bluuebunny/crossref_metadata_2025 huggingface dataset:
Power, status and marginalisation: Rural social workers and evidence‐based practice in multidisciplinary teams
Authors: Murphy Angela , McDonald John
Published: July 2004

The present paper examines how evidence‐based practice (EBP) is impacting on the professional status of social workers working in multidisciplinary health teams in rural Victoria. Questionnaires and interviews were used to investigate the use and perceived appropriateness of EBP and the implications for the professional status of social workers. The results indicated that social workers have the lowest levels of knowledge and application of EBP. The qualitative data revealed a fundamental incompatibility between social work practice approaches and the science of EBP. The key themes identified were: how undergraduate and professional training shapes practitioner perspectives around EBP; divergent knowledge of EBP and how this influences team perceptions around the validity of social work practice; the ways EBP validates and reinforces existing power hierarchies, frequently to the exclusion of social work practitioners; the power of EBP as a mechanism for practice legitimisation; the marginalisation of social work as a discipline resisting the science of EBP; and the way the rural context shapes the impact of EBP in the practice setting.
Voices from the bottom
Authors: Serr Klaus
Published: July 2004

Despite many years of poverty eradication programs in numerous countries, 25% of the world's population continues to live in poverty. In the light of this global crisis, it is clear that anti‐poverty strategies have not been as successful as they should have been. This paper argues that continuing poverty may be related in part to the fact that policies developed to alleviate the problem are mainly based on monetary definitions developed by ‘experts’, rather than by the poor themselves. Thus this paper will demonstrate that expert definitions invariably neglect the more qualitative aspects and experiences of poverty. In contrast, it is argued here that the poor are the ‘real’ poverty experts and their voices should be included in the definition of poverty and the formulation of solutions. While there is increasing recognition of this latter approach in developing nations, often taking a human needs perspective, this response is only in its infancy in Australia. After a discussion of the conceptualisation of human needs, this paper reports on a small pilot study that presents the voices of 10 disadvantaged men, identifying what poverty is for them in Melbourne
After the accident: Survivors' perceptions of recovery following road trauma
Authors: Harms Louise
Published: July 2004

Road accidents affect thousands of lives each year in Australia. This article discusses findings from three years of research into survivors of major road trauma. The research aimed to examine how survivors of road trauma understood their own experiences of recovery, after sustaining serious orthopaedic injuries and undergoing rehabilitation at a Victorian rehabilitation centre. Seventy‐nine respondents completed a self‐administered survey and 24 of these respondents then participated in in‐depth telephone interviews. Using an ecological framework, the research focused on psychosocial and subjective factors in recovery. The qualitative aspects of recovery are presented – the analysis of perceptions of trauma, recovery, recovery resources and coping in the future. Four main themes of recovery are identified – finding a new fit, the privacy of suffering, anticipatory coping and survivor pride. These themes highlight the complexity of the recovery process.
Beyond psychiatry: How social workers conceptualise women and self‐starvation
Authors: Wilson Jennifer
Published: July 2004

In the present study, I outline how four social workers, with experience in working with women who self‐starve, commonly known as anorexia nervosa, conceptualise this phenomenon. I conducted single, in‐depth interviews with each worker and feminist discourse analysis was chosen as the method of text interpretation. Alternative (non‐psychiatric) ways of understanding women's self‐starvation were explicitly privileged. Hence, the alternative discourses of feminist and poststructural theories were used to design the research and analyse the data. The literature review outlines the historical ‘discovery’ of ‘anorexia nervosa’ as a discrete illness category. Contemporary and dominant ‘pathological’ perspectives and marginalised ‘cultural’ perspectives are presented. Three dominant themes emerged from the interviews. They were ‘control and perfection’, ‘femininity’ and ‘self‐destruction/self‐preservation’. These themes are presented, as are their critical implications for social work.
Below‐ground competition between trees and grasses may overwhelm the facilitative effects of hydraulic lift
Authors: Ludwig F. , Dawson T. E. , Prins H. H. T. , Berendse F. , de Kroon H.
Published: July 2004

Under large East African Acacia trees, which were known to show hydraulic lift, we experimentally tested whether tree roots facilitate grass production or compete with grasses for below‐ground resources. Prevention of tree–grass interactions through root trenching led to increased soil water content indicating that trees took up more water from the topsoil than they exuded via hydraulic lift. Biomass was higher in trenched plots compared to controls probably because of reduced competition for water. Stable isotope analyses of plant and source water showed that grasses which competed with trees used a greater proportion of deep water compared with grasses in trenched plots. Grasses therefore used hydraulically lifted water provided by trees, or took up deep soil water directly by growing deeper roots when competition with trees occurred. We conclude that any facilitative effect of hydraulic lift for neighbouring species may easily be overwhelmed by water competition in (semi‐) arid regions.
Arbuscular mycorrhizae and terrestrial ecosystem processes
Authors: Rillig Matthias C.
Published: July 2004

Arbuscular mycorrhizal fungi (AMF; phylum Glomeromycota) are ubiquitous in terrestrial ecosystems. Despite their acknowledged importance in ecology, most research on AMF has focused on effects on individual plant hosts, with more recent efforts aimed at the level of the plant community. Research at the ecosystem level is less prominent, but potentially very promising. Numerous human‐induced disturbances (including global change and agro‐ecosystem management) impinge on AMF functioning; hence study of this symbiosis from the ecosystem perspective seems timely and crucial. In this paper, I discuss four (interacting) routes via which AMF can influence ecosystem processes. These include indirect pathways (through changes in plant and soil microbial community composition), and direct pathways (effects on host physiology and resource capture, and direct mycelium effects). I use the case study of carbon cycling to illustrate the potentially pervasive influence of AMF on ecosystem processes. A limited amount of published research on AMF ecology is suited for direct integration into ecosystem studies (because of scale mismatch or ill‐adaptation to the ‘pools and flux’ paradigm of ecosystem ecology); I finish with an assessment of the tools (experimental designs, response variables) available for studying mycorrhizae at the ecosystem scale.
Mechanisms responsible for the positive diversity–productivity relationship in Minnesota grasslands
Authors: Lambers Janneke Hille Ris , Harpole W. Stanley , Tilman David , Knops Johannes , Reich Peter B.
Published: July 2004

Species’ extinctions have spurred debate on whether interactions among few or among many species cause a positive diversity–productivity relationship in experimentally assembled grasslands. We addressed this question by quantifying the productivity of 14 species across an experimental diversity gradient in Minnesota. We found that interspecific interactions leading to coexistence and competitive displacement both determine which species overyield; i.e. are more productive at high diversity. Overyielding species were either superior N competitors (C4 grasses) or N fixers (legumes). Surprisingly, these species were not most productive in monoculture, thus, the ‘selection’ of productive species in diverse plots did not cause the positive diversity–productivity relationship. Both positive (with legumes) and negative interspecific interactions (with C4 grasses) determined whether individual species overyielded. Foliar pathogens did not cause overyielding, although other natural enemies may be responsible. Overyielding species are not displacing underyielding species over time, implying that other diversity‐promoting interactions also operate in this experiment.
Differentiation in sex investment by clones and populations of Daphnia
Authors: Tessier Alan J. , Cáceres Carla E.
Published: July 2004

Dormancy is an ecological strategy by which organisms avoid stressful environments, but it also can have genetic consequences. Many facultative parthenogens shift from asexual to sexual reproduction to enter dormancy. Hence, conditions that favour dormancy are predicted to select for more sex, which should increase clonal diversity. We examined lake populations of Daphnia that face different ecological risks to remaining active year‐round, and quantified the extent to which they have differentiated in their investment in dormancy and sex. There was substantial genetic variation among populations and clones for sex induction and production of dormant eggs, and striking evidence of gender specialization. We also observed a positive association between the magnitudes of population‐level investment in dormancy and of variance among clones in sex induction. These results document an ecological gradient in dormancy that is manifest as a genetic gradient in clonal variation for the propensity to engage in sex.
West Nile virus: pending crisis for greater sage‐grouse
Authors: Naugle David E. , Aldridge Cameron L. , Walker Brett L. , Cornish Todd E. , Moynahan Brendan J. , Holloran Matt J. , Brown Kimberly , Johnson Gregory D. , Schmidtmann Edward T. , Mayer Richard T. , Kato Cecilia Y. , Matchett Marc R. , Christiansen Thomas J. , Cook Walter E. , Creekmore Terry , Falise Roxanne D. , Thomas Rinkes E. , Boyce Mark S.
Published: July 2004

Scientists have feared that emerging infectious diseases could complicate efforts to conserve rare and endangered species, but quantifying impacts has proven difficult until now. We report unexpected impacts of West Nile virus (WNv) on radio‐marked greater sage‐grouse (Centrocercus urophasianus), a species that has declined 45–80% and is endangered in Canada and under current consideration for federal listing in the US. We show that WNv reduced late‐summer survival an average of 25% in four radio‐marked populations in the western US and Canada. Serum from 112 sage‐grouse collected after the outbreak show that none had antibodies, suggesting that they lack resistance. The spread of WNv represents a significant new stressor on sage‐grouse and probably other at‐risk species. While managing habitat might lessen its impact on sage‐grouse populations, WNv has left wildlife and public health officials scrambling to address surface water and vector control issues in western North America.
The effect of neem (Azadirachta indica A. Juss) oil on oviposition, development and reproductive potentials of Sesamia calamistis Hampson (Lepidoptera: Noctuidae) and Eldana saccharina Walker (Lepidoptera: Pyralidae)
Authors: Bruce Yaovi Anani , Gounou Saka , Chabi‐Olaye Adenirin , Smith Homa , Schulthess Fritz
Published: July 2004

Abstract  1 The effect of different treatments of neem oil (0, 0.075, 0.1 and 0.15 mL/plant) and their persistence (0, 5 and 10 days after application; DAA) on the oviposition behaviour and the bionomics of the noctuid Sesamia calamistis and the pyralid Eldana saccharina were tested in laboratory and greenhouse experiments.

2 For most variables, no difference was found between DAA, showing that the treatments had a long‐term effect, and pooled analyses across DAA were performed. Compared with the control (0 mL/plant), mean reductions due to neem in numbers of egg batch and eggs laid were 70 and 88% for S. calamistis and 50 and 49% for E. saccharina, respectively, but no differences were found among neem concentrations.

3 For both species, larval and pupal development time was shortest in the control and longest with the highest oil concentration. Immature survival, larval weight and fecundity were highest in the control and similar in the neem treatments.

4 No differences were found in sex ratios. Egg viability was highest in the control (approximately 87%) and lowest (72%) with the highest oil concentration. As a result of lower fecundity and longer developmental time, on average, the intrinsic rates of increase in the neem treatments were 30% lower than in the control.

5 In view of the low oviposition rates, immature survival, fecundity and egg viability in the neem treatments, and the relatively high persistence of neem oil, it can be expected that the reduction in densities of the two borers species in the field will be considerable.
Spatial distribution of populations of solitarious adult desert locust (Schistocerca gregaria Forsk.) on the coastal plain of Sudan
Authors: Woldewahid Gebremedhin , Van Der Werf Wopke , Van Huis Arnold , Stein Alfred
Published: July 2004

Abstract  1 Densities of solitarious adult desert locusts were measured on regular grids of up to 126 sample sites in the southern part of the coastal plain of Sudan during the winters of 1999/2000 and 2000/2001. Geostatistical procedures were used to characterize spatial dependence of locust density, to evaluate the possibility of estimating locust densities at unvisited sites, based on information obtained at surveyed sites, and to create density maps.

2 Sample variograms indicate that population densities were spatially correlated over ranges from 5 to 24 km. The range of spatial correlation decreased as dry conditions towards the end of the rainy season concentrated the locusts in contracting areas of sufficient humidity and availability of green vegetation. The rather small ranges of spatial correlation indicate that sampling needs to be conducted at a refined scale (< 24 km between sample points) to avoid missing hot spots of desert locust.

3 Locust densities were highly correlated with cover abundance of the wild plant Heliotropium arbainense and cultivated millet, Pennisetum typhoidum. The association of locusts with these host plants can be used to target sampling and enhance detection chance.

4 The relationship between sampling intensity and kriging variance was explored. Implications for monitoring of desert locust are discussed.
Effect of trap height and within‐planting location on captures of cranberry fruitworm (Lepidoptera: Pyralidae) in highbush blueberries
Authors: Sarzynski Erin M. , Liburd Oscar E.
Published: July 2004

Abstract  1 Winged traps baited with synthetic sex pheromone lures [(E,Z)‐8,10‐pentadecadien‐1‐ol and (E)‐9‐pentadecen‐1‐ol acetate] were evaluated for their effectiveness in monitoring cranberry fruitworm, Acrobasis vaccinii Riley, in highbush blueberry, Vaccinium corymbosum L., plantings. Trap effectiveness was compared at different heights within the bush canopy and different locations within plantings.

2 In our trap height study, three positions were evaluated: (i) at the top of bush canopy (15 cm below the uppermost branch); (ii) centrally within bush canopy (60 cm below the uppermost branch); and (iii) at the bottom of the bush, 20 cm above ground level. Traps placed 15 and 60 cm below the uppermost branch captured significantly more male moths compared with traps placed 20 cm above ground level at two organic sites.

3 In our trap location study, four treatments were evaluated based on trap location relative to adjacent woodlands: (i) in trees within 1 m of the woodland boundary; (ii) in blueberry bushes adjacent to woodlands, 15 m from the woodland boundary; (iii) in blueberry bushes in the centre of the planting, 75 m from the woodland boundary; and (iv) in blueberry bushes furthest away from woodlands, 150 m from the woodland boundary. Traps located within 1 m of woodland boundary captured significantly more male moths compared with traps located centrally (15 and 75 m) within plantings.
Impact and management of the eriophyoid mite Trisetacus juniperinus on the evergreen cypress Cupressus sempervirens
Authors: Simoni S. , Cantini R. , Castagnoli M. , Battisti A.
Published: July 2004

Abstract  1 In the Mediterranean region, the eriophyoid mite Trisetacus juniperinus causes considerable damage to the evergreen cypress, Cupressus sempervirens L., particularly in nurseries and young stands, disturbing the apical growth of the tree.

2 The impact of mites on survival and apical growth of two commercial clones of cypress (Agrimed and Bolgheri), as well as the results of differently timed pesticide applications to suppress mite population on newly grafted trees, were evaluated.

3 Mites easily infested clonal scions from rootstocks that were previously infested in the nursery, inducing tip deformation and disturbance of the growth. Apical growth was significantly lower in infested than in control trees 2 years following the graft.

4 Deformed apical buds were left early by mites, which dispersed in the crown and may have incurred high mortality. This is interpreted as a defensive reaction of the cypress to the mite attack, which involves costs resulting in reduced apical growth in both clones. However, mites partly overcame tree defences in the Bolgheri clone.

5 Healthy rootstock and graft material should be used to limit damage and maintain plant growth because natural infestations rarely occur. In case of attack, a pesticide should be applied as soon as possible because precocious mite infestation has a log‐lasting effect on tree growth, with considerable economic damage.
Oviposition by autumn gum moth (Mnesampela privata) in relation to Eucalyptus globulus defoliation, larval performance and natural enemies
Authors: Rapley Luke P. , Allen Geoff R. , Potts Brad M.
Published: July 2004

Abstract  1 Eucalyptus globulus Labill. exhibited consistent intraspecific variation in oviposition choice by Mnesampela privata (Guenée) (Lepidoptera: Geometridae) in field surveys of host plants that had been designated, based on the prior season's defoliation levels, as resistant or susceptible to M. privata. At both field sites significantly fewer egg batches were found on resistant compared to susceptible trees.

2 In cage bioassays we demonstrated a significant oviposition preference by M. privata, with over two‐fold greater number of egg batches laid on foliage sprigs from susceptible compared to resistant trees. Despite differences in tree oviposition choice, we found no evidence in the field or the laboratory of adult females adjusting egg batch size in accordance to oviposition preference.

3 Caged larval survival, development times and pupal weight did not vary significantly between resistant and susceptible trees. Similarly, in a laboratory feeding experiment, neonates utilized resistant and susceptible foliage equally.

4 Larval mortality in the field attributed to natural enemies did not vary significantly between resistant and susceptible trees, nor did the percentage of Telenomus sp. parasitism of M. privata eggs within a batch and batches per tree.

5 Failure to associate either larval performance or natural enemy efficacy with the observed intraspecific variation in E. globulus susceptibility to M. privata oviposition indicates that some other unidentified factors drive the evolution of host selection for oviposition.
Effects of delayed mating and male mating history on the reproductive potential of Leucoptera coffeella (Lepidoptera: Lyonetiidae)
Authors: Michereff Mirian Fernandes Furtado , Vilela Evaldo Ferreira , Filho Miguel Michereff , Nery Daniela M. S. , Thièbaut José T.
Published: July 2004

Abstract  1 Despite the importance of Leucoptera coffeella (Guérin‐Mèneville) in coffee production worldwide, there is a lack of information on its reproduction. This knowledge will help in mass rearing, and support the development of behavioural control techniques for this insect. The present study determined the effects of delayed mating and previous matings of male L. coffeella on fecundity, egg viability and frequency of female remating.

2 The highest levels of fecundity and egg viability were obtained from matings of 1–3‐day‐old females. When females mated at 5 days of age, there were reductions of 40% in oviposition and of 43% in egg viability.

3 Females mated with 2‐day‐old virgin males were more fecund than those mated with older males; egg viability was also low (18%) from females mated with older males.

4 Virgin females that mated with virgin males laid a greater number of eggs than those mated with previously copulated males. Egg viability decreased with the increase in the number of previous male matings.

5 Five‐day‐old females remated in greater proportion than 2–3‐day‐old females. Females that copulated with males that had previously mated three times had higher rates of remating than those that copulated with virgin males.

6 The results obtained indicate that 1–3 days after emergence is the optimum age for mating. The implications of these findings for the control of L. coffeella by synthetic sex pheromone are discussed.
Bayesian Variable Selection and Regularization for Time–Frequency Surface Estimation
Authors: Wolfe Patrick J. , Godsill Simon J. , Ng Wee-Jing
Published: July 2004

We describe novel Bayesian models for time–frequency inverse modelling of non-stationary signals. These models are based on the idea of a Gabor regression, in which a time series is represented as a superposition of translated, modulated versions of a window function exhibiting good time–frequency concentration. As a necessary consequence, the resultant set of potential predictors is in general overcomplete—constituting a frame rather than a basis—and hence the resultant models require careful regularization through appropriate choices of variable selection schemes and prior distributions. We introduce prior specifications that are tailored to representative time series, and we develop effective Markov chain Monte Carlo methods for inference. To highlight the potential applications of such methods, we provide examples using two of the most distinctive time–frequency surfaces—speech and music signals—as well as standard test functions from the wavelet regression literature.
Wavelet Deconvolution in a Periodic Setting
Authors: Johnstone Iain M. , Kerkyacharian Gérard , Picard Dominique , Raimondo Marc
Published: July 2004

Deconvolution problems are naturally represented in the Fourier domain, whereas thresholding in wavelet bases is known to have broad adaptivity properties. We study a method which combines both fast Fourier and fast wavelet transforms and can recover a blurred function observed in white noise with O{n log (n)2} steps. In the periodic setting, the method applies to most deconvolution problems, including certain ‘boxcar’ kernels, which are important as a model of motion blur, but having poor Fourier characteristics. Asymptotic theory informs the choice of tuning parameters and yields adaptivity properties for the method over a wide class of measures of error and classes of function. The method is tested on simulated light detection and ranging data suggested by underwater remote sensing. Both visual and numerical results show an improvement over competing approaches. Finally, the theory behind our estimation paradigm gives a complete characterization of the ‘maxiset’ of the method: the set of functions where the method attains a near optimal rate of convergence for a variety of Lp loss functions.
Nonparametric Multistep-Ahead Prediction in Time Series Analysis
Authors: Chen Rong , Yang Lijian , Hafner Christian
Published: July 2004

We consider the problem of multistep-ahead prediction in time series analysis by using nonparametric smoothing techniques. Forecasting is always one of the main objectives in time series analysis. Research has shown that non-linear time series models have certain advantages in multistep-ahead forecasting. Traditionally, nonparametric k-step-ahead least squares prediction for non-linear autoregressive AR(d) models is done by estimating E(Xt+k |Xt, …, Xt−d+1) via nonparametric smoothing of Xt+k on (Xt, …, Xt−d+1) directly. We propose a multistage nonparametric predictor. We show that the new predictor has smaller asymptotic mean-squared error than the direct smoother, though the convergence rate is the same. Hence, the predictor proposed is more efficient. Some simulation results, advice for practical bandwidth selection and a real data example are provided.
A Method for Combining Inference Across Related Nonparametric Bayesian Models
Authors: Müller Peter , Quintana Fernando , Rosner Gary
Published: July 2004

We consider the problem of combining inference in related nonparametric Bayes models. Analogous to parametric hierarchical models, the hierarchical extension formalizes borrowing strength across the related submodels. In the nonparametric context, modelling is complicated by the fact that the random quantities over which we define the hierarchy are infinite dimensional. We discuss a formal definition of such a hierarchical model. The approach includes a regression at the level of the nonparametric model. For the special case of Dirichlet process mixtures, we develop a Markov chain Monte Carlo scheme to allow efficient implementation of full posterior inference in the given model.
Joint Response Graphs and Separation Induced by Triangular Systems
Authors: Wermuth Nanny , Cox D. R.
Published: July 2004

We consider joint probability distributions generated recursively in terms of univariate conditional distributions satisfying conditional independence restrictions. The independences are captured by missing edges in a directed graph. A matrix form of such a graph, called the generating edge matrix, is triangular so the distributions that are generated over such graphs are called triangular systems. We study consequences of triangular systems after grouping or reordering of the variables for analyses as chain graph models, i.e. for alternative recursive factorizations of the given density using joint conditional distributions. For this we introduce families of linear triangular equations which do not require assumptions of distributional form. The strength of the associations that are implied by such linear families for chain graph models is derived. The edge matrices of chain graphs that are implied by any triangular system are obtained by appropriately transforming the generating edge matrix. It is shown how induced independences and dependences can be studied by graphs, by edge matrix calculations and via the properties of densities. Some ways of using the results are illustrated.
Analysis of Longitudinal Data with Irregular, Outcome-Dependent Follow-Up
Authors: Lin Haiqun , Scharfstein Daniel O. , Rosenheck Robert A.
Published: July 2004

A frequent problem in longitudinal studies is that subjects may miss scheduled visits or be assessed at self-selected points in time. As a result, observed outcome data may be highly unbalanced and the availability of the data may be directly related to the outcome measure and/or some auxiliary factors that are associated with the outcome. If the follow-up visit and outcome processes are correlated, then marginal regression analyses will produce biased estimates. Building on the work of Robins, Rotnitzky and Zhao, we propose a class of inverse intensity-of-visit process-weighted estimators in marginal regression models for longitudinal responses that may be observed in continuous time. This allows us to handle arbitrary patterns of missing data as embedded in a subject's visit process. We derive the large sample distribution for our inverse visit-intensity-weighted estimators and investigate their finite sample behaviour by simulation. Our approach is illustrated with a data set from a health services research study in which homeless people with mental illness were randomized to three different treatments and measures of homelessness (as percentage days homeless in the past 3 months) and other auxiliary factors were recorded at follow-up times that are not fixed by design.
Smoothing Spline Estimation in Varying-Coefficient Models
Authors: Eubank R. L. , Huang Chunfeng , Maldonado Y. Muñoz , Wang Naisyin , Wang Suojin , Buchanan R. J.
Published: July 2004

Smoothing spline estimators are considered for inference in varying-coefficient models with one effect modifying covariate. Bayesian ‘confidence intervals’ are developed for the coefficient curves and efficient computational methods are derived for computing the curve estimators, fitted values, posterior variances and data-adaptive methods for selecting the levels of smoothing. The efficacy and utility of the methodology proposed are demonstrated through a small simulation study and the analysis of a real data set.
Chemokine CCL2 and chemokine receptor CCR2 in early active multiple sclerosis
Authors: Sørensen T. L. , Ransohoff R. M. , Strieter R. M. , Sellebjerg F.
Published: July 2004

The chemokine monocyte chemoattractant protein (MCP)‐1/CCL2 and its receptor CCR2 have been strongly implicated in disease pathogenesis in experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis (MS), whereas data on the CCL2–CCR2 axis are scarce in MS. We studied the expression of CCR2 on leukocytes in blood and cerebrospinal fluid (CSF) from patients with monosymptomatic optic neuritis and MS, and the concentration of CCL2 in the CSF from these patients. Results were compared with the results in non‐inflammatory neurological controls and were correlated with other parameters (magnetic resonance imaging and CSF data). Our findings suggest a limited role for CCL2/CCR2 in early active MS.
β2‐microglobulin serum level is not a marker of disease activity in multiple sclerosis
Authors: Bagnato F. , Zivadinov R. , Cecchinelli D. , Tancredi A. , Grop A. , Pierallini A. , De Lena C. , Prencipe M. , Reale G. , Zorzon M. , Millefiorini E.
Published: July 2004

Beta2‐microglobulin (β2‐MG) is a pharmacodynamic marker of interferon‐β activity in multiple sclerosis (MS). Its role in the natural course of the disease is not fully known. We analyzed the spontaneous fluctuation of β2‐MG in free‐treatment MS patients during a short‐time course to quantify β2‐MG as a marker of disease activity/progression. Thirty MS patients were clinically assessed and imaged monthly over a 3‐month period. Sera were collected concomitantly for the evaluation of β2‐MG, by means of an enzyme‐linked immunosorbent assay. Sera from 20 healthy individuals (HI) were drawn and used as controls. The Mann–Whitney test was used when appropriate and time effect on radiological and biological measures was assessed by means of the random effect models. Eight (26.7%) patients experienced a clinical relapse but three (10%) required steroid treatment. A reduction in the contrast‐enhancing lesion load (P = 0.02) and a trend (P = 0.07) toward a decrease in brain parenchyma fraction were observed. Baseline levels of β2‐MG were similar in patients and HI. Patients’β2‐MG values increased over the 3‐month time period (P = 0.05) but did not exceed those detected in HI at any time point. These results failed to demonstrate the validity of β2‐MG as a surrogate marker of disease in MS.
A new approach in anti‐epileptic drug evaluation
Authors: Stefan H. , Wang Y. , Pauli E. , Schmidt B.
Published: July 2004

Presurgical trials with video‐electroencephalogram (EEG) monitoring for a couple of days provide the possibility to objectively and quantitatively analyze seizure activity during different drug treatments. Patients are provided with the optimal medical care and safety precautions when hospitalized. Hereby a method used in the antiepileptic drug (AED) trials called therapeutic intensive seizure analysis (TISA) has been recently introduced, by which AED efficacy on seizure activity can be objectively quantified by using continuous video‐EEG monitoring. This could be used not only as a supplement to the traditional evaluation of AEDs’ efficacy by treatment failure designs in large groups, but also can provide early individual information on the changes of seizure activity of each patient during the therapy. Data from TISA studies suggest that secondarily generalized tonic‐clonic seizures (SGTCs) mostly occur in patients with a SGTC history after withdrawal of AED. The first 3 days of titration of a newly introduced AED was important for efficacy assessment; with a low risk of SGTCs. By using the TISA method an early recognition of first effects of a new AED on seizure activity and neuropsychological changes is possible, which can be correlated to serum concentration levels in a small sample size. The essentials of the proposed modification to the conventional presurgical trial are: (1) a complete withdrawal of AEDs should be avoided, if possible and (2) a titration phase limited to 3 days is suggested, using a condensed evaluation setting including the TISA method, serum concentration and neuropsychological monitoring. In addition long‐term effects can be evaluated by repeated video‐EEG monitoring.
High‐dose riboflavin treatment is efficacious in migraine prophylaxis: an open study in a tertiary care centre
Authors: Boehnke C. , Reuter U. , Flach U. , Schuh‐Hofer S. , Einhäupl K. M. , Arnold G.
Published: July 2004

The aim of this study was to investigate the efficacy of riboflavin for the prevention of migraine. An open label study was performed in a specialized outpatient clinic. Patients received 400 mg riboflavin capsules per day. Headache frequency, duration, intensity and the use of abortive drugs were recorded at baseline and 3 and 6 months after treatment. Headache frequency was significantly reduced from 4 days/month at baseline to 2 days/month after 3 and 6 months (P < 0.05). The use of abortive drugs decreased from 7 units/month to 4.5 units/month after 3 and 6 months of treatment (P < 0.05). In contrast, headache hours and headache intensity did not change significantly. We could demonstrate a significant reduction of headache frequency following riboflavin treatment. In addition, the number of abortive anti‐migraine tablets was reduced. In line with previous studies our findings show that riboflavin is a safe and well‐tolerated alternative in migraine prophylaxis.
Trousseau's syndrome related to adenocarcinoma of the colon and cholangiocarcinoma
Authors: Tasi S.‐H. , Juan C.‐J. , Dai M.‐S. , Kao W.‐Y.
Published: July 2004

Malignancy‐related thromboembolism, so‐called Trousseau's syndrome, can present as acute cerebral infarction, non‐bacterial thrombotic endocarditis (NBTE) and migratory thrombophlebitis. It is usually attributed to a cancer‐related hypercoagulable state, chronic disseminated intravascular coagulopathy (DIC), or tumour embolism. We report on two patients with adenocarcinoma of the colon and cholangiocarcinoma who developed widespread thromboembolism during disease progression. Both did poorly despite aggressive institution of anticoagulation therapy. These cases emphasize that cerebral infarction or refractory thromboembolism in cancer‐treated patients should prompt investigation for recurrent or metastatic disease or progression of the underlying malignancy. Optimal treatment remains to be established.
Pain and sensory complaints in multiple sclerosis
Authors: Beiske A. G. , Pedersen E. D. , Czujko B. , Myhr K.‐M.
Published: July 2004

Pain is a frequent and disabling symptom among multiple sclerosis (MS) patients. The importance of this problem was investigated in a hospital based MS population.

A total of 142 MS patients underwent neurological examination and a structured interview for registration of pain and sensory symptoms.

One‐hundred and five patients reported sensory and/or pain symptoms. Pain was reported by 93 patients and was most frequently located in the limbs and lumbar region. The presence of pain was independent of gender, age at onset and examination, disability, disease course and duration. The most frequently reported characteristics of the symptoms were paresthesia, neuralgia and deep muscular aching. About 40% of the patients reported that the symptoms had important influence on daily activities. Only one‐third of the patients were treated for their pain.

Pain is a frequent and disabling symptom, independent of demographic and clinical variables in MS patients. The low frequency of treatment for these symptoms indicates a need for improved attention to this problem.
Pergolide mesylate can improve sexual dysfunction in patients with Parkinson's disease: the results of an open, prospective, 6‐month follow‐up
Authors: Pohanka M. , Kaňovský P. , Bareš M. , Pulkrábek J. , Rektor I.
Published: July 2004

One of the most disabling problems in males suffering from advanced Parkinson's disease (PD) is complex sexual dysfunction. The effect of dopamine replacement or dopaminergic stimulation on sexual dysfunction has been recently examined and described in patients treated by L‐DOPA or apomorphine. Pergolide mesylate is another dopamine agonist with a known high affinity to hD(2S) subtype and a lower affinity to hD(2L) subtype of D2 dopaminergic receptors. It has been repeatedly shown to be a highly effective treatment of the complicated and advanced stages of PD. The current study has been designed to assess its efficacy in the treatment of sexual dysfunction, which frequently accompanies the complicated stage of PD in males. Fourteen male patients suffering from PD, each of whom had been treated with L‐DOPA, and in whom additional treatment with peroral dopaminergic agonist (DA) was needed, were followed for a 6‐month period. Pergolide mesylate (Permax) was given to each patient, and titrated to a total daily dose of 3 mg. All of the patients were taking L‐DOPA. The assessments performed before the start of pergolide treatment consisted of a neurological examination, including Unified Parkinson's Disease Rating Scale (UPDRS) III and IV subscales scoring, Mini Mental State Examination (MMSE) scoring, the neuropsychological examination including Zung scale scoring to exclude depression, biochemical and haematological examinations including the examination of prolactine serum levels; and a sexological examination during which the patients filled‐in the International Index of Erectile Function (IIEF) questionnaire. These examinations were repeated during the control assessments at months 1, 3 and 6. To compare the examination results, anova, Friedmann's anova (non‐parametric) and Tukey post hoc tests were used. There were statistically significant differences between the values of UPDRS III motor subscale, UPDRS IV (complications of therapy) subscale and all subscales of IIEF when months 0 and 1 were compared with the results obtained at months 3 and 6. The differences between months 0 and 1 and months 3 and 6 (in these items) were virtually insignificant. In conclusion, pergolide substantially improved sexual function in the younger male patients who were still interested in sexual activities. In such cases, the introduction of pergolide might be a better choice than treatment with sildenafile, which usually meets several contraindications in common PD male population.
The clinical outcomes of neonatal and childhood stroke: review of the literature and implications for future research
Authors: Härtel C. , Schilling S. , Sperner J. , Thyen U.
Published: July 2004

A detailed assessment of clinical outcomes after ischemic stroke in childhood is necessary to evaluate prognostic factors. Previous studies are difficult to compare because of differences in test instruments, study design, heterogeneity of cohorts and number of included cases. Depending on neurodevelopmental assessment methods, major and subtle/minor disabilities, especially in infants, may not have been detected. Most outcome studies reveal only limited information about behavioral changes and quality of life in children with ischemic stroke. Thus the assumption that children make a better recovery from stroke than adults due to the immature brain's capacity to reorganize function is not evidence‐based. We systematically review the current literature with regard to the neurological and psychosocial development of affected children as well as their quality of life. Implications for future research strategies follow the review to encourage further clinical study of the neurobehavioral trajectory of childhood stroke.
Healing of intrabony defects following surgical treatment with or without an Er:YAG laser
Authors: Sculean Anton , Schwarz Frank , Berakdar Mohammad , Windisch Péter , Arweiler Nicole B. , Romanos Georg E.
Published: July 2004

Aim: The aim of this controlled, parallel design clinical study was to compare the healing of intrabony periodontal defects following treatment with access flap surgery with and without debridement with an Er:YAG laser.

Methods: Twenty‐three patients each of whom exhibited one deep intrabony defect were randomly treated with either access flap surgery followed by root surface and defect debridement using an Er:YAG laser (KEY3®) (160 mJ, 10 Hz) (test), or with access flap surgery followed by root surface and defect debridement using hand and ultrasonic instruments (control). The following clinical parameters were recorded at baseline and at 6 months: plaque index; gingival index; bleeding on probing; probing depth (PD); gingival recession; and clinical attachment level (CAL). The primary outcome variable was CAL. No statistically significant differences between the groups were found at baseline.

Results: No serious adverse events were observed after any of the treatments. The results have shown that in the test group the PD decreased from 7.8±1.3 to 4.1±1.3 mm (p<0.001) and the CAL changed from 9.8±2.9 to 7.2±2.5 mm (p<0.001). In the control group the PD decreased from 7.8±0.8 to 4.6±1.6 mm (p<0.001) and the CAL changed from 9.2±1.2 to 7.7±1.6 mm (p<0.01). The test group displayed a higher tendency for CAL gain, although this tendency did not prove to be statistically significant.

Conclusion: Within the limits of the present study, it can be concluded that: (i) at 6 months following treatment both therapies led to significant improvements of the investigated clinical parameters, and (ii) an Er:YAG laser may represent a suitable alternative for defect and root surface debridement in conjuction with periodontal surgery.
The effect of a chlorhexidine regimen on de novo plaque formation
Authors: Sekino Satoshi , Ramberg Per , Guzin Uzel Naciye , Socransky Sigmund , Lindhe Jan
Published: July 2004

Objective: To evaluate the effect of a pretreatment regimen that combined meticulous mechanical tooth cleaning with the daily use of chlorhexidine (rinse, gargle and tongue application) on de novo plaque formation and on the recolonization of various microbiological species in plaque and saliva during a 4‐day period of no oral hygiene.

Material and Methods: Ten subjects aged 24–36 years with gingivitis were recruited. The study was designed as a double blind cross‐over clinical trial including two phases. Each experimental phase comprised one preparatory period of 7 days and one plaque accumulation period of 4 days. During the preparatory period, the volunteers (i) performed meticulous mechanical tooth cleaning using toothbrush and dentifrice and (ii) were, in addition, given two sessions of professional tooth cleaning (PTC) The final PTC was delivered after bacterial sampling had been made on Day 0. In the Control group, no additional plaque control measures were included. In the Test group, the participants in addition to the mechanical measures (i) rinsed twice daily, for 60 s each time with a 0.2% chlorhexidine solution, (ii) gargled twice daily for 10 s with the chlorhexidine preparation, and finally (iii) brushed the dorsum of the tongue for 60 s, twice daily, with a 1.0% chlorhexidine gel. During the 4‐day plaque accumulation period, the participants abstained from all mechanical and chemical plaque control measures. On Days 0, 1, 2 and 4 the quantity and quality of plaque formed was assessed by clinical means and by DNA probe techniques. The microbiota of the saliva was studied in samples obtained on Days 0 and 4.

Results: It was demonstrated that chlorhexidine used as a mouthrinse combined with gargling and tongue application during the preparatory period significantly retarded the amount of plaque that formed on tooth surfaces during the following 4 days of no oral hygiene. Further, the number of microorganisms present in the biofilm representing Days 0, 1 and 2 of the “plaque accumulation period” was apparently affected by the use of the antiseptic. Among the microorganisms influenced by the chlorhexidine regimen, a substantial number belonged to the genus Actinomyces. It was also observed that the adjunctive use of chlorhexidine reduced the number of bacteria present in saliva at the end of the preparatory period (i.e. on Day 0). After 4 days of no oral hygiene, the microbiota of the newly formed plaque in the Test and Control groups had many features in common.

Conclusion: Habitat is critical in controlling the bacterial composition of the dental biofilm. The microbiota will tend to go back to the one that is characteristic of a given subject, once chemical antimicrobial means are withdrawn.
A model of periodontitis in the rat: effect of lipopolysaccharide on bone resorption, osteoclast activity, and local peptidergic innervation
Authors: Dumitrescu Alexandrina L. , Abd El‐Aleem Seham , Morales‐Aza Begonia , Donaldson Lucy F.
Published: July 2004

Objective: To establish and characterise a rat model of periodontitis that reiterates the features of human disease.

Methods: Periodontal inflammation was induced by a single injection of 10 μg liposaccharide (LPS) (Salmonella typhimurium) in 1 μl saline into rat mandibular gingiva at the buccomesial aspect of the second molar. Animals were killed after 3, 7 and 10 days, mandibles dissected and sectioned for histological and immunocytochemical analysis.

Results: LPS injection resulted in a significant gingival and periodontal inflammation with inflammatory infiltrate, apical migration of the junctional epithelium, interdental bone loss, and activation of osteoclasts at the site of injection 7 and 10 days after injection. At 10 days post injection, there was a significant trend for bone loss on both sides of the mandible. Periodontal inflammation was associated with alteration in the levels of calcitonin gene‐related peptide‐like immunoreactivity in nerve terminals innervating the inflamed gingival papilla.

Conclusion: Intragingival injection of LPS in the rat provides an easily induced reproducible experimental model of periodontal inflammation that reiterates features of human disease.