bluuebunny/crossref_metadata_2025 huggingface dataset:
A proof of superlensing in the quasistatic regime, and limitations of superlenses in this regime due to anomalous localized resonance
Authors: Milton Graeme W , Nicorovici Nicolae-Alexandru P , McPhedran Ross C , Podolskiy Viktor A
Published: October 2005

Enlarging upon work of Nicorovici, McPhedran & Milton (

Nicorovici
et al
. 1994

Phys. Rev. B
49
(12), 8479–8482), a rigorous proof is given that in the quasistatic regime a cylindrical superlens can successfully image a dipole line source in the limit as the loss in the lens tends to zero. In this limit it is proved that the field magnitude diverges to infinity in two sometimes overlapping annular anomalously locally resonant regions, one of which extends inside the lens and the other of which extends outside the lens. The wavelength of the oscillations in the locally resonant regimes is set by the geometry and the loss, and goes to zero as the loss goes to zero. If the object or source being imaged responds to an applied field it is argued that it must lie outside the resonant regions to be successfully imaged. If the image is being probed it is argued that the resonant regions created by the probe should not surround the tip of the probe. These conditions taken together make it difficult to directly probe the potential in the near vicinity of the image of a source or object having small extent. The corresponding quasistatic results for the slab lens are also derived. If the source is too close to the slab lens, i.e. lying within the resonant region, then the power dissipation in the lens tends to infinity as the loss goes to zero, which makes the lens impractical for imaging such quasistatic sources. Perfect imaging in a cylindrical superlens is shown to extend to the static equations of magnetoelectricity or thermoelectricity, provided they have a special structure which makes these equations equivalent to the quasistatic equations.
Comparing upriver spawning migration of Atlantic salmon Salmo salar and sea trout Salmo trutta
Authors: Finstad A. G. , Økland F. , Thorstad E. B. , Heggberget T. G.
Published: October 2005

Radio tagged wild Atlantic salmon Salmo salar(n = 30) and sea trout Salmo trutta(n = 19) were simultaneously released from a sea pen outside the mouth of the River Lærdalselva and their migration to spawning areas was recorded. The distance from the river mouth to a position held at spawning ranged from 2 to 24 km and did not differ between the species (mean ± s.d. 15·9 ± 4·3 and 14·9 ± 5·2 km for Atlantic salmon and sea trout, respectively). The duration of the migration phase, however, was significantly shorter for Atlantic salmon than for sea trout (8–12 days, respectively). All Atlantic salmon migrated straight to an area near the spawning ground, whereas 50% of the sea trout had a stepwise progression with one or more periods with erratic movements before reaching the spawning area. After the migration phase, a distinct search phase with repeated movements up‐ and downstream at or close to the position held at spawning was identified for the majority of the fishes (75%, both species). This search phase was significantly shorter for Atlantic salmon than for sea trout (mean 13–31 days, respectively). Mean ± s.d. length of the river stretch used during the search phase was larger for sea trout (3·3 ± 2·5 km) than for Atlantic salmon (1·2 ± 0·9 km). A distinct holding phase, with no movements until spawning, was also observed in the majority of the Atlantic salmon (80%, mean duration 22 days) and sea trout (65%, mean duration 12 days). For both species, a weak, non‐significant trend was observed in the relationship between time spent on the migration phase, and time spent on the search (r2 = 0·43) and holding phase (r2 = 0·24). There was a highly significant decrease, however, in the duration of the holding phase with an increase in the time spent on the search phase (r2 = 0·67).
Temporal changes in Sander vitreus egg thiamine levels
Authors: Barnes M. E. , Zehfus M. H. , Soupir C. A. , Sayler W. A.
Published: October 2005

Thiamine pyrophosphate was the predominant form of thiamine present initially in walleye Sander vitreus eggs from two spawning locations in Lake Oahe, South Dakota, U.S.A. Total thiamine content in the eggs at fertilization was 5·18 and 7·97 nmol g−1 for eggs from the Moreau and Grand River spawning sites respectively, and egg thiamine content in all its forms dropped dramatically at the next sampling period of 48 temperature units (TU). Thiamine values did not significantly drop after the 48 TU period, but mean total thiamine composition was < 0·9 nmol g−1 at the last sampling date (156 TU) just prior to hatching.
Multiple mating influences offspring size in guppies
Authors: Ojanguren A. F. , Evans J. P. , Magurran A. E.
Published: October 2005

Multiply mated female guppies Poecilia reticulata descended from the Tacarigua population in Trinidad produced individually larger offspring than their singly mated counterparts.
Habitat selection by juvenile Atlantic salmon: the interaction between physical habitat and abundance
Authors: Hedger R. D. , Dodson J. J. , Bergeron N. E. , Caron F.
Published: October 2005

The effect of physical river habitat variables on the distribution of juvenile Atlantic salmon Salmo salar L. in the Rivière de la Trinité, Québec, Canada, was examined using generalized additive modelling. A survey of Atlantic salmon fry and parr densities and habitat variables (flow velocity, water column depth and substratum size) was conducted in the summer months from 1984 to 1992. Clear patterns of habitat use existed: specific ranges of habitat variables were selected, with parr preferring greater velocities, depths and substratum sizes than fry. There was a large variation, however, in juvenile densities for given velocities, depths or substratum sizes, with this variation being greatest in optimal habitats. On examination of an individual year, interaction between the variables was found to explain some of the variation. On a year‐to‐year basis the juvenile Atlantic salmon population was found to exhibit an ‘Ideal Free Distribution’, which resulted in greatest variation in optimal habitats with year‐to‐year changes in population abundance.
Sublittoral abundance and food consumption of Baltic gobies
Authors: Ehrenberg S. Z. , Hansson S. , Elmgren R.
Published: October 2005

Two small demersal fishes, the sand goby Pomatoschistus minutus and the common goby Pomatoschistus microps, were quantified on soft bottoms at 20–40 m depth in the Baltic Sea, using a camera placed above the bottom. The largest numbers of gobies were seen following the settlement of young in late summer and autumn. Most recorded fishes were sand gobies. An annual average of 4·7 individuals m−2(0·24 g dry mass m−2) was recorded in 1983–1985 and 2·5 individuals m−2(0·13 g m−2) in 1997–1998. Using these densities, the annual goby food consumption was estimated to 100 kJ m−2 in 1983–1985 and 50 kJ m−2 in 1997–1998, corresponding to most of the annual macrobenthos production available to the gobies. The resulting goby production, assumed equal to 25% of the food consumed, must have been an important food source for the larger fishes occasionally recorded in the photographs.
Recognizing and managing patients with irritable bowel syndrome
Authors: Croghan Anne , Heitkemper Margaret M.
Published: October 2005

Purpose

To address the diagnosis and clinical management of irritable bowel syndrome (IBS) and provide a discussion of the available serotonergic agents.

Data sources

Recent studies examining the pathophysiology of IBS.

Conclusions

Diagnostic testing may be required in the subset of patients with IBS who present with alarm symptoms, or “red flags,” suggestive of underlying organic disease. An important role has been suggested for the neurotransmitter serotonin in both gut motility and visceral pain sensitivity.

Implications for practice

A diagnosis of IBS is largely based on symptoms; therefore, effective clinician–patient communication and careful attention to details of patient presentation, history, and physical examination are essential.
The use of personal digital assistants by nurse practitioner students and faculty
Authors: Stroud Sally D. , Erkel Elizabeth A. , Smith Carol A.
Published: October 2005

Purpose

To describe the prevalence and patterns of use of personal digital assistants (PDAs) by nurse practitioner (NP) students and faculty, examine relationships between patterns of use of PDAs and demographic characteristics of NP students and faculty, and describe patterns of use of PDAs that support evidence‐based practice (clinical scholarship).

Data sources

Responses to a 20‐item questionnaire administered via electronic or postal mail from 227 NP students and faculty.

Conclusions

A majority (67%) of the participants used PDAs. Use was higher among men (82%) than women (64%) (p < .05). On average, respondents who used a PDA (N = 153) had been using it just over a year (M = 13 months). Respondents reported using a PDA most days of the week (M = 5 days). The top three medical software programs identified by respondents as the most useful in clinical practice were ePocrates Rx (82%), Griffith's 5‐Minute Clinical Consult (26%), and MedCalc (22%). Most participants (96%) related that PDA use supported clinical decision making.

Implications for practice

Personal digital assistants may facilitate the application of evidence‐based knowledge to practice. However, until there is evidence that PDA software is valid and reliable, clinicians should continue to use a multitude of references to assure the quality and safety of care provided.
Homocysteine and cardiovascular disease: A review of current recommendations for screening and treatment
Authors: Chamberlain KarenL.
Published: October 2005

Purpose

To review the literature for, and provide advanced practice nurses (APNs) with, current recommendations for screening and treatment of hyperhomocysteinemia.

Data sources

Medscape literature search of selected research studies and related journal articles.

Conclusions

While data from most epidemiologic studies support the argument that hyperhomocysteinemia is an independent risk factor for cardiovascular disease, the debate continues as to when screening and treating patients is appropriate. The consensus is that more randomized controlled trials are needed to further study the benefits of routine screening and the efficacy of treating hyperhomocysteinemia.

Implications for practice

Until the results of ongoing clinical trials are available, APNs should follow the American Heart Association guidelines for screening for elevated levels of homocysteine and continue to promote a well‐balanced diet that includes foods rich in folic acid as part of health promotion through primary prevention.
When cure is care: Diagnosis and management of pulmonary arterial hypertension
Authors: Widmar Brian
Published: October 2005

Purpose

The purpose of this article is to provide nurse practitioners with an understanding of the pathophysiology of pulmonary arterial hypertension (PAH) disease, clinical manifestations, diagnostic evaluation, drug therapy, strategies for health promotion, and relevant care issues for patients and families.

Data sources

Selected clinical and research articles, as well as current government guidelines.

Conclusions

Symptoms expressed are more apparent as PAH disease progresses, leaving fewer treatment options in advanced disease stages. New drugs are currently being tested for the treatment of PAH; however, the costs of many of the currently approved treatments may be prohibitive.

Implications for practice

Earlier recognition of disease symptoms leads to prompt initiation of diagnostic evaluation and referral to specializing medical centers. Upon referral, specialty centers may begin appropriate treatment regimens earlier in the disease process, which could improve clinical outcomes and quality of life.
An examination of ethnic differences in cigarette smoking intention among female teenagers
Authors: Hanson Mary Jane S.
Published: October 2005

Purpose

To describe and compare predictors of cigarette smoking intention, as defined by the theory of planned behavior, among African American, Puerto Rican, and non‐Hispanic white female teenagers.

Data sources

A convenience sample of 430 English‐speaking female teenagers (141 African American, 146 Puerto Rican, and 143 non‐Hispanic white teenagers), aged 13–19 years, who were patients at family planning clinics in eastern Pennsylvania. The data were obtained through a self‐administered questionnaire.

Conclusions

Regression analyses demonstrated attitude, subjective norm, and perceived behavioral control predicted 70% of the variance in smoking intention in African American, 69% in Puerto Rican, and 88% in non‐Hispanic white teenagers. In addition, ethnic group differences were identified. For African Americans, smoking intention was mediated principally by perceived behavioral control, whereas for Puerto Rican and non‐Hispanic white teenagers, attitudes were the greatest predictor of intention to smoke. Moreover, non‐Hispanic white smokers had a stronger intention to smoke than either the African American or Puerto Rican smokers.

Implications for practice

Cigarette smoking is the leading preventable cause of death in the United States, with the majority of smokers initiating the habit in their teen years. Nurse practitioners are in key positions to counsel young women about the dangers of smoking. The identification of cultural‐specific predictors of smoking will assist in the development of tailored antismoking messages.
Stress Corrosion of Silicon Nitride
Authors: GULDEN M. E. , METCALFE A. G.
Published: October 2005

The results of an investigation to determine stress corrosion effects on Si3N4 are presented. Variable‐strain‐rate and static‐fatigue tests were performed on hot‐pressed and reaction‐sintered materials. Both materials exhibited time‐dependent failure in an atmosphere of water‐saturated flowing air. The effect is moisture‐dependent, as indicated by a strength increase of = 10% for tests performed in dry air. A model is proposed for the mechanism of stress corrosion of hot‐pressed Si3N4 based on ion exchange occurring in the glassy grain‐boundary phase.
Characterization of Hot‐Pressed Cement Pastes
Authors: GOUDA GEORGE R. , ROY DELLA M.
Published: October 2005

Very‐high‐strength cement pastes (compressive strengths ∼100,000 psi) were prepared using hot‐pressing techniques at temperatures up to 250°C. The results of characterization studies summarized include X‐ray diffraction, DTA, ir spectra, and microstructural investigations. Much less Ca(OH)2 is formed than in normally hydrated pastes. Some well‐ crystallized hydroxyl‐containing hydrates, C5S2H, C3SH1.5, C3AH6, and C4A3H3, as well as poorly crystalline CSH, are formed. The structure of the CSH, as revealed by ir absorption studies, does not appear to be very different from that in low‐ temperature hydrated cement pastes. Microstructures are extremely dense and, in some cases, the sulfate‐containing phase concentrates along original grain boundaries.
Crack Healing and Strength Recovery in UO2
Authors: BANDYOPADHYAY G. , ROBERTS J. T. A.
Published: October 2005

The kinetics of the final stages of crack healing and strength recovery are formulated from a simple mechanistic point of view. Experimental verification is obtained from literature data and from healing data on notched UO2 bars with small cracks introduced by local thermal shock at the notch. The analysis indicates that the initial strength recovery resulting from crack healing is apparently controlled by pinching off of the crack and by some sintering of crack‐like pores (termed stage 1 of healing). At a later stage, however, strength recovery is controlled only by the sintering of crack‐like pores through a diffusional process (termed stage 2). “Crack‐healing diagrams” that can be used to predict the stages of healing and the time required for complete strength recovery are developed from the experimental data. The information obtained from these diagrams can be used in the kinetic equation for stage 2 healing to estimate the strength recovery at that stage.
High‐Resolution Techniques and Application to Nonoxide Ceramics
Authors: CLARKE DAVID R.
Published: October 2005

The microstructure of ceramic materials can be observed directly at the atomic level by using high‐resolution electron microscopy. These techniques are described in detail and the new information that they reveal about ceramic microstructures is illustrated with examples of hot‐pressed silicon nitrides, sintered silicon sarbide, and a “sialon” system.
Applications of Dedicated Scanning Transmission Electron Microscopy to Nonmetallic Materials
Authors: SANDE J. B. VANDER , HALL E. L.
Published: October 2005

The operating characteristics of a scanning transmission electron microscope are described and discussed with particular emphasis on those operating modes where scientific advantages and/or advantages of convenience can be realized in microstructural analysis. Several examples demonstrating these operating modes are presented.
Delayed spinocerebellar ataxia in transgenic mice expressing mutant ubiquitin
Authors: Tsirigotis M. , Tang M. Y. , Beyers M. , Zhang M. , Woulfe J. , Gray D. A.
Published: October 2005

Spinocerebellar ataxia type 1 (SCA1) is an incurable neurodegenerative disease resulting from loss of Purkinje neurones within the cerebellum. The ubiquitin proteasome pathway (UPP) has been implicated in SCA1 but the role of proteolysis in the disease is still poorly understood. To further investigate this issue in vivo, genetic crosses were performed between an established mouse model of SCA1 and novel strains expressing elevated levels of wild type or mutant isoforms of ubiquitin. The K48R mutant isoform of ubiquitin (a dominant negative inhibitor of proteolysis) was found to significantly delay the deterioration of Purkinje neurones as evidenced by behavioural, morphological, and molecular indicators. This delay was accompanied by stabilization of p300/CBP, transcriptional mediators whose abundance and activity would otherwise decline in the course of the SCA1 disease, and persistence of protein kinase C gamma (PKCγ), a protein involved in Purkinje cell dendritic development that is mutated in one form of spinocerebellar ataxia. Whereas the stabilization of p300/CBP was found to occur at the post‐translational level the modulation of PKCγ was at the level of transcription. These results are consistent with transcriptional dysregulation as a key mechanism in neurodegeneration through loss of p300/CBP. Further, the results suggest that the UPP is a potentially useful target for the development of novel therapies for the treatment of neurodegenerative disease.
Vascular colocalization of P‐glycoprotein, multidrug‐resistance associated protein 1, breast cancer resistance protein and major vault protein in human epileptogenic pathologies
Authors: Sisodiya S. M. , Martinian L. , Scheffer G. L. , Van Der Valk P. , Scheper R. J. , Harding B. N. , Thom M.
Published: October 2005

Multidrug transporters, such as P‐glycoprotein (P‐gp), multidrug‐resistance associated protein 1 (MRP1) and breast cancer resistance protein (BCRP), are associated with multidrug resistance in cancers; other molecules, such as major vault protein (MVP), have a similar association with drug‐resistant cancer. These proteins are postulated to generate drug resistance in epilepsy. They have been shown individually to be up‐regulated in epileptogenic brain tissue. In any consideration of the function, inhibition or evasion of the activity of such proteins, the colocalization of such proteins needs to be understood. We systematically determined the presence of such colocalization, focusing on microvascular endothelium from epileptogenic human brain tissue. Double labelling immunofluorescence and confocal laser scanning microscopy were used to determine colocalization of P‐gp, MRP1, BCRP and MVP in one case of hippocampal sclerosis and two cases of focal cortical dysplasia type IIb. Endothelial colocalization was examined with double labelling using antibodies to CD34 and Factor VIII. The presence of P‐gp, BCRP and MVP in microvascular endothelium was confirmed. P‐gp, BCRP and MVP colocalized in microvascular endothelium, though not all proteins appeared to be identically distributed within this tissue. MRP1 did not colocalize to endothelium. These findings were not unexpected but required formal confirmation. The demonstrated colocalization of P‐gp, BCRP and MVP in microvascular endothelium in epileptogenic human brain tissue has important implications for functional experiments (including single knock‐out mice studies), work with specific and broad‐spectrum inhibitors of transport function, and any eventual trials of treatment of refractory epilepsy involving modulation of the function of these proteins.
Histiocytosis and bone: experience from one major Sydney teaching hospital
Authors: Geevasinga N. , Jeremy R. , Crombie C. M. , Manolios N.
Published: October 2005

Abstract

Langerhans cell histiocytosis (LCH) has diverse presentations which can bring it before all physicians regardless of specialty. A retrospective audit was undertaken at Westmead Hospital, Sydney, Australia, to ascertain the incidence, epidemiology and clinical features of patients with LCH over a 10‐year period (1994–2004). A total of 12 patients was identified (six male, six female). Eleven patients had involvement of the skeletal system, three of the patients had pulmonary LCH and only one patient presented with soft tissue involvement (nose and antrum). Three patients had diabetes insipidus. Our results are consistent with that noted in the published literature and confirm the low incidence, diverse nature of presentation and the differing treatment strategies available for this rare and yet interesting condition. (Intern Med J 2005; 35: 622–625)
Linezolid‐induced dyserythropoiesis: chloramphenicol toxicity revisited
Authors: Dawson M. A. , Davis A. , Elliott P. , Cole‐Sinclair M.
Published: October 2005

Abstract

We report here two cases of dyserythropoietic anaemia associated with long‐term linezolid use that share striking similarities to chloramphenicol‐associated myelotoxicity. (Intern Med J 2005; 35: 626–628)
Triglycerides + high‐density‐lipoprotein‐cholesterol dyslipidaemia, a coronary risk factor in elderly women: the CArdiovascular STudy in the ELderly
Authors: Mazza A. , Tikhonoff V. , Schiavon L. , Casiglia E.
Published: October 2005

Abstract

Background:  The relationship between serum triglycerides (TG) level and the risk of coronary heart disease (CHD) mortality remains controversial.

Aims:  To evaluate whether TG level is a risk factor for CHD in elderly people from general population, and to look for interactions between TG and other risk factors.

Methods:  3257 subjects aged ≥ 65 years followed up for 12 years from the CArdiovascular STudy in the ELderly. Blood tests and anthropometric measurements were performed. Continuous items were divided into quintiles and, for each quintile, adjusted hazard ratio (HR) with 95% confidence interval (CI) for CHD mortality was derived by genders from Cox analysis.

Results:  In women, the HR of being in the fifth rather than in the first quintile of TG was 2.45 (CI 1.48−3.51). In turn, high‐density‐lipoprotein cholesterol (HDL‐C) inversely predicted CHD mortality; the HR of being in the first rather than in the fifth quintiles of HDL‐C was 1.52 (CI 1.24−2.36). The risk of CHD mortality further increased up to 3.81 (CI 1.62−5.43) when high TG and low HDL‐C were combined. No predictive role for either TG or HDL‐C was detected in men.

Conclusions:  TG and HDL‐C were independent predictors of CHD mortality in elderly women. The combination high TG + low HDL‐C quadrupled the risk of CHD mortality in this gender only. (Intern Med J 2005; 35: 604−610)
Combination therapy using metformin or thiazolidinediones and insulin in the treatment of diabetes mellitus
Authors: Strowig Suzanne M. , Raskin Philip
Published: October 2005

The biguanide, metformin, sensitizes the liver to the effect of insulin, suppressing hepatic glucose output. Thiazolidinediones such as rosiglitazone and pioglitazone enhance insulin‐mediated glucose disposal, leading to reduced plasma insulin concentrations. These classes of drugs may also have varying beneficial effects on features of insulin resistance such as lipid levels, blood pressure and body weight. Metformin in combination with insulin has been shown to significantly improve blood glucose levels while lowering total daily insulin dose and body weight. The thiazolidinediones in combination with insulin have also been effective in lowering blood glucose levels and total daily insulin dose. Triple combination therapy using insulin, metformin and a thiazolidinedione improves glycaemic control to a greater degree than dual therapy using insulin and metformin or insulin and a thiazolidinedione. There is insufficient evidence to recommend the use of metformin or thiazolidinediones in type 1 diabetic patients. Although these agents are largely well tolerated, some subjects experience significant gastrointestinal problems while using metformin. Metformin is associated with a low risk of lactic acidosis, but should not be used in patients with elevated serum creatinine or those being treated for congestive heart failure. The thiazolidinediones are associated with an increase in body weight, although this can be avoided with careful lifestyle management. Thiazolidinediones may also lead to oedema and are associated with a low incidence of hepatocellular injury. Thiazolidinediones are contraindicated in patients with underlying heart disease who are at risk of congestive heart failure and in patients who have abnormal hepatic function. The desired blood glucose‐lowering effect and adverse event profiles of these agents should be considered when recommending these agents to diabetic patients. The potential for metformin or the thiazolidinediones to impact long‐term cardiovascular outcomes remains under investigation.
Fermented mushroom milk‐supplemented dietary fibre prevents the onset of obesity and hypertriglyceridaemia in Otsuka Long‐Evans Tokushima fatty rats
Authors: Jeon B. S. , Park J. W. , Kim B. K. , Kim H. K. , Jung T. S. , Hahm J. R. , Kim D. R. , Cho Y. S. , Cha J. Y.
Published: October 2005

Aim:  Fermented milk product containing edible mushroom water extracts (mushroom yogurt; MY) has been reported to have glycaemic control and triglyceride‐lowering effects in streptozotocin (STZ)‐induced diabetic rats and Zucker diabetic fatty (ZDF) rats. Here, we investigated how MY‐supplemented dietary fibre (10 and 20%, v/w) influences the onset of obesity and hypertriglyceridaemia in Otsuka Long‐Evans Tokushima fatty (OLETF) rats.

Methods:  The OLETF rats were fed a powdered chow diet supplemented with MY at the levels of 10 (v/w) and 20% for 6 weeks from 10 weeks of age, but the OLETF control rats were not supplemented. Their weight, fat distribution and lipid profile have been determined.

Results:  The body weights in MY‐fed rats were reduced compared with the control rats. The perirenal fat was decreased in both MY groups, but the visceral and epididymal fats reduced only in the MY 20% group. The concentrations of serum triglyceride and non‐esterified fatty acid in MY‐fed rats were decreased in a dose‐dependent manner. However, the levels of other serum lipid profiles [total cholesterol, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol] were comparable among all rats.

Conclusion:  Antiobesity and triglyceride lowering by MY‐supplemented dietary fibre in OLETF rats might have resulted from the synergistic effect of components in the fermented mushroom‐milk product.
X‐PERT: weight reduction with orlistat in obese subjects receiving a mildly or moderately reduced‐energy diet. Early response to treatment predicts weight maintenance
Authors: Toplak H. , Ziegler O. , Keller U. , Hamann A. , Godin C. , Wittert G. , Zanella M.‐T. , Zúñiga‐Guajardo S. , Van Gaal L.
Published: October 2005

Aim:  To determine the effect of two different levels of energy deficit on weight loss in obese patients treated with orlistat.

Methods:  Patients (n = 430) were randomized in a 1‐year, multicentre, open‐label, parallel group study conducted at 23 hospital centres and university medical departments worldwide. Obese outpatients (body mass index 30–43 kg/m2) aged 18–70 years with a body weight of ≥90 kg and a waist circumference of ≥88 cm (women) or ≥102 cm (men) were treated with orlistat 120 mg three times daily plus a diet that provided an energy deficit of either 500 or 1000 kcal/day for 1 year. Orlistat treatment was discontinued in patients who did not achieve ≥5% weight loss after assessment at 3 and 6 months. The primary outcome measure was change in body weight from baseline at week 52.

Results:  Reported mean difference in energy intake between the two groups (500–1000 kcal/day deficit) at weeks 24 and 52 was actually 111 and 95 kcal/day respectively. Of the 430 patients involved in the study, 295 achieved ≥5% weight loss at both 3 and 6 months. In this population, at week 52, weight loss from baseline was similar for patients randomized to either the 500 or the 1000 kcal/day deficit diet (−11.4 kg vs. −11.8 kg, respectively; p = 0.778). After 12 months of treatment with orlistat, 84% (n = 118/141) and 85% (n = 131/154) of patients in the 500 and 1000 kcal/day deficit groups, respectively, achieved ≥5% weight loss, and 50% (n = 70/141) and 53% (n = 82/154) of patients, respectively, achieved ≥10% weight loss. Patients in both the diet treatment groups showed similar significant improvements in blood pressure, lipid levels and waist circumference at week 52.

Conclusions:  Treatment with orlistat was associated with a clinically beneficial weight loss, irrespective of the prescribed dietary energy restriction (−500 or −1000 kcal/day). Patients who achieved ≥5% weight loss at 3 months achieved long‐term, clinically beneficial weight loss with orlistat plus either diet. Therefore, identifying patients who lose at least 5% weight after 3 months and who maintain this weight loss up to 6 months is a valuable treatment algorithm to select patients who will benefit most from orlistat treatment in combination with diet.
Treating insulin resistance in type 2 diabetes with metformin and thiazolidinediones
Authors: Bailey C. J.
Published: October 2005

Insulin resistance underlies the pathogenesis of hyperglycaemia and cardiovascular disease in most people with type 2 diabetes. Metformin and thiazolidinediones (pioglitazone and rosiglitazone) counter insulin resistance by different cellular mechanisms and with complementary effects, making them suited for use in combination. Metformin exerts a stronger suppression of hepatic glucose output, while thiazolidinediones produce a greater increase in peripheral glucose uptake, enabling metformin‐thiazolidinedione combinations to improve glycaemic control in type 2 diabetes with additive efficacy. Basal insulin concentrations are not raised by metformin or thiazolidinediones, so there is minimal risk of hypoglycaemia, and metformin can reduce the weight gain associated with thiazolidinediones. There are overlapping effects of metformin and thiazolidinediones against a range of athero‐thrombotic factors and markers. These include decreased plasminogen activator inhibitor‐1, reduced platelet aggregation, reductions of several vascular adhesion molecules, and reduced markers of low‐grade inflammation such as C‐reactive protein. Additionally, thiazolidinediones increase adiponectin and slightly reduce blood pressure. Both metformin and thiazolidinediones can improve components of the lipid profile: thiazolidinediones consistently reduce free fatty acid concentrations and decrease the proportion of small dense low‐density‐lipoprotein, and pioglitazone also decreases triglycerides. During co‐administration, metformin and thiazolidinediones do not interfere with each other's pharmacokinetics, and lower doses of the two agents together can achieve efficacy with fewer side effects. Metformin‐thiazolidinedione combinations require attention to the precautions for both agents, especially renal, cardiac and hepatic status. Thus, metformin and thiazolidinediones can be used in combination to address the hyperglycaemia and vascular risk in type 2 diabetes
Occurrence of cirrhosis‐related complications is a time‐dependent prognostic predictor independent of baseline model for end‐stage liver disease score
Authors: Huo Teh‐Ia , Lin Han‐Chieh , Lee Fa‐Yauh , Hou Ming‐Chih , Lee Pui‐Ching , Wu Jaw‐Ching , Chang Full‐Young , Lee Shou‐Dong
Published: October 2005

Abstract: Background: The model for end‐stage liver disease (MELD) is used to prioritize cirrhotic patients awaiting liver transplantation. Many cirrhosis‐related complications are indications for transplantation but are not included in MELD. This study investigated the impact of these complications on survival and association with MELD.

Methods: The mortality risk of cirrhosis‐related complications, including bleeding esophageal varices, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome and hepatic decompensation, was analyzed using a time‐dependent Cox regression model in 227 cirrhotic patients.

Results: A total of 281 episodes of complications occurred in 142 (63%) patients. Patients who died had a significantly higher baseline MELD score compared with those who survived (14.5±4.5 vs 12.8±3.9, P=0.004). There was no significant difference in the MELD score between patients with and without the occurrence of complications (13.6±4.3 vs 12.9±4.0, P=0.093). Patients with a higher baseline MELD score tended to develop early complications (ρ=−0.598, P< 0.001). Using the Cox regression model, the risk ratio of mortality was 4.9 (95% confidence interval: 3.9–6.3, P< 0.0001) for each additional episode of complication.

Conclusions: The mortality risk increases as the number of complication episodes increases. While patients with repeated complications have a poor outcome, they do not necessarily have a higher baseline MELD score and could be down‐staged in the MELD era.
Healthcare Utilization of Nursing Home Residents: Comparison Between Decedents and Survivors
Authors: Bercovitz Anita , Gruber‐Baldini Ann L. , Burton Lynda C. , Hebel J. Richard
Published: October 2005

Objectives: To determine whether residents who die while in the nursing home have higher healthcare utilization than survivors and whether the utilization in the periods before death varies with length of stay in the nursing home.

Design: Descriptive, longitudinal study comparing medical service use of residents who died during the study period with that of residents who remained alive in the facility.

Setting: Fifty‐nine nursing homes in Maryland. Data were collected between 1992 and 1995.

Participants: A random sample of 1,195 residents.

Measurements: Rates of hospitalization, emergency department visits, and medical visits in aggregate and in an initial 30‐day and subsequent 90‐day intervals after admission to the nursing home.

Results: Residents who died during the 2‐year study period had significantly greater mean rates of utilization of all types of health care than residents who were not discharged from the nursing home, even when controlling for dementia diagnosis, age, functional status, and number of comorbid conditions. Those who died within a month of admission had significantly more emergency department and medical visits than those who died after a longer stay.

Conclusion: The pattern of high healthcare utilization before death is consistent with studies of the overall Medicare population that show an increase in Medicare expenditures in the period before death.
Rating the Importance of Nursing Home Residents' Quality of Life
Authors: Kane Robert L. , Rockwood Todd , Hyer Kathryn , Desjardins Karen , Brassard Andrea , Gessert Charles , Kane Rosalie
Published: October 2005

Objectives: To assess how various stakeholders involved with nursing home care rate the importance of various quality‐of‐life (QoL) items for hypothetical residents with varying types of impairment.

Design: A community‐based exploratory description of a convenience sample.

Setting: Eleven nursing homes in Florida, New Jersey, and Minnesota.

Participants: Samples of registered and licensed nurses (RNs and LPNs), certified nursing assistants (CNAs), activities personnel, social workers, physicians, residents, and family members.

Measurements: Using a magnitude estimation approach, 17 QoL items were rated in order of importance on each of three hypothetical types of nursing home residents.

Results: Overall, there was little variation in the ratings for individual items. Ratings for persons with cognitive impairment were consistently lower. RNs'/LPNs' and CNAs' ratings were generally higher than the others, and physicians' ratings were generally lower. Residents' and families' ratings were generally lower than nurses' ratings.

Conclusion: All stakeholders considered QoL to be important and felt that it deserves more attention in practice and regulation. A summary QoL score need not be weighted. Respondents (who were not cognitively impaired) considered QoL less important for residents with cognitive impairment. Value differences between those involved in nursing home care deserve more exploration.
Host response to microbial challenge following resective/non‐resective periodontal therapy
Authors: Zitzmann N. U. , Lindhe J. , Berglundh T.
Published: October 2005

Background: The host response to microbial challenge depends on the recruitment of homing leucocytes and may be related to the experience to infectious insults over years.

Purpose: The aim of this study was to investigate the soft tissue reactions to de novo plaque formation at sites treated with either open flap debridement or with the use of resective means during periodontal therapy.

Material and Methods: Fifteen patients, who had been treated for periodontal disease (severe generalized chronic periodontitis), participated in the study. Surgical therapy was performed using either gingivectomy (GV) or open flap debridement (OFD) procedures in a split mouth design. After 6 months of healing (day 0), two gingival biopsies were obtained, one from the GV‐ and one from the OFD‐treated sites. The experimental gingivitis model was applied and plaque accumulation was allowed for 3 weeks. New biopsies were obtained from the remaining quadrants on day 21 of plaque formation. The biopsies were snap frozen and prepared for immunohistochemical analysis.

Results: Following 3 weeks of plaque accumulation, the size of the lesion in OFD sites was more than twice as large than that in GV sites (0.42 versus 0.19 mm2). In the GV units, the lesion was characterized by almost similar proportions of T cells (CD3+, 6.0%) and B cells (CD19+, 6.6%), while the ICT in OFD sites was dominated by B cells (13.8%). During the 3‐week period of plaque formation the increase in cell densities of T and B cells was three times larger in OFD than in GV sites. The proportion of ELAM‐1 (CD62+ cells) decreased in GV (−0.4%) and increased in OFD (0.9%) sites.

Conclusions: The host response that occurred in the gingival sites treated with OFD was more pronounced than the reaction that under similar experimental conditions took place in the regenerated gingiva at sites treated by resective means.
Removal of Streptococcus mutans biofilm by bubbles
Authors: Parini Michael R. , Eggett Dennis L. , Pitt William G.
Published: October 2005

Background: Air bubbles had been shown to remove particles and bacteria from surfaces, but they had not yet been studied regarding the removal of mature biofilm from a surface.

Methods: Streptococcus mutans were grown as a biofilm on glass coverslips and were exposed to a fluid stream with or without bubbles. Three parameters (stream velocity, gas fraction, and bubble size) were varied in the bubble stream to determine which conditions best remove the biofilm.

Results: At low velocities bubbles enhance biofilm removal compared with the liquid alone. Stream conditions that were shown to be the most effective in removing biofilm were large bubbles at low gas fractions.

Conclusions: These results suggest that flowing bubble streams may be a desirable feature to incorporate into oral hygiene products to remove accumulated biofilms such as dental plaque.
Dental hygienists on top of the world: supporting oral health education in Nepal
Authors: Knevel RJM
Published: October 2005

Abstract:  This article describes the oral health situation in Nepal. Based on research and strategic planning reports from the WHO and the Ministry of Health in Nepal the value of Oral Health Promotion in Nepal is being promoted. The implications of possible dental treatment and/or oral health promotions are being discussed. A plan for support of improvement of the oral health in Nepal is presented. The main focus is the support of the development of the dental hygiene education and profession in Nepal. Another focus of attention is the ability of dental hygienists in Nepal to develop them individually and to create independent professionalization. This article forms the basis for developing a 5‐year collaborative programme with Kantipur School of Dentistry and the Dental Hygiene Education, Amsterdam. It can be a means to inspire dental hygienists around the world to put efforts into improving oral health in developing countries.
The effectiveness of self‐performed mechanical plaque control with triclosan containing dentifrices
Authors: Hioe KPKJ , van der Weijden GA
Published: October 2005

Abstract:  Objective:  To assess the effectiveness of self‐performed mechanical plaque control with triclosan (5‐chloro‐2‐(2,4 dichlorophenoxy)phenol) containing dentifrice.

Search strategy:  An electronic search of the National Library of Medicine, Washington DC (Medline‐PubMed; up to and including March 2005) was performed using specific search terms to identify clinical trials of ≥6 months in duration, which assessed the effect of various forms of plaque control in gingivitis subjects. In those trials the manual toothbrush group (frequently the control group) served to provide data for the assessment of the effectiveness of self‐performed mechanical plaque control with a triclosan‐containing dentifrice. The data were analysed depending on the (baseline) intervention, being either a professional oral hygiene instructions, a prophylaxis, or both.

Data collection and analysis:  Two reviewers extracted information (KPKJH and GAW). Where appropriate plaque and gingivitis data for baseline and end‐trial were used to calculate weighted mean differences (WMD) with the appropriate 95% confidence intervals (CI) using a random effect models.

Main results:  Of 105 titles and abstracts, 18 trials were found suitable for clinical data were extracted. Meta‐analysis were conducted. In studies (n = 9) evaluating a triclosan/copolymer dentifrice, plaque control [Quigley and Hein (1962) Journal of American Dental Association, Vol. 65: pp. 26–29] was significantly improved compared with a control fluoride dentifrice, with a WMD of −0.48 (95% CI: −0.73 to −0.24). For gingival inflammation as assessed with the gingival index [Löe and Silness (1963) Acta Odontologica Scandinavica, Vol. 21: pp. 533–551] a significant WMD of −0.24 (95% CI: −0.35 to −0.13) was found. From studies (n = 6) evaluating the Triclosan zinc/citrate dentifrices a small but significant WMD for plaque control [Silness and Löe (1964) Acta Odontologica Scandinavica, Vol. 22: pp. 121–135] was observed in favour of the test group as compared with the standard fluoride dentifrice formulations (WMD −0.07, 95% CI: −0.10 to 0.05). While at baseline the proportion of bleeding was comparable, at the end of the studies a significant −10.81% WMD (95% CI: −12.69 to −8.93) in favour of the triclosan/zinc citrate dentifrice was observed.

Conclusion:  This systematic review indicates, based on studies ≥6 months of duration in adults with gingivitis, that the effectiveness of self‐performed mechanical plaque control with a triclosan‐containing dentifrice, had a significant albeit small positive effect on the reduction of plaque and gingivitis.
A proposed model for a collaborative approach to dental hygiene research
Authors: Cobban SJ , Wilson MP , Covington PA , Miller B , Moore DP , Rudin SL
Published: October 2005

Abstract:  As dental hygiene responds to the increased need for quality oral health services, dental hygienists seek quality research findings on which to base their practice decisions. However, the amount of research published by dental hygienists, and addressing dental hygiene interventions, remains limited. There are few dental hygienists in Canada working in positions that have time dedicated to research activities. To increase the amount of dental hygiene research, innovative approaches such as collaborative research must be considered. This paper considers measures that facilitate the conduct of collaborative research, and discusses challenges to the process that should be considered during the design. An example of a group investigation is presented, involving dental hygiene educators who collaborated on a research project implemented within their respective educational institutions. A model for a collaborative approach to future research initiatives is proposed. Lessons learned are shared and recommendations are put forward. It is suggested that innovative collaborations such as this may help to increase the body of knowledge for dental hygiene in Canada.
Cdk2 activity is dispensable for triggering replicon initiation after transient hypoxia in T24 cells
Authors: Stabenow Dirk , Probst Hans , van Betteraey‐Nikoleit Maria
Published: October 2005

We examined whether the fast release of replicon initiation after sudden O2 recovery of hypoxically incubated mammalian cells depends on kinase activity of Cdk2. We used a system based on starved/refed T24 cells elaborated previously for such investigations [van Betteraey‐Nikoleit M, Eisele KH, Stabenow D & Probst H (2003) Eur J Biochem270, 3880–3890]. Cells subjected to hypoxia concurrently with refeeding accumulate the G1 DNA content within 5–6 h. In this state they are ready to perform, within 1–2 min after O2 recovery, a burst of replicon initiations that marks the start of a synchronous S‐phase. We found that Cdk2 binds to the chromatin fraction within 4–6 h after refeeding with fresh medium, irrespective of whether the cells were incubated normoxically or hypoxically. However, inhibition of Cdk2 by olomoucine, roscovitine or the Cdk2/cyclin inhibitory peptide II had no influence on the synchronous burst of replicon initiations. Cdc6 and pRb, possible targets of Cdk2 phosphorylation, behaved differentially. Inhibition did not affect phosphorylation of Cdc6 after reoxygenation, whilst chromatin bound pRb remained hypophosphorylated beyond the initiation burst. Thus, neither Cdk2 activity, though present at the end of the hypoxic period, nor pRb phosphorylation are necessary for releasing the burst of replicon initiations upon oxygen recovery. Consequentially, Cdk2 dependent phosphorylation(s) cannot be a critical trigger of replicon initiation in response to reoxygenation after several hours of hypoxia, at least in the T24 cells studied.