bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparisons of Scatterometer and TAO Winds Reveal Time-Varying Surface Currents for the Tropical Pacific Ocean*
Authors: Kelly Kathryn A. , Dickinson Suzanne , Johnson Gregory C.
Published: July 2005

The differences between Tropical Atmosphere Ocean (TAO) anemometer and QuikSCAT scatterometer winds are analyzed over a period of 3 yr. Systematic differences are expected owing to ocean currents because the anemometer measures absolute air motion, whereas a radar measures the motion of the air relative to the ocean. Monthly averaged collocated wind differences (CWDs) are compared with available near-surface current data at 15-m depth from drifters, at 25-m depth from acoustic Doppler current profilers (ADCPs), and at 10-m depth from current meters and with geostrophic currents at the surface from the TOPEX/Poseidon radar altimeter. Because direct current observations are so sparse, comparisons are also made with climatological currents from these same sources. Zonal CWDs are in good agreement with the zonal current observations, particularly from 2°S to 2°N where there are strong currents and a robust seasonal cycle, with the altimeter-derived anomalous currents giving the best match. At higher latitudes there is qualitative agreement at buoys with relatively large currents. The overall variance of the zonal component of the CWDs is reduced by approximately 25% by subtracting an estimate of the zonal currents. The meridional CWDs are nearly as large as the zonal CWDs but are unpredictable. The mean CWDs show a robust divergence pattern about the equator, which is suggestive of Ekman currents, but with unexpectedly large magnitudes.

Coefficients for estimating climatological zonal surface currents from the altimeter at the TAO buoys are tabulated: the amplitudes and phases for the annual and semiannual harmonics, and a linear regression against the Southern Oscillation index, are combined with the mean from the drifter currents. Examples are shown of the application of these estimators to data from SeaWinds on the Midori satellite. These estimators are also useful for deriving air–sea fluxes from TAO winds.
Wide-Angle Imaging Lidar Deployment at the ARM Southern Great Plains Site: Intercomparison of Cloud Property Retrievals
Authors: Polonsky Igor N. , Love Steven P. , Davis Anthony B.
Published: July 2005

The Wide-Angle Imaging Lidar (WAIL), a new instrument that measures cloud optical and geometrical properties by means of off-beam lidar returns, was deployed as part of a multi-instrument campaign to probe a cloud field at the Atmospheric Radiation Measurement (ARM) Southern Great Plain (SGP) site on 25 March 2002. WAIL is designed to determine physical and geometrical characteristics using the off-beam component of the lidar return that can be adequately modeled within the diffusion approximation. Using WAIL data, the extinction coefficient and geometrical thickness of a dense cloud layer is estimated, from which optical thickness is inferred. Results from the new methodology agree well with counterparts obtained from other instruments located permanently at the SGP ARM site and from the WAIL-like airborne instrument that flew over the site during our observation period.
Spinocerebellar ataxia type 17: Report of a family with reduced penetrance of an unstable Gln49TBP allele, haplotype analysis supporting a founder effect for unstable alleles and comparative analysis of SCA17 genotypes
Authors: Zühlke Christine , Dalski Andreas , Schwinger Eberhard , Finckh Ulrich
Published: July 2005

Background

Spinocerebellar ataxia type 17 (SCA17), a neurodegenerative disorder in man, is caused by an expanded polymorphic polyglutamine-encoding trinucleotide repeat in the gene for TATA-box binding protein (TBP), a main transcription factor. Observed pathogenic expansions ranged from 43 – 63 glutamine (Gln) codons (Gln43–63). Reduced penetrance is known for Gln43–48 alleles. In the vast majority of families with SCA17 an expanded CAG repeat interrupted by a CAA CAG CAA element is inherited stably.

Results

Here, we report the first pedigree with a Gln49 allele that is a) not interrupted, b) unstable upon transmission, and c) associated with reduced penetrance or very late age of onset. The 76-year-old father of two SCA17 patients carries the Gln49 TBP allele but presents without obvious neurological symptoms. His children with Gln53 and Gln52 developed ataxia at the age of 41 and 50. Haplotype analysis of this and a second family both with uninterrupted expanded and unstable pathological SCA17 alleles revealed a common core genotype not present in the interrupted expansion of an unrelated SCA17 patient. Review of the literature did not present instability in SCA17 families with expanded alleles interrupted by the CAA CAG CAA element.

Conclusion

The presence of a Gln49 SCA17 allele in an asymptomatic 76-year-old male reams the discussion of reduced penetrance and genotypes producing very late disease onset. In SCA17, uninterrupted expanded alleles of TBP are associated with repeat instability and a common founder haplotype. This suggests for uninterrupted expanded alleles a mutation mechanism and some clinical genetic features distinct from those alleles interrupted by a CAA CAG CAA element.
Lumbar position sense acuity during an electrical shock stressor
Authors: Hjortskov Nis , Hye-Knudsen Christian , Fallentin Nils
Published: July 2005

Background

Optimal motor control of the spine depends on proprioceptive input as a prerequisite for co-ordination and the stability of the spine. Muscle spindles are known to play an important role in proprioception. Animal experiments suggest that an increase in sympathetic outflow can depress muscle spindle sensitivity. As the muscle spindle may be influenced by sympathetic modulation, we hypothesized that a state of high sympathetic activity as during mental stress would affect the proprioceptive output from the muscle spindles in the back muscles leading to alterations in proprioception and position sense acuity. The aim was to investigate the effect of mental stress, in this study the response to an electrical shock stressor, on position sense acuity in the rotational axis of the lumbar spine.

Methods

Passive and active position sense acuity in the rotational plane of the lumbar spine was investigated in the presence and absence of an electrical shock stressor in 14 healthy participants. An electrical shock-threat stressor lasting for approximately 12 minutes was used as imposed stressor to build up a strong anticipatory arousal: The participants were told that they were going to receive 8 painful electrical shocks however the participants never received the shocks. To quantify the level of physiological arousal and the level of sympathetic outflow continuous beat-to-beat changes in heart rate (beats*min-1) and systolic, diastolic and mean arterial blood pressure (mmHg) were measured. To quantify position sense acuity absolute error (AE) expressed in degrees was measured. Two-way analysis of variance with repeated measurements (subjects as random factor and treatments as fixed factors) was used to compare the different treatments.

Results

Significant increases were observed in systolic blood pressure, diastolic blood pressure, and heart rate during the stress sessions indicating elevated sympathetic activity (15, 14 and 10%, respectively). Despite pronounced changes in the sympathetic activity and subjective experiences of stress no changes were found in position sense acuity in the rotational plane of the lumbar spine in the presence of the electrical shock stressor compared to the control period.

Conclusion

The present findings indicate that position sense acuity in the rotational plane of the spine was unaffected by the electrical shock stressor.
Geographical variation in rates of common mental disorders in Britain: Prospective cohort study
Authors: Weich Scott , Twigg Liz , Lewis Glyn , Jones Kelvyn
Published: July 2005

Background

There is little geographical variation in the prevalence of the common mental disorders. However, there is little longitudinal research.

Aims

To estimate variance in rates of common mental disorders at individual, household and electoral ward levels prospectively.

Method

A 12-month cohort study of 7659 adults aged 16–74 years in 4338 private households, in 626 electoral wards. Data were collected as part of the British Household Panel Survey. Common mental disorders were assessed using the 12-item General Health Questionnaire (GHQ). Ward-level socio-economic deprivation was measured using the Carstairs index.

Results

Less than 1% of total variance, in onset and maintenance of common mental disorders and change in GHQ score between waves, occurred at ward level. However, 12% of variance, which is a statistically significant difference, was found at household level (a much smaller geographical unit) and this difference remained after further analyses.

Conclusions

Ward level socio-economic deprivation does not influence the onset and maintenance of common mental disorders in Britain but local factors at the household level do. Reasons for this remain unclear.
Post‐It® Note Persuasion: A Sticky Influence
Authors: Garner Randy
Published: July 2005

Four studies examine the influence of attaching a seemingly insignificant Post‐it® note to a survey packet on the likelihood of completing the survey. Participants who received a packet with an affixed Post‐it note request had significantly higher return rates than participants who received the identical survey with (a) no sticky note, (b) the same message written on the cover sheet but without a Post‐it, or (c) a blank Post‐it with no message provided. Furthermore, they returned the materials more promptly with higher quality responses. A more personalized Post‐it appeal increased returns when the survey was long and time consuming but was no more effective than a nonpersonalized Post‐it when the survey was easy to complete. Results suggest that the Post‐it leads the request to be interpreted as a solicitation for a personal favor, facilitating a normative compliance response.
Role of Endothelin-1 in the Migration of Human Olfactory Gonadotropin-Releasing Hormone-Secreting Neuroblasts
Authors: Romanelli Roberto G. , Barni Tullio , Maggi Mario , Luconi Michaela , Failli Paola , Pezzatini Anna , Morelli Annamaria , Maggi Roberto , Zaninetti Roberta , Salerno Roberto , Ambrosini Stefano , Marini Mirca , Rotella Carlo M. , Vannelli Gabriella B.
Published: July 2005

FNC-B4 neuroblasts that express both neuronal and olfactory markers have been established and cloned. These cells express GnRH and both the endothelin-1 (ET-1) gene and protein and respond in a migratory manner to GnRH in a dose-dependent manner. Previous research has shown that FNC-B4 cells produce and respond to ET-1 by regulating the secretion of GnRH through endothelin type A receptors and by stimulating their proliferation through endothelin type B (ETB) receptors. In this study, we found that FNC-B4 cells are able to migrate in response to ET-1 through the involvement of ETB receptors. Combined immunohistochemical and biochemical analyses showed that ET-1 triggered actin cytoskeletal remodeling and a dose-dependent increase in migration (up to 6-fold). Whereas the ETB receptor antagonist (B-BQ788) blunted the ET-1-induced effects, the ETA receptor antagonist (A-BQ123) did not. Moreover, we observed that FNC-B4 cells were independently and selectively stimulated by ET-1 and GnRH. We suggest that ET-1, through ETB receptor activation, may be required to maintain an adequate proliferative stem cell pool in the developing olfactory epithelium and the subsequent commitment to GnRH neuronal migratory pattern. The coordinate interaction between ET receptors and GnRH receptor participates in the fully expressed GnRH-secreting neuron phenotype.
Insulin-Like Growth Factor Binding Protein-2 Binding to Extracellular Matrix Plays a Critical Role in Neuroblastoma Cell Proliferation, Migration, and Invasion
Authors: Russo V. C. , Schütt B. S. , Andaloro E. , Ymer S. I. , Hoeflich A. , Ranke M. B. , Bach L. A. , Werther G. A.
Published: July 2005

IGF binding proteins (IGFBPs) modulate IGF cellular bioavailability and may directly regulate tumor growth and invasion. We have previously shown that IGFBP-2 binds and localizes IGF-I to the pericellular matrix and have provided some evidence suggesting that the heparin binding domain (HBD) or the arginine-glycine-aspartic acid (RGD) integrin binding motif may be involved in these interactions. However, the precise mechanisms involved remain to be elucidated. We therefore mutated the HBD or RGD sequence of IGFBP-2 and investigated consequent effects on extracellular matrix (ECM) binding, IGF-induced proliferation, and migration of neuroblastoma cells. IGFBP-2 and its arginine-glycine-glutamic acid (RGE) mutant similarly bound ECM components, whereas binding of mutant HBD-IGFBP-2 to each of the ECM substrates was markedly reduced by 70–80% (P < 0.05). IGF-I (100 ng/ml) increased incorporation of 3H-thymidine in neuroblastoma SK-N-SHEP cells by approximately 30%, an effect blunted by exogenously added native or either mutant IGFBP-2. Overexpression of IGFBP-2 and its RGE mutant potently promoted SHEP cell proliferation (5-fold), whereas SHEP cell proliferation was negligible when HBD-IGFBP-2 was overexpressed. Addition or overexpression of IGFBP-2 and its RGE mutant potently (P < 0.05) enhanced SHEP cell migration/invasion through the ECM. However, overexpression of the HBD-IGFBP-2 mutant potently inhibited (50–60%) SHEP cell invasion through ECM. Thus, IGFBP-2, which binds to the ECM, enhances proliferation and metastatic behavior of neuroblastoma cells, functions that directly or indirectly use the HBD but not the integrin binding sequence. Our novel findings thus point to a key role for the HBD of IGFBP-2 in the control and regulation of neuroblastoma growth and invasion.
Synthesis of 3-Alkynyl-2,5-dibromothiophene and 3,3′-Dialkynyl-5,5′-dibromo-2,2′-bithiophene as the Starting Compounds for π-Conjugated Polymer
Authors: Sato Takao , Kokubo Hisashi , Fukumoto Hiroki , Yamamoto Takakazu
Published: July 2005

3-Alkynyl-2,5-dibromothiophene 2 and 3,3′-dialkynyl-5,5′-dibromo-2,2′-bithiophene have been prepared. Pd-catalyzed polycondensation between 2 and 2,2′-p-[2,5-bis(dodecyloxy)-1,4-phenylene]bis(5,5-dimethyl-1,3,2-dioxaborinane) gave a novel soluble red π-conjugated polymer.
A Survey of Self-Perceived Educational Needs of General Dental Practitioners in the Merseyside Region
Authors: Sutton Finlay , Ellituv Zvi N , Seed Rachel
Published: July 2005

Aim

The aim of this study was to evaluate the self-perceived educational needs of a randomly selected group of general dental practitioners (GDPs) in the Merseyside region (UK).

Materials and Methods

Eighty-seven GDPs were randomly selected from 850 in the region and asked to complete a self-evaluation questionnaire regarding their self-perceived educational needs.

Results

Seventy-five (86%) responded, of which 52 (69.3%) were male and 23 (30.7%) female. There was no significant difference in self-perceived knowledge in any of the dental disciplines when gender and period of time since qualification were used as predictor variables. The majority of the GDPs felt they had a good knowledge of restorative dentistry and dental radiography. Some of the GDPs felt they had poor knowledge in implant dentistry, oral medicine, orthodontics, dental sedation techniques, oral surgery, endodontics, periodontics and dental radiography. None of the respondents felt they had poor knowledge in restorative dentistry, prosthodontics and paediatric dentistry. Seventy-four (98.7%) of the responding GDPs were motivated to attend continuing professional development (CPD) courses because of an interest in a particular dental discipline and only one reported attending out of personal learning needs. Implant dentistry was indicated by 30 (40.0%) of the respondents as their training programme of choice.

Conclusions

The respondents had high self-perceived knowledge of restorative dentistry, dental radiography, periodontics, endodontics, paediatric dentistry and prosthodontics. The respondents had low self-perceived knowledge of implant dentistry, orthodontics, oral medicine and dental sedation techniques. Of GDPs surveyed, 98.7% applied for courses they liked to attend, rather than needed to attend. Fifty-two per cent of male GDPs surveyed expressed a desire for training in implant dentistry.
Orofacial Piercings: Perceptions of Dental Practitioners and Piercing Parlours
Authors: Chadwick Barbara L , Groves Gemma , Dransfield Kathryn
Published: July 2005

Objectives

To identify the advice given by piercing parlours prior to orofacial piercing and to determine how many dental practitioners see complications from orofacial piercings.

Method

Administered questionnaire to 19 piercing parlours and postal questionnaire to 400 dental practitioners in southeast Wales.

Results

Ninety-nine per cent of 227 dental practitioners in south-east Wales had treated patients with orofacial piercings, over three-quarters had seen a patient for a complication caused by the piercing, and over half (N=120) had treated a patient for a complication of piercing. Tongue (N=225) and lip (N=209) piercings were most frequently seen and the most commonly occurring complication was fractured or cracked teeth (N=176). Almost all practitioners wanted more information on orofacial piercing and its sequelae. All 19 piercing parlours in south-east Wales warned clients about pain following piercing and 18 mentioned swelling; only four discussed possible damage to teeth and none discussed the risk of airway obstruction.

Conclusions

Despite the concerns of dental and medical professionals orofacial piercing remains popular and the complications it causes are frequently seen by dental practitioners. There is a need for literature to assist both dental practitioners and piercers in advising and safeguarding patients.
“This beats a cake stall!”: farm women's shifting encounters with the Australian state
Authors: Panelli Ruth , Pini Barbara
Published: July 2005

English

The mid-1990s saw Australian farm women benefit from affirmative government policies at both state and federal levels. Numerous avenues developed for the increased recognition and participation of women in rural industries and policy circles. This article traces the subsequent decade, noting the political and gender relations that have seen the policy climate cool. It analyses the discursive shift in policy from affirmative action to mainstreaming and diversity, and critiques the effects on farm women of this shift. The article concludes by speculating on the future paths and positions farm women might take.
A decade of social policy under John Howard: social policy in Australia
Authors: Ryan Neal
Published: July 2005

English

This paper provides an analysis of the broad policy agenda pursued by governments led by John Howard during the period 1996–2004. During this period, market economics has tended to dominate social policy. The paper provides a brief history of social policy during these governments, especially in relation to education, Indigenous affairs, retirement policy, women and regional issues, and social services. The paper concludes that social policy during this period has been characterised by an emphasis on conservative social values, control of the policy process, mainstreaming, market models of service delivery and individual responsibility over government provision.
Social expenditure in the 1990s: data and determinants
Authors: Bonoli Giuliano
Published: July 2005

English

This article examines patterns of social expenditure change in 21 OECD countries in the period 1990-2001 and seeks to uncover their determinants. Key trends identified include an overall stability of spending patterns, a marginal shift from transfers to inkind service provision and emergent signs of increased control of age-related spending. Important conclusions derived from a multivariate analysis include the major impact of economic growth, a marked programme maturation effect in fields other than age-related spending and confirmation of the central relevance of policy reform initiatives in the age-spending arena. Although in this period, unlike earlier ones, there is no sign that party ideology influences expenditure patterns, the findings concerning reform initiatives underscore the continuing impact of policy choices on policy outcomes.
The politics of the new social policies: providing coverage against new social risks in mature welfare states
Authors: Bonoli Giuliano
Published: July 2005

English

Current socioeconomic transformations that have brought into existence postindustrial labour market and family structures are generating new social needs and demands, labelled new social risks (NSRs). These include reconciling work and family life, lone parenthood, long-term unemployment, being among the working poor, or having insufficient social security coverage. These new risks tend to be concentrated among women, the young and the low skilled. This article shows that these groups have little mobilising capacity and that if policies covering their needs are to be adopted, this is likely to happen as a result of alliances and political exchange with other political actors pursuing different policy objectives.
Circulating ghrelin in thyroid dysfunction is related to insulin resistance and not to hunger, food intake or anthropometric changes
Authors: Giménez-Palop Olga , Giménez-Pérez Gabriel , Mauricio Dídac , Berlanga Eugenio , Potau Neus , Vilardell Carme , Arroyo Jaume , González-Clemente José-Miguel , Caixàs Assumpta
Published: July 2005

Objective: Ghrelin is a gastric peptide that plays a role in appetite stimulation, energy balance and possibly in insulin resistance. Hyperthyroidism is a situation where negative energy balance and insulin resistance coexist, while in hypothyroidism a positive energy balance and normal insulin sensitivity predominate. We investigated ghrelin levels and their relationship with hunger, food intake and both anthropometric and insulin resistance parameters in patients with thyroid dysfunction.

Design and methods:We studied 24 hyperthyroid and 17 hypothyroid patients before and after normalisation of thyroid hormone levels and their respective body mass index (BMI)-matched control group. We measured plasma ghrelin levels, homeostasis model assessment of insulin resistance (HOMA-IR) index, a hunger score, mean three-day calorie intake and anthropometric parameters.

Results: In hyperthyroidism, HOMA-IR index was higher (3.21 ± 0.60 vs 1.67 ± 0.15mMmU/l; P = 0.014, t test for independent data) and ghrelin levels were lower (463.6 ± 36.4 vs 561.1 ± 32.1 pg/ml; P = 0.041, Mann–Whitney U-test) than in its control group and both normalised after treatment (HOMA-IR: 2.28 ± 0.38mMmU/l; P = 0.106, t test for independent data, and ghrelin: 539.7 ± 45.4 pg/ml; P = 0.549, Mann–Whitney U-test). Glucose, as a component of HOMA-IR index was the only predictor for ghrelin levels (β = −0.415, P = 0.044, stepwise multiple regression analysis). In hypothyroidism, HOMA-IR index and ghrelin levels were similar to those in its control group both before and after treatment. In both thyroid dysfunction states, no correlations were observed between changes in ghrelin levels and in free T4, free T3, anthropometric parameters, total calorie intake and hunger score.

Conclusions: In thyroid dysfunction states, ghrelin levels seemed to be in relation to insulin resistance and not to energy balance and food intake regulation, as seen in other physiological and pathological states.
Intravenously Administered Immunoglobulin in the Treatment of Childhood Guillain-Barré Syndrome: A Randomized Trial
Authors: Korinthenberg Rudolf , Schessl Joachim , Kirschner Janbernd , Mönting Jürgen Schulte
Published: July 2005

Objective. To determine the optimal treatment for childhood Guillain-Barré syndrome (GBS).

Methods. We performed a randomized, multicenter study of GBS according to international diagnostic criteria. In study 1 (early treatment), children able to walk unaided for 5 meters were randomized for 1 g/kg intravenously administered immunoglobulin (IVIG) over 2 days or no treatment. The primary outcome measure was the degree of disability at nadir. In study 2 (treatment for severe GBS), children unable to walk 5 meters unaided were randomized for 1 g/kg IVIG over 2 days or 0.4 g/kg IVIG over 5 days. The primary outcome measure was the number of days needed to regain the ability to walk unaided. Children randomized for no treatment in study 1 could enter study 2 if loss of unaided walking occurred.

Results. Ninety-five children with GBS were registered in 40 months. Twenty-one children were randomized in study 1 and 51 in study 2 (5 after deterioration in study 1). Twenty-eight children were not randomized for various reasons. Eleven of 21 patients in study 1 lost the ability to walk unassisted and 6 were bedridden, with no statistically significant difference between the children initially randomized for treatment versus no treatment. Recovery occurred faster in the group randomized for early treatment. In study 2, recovery did not differ significantly between the children treated for 2 days versus 5 days (median time to unaided walking: 19 days vs 13 days). Secondary transient deterioration in the disability score occurred more frequently in the group with the 2-day regimen than in the group treated for 5 days (5 of 23 patients vs 0 of 23 patients). Multivariate analysis with Cox regression showed that disease severity at the nadir was the only prognostic factor for recovery.

Conclusions. Treatment with IVIG before loss of unaided walking did not give rise to a less severe course, but recovery occurred somewhat faster. However, given the small number of patients, the power of this conclusion is low. For treatment after loss of unaided walking, there was no significant difference in the effectiveness of 2 g/kg IVIG administered over 2 days versus 5 days. Early “relapses” occurred more frequently after the shorter treatment regimen.
Comparison of Mothers' and Counselors' Perceptions of Predelivery Counseling for Extremely Premature Infants
Authors: Keenan Heather T. , Doron Mia W. , Seyda Beth A.
Published: July 2005

Objective. To understand mothers' and counselors' perceptions of their roles in decision-making about resuscitation of extremely premature infants at delivery and to assess mothers' and counselors' satisfaction with the counseling and decision-making process.

Methods. Mothers who delivered an infant between 22 and 27 completed weeks of gestation and their self-identified counselor were interviewed using a structured interview format. Mothers' and counselors' perceptions of the content, tone, and directiveness of predelivery counseling and their satisfaction with the decision-making process were compared. Demographic data were collected for the mothers, infants, and counselors. Simple descriptive statistics described demographic characteristics of mothers, counselors, and infants. Pearson’s correlation coefficient was used to determine agreement within individual mother-counselor pairs about the content and directiveness of counseling.

Results. Thirty-three counselors and 15 mother-counselor pairs were interviewed. The majority (66.7%) of mothers stated that the counselor had made a treatment recommendation, and 60% stated that they had no choice in how their infant would be treated. Only 27.3% of counselors stated that they had made a recommendation, saying instead that they had described the treatment plan or offered options. Counselors believed that mothers were given a treatment choice in 57.6% of encounters. Specific mother-counselor pairs showed little correlation in their perceptions of whether a treatment recommendation had been made (R = 0.0) or a choice had been given about resuscitation (R = 0.07). Despite a lack of perceived choice, mothers generally believed that they were included in treatment decisions (66.7%) and were satisfied with the amount of influence that they had in the decision-making process (73.3%).

Conclusions. The decision-making process in this study conforms most closely to a model of informed assent. Mothers may have been satisfied with this type of counseling because they felt informed and included in the decision-making process. Physicians and nurses need to elicit mothers' preferences to incorporate them into the treatment plan, as counseling about the resuscitation of extremely premature infants at delivery is considered directive by mothers even when it is not intended to be directive.
Lactobacillus paracasei Strain ST11 Has No Effect on Rotavirus but Ameliorates the Outcome of Nonrotavirus Diarrhea in Children From Bangladesh
Authors: Sarker Shafiqul A. , Sultana Shamima , Fuchs George J. , Alam Nur H. , Azim Tasnim , Brüssow Harald , Hammarström Lennart
Published: July 2005

Background. Previous studies have shown that selected strains of lactobacilli that are administered orally result in a modest reduction of diarrhea duration. However, duration alone is not considered optimal for therapeutic evaluation of any agent in diarrhea.

Objective. To examine the effect of a new probiotic, Lactobacillus paracasei strain ST11 (ST11), in acute childhood diarrhea by using evaluation criteria recommended by the World Health Organization.

Methods. In a randomized, double-blind, placebo-controlled clinical trial, 230 male infants and young children, 4 to 24 months of age, presenting with diarrhea of <2 days' duration were admitted to the metabolic research ward of the International Centre for Diarrheal Disease Research, Bangladesh, and fed 1010 colony-forming units of lyophilized ST11 or placebo daily for 5 days. Stool output and frequency, oral rehydration solution intake, and excretion of rotavirus were monitored daily.

Results. No effect of ST11 treatment on severe rotavirus diarrhea was observed. However, the probiotic treatment did significantly reduce cumulative stool output (225 ± 218 vs 381 ± 240 mL/kg), stool frequency (27.9 ± 17 vs 42.5 ± 26), and oral rehydration solution intake (180 ± 207 vs 331 ± 236 mL/kg) in children with less-severe nonrotavirus diarrhea compared with those receiving placebo treatment. A significantly higher proportion of nonrotavirus children receiving ST11 had their diarrhea resolve within 6 days of therapy (ST11 versus placebo: 76% vs 49%).

Conclusions. ST11 has a clinically significant benefit in the management of children with nonrotavirus-induced diarrhea, but it is ineffective in those with rotavirus diarrhea.
US Department of Education Data on “Autism” Are Not Reliable for Tracking Autism Prevalence
Authors: Laidler James R.
Published: July 2005

Many autism advocacy groups use the data collected by the US Department of Education (USDE) to show a rapidly increasing prevalence of autism. Closer examination of these data to follow each birth-year cohort reveals anomalies within the USDE data on autism. The USDE data show not only a rise in overall autism prevalence with time but also a significant and nearly linear rise in autism prevalence within a birth-year cohort as it ages, with significant numbers of new cases as late as 17 years of age. In addition, an unexpected reduction in the rise of autism prevalence occurs in most cohorts at 12 years of age, the age when most children would be entering middle school. These anomalies point to internal problems in the USDE data that make them unsuitable for tracking autism prevalence.
Clinical and Biological Features at Diagnosis in 40 Children With Chronic Myeloid Leukemia
Authors: Millot Frédéric , Traore Philippe , Guilhot Joelle , Nelken Brigitte , Leblanc Thierry , Leverger Guy , Plantaz Dominique , Bertrand Yves , Bordigoni Pierre , Guilhot François
Published: July 2005

Objective. The purpose of this study was to determine the clinical and biological characteristics at diagnosis in children and adolescents with chronic myelogenous leukemia (CML) in contemporary practice.

Methods. Analysis was conducted on data from 3 prospective trials conducted in children and adolescents with CML. Forty pediatric patients were evaluated in 16 French pediatric oncology units between 1991 and 2003.

Results. The disease predominately affected children who were older than 10 years (67% of the patients), with a higher prevalence in boys than girls (gender ratio: 1.5). Approximately 20% of cases were diagnosed incidentally. The main presenting symptoms were asthenia, weight loss, and complaints related to splenomegaly. Occasional patients presented with signs evocative of leukostasis. Symptoms were more common in patients with splenic enlargement, which was present in 70% of patients, and higher leukocyte counts. Markedly raised leukocyte counts were common (median white blood cell count: 242 × 109/L). The age and the gender of the patients had no effect on the leukocyte count, the hemoglobin level, or the platelet count. A predominance of b3a2 transcript was observed in the 16 children who were studied for the type of chimeric BCR-ABL mRNA.

Conclusions. This is largest reported series of CML at diagnosis in children and adolescents. It shows that the characteristics of CML seem to differ in children compared with previously published adult series; in particular, the presenting leukocyte counts are often higher in children.
Open Access in Primary Care: Results of a North Carolina Pilot Project
Authors: Bundy David G. , Randolph Greg D. , Murray Mark , Anderson John , Margolis Peter A.
Published: July 2005

Objective.

Appointment delays impede access to primary health care. By reducing appointment delays, open access (OA) scheduling may improve access to and the quality of primary health care. The objective of this pilot study was to assess the potential impact of OA on practice and patient outcomes by using pilot-study data from 4 North Carolina primary care practices.

Methods.

We conducted an interrupted time-series pilot study of 4 North Carolina primary care practices (2 family medicine and 2 pediatric practices) participating in a quality-improvement (QI) collaborative from May 2001 to May 2002. The year-long collaborative comprised 25 practices and consisted of three 2-day meetings led by expert faculty, monthly data feedback, and monthly conference calls. Our main outcome measures were appointment delays, appointment no-shows, patient satisfaction, continuity of care, and staff satisfaction during the 12-month study period.

Results.

Providers in all 4 practices successfully implemented OA. On average, providers reduced their delay to the third available preventive care appointment from 36 to 4 days. No-show rates declined (first quarter [Q1] rate: 16%; fourth quarter [Q4] rate: 11%; no-show reduction: 5% [95% confidence interval: 1%, 10%]), and overall patient satisfaction improved (Q1: 45% rated overall visit quality as excellent; Q4: 61% rated overall visit quality as excellent; change in satisfaction: 16% [95% confidence interval: 0.2%, 30%]). Continuity of care followed a similar pattern of improvement, but the change was not statistically significant. Staff satisfaction neither improved nor declined.

Conclusions.

This pilot study suggests that primary care practices can implement OA successfully by using QI-collaborative methods. These results provide preliminary evidence that OA may improve practice and patient outcomes in primary care. These analyses should be repeated in larger groups of practices with longer follow-up.
Pediatrician Workforce Statement
Authors:   Committee on Pediatric Workforce
Published: July 2005

This statement discusses the importance of pediatrician-workforce issues and their relevance to the provision of pediatric health care. It reviews previous work in the health policy arena on physician and pediatrician workforce. Key pediatrician-workforce trends are described, including the growth in the number of pediatricians in relation to the child population, the increase in the number of female pediatricians, the role of international medical graduates, the diversity of the pediatrician workforce, the contributions of internal medicine-pediatrics physicians, the increasing number of nonpediatrician providers of pediatric care, geographic distribution of physicians, and the future of pediatric subspecialists. Methods of influencing the pediatrician workforce are also considered. In the concluding series of recommendations, the statement identifies both overarching policy goals for the pediatrician workforce and implementation strategies designed to ensure that all of America's infants, children, adolescents, and young adults have access to appropriate pediatric health care.
Prevention and Control of Meningococcal Disease: Recommendations for Use of Meningococcal Vaccines in Pediatric Patients
Authors:   Committee on Infectious Diseases
Published: July 2005

This Policy Statement was retired January 2009.

Two peaks in the incidence of invasive meningococcal disease (IMD) occur in pediatric patients: infants younger than 1 year and adolescents 15 to 18 years of age. Although the incidence of IMD is highest in infants, the case-fatality rate is highest in adolescents (∼20%). Epidemiologic studies also have demonstrated increased risk of IMD among college freshman living in dormitories compared with other college students and similarly aged persons in the general population. At least 75% of cases of IMD in 11- to 18-year-olds are caused by serogroups A, C, Y, and W-135; thus, IMD potentially is preventable by immunization with quadrivalent meningococcal vaccines. Meningococcal A, C, Y, W-135 conjugate vaccine (MCV4) was licensed in 2005 for use in people 11 to 55 years of age. On the basis of data indicating increased risk of meningococcal disease and fatality among certain adolescents and college students, the American Academy of Pediatrics recommends administration of MCV4 to young adolescents (at the 11- to 12-year visit), students entering high school or 15-year-olds, and college freshmen who will be living in dormitories. For pediatric patients 11 years and older who are at increased risk of meningococcal disease, MCV4 also is recommended. The purposes of this statement are to provide the rationale for routine use of MCV4 in adolescents and to update recommendations for use of the meningococcal polysaccharide vaccine in pediatric patients.
Up to equimorphism, hyperarithmetic is recursive
Authors: Montalbán Antonio
Published: July 2005

Two linear orderings areequimorphicif each can be embedded into the other. We prove that every hyperarithmetic linear ordering is equimorphic to a recursive one.

On the way to our main result we prove that a linear ordering has Hausdorff rank less thanif and only if it is equimorphic to a recursive one. As a corollary of our proof we prove that, given a recursive ordinal α, the partial ordering of equimorphism types of linear orderings of Hausdorff rank at most α ordered by embeddablity is recursively presentable.
Lexicographic exponentiation of chains
Authors: Holland W. C. , Kuhlmann S. , McCleary S. H.
Published: July 2005

The lexicographic power ΔΓ of chains Δ and Γ is, roughly, the Cartesian power ΠγЄΓΔ totally ordered lexicographically from the left. Here the focus is on certain powers in which either Δ = ℝ or ℚ = ℝ, with emphasis on when two such powers are isomorphic and on when ΔΓ is 2-homogeneous. The main results are:

(1) For a countably infinite ordinal

(2) ℝℝ ≄ ℝℚ.

(3) For Δ a countable ordinal ≥ 2, Δℝ with its smallest element deleted, is 2-homogeneous.
Elementary epimorphisms
Authors: Rothmaler Philipp
Published: July 2005

The concept ofelementary epimorphismis introduced. Inverse systems of such maps are considered, and a dual of the elementary chain lemma is found (Cor. 4.2). The same is done forpure epimorphisms(Cor. 4.3 and 4.4). Finally, this is applied to certain inverse limits of flat modules (Thm. 6.4) and certain inverse limits of absolutely pure modules (Cor. 6.3).
Dimension theory and parameterized normalization for D-semianalytic sets over non-Archimedean fields
Authors: Çelikler Y. Firat
Published: July 2005

We develop a dimension theory for D-semianalytic sets over an arbitrary non-Arehimedean eomplete field. Our main results are the equivalence of several notions of dimension and a theorem on additivity of dimensions of projections and fibers in characteristic 0. We also prove a parameterized version of normalization for D-semianalytic sets.
A Schanuel condition for Weierstrass equations
Authors: Kirby Jonathan
Published: July 2005

I prove a version of Schanuel's conjecture for Weierstrass equations in differential fields, answering a question of Zilber, and show that the linear independence condition in the statement cannot be relaxed.
Bias, Overview
Authors: Choi Bernard C. K. , Pak Anita W. P.
Published: July 2005

This article provides an overview on bias. Bias is defined as the deviation of results or inferences from the truth, or processes leading to such deviation. The article also provides a catalogue of 109 biases at the following stages of research: literature review 4, study design 31, study execution 3, data collection 46, analysis 15, interpretation of results 7, and publication 3.
Biostatistics, Overview
Authors: Brown W. Byron
Published: July 2005

Biostatistics is concerned with the development and use of statistical methods to solve problems and to answer questions that arise in human biology and medicine. Its development is traced through early work in vital and health statistics, and in heredity, with the important influence of R.A. Fisher on experimental design and statistical inference. Applications in clinical trials, epidemiology, psychometrics, and health services research are described. Current challenges include the impact of computers, Bayesian methods, the use of data banks, longitudinal studies, and research on the human genome. The organization of biostatistics as a professional discipline is discussed.
Risk Assessment for Environmental Chemicals
Authors: Burmaster David E. , Willson Jeanne C.
Published: July 2005

Probabilistic methods are increasingly used in risk assessment, to represent uncertainty and known variability in factors such as exposure and toxicity. Risk assessment follows a five‐step process involving hazard identification, dose‐response assessment (with the development of reference doses and cancer slope factors), exposure assessment (with consideration of exposure pathways and dose estimation), risk characterization, and the analysis of variability and uncertainty. The distinction between assessment and management is discussed.
Statistics, Overview
Authors: Cox D. R.
Published: July 2005

The current topic may be called “statistical science”, encompassing statistical theory and its applications in science and technology. One pillar is probability theory, underpinning statistical inference and forming the basis for special models. Various types of models are distinguished. A second pillar is the design, analysis and interpretation of investigations. The discussion here touches on measurement issues, methods of analysis, detailed techniques, causation, and decision analysis. Formal theories of inference are discussed. Issues arising in the provision and use of official statistics are briefly discussed.
Benefit/Risk Assessment in Prevention Trials
Authors: Costantino Joseph P.
Published: July 2005

Benefit/risk assessment (B/RA) is a mathematical procedure to estimate the probability of detrimental outcomes, beneficial outcomes and the net‐effect anticipated from exposure to a given agent or procedure. B/RAs of health‐related outcomes are used for public health planning, decision‐making regarding health care financing, and therapeutic decision‐making in clinical practice. Information obtained from B/RAs based on findings from controlled clinical trials, particularly those with double‐masking of treatment, are most informative for health care planning and decision making because such information is less likely to be bias than is information obtained from observational studies. Thus, B/RAs in prevention trials are an excellent source of information to use as the basis for health care planning and decision‐making. Applications of R/BA in prevention trials are performed as supplements for planning, monitoring and analyzing the trial. These applications can be categorized into three types of assessments. This article provides a description of the three types of assessment performed in prevention trials, defines the statistical algorithms used for each type of assessment and discusses several key methodological and practical issues involve with the application of B/RA to health‐related outcomes.
Clinical Significance versus Statistical Significance
Authors: Friedman Lawrence M.
Published: July 2005

Clinical significance (medical importance) and statistical significance (whether or not the value of a statistical test exceeds some prespecified level) are contrasted. Factors that affect the interpretation of these, such as sample size, outcome measure, and level of risk, are discussed, as are situations where one, but not the other, may exist.
Clinical Trials Protocols
Authors: Collins Joseph F.
Published: July 2005

A system is chaotic if it is governed by a set of deterministic equations, but displays erratic, apparently random, behavior. The mathematical structure may be the iteration of linked difference equations in discrete time, or the evolution of a set of linked differential equations in continuous time. Stochastic interpretations, especially those involving time series analysis, are described.
Data and Safety Monitoring
Authors: O'Brien Peter C.
Published: July 2005

We consider the role of a Data and Safety Monitoring Board (DSMB) in overseeing the conduct of a randomized clinical trial. This includes insuring both the scientific integrity of the study and patient safety, monitoring the occurrence of adverse events and assessing efficacy. Formal stopping rules are particularly useful in clinical trials for monitoring efficacy, with a view towards terminating the trial early if the evidence for or against efficacy becomes overwhelming prior to the scheduled completion of the trial. The most commonly used approaches in formal stopping rules are discussed in some detail. These include the Pocock and O'Brien–Fleming boundaries and the spending function approach developed by Lan and DeMets. Discussion of stochastic curtailment, point and interval estimation associated with early termination, multiple endpoints, and a brief overview of decision theoretic methods (including Bayesian methods) is provided.
Data Monitoring Committees
Authors: Demets David L.
Published: July 2005

Randomized clinical trials are the standard by which new interventions are evaluated for benefit or harm. Federal guidelines in the United States now recommend that all trials have a monitoring plan for early evidence of harm. For trials that have serious irreversible outcomes such as death, heart attack, stroke, or cancer recurrence, an external independent committee called a Data Monitoring Committee (DMCs) is recommended to evaluate the accumulating interim data. Trials for which interim data are convincing for benefit or harm may be terminated early. DMCs began in the early 1970s by trials sponsored by the National Institutes of Health and more recently by the pharmaceutical industry. DMCs review not only the primary outcome data and the serious adverse events but also the recruitment progress, patient compliance to the intervention, other secondary outcome variables, and high risk subgroups of patients if such exist. Because of the complexity of such monitoring, DMCs have a composition with biological, clinical, and biostatistical expertise.
Eligibility and Exclusion Criteria
Authors: Foulkes Mary A.
Published: July 2005

Design characteristics of a clinical trial, such as eligibility and exclusion criteria, are broadly influential in the conduct, interpretation, and impact of trials. The research objectives, the intended inference or generalization of results, the balance of factors affecting the trial recruitment and conduct, all impact the determination of eligibility and exclusion criteria. Clinical contraindications, regulatory and ethical considerations also relate to this determination.