significant positive associations between fluorosis prevalence and levels of fluoride intake. Cumulatively from birth to 36 months, average daily intake of 0.04 mg F/kg BW or less carried relatively low risk for fluorosis (12.9% for maxillary central incisors, 6.8% for first molars). Average daily intake of 0.04–0.06 mg F/kg BW showed a significantly elevated risk for fluorosis (23.0% for maxillary central incisors, 14.5% for first molars), while fluorosis risk was even higher for average intake above 0.06 mg F/kg BW (38.0% for maxillary central incisors, 32.4% for first molars). The study suggests that fluorosis prevalence is related to elevated fluoride intake when averaged over the first 3 years of life, but is even more strongly related to fluoride intake that is elevated for all of the first 3 years of life.
Influence of a Fluoride Mouthrinse on Mutans Streptococci in Schoolchildren
Authors: Kaneko Noboru , Yoshihara Akihiro , Ida Hirohisa , Nomura Yoshiaki , Imai Susumu , Nisizawa Toshiki , Sakuma Shihoko , Hanada Nobuhiro , Miyazaki Hideo
Published: October 2006

This study aimed to determine whether the long-term use of a fluoride mouthrinse affects the salivary levels of mutans streptococci. Two hundred and fifteen schoolchildren (aged 9–10 years) participated. One hundred and forty-nine of these children had used a fluoride mouthrinse since 5 years of age at nursery school, and the remaining 66 children had not. DFT (decayed and filled teeth) was recorded, and the salivary levels of Streptococcus mutans and Streptococcus sobrinus were measured using mitis salivarius bacitracin agar. The group that had used a fluoride mouthrinse had a significantly lower prevalence of both S. mutans and S. sobrinus (p = 0.038) and a significantly lower DFT score (p < 0.001) than the other group. Using logistic regression analysis including caries experience at baseline as a dependent variable, the odds ratio of carrying S. mutans alone was 8.0 (p = 0.066) and that of carrying both S. mutans and S. sobrinus was 16.5 (p = 0.022) in the group that had not used the fluoride mouthrinse. Children carrying both S. mutans and S. sobrinus had a higher caries incidence in 1 year than the others, with odds ratios of 5.73 (p = 0.067) in the group with a fluoride mouthrinse and 3.47 (p = 0.035) in the group without it. These results show that the long-term use of a fluoride mouthrinse is associated with reduced salivary levels of mutans streptococci and this bacterial reduction may partly contribute to the suppression of dental caries in children using a long-term fluoride mouthrinse.
The Effect of Lesion Characteristics at Baseline on Subsequent De- and Remineralisation Behaviour
Authors: Lynch R.J.M. , ten Cate J.M.
Published: October 2006

The aim was to study the effect of lesion characteristics at baseline on subsequent de- and remineralisation behaviour. Artificial lesions used during in vitro and intra-oral studies exhibit an increasing tendency toward net remineralisation with increasing integrated mineral loss at baseline (ΔZbase). Proposed explanations include: (i) small lesions may be more vulnerable to demineralisation, and (ii) large lesions may be more difficult to remineralise. To evaluate these hypotheses, subsurface lesions were created in numerous blocks of human and bovine enamel, with a range of depths and ΔZbase, measured by microradiography. One group of lesions was further demineralised, a second group remineralised, and subsequently, both groups re-analysed. Under demineralising conditions, there was a marked decrease in further mineral loss with increasing ΔZbase. Under remineralising conditions lesions gained mineral in proportion to ΔZbase. The decrease in demineralisation of lesions with larger ΔZbase may be partially a result of decreased intrinsic solubility through modified chemical composition, e.g. loss of magnesium, carbonate etc. The results may explain the tendency toward net remineralisation with increasing ΔZbase in pH-cycling regimes.
Microbial Contamination of Noncavitated Caries Lesions: A Scanning Electron Microscopic Study
Authors: Parolo C.C.F. , Maltz M.
Published: October 2006

Contamination by microorganisms of active and inactive noncavitated lesions was analyzed by scanning electron microscopy. The sample comprised 10 active and 14 inactive smooth surface lesions and 5 sound tooth surfaces. The active lesions were obtained through an in situ model. The inactive lesions and the sound surfaces were obtained from extracted teeth. The samples were split and the two resulting halves were analyzed. The lesion areas were measured in order to compare bacterial contamination in active and inactive lesions. Microorganisms were detected within the enamel in all lesions studied (active and inactive). Sound teeth did not harbor bacteria with the exception of one half tooth where one rod was observed in the enamel. Great variation was observed in bacterial contamination in both active and inactive lesions. Microorganisms penetrated rather deeply into some active as well as into inactive lesions, reaching the dentin in 5 inactive lesions. Bacteria were present in the tubular and intertubular dentin. No difference was observed in the number of microorganisms per square millimeter in the active and inactive lesions (p > 0.05). Cocci and rods comprised 99% of the organisms, while filamentous and spiral bacteria were seldom present. Yeast-like microorganisms were found in inactive lesions. The presence of microorganisms in inactive as well as active noncavitated lesions shows that bacteria inside dental tissue (enamel and dentin) do not impede the arrestment of the caries process.
Data-Mining Methods as Useful Tools for Predicting Individual Drug Response: Application to CYP2D6 Data
Authors: Sabbagh Audrey , Darlu Pierre
Published: October 2006

Objectives: Selecting a maximally informative subset of polymorphisms to predict a clinical outcome, such as drug response, requires appropriate search methods due to the increased dimensionality associated with looking at multiple genotypes. In this study, we investigated the ability of several pattern recognition methods to identify the most informative markers in the CYP2D6 gene for the prediction of CYP2D6 metabolizer status. Methods: Four data-mining tools were explored: decision trees, random forests, artificial neural networks, and the multifactor dimensionality reduction (MDR) method. Marker selection was performed separately in eight population samples of different ethnic origin to evaluate to what extent the most informative markers differ across ethnic groups. Results: Our results show that the number of polymorphisms required to predict CYP2D6 metabolic phenotype with a high accuracy can be dramatically reduced owing to the strong haplotype block structure observed at CYP2D6. MDR and neural networks provided nearly identical results and performed the best. Conclusion: Data-mining methods, such as MDR and neural networks, appear as promising tools to improve the efficiency of genotyping tests in pharmacogenetics with the ultimate goal of pre-screening patients for individual therapy selection with minimum genotyping effort.
TLINKAGE-IMPRINT: A Model-Based Approach to Performing Two-Locus Genetic Imprinting Analysis
Authors: Shete Sanjay , Zhou Xiaojun
Published: October 2006

Objectives: Imprinting refers to the expression of only one copy of a gene pair, which is determined by the parental origin of the copy. Imprinted genes play a role in the development of several complex diseases, including cancers and mental disorders. In certain situations, two-trait-loci models are shown to be more powerful than one-trait-locus models. However, no current methods use pedigree structure efficiently and perform two-locus imprinting analyses. In this paper, we apply the Elston-Stewart algorithm to the parametric two-trait-loci imprinting model used by Strauch et al. [2000] to obtain a method for qualitative trait linkage analyses that explicitly models imprinting and can be applied to large pedigrees. Methods: We considered a parametric approach based on 4 × 4 penetrance matrix to account for imprinting and modified TLINKAGE software to implement this approach. We performed simulation studies using a small and a large pedigree under dominant and imprinted and dominant or imprinted scenarios. Furthermore, we developed a likelihood ratio-based test for imprinting that compares the logarithm of odds (LOD) score obtained using the two-locus imprinting model with that obtained using the standard two-locus model that does not allow for imprinting. Results: In simulation studies of three scenarios where the true mode of inheritance included imprinting, accurate modeling through the proposed approach yielded higher LOD scores and better recombination fraction estimates than the traditional two-locus model that does not allow for imprinting. Conclusions: This imprinting model will be useful in identifying the genes responsible for several complex disorders that are potentially caused by a combination of imprinted and non-imprinted genes.
Five Patients with Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency (One with Associated Neuroblastoma) Discovered in Three Generations of One Family
Authors: Janjanin Nevena , Dumic Miroslav , Skrabic Veselin , Kusec Vesna , Grubic Zorana , Spehar Uroic Anita
Published: October 2006

Background: Most patients with 21-hydroxylase deficiency (21-OHD) are compound heterozygous carriers. Their phenotype usually reflects a less severe allelic mutation, although discordance between the genotype and the phenotype has been observed. Case Report: We present 5 patients with congenital adrenal hyperplasia (CAH) due to 21-OHD belonging to the 3 generations of the same family (grandmother, parents and their 2 children). As each patient carries at least one mild mutation of the CYP21 gene, their genotypes correspond to nonclassical CAH. The propositus is the older brother, who is compound heterozygous with a mild and severe CYP21 mutation (P30L/R356W). In spite of one mild CYP21 mutation, he presented with the clinical picture of a simple virilizing form of 21-OHD and required glucocorticoid replacement therapy from the age of 4. Both probands’ parents are compound heterozygous carriers of different CYP21 gene mutations causing various degrees of enzymatic activity impairment, which explains the different genotypes and phenotypes in their offspring. The probands’ mother, besides the nonclassical 21-OHD, also had neuroblastoma of the adrenal gland. Conclusion: The potential discordance between the genotype and the phenotype in some patients with CAH is emphasized. The existence of a mild CYP21 mutation P30L in a compound heterozygous with CAH might be associated with progressive virilization requiring glucocorticoid therapy from early childhood. The occurrence of neuroblastoma with 21-OHD may support the hypothesis that an impairment in the synthesis and secretion of glucocorticoids may play role in the development and functioning of the adrenal medulla.
Non-Pharmacological Interventions in Older People with Heart Failure: Effects of Exercise Training and Relaxation Therapy
Authors: Yu Doris S.F. , Lee Diana T.F. , Woo Jean , Hui Elsie
Published: October 2006

Background: Effective management of heart failure relies on optimal use of non-pharmacological therapy alongside medical treatment. Yet, there is an inadequate use of non-pharmacological therapy in caring for older people with heart failure. Objective: To examine the effects of relaxation therapy and exercise training on psychological outcomes and disease-specific quality of life of older heart failure patients. Methods: Subjects undertook relaxation (n = 59), exercise training (n = 32) or received attention placebo (n = 62) for 12 weeks. The relaxation group attended two training sessions, one revision workshop, and continued with twice-daily taped-directed home relaxation practice, with support from the intervener through bi-weekly telephone contact, for 12 weeks. The exercise group undertook 12 weekly sessions of resistance training and aerobic exercise and thrice weekly home exercise. The control group received regular telephone calls for general ‘greetings’. Results: The relaxation and exercise groups reported a significantly greater improvement in psychological [F(2, 149) = 6.69, p = 0.002] and various disease-specific quality of life outcomes [dyspnea: F(2, 149) = 5.72, p = 0.004; fatigue: F(2, 149) = 3.78, p = 0.25; emotion: F(2, 149) = 6.68, p = 0.001], compared with those who received the attention placebo. While relaxation therapy was more effective to reduce psychological distress, with depression in particular (p < 0.001), exercise therapy worked better to control fatigue symptoms (p = 0.03). Conclusion: Relaxation therapy and exercise training are effective to improve the psychological and physical health of older heart failure patients. They should be used as an individual treatment modality, or as care components of a disease management program.
Hysterectomy Is Associated with Stress Incontinence in Women Who Previously Had a Transcervical Endometrial Resection
Authors: Krogh Rubab Agha , Neumann Gudrun Astrid , Lauszus Finn Friis , Guttorm Eigil , Rasmussen Kjeld Leisgaard
Published: October 2006

Objectives: To compare the prevalence of urological symptoms in a population of women, who had a transcervical endometrial resection (TCER) only, and a population of women, who had a TCER and a subsequent hysterectomy. The superior goal was to evaluate the possible association between hysterectomy and urinary incontinence. Design: All women, who had a TCER at our department during the period of 1990–1996 received a questionnaire with focus on urological symptoms. The answers from women, who later had a hysterectomy were compared to the answers from women, who were sufficiently treated with TCER only. Results: Of 356 women, who were alive, 16 were lost to follow-up, leaving 340 women to receive the questionnaire, which was returned by 310 women (85%). Ninety-three (31%) had a subsequent hysterectomy mainly indicated by metrorrhagia or dysmenorrhea. Of the hysterectomized women 24% reported bothersome stress incontinence against 14% in the group of women, who had TCER only (p = 0.03). No significant difference was seen with respect to urge incontinence, urgency, pollakisuria or nocturia. Significantly more women with a normal sized uterus reported bothersome stress incontinence after the hysterectomy compared to women with a slightly enlarged uterus. Conclusion:Hysterectomy is significantly associated with stress urinary incontinence in women, who previously had a TCER.
Diagnostic and Subdiagnostic Accumulation of Mast Cells in the Bone Marrow of Patients with Anaphylaxis: Monoclonal Mast Cell Activation Syndrome
Authors: Sonneck Karoline , Florian Stefan , Müllauer Leonhard , Wimazal Friedrich , Födinger Manuela , Sperr Wolfgang R. , Valent Peter
Published: October 2006

Background: Patients with mastocytosis may suffer from severe hypotension after wasp or bee stings. In these patients, no specific IgE is detectable, but they usually have skin lesions and an elevated serum tryptase level. Methods: We report on 6 patients who were referred to our department because of severe hypotension following bee or wasp stings without cutaneous lesions. Results: In 3 patients, the baseline serum tryptase level was elevated (26, 36, and 67 ng/ml, respectively), and investigation of their bone marrow revealed systemic mastocytosis (SM). In the remaining 3 patients, serum tryptase levels were <20 ng/ml, and bone marrow histology and tryptase immunohistochemistry did not reveal diagnostic mast cell infiltrates. However, in 1 patient, three minor SM criteria were demonstrable leading to the diagnosis SM, and in the 2nd patient, two minor SM criteria, including an aberrant mast cell phenotype, were found. In the 3rd patient, no minor SM criteria were detected. Conclusions: All patients with unexplained hypotension after hymenoptera stings should undergo a thorough investigation for major and minor SM criteria regardless of the tryptase level or presence of skin lesions, in order to diagnose or exclude SM or a related subdiagnostic condition (1 or 2 minor SM criteria) tentatively termed monoclonal mast cell activation syndrome.
Risk Factors for Early Recurrent Cerebral Ischemia Before Treatment of Symptomatic Carotid Stenosis
Authors: Kastrup Andreas , Ernemann Ulrike , Nägele Thomas , Gröschel Klaus
Published: October 2006

Background and Purpose—

In patients with a recently symptomatic carotid stenosis, surgical or interventional treatment is often delayed for weeks to months. Because therapy should be instituted as early as possible in patients at highest risk for recurrent ischemia, the aim of this study was to identify these individuals using clinical data and serial diffusion-weighted imaging (DWI).

Methods—

One hundred thirty-one patients (98 male; mean age 68±9 years) who had been referred to our department within 14 days (median; interquartile range, 4 to 36 days) after experiencing an ischemic event caused by a carotid stenosis were followed-up until carotid angioplasty and stenting. Risk factors predicting recurrent transient ischemic attack, stroke, or new DWI lesions were examined.

Results—

During a median follow-up period of 7 days (interquartile range, 5 to 13 days) no patient experienced a stroke, 4 patients (3.1%) developed a hemispherical transient ischemic attack, and in 15 patients (12%) new asymptomatic DWI lesions were present in the territory of the treated artery. Multivariable regression analysis revealed that motor symptoms (odds ratio, 5.6; 95% CI, 1.2 to 26.3;
P
<0.05) or the presence of a contralateral carotid occlusion (odds ratio, 4.6; 95% CI, 1.0 to 20.4;
P
<0.05) were significant independent predictors of further cerebral ischemic events before carotid angioplasty and stenting.

Conclusions—

In patients with a recently symptomatic carotid stenosis, the risk of early recurrent ischemia is highest in those with motor symptoms and in those with a contralateral carotid occlusion. In these high-risk patients urgent preventive treatment might be warranted.
Municipally Operated Charter Schools
Authors: Brown Pamela M.
Published: October 2006

Many cities throughout the United States are experiencing rapid population growth and an increased demand for public services delivered in safe, livable neighborhoods. Some of those cities have recognized the need to offer an improved urban school system for their residents and have begun to embrace the charter school movement through the use of innovative local partnerships. There is a nexus between these educational strategies and the principles of community education. Advocates of community education emphasize the importance of community agencies and local residents becoming active partners in community concerns, including the school system. Schools are viewed as localized and community based. This study was undertaken in an attempt to identify the number and location of municipally operated charter schools in the United States, examine the potential nexus with municipal economic development strategies, and measure the schools against community education principles.
Preparing High-Quality Teachers for Urbanized Schools
Authors: Masci Frank J. , Stotko Elaine M.
Published: October 2006

The Professional Immersion Master of Arts in Teaching (ProMAT) program is a cooperative venture between Johns Hopkins University and Montgomery County (Maryland) Public Schools, a large school district that has experienced increased urbanization. This graduate-level teacher preparation program provides candidates with extensive internship experiences, a high degree of supervisory support, and significant financial assistance. The school district provides tuition assistance in return for a multiyear commitment by candidates to teach in the district. Data from an exit survey indicate candidate satisfaction with the program. A comparison of Praxis II Pedagogy examination scores with state minimum passing scores shows that in two thirds of the ProMAT certification areas, candidates score significantly higher than the state’s required passing scores.
Can Rapid Assessment Moderate the Consequences of High-Stakes Testing?
Authors: Yeh Stuart S.
Published: October 2006

Critics of the No Child Left Behind Act (NCLB) suggest that the effects of state-mandated testing are primarily negative, causing teachers to narrow the curriculum and drill students on tested material. However, the implementation of assessment programs that provide rapid diagnostic information about student progress may allow teachers to prepare students for state-mandated tests while preserving a balanced curriculum. This study investigated teachers’ instructional decision-making processes in a Texas school district that implemented an assessment program that provides rapid feedback to teachers regarding student progress throughout the school year. The study suggests how the implementation of rapid assessment systems can foster balanced instruction and positive use of test results, resulting in positive effects of state-mandated testing on teaching and learning. Funding to implement this type of rapid assessment system may improve the probability that the No Child Left Behind Act will have a positive impact on public education.
Gap or Gaps
Authors: Carpenter Dick M. , Ramirez Al , Severn Laura
Published: October 2006

For decades, researchers examined the “achievement gap” between minority and nonminority students. This singular definition of achievement gap ignores important within-group differences. This article uses National Education Longitudinal Study (NELS:88) data to examine within-group differences and compares those across Latino, African American, and White populations. Results question the singular definition of achievement gap. Given the importance of how issues are defined, a singular definition of achievement gap may mean current policies miss the mark in raising achievement levels between and within groups.
Familial Roles and Social Transformations
Authors: Oppong Christine
Published: October 2006

By focusing on old people in sub-Saharan Africa, the author illustrates the need for comparative analyses of how culture, sociopolitical systems, and sweeping social change shape lives, interconnections, opportunities, and constraints among older people. In such work, gender contrasts are critical. Because of their position in reproduction and marital patterns, women in sub-Saharan Africa have tended to use lineal strategies, focused on children and grandchildren, in contrast to the more lateral, partner-oriented strategies followed by men. Migration into urban areas and the AIDS pandemic have left many older women in charge of grandchildren in rural areas with inadequate resources and infrastructure. Shaped by traditional values, norms, and roles in their early lives, they currently find many expectations unmet. Indeed, some of the traditional norms that ensured respect, support, reciprocity, and embeddedness may now leave many older people, especially women, isolated, weakened, and victims of illness and violence.
Employment and Social Integration in Midlife
Authors: Ginn Jay , Fast Janet
Published: October 2006

Policy makers aim to raise the retirement age for economic reasons. For individuals, longer employment maintains income and social contacts. However, retirement allows more time for socially integrating activities with family and friends. There is therefore tension for midlife individuals between the perceived advantages of employment and retirement. Welfare states vary in policies toward older workers, in terms of incentives for working longer or “early exit,” which may influence individuals’ preferences concerning retirement timing. Data from 20 European countries were used to examine middle-aged women’s and men’s attitudes toward employment and other time uses. The analysis incorporated age, gender, socioeconomic circumstances, and type of welfare regime. Work-life conflict was evident, expressed as preferring more time for family, friends, and leisure, especially where employment rates were highest and more for women than men. Many full-timers preferred shorter hours. Differences between desired and actual employment status were greatest among working-class, female, and older individuals. Unmet demand for jobs was most common in transitional and Mediterranean welfare states. The likelihood of employment was related to the type of welfare regime.
Perspectives on the Integration of Older Men and Women
Authors: de Jong Gierveld Jenny , Hagestad Gunhild O.
Published: October 2006

This introduction to the special issue “Social Integration in Later Life” addresses the background ideas and concepts of the articles encompassing research into the extent and quality of older adults’ integration in organizations, family, and personal networks. A rough conceptual framework is provided, distinguishing between types of integration and different units of analysis. The macro level of society and its social institutions as well as smaller groups and the social locations of individuals are addressed. On a macro level, integration and segregation are juxtaposed, building on classic discussions of integration, as well as recent ideas about social resources, welfare states, and rekindled considerations of age segregation. At the individual level, the concepts of integration and isolation and the subjective assessments of embeddedness and loneliness are contrasted.
Should We Be Concerned About Age Segregation?
Authors: Hagestad Gunhild O. , Uhlenberg Peter
Published: October 2006

With its complex links to the division of labor and culture, age is also related to social integration. It can form a basis for social integration and form contrasts, chasms, and conflicts in society. After providing a brief history of how social scientists have viewed age as an integrative and a segregative force in society, the authors consider dimensions of age segregation in contemporary Western societies, which are marked by widespread institutional, spatial, and cultural age segregation, with only the family surviving as an age-integrated institution. For older adults, ties to children and grandchildren represent possibilities for learning and the development of generativity: investment in the lives of others and in the future of human communities. The link between cross-generational ties and generativity appears to be particularly clear for men. Can we rely on families to counter the potentially negative consequences of societal age segregation, or should we be concerned about family change, such as rising rates of childlessness?
African American Culture and Hypertension Prevention
Authors: Peters Rosalind M. , Aroian Karen J. , Flack John M.
Published: October 2006

A qualitative study was done to explore attitudes and beliefs of African Americans regarding hypertension-preventive self-care behaviors. Five focus groups, with 34 participants, were held using interview questions loosely based on the Theory of Planned Behavior (TPB). Analysis revealed themes broadly consistent with the TPB and also identified an overarching theme labeled “circle of culture.” The circle is a metaphor for ties that bind individuals within the larger African American community and provides boundaries for culturally acceptable behaviors. Three subthemes were identified: One describes how health behaviors are “passed from generation to generation,” another reflects a sense of being “accountable” to others within the culture, and the third reflects negative views toward people who are “acting different,” moving outside the circle of culture. Findings provide an expanded perspective of the TPB by demonstrating the influence of culture and collective identity on attitude formation and health-related behaviors among African Americans.
Enhanced natural-killer cell and erythropoietic activities in VEGF-A–overexpressing mice delay F-MuLV–induced erythroleukemia
Authors: Cervi David , Shaked Yuval , Haeri Mehran , Usenko Tatiana , Lee Christina R. , Haigh Jody J. , Nagy Andras , Kerbel Robert S. , Yefenof Eitan , Ben-David Yaacov
Published: October 2006

We have previously reported that VEGF-A, in combination with MCP-5, contributes to leukemia progression within the splenic microenvironment of mice infected with F-MuLV. To study the influence of constitutively elevated VEGF-A levels on the progression of erythroleukemia, mice heterozygous for a VEGF-A “hypermorphic” allele (Vegfhi/+) were inoculated with F-MuLV. Unexpectedly, a significant delay in erythroleukemia was observed in Vegfhi/+ mice when compared with wild-type controls. These results suggested an altered physiologic response arising from elevated VEGF-A levels that decelerated erythroleukemic progression. Characterization of hematopoiesis in Vegfhi/+ spleens showed a higher natural killer cell activity, elevated B cells, and a decrease in T-cell number. Furthermore, higher erythroid progenitors (ie, CD34+, CD36+, and Ter119+ cells) were evident in the bone marrow, spleen, and peripheral blood of Vegfhi/+ mice. The CFU-E levels were significantly elevated in Vegfhi/+ bone marrow cultures, and this elevation was blocked by a neutralizing antibody to VEGF-A receptor (VEGFR-2). Moreover, erythroleukemic mice were treated with recombinant erythropoietin and, similar to diseased Vegfhi/+ mice, showed a delay in disease progression. We propose that a compensatory erythropoietic response combined with increased natural killer (NK) cell activity account for the extended survival of erythroleukemic, Vegfhi/+ mice.
Genome-wide analysis of DNA copy number changes and LOH in CLL using high-density SNP arrays
Authors: Pfeifer Dietmar , Pantic Milena , Skatulla Ilona , Rawluk Justyna , Kreutz Clemens , Martens Uwe M. , Fisch Paul , Timmer Jens , Veelken Hendrik
Published: October 2006

Recurrent genomic aberrations are important prognostic parameters in chronic lymphocytic leukemia (CLL). High-resolution 10k and 50k Affymetrix SNP arrays were evaluated as a diagnostic tool for CLL and revealed chromosomal imbalances in 65.6% and 81.5% of 70 consecutive cases, respectively. Among the prognostically important aberrations, the del13q14 was present in 36 (51.4%), trisomy 12 in 9 (12.8%), del11q22 in 9 (12.8%), and del17p13 in 4 cases (5.7%). A prominent clustering of breakpoints on both sides of the MIRN15A/MIRN16-1 genes indicated the presence of recombination hot spots in the 13q14 region. Patients with a monoallelic del13q14 had slower lymphocyte growth kinetics (P = .002) than patients with biallelic deletions. In 4 CLL cases with unmutated VH genes, a common minimal 3.5-Mb gain of 2p16 spanning the REL and BCL11A oncogenes was identified, implicating these genes in the pathogenesis of CLL. Twenty-four large (> 10 Mb) copy-neutral regions with loss of heterozygosity were identified in 14 cases. These regions with loss of heterozygosity are not detectable by alternative methods and may harbor novel imprinted genes or loss-of-function alleles that may be important for the pathogenesis of CLL. Genomic profiling with SNP arrays is a convenient and efficient screening method for simultaneous genome-wide detection of chromosomal aberrations.
Listeriosis in Portugal: an existing but under reported infection
Authors: Almeida Gonçalo N , Gibbs Paul A , Hogg Tim A , Teixeira Paula C
Published: October 2006

Background

Listeriosis is a rare disease caused by the bacterium Listeria monocytogenes, the normal vehicle of which is food. The disease, which is largely confined to its risk groups of pregnant women, the elderly and immunocompromised individuals, has increased in incidence in recent years.

In Portugal, listeriosis is not a notifiable infection and available data are scarce.

The objective of this work was to collate the available information concerning listeriosis in Portugal by compiling a retrospective study of cases recorded over a decade.

Methods

Requests for case data on clinically confirmed listeriosis, recorded over the previous decade, were replied to by 23 hospitals and a National Institute of Health delegation.

Results

35 cases of listeriosis were identified for the period between 1994 and 2003 inclusive, the mortality rate being greater than 17%. According to the data collected in this study for the year 2003, the incidence of this disease in Portugal was at least 1.4 cases per million inhabitants in that year.

Conclusion

The study demonstrates, for the first time in the widely available literature, that despite their being no cases of listeriosis in Portugal recorded in official reports, the threat of L. monocytogenes to public health is of a similar dimension to that in other countries.
Associations between preschool attendance and developmental impairments in pre-school children in a six-year retrospective survey
Authors: Stich Heribert L , Baune Bernhard T , Caniato Riccardo N , Krämer Alexander
Published: October 2006

Background

Many school-aged children suffer physical and mental impairments which can adversely affect their development and result in significant morbidity. A high proportion of children in western countries attend pre-school, and it is likely that the preschool environment influences the prevalence and severity of these impairments. Currently there is insufficient data available on the prevalence of these impairments and their causal associations. The influence that location of a pre-school and the duration of preschool attendance have on the prevalence of these impairments is not known.

Methods

In a retrospective survey spanning six years (1997–2002) we reviewed the records of 6,230 preschool children who had undergone routine school entry assessments. These children had been assessed utilising a modified manual of the "Bavarian Model" for school entry examinations. This model outlines specific criteria for impairments of motor, cognitive, behavioural and psychosocial functioning. Prevalence rates for physical and behavioural impairments were based on the results of these assessments. The relationship between the prevalence of impairments and the duration of preschool attendance and the location of the preschool attended was estimated utilizing logistic regression models.

Results

We found that 20.7% of children met the criteria for at least one type of impairment. Highest prevalence rates (11.5%) were seen for speech impairments and lowest (3.5%) for arithmetic impairments. Boys were disproportionately over represented, with 25.5% meeting the criteria for impairment, compared to 13.0% for girls. Children who had attended preschool for less than one year demonstrated higher rates of impairment (up to 19.1% for difficulties with memory, concentration or perseverance) compared to those who had attended for a longer duration (up to 11.6% for difficulties with pronouncation). Children attending preschool in an urban location had slightly elevated rates of impairment (up to 12.7%), compared to their rural counterparts (up to 11.1%).

Conclusion

Our results demonstrate that there are high prevalence rates for physical and mental impairments among preschool children. Furthermore, children without preschool experience are a risk group for struggling with educational successes. The associations between the duration of preschool attendance and location of preschool attended and rates of impairment need replication and further exploration. Larger prospective studies are needed to examine if these relationships are causal and may therefore lend themselves to specific intervention strategies.
Relationship between ozone and temperature during the 2003 heat wave in France: consequences for health data analysis
Authors: Lacour Sandrine A , de Monte Michèle , Diot Patrice , Brocca Jérôme , Veron Nadège , Colin Patrice , Leblond Valérie
Published: October 2006

Background

PAPRICA is a research program designed to estimate the impact on the health of patients with chronic respiratory insufficiency of a prevention strategy based on notification of ozone pollution. The first year of this study was conducted during the 2003 heat wave, and high temperatures were therefore considered as a confounding factor in the data analysis. The aim of the present study was to assess the relationship between ozone and temperature in order to propose a methodology to distinguish between the effects of ozone and temperature on the impact of a prevention strategy with regard to ozone pollution.

Methods

Multivariate analyses were used to identify associated climate and ozone pollution profiles. This descriptive method is of great value to highlight the complexity of interactions between these parameters.

Results

Ozone concentration and temperature were strongly correlated, but the health impact of ozone pollution alone will be evaluated by focusing on situations characterized by ozone concentrations above 110 μg/m3/8h (air quality guidelines to protect human health defined by the French legislation) and temperatures lower than 26°C, below the discomfort threshold.

Conclusion

The precise relationship between ambient ozone concentration and temperature identified during the PAPRICA 2003 study period will be used in analysing the PAPRICA health data.
A randomized controlled trial to prevent glycemic relapse in longitudinal diabetes care: Study protocol (NCT00362193)
Authors: Huizinga Mary Margaret , Shintani Ayumi , Michon Stephanie , Brown Anne , Wolff Kathleen , Shackleford Laurie , King Elaine Boswell , Gregory Rebecca Pratt , Davis Dianne , Stiles Renee , Gebretsadik Tebeb , Chen Kong , Rothman Russell , Pichert James W , Schlundt David , Elasy Tom A
Published: October 2006

Background

Diabetes is a common disease with self-management a key aspect of care. Large prospective trials have shown that maintaining glycated hemoglobin less than 7% greatly reduces complications but translating this level of control into everyday clinical practice can be difficult. Intensive improvement programs are successful in attaining control in patients with type 2 diabetes, however, many patients experience glycemic relapse once returned to routine care. This early relapse is, in part, due to decreased adherence in self-management behaviors.

Objective

This paper describes the design of the Glycemic Relapse Prevention study. The purpose of this study is to determine the optimal frequency of maintenance intervention needed to prevent glycemic relapse. The primary endpoint is glycemic relapse, which is defined as glycated hemoglobin greater than 8% and an increase of 1% from baseline.

Methods

The intervention consists of telephonic contact by a nurse practitioner with a referral to a dietitian if indicated. This intervention was designed to provide early identification of self-care problems, understanding the rationale behind the self-care lapse and problem solve to find a negotiated solution. A total of 164 patients were randomized to routine care (least intensive), routine care with phone contact every three months (moderate intensity) or routine care with phone contact every month (most intensive).

Conclusion

The baseline patient characteristics are similar across the treatment arms. Intervention fidelity analysis showed excellent reproducibility. This study will provide insight into the important but poorly understood area of glycemic relapse prevention.
Gene expression signatures of morphologically normal breast tissue identify basal-like tumors
Authors: Finak Greg , Sadekova Svetlana , Pepin Francois , Hallett Michael , Meterissian Sarkis , Halwani Fawaz , Khetani Karim , Souleimanova Margarita , Zabolotny Brent , Omeroglu Atilla , Park Morag
Published: October 2006

Introduction

The role of the cellular microenvironment in breast tumorigenesis has become an important research area. However, little is known about gene expression in histologically normal tissue adjacent to breast tumor, if this is influenced by the tumor, and how this compares with non-tumor-bearing breast tissue.

Methods

To address this, we have generated gene expression profiles of morphologically normal epithelial and stromal tissue, isolated using laser capture microdissection, from patients with breast cancer or undergoing breast reduction mammoplasty (n = 44).

Results

Based on this data, we determined that morphologically normal epithelium and stroma exhibited distinct expression profiles, but molecular signatures that distinguished breast reduction tissue from tumor-adjacent normal tissue were absent. Stroma isolated from morphologically normal ducts adjacent to tumor tissue contained two distinct expression profiles that correlated with stromal cellularity, and shared similarities with soft tissue tumors with favorable outcome. Adjacent normal epithelium and stroma from breast cancer patients showed no significant association between expression profiles and standard clinical characteristics, but did cluster ER/PR/HER2-negative breast cancers with basal-like subtype expression profiles with poor prognosis.

Conclusion

Our data reveal that morphologically normal tissue adjacent to breast carcinomas has not undergone significant gene expression changes when compared to breast reduction tissue, and provide an important gene expression dataset for comparative studies of tumor expression profiles.
Cytomegalovirus blocks intestinal stroma-induced down-regulation of macrophage HIV-1 infection
Authors: Maheshwari Akhil , Smythies Lesley E , Wu Xiaoyun , Novak Lea , Clements Ronald , Eckhoff Devin , Lazenby Audrey J , Britt William J , Smith Phillip D
Published: October 2006

Intestinal macrophages, unlike macrophages from other tissues, do not support HIV-1 infection or produce proinflammatory cytokines. In vitro studies suggest this unique, functional phenotype is a result of the exposure of newly recruited blood monocytes to intestinal stromal products. However, in AIDS-related CMV colitis, mucosal macrophages express HIV-1 and proinflammatory cytokines. Therefore, we investigated the mechanism by which CMV confers permissiveness to HIV-1 and cytokine production on intestinal macrophages. We show that intestinal stroma-conditioned media (S-CM) down-regulated monocyte-derived macrophage infection by HIV-1 (pseudotyped with YU2 envelope or vesicular stomatitis virus glycoprotein) and production of TNF-α, but preinfection of the cells with CMV reversed this down-regulation, enhancing HIV-1 infection, p24 production, and TNF-α release. The ability of CMV to reverse S-CM down-regulation of macrophage HIV-1 infection was blocked by anti-TNF-α antibodies and over-ridden by exogenous TNF-α. Immunohistochemical analysis of monocyte-derived macrophages exposed to CMV and HIV-1 (YU2 pseudotype) revealed that the cells infrequently contained CMV and HIV-1 viral proteins. In addition, analysis of colon tissue sections from HIV-1-infected patients with CMV colitis showed that some macrophage-like cells contained CMV and TNF-α proteins, others contained HIV-1 and TNF-α proteins, but cells infrequently contained CMV and HIV-1 proteins. These results indicate that CMV blocks stromal product inhibition of HIV-1 infection in macrophages, and this inhibition is mediated, at least in part, by CMV-induced TNF-α acting in trans to enhance HIV-1 infection.