bluuebunny/crossref_metadata_2025 huggingface dataset:
Swallow Syncope, a Case Report and Review of the Literature
Authors: Omi Wataru , Murata Yoshiharu , Yaegashi Takanori , Inomata Jun-ichiro , Fujioka Masahiko , Muramoto Shingo
Published: November 2005

Swallow syncope is a relatively rare syndrome that is treatable when diagnosed. A 66-year-old woman was referred to the department of cardiology because she had been suffering from recurrent syncopal attacks associated with swallowing. An ambulatory electrocardiogram revealed atrial and ventricular asystoles immediately after swallowing soup or tea that were reproducible (max. RR 3.5 s). An electrophysiological study did not detect sinus nodal or atrioventricular nodal dysfunction. The patient had no underlying esophageal disease or cardiac disorder. The patient’s symptoms resolved after permanent pacemaker implantation. This report reviews the diagnosis, mechanism and management of swallow syncope.
Assessment of Aqueous Humor Zinc Status in Human Age-Related Cataract
Authors: Nourmohammadi I. , Modarress M. , Pakdel F.
Published: November 2005

Age-related cataract is an ever-increasing health problem among the elderly population worldwide. In recent years, there has been speculation that the levels of micronutrients in ocular tissue may play a role in the pathogenesis of cataract, especially zinc, since it is found in high concentrations in the eye tissues, including the aqueous humor. 44 subjects diagnosed with cataract were chosen for study and matched with 21 healthy controls to determine the concentration of zinc in aqueous humor. The findings revealed that a significantly higher concentration of zinc was present in the aqueous humor of our study population compared to controls (p < 0.001). These findings, in agreement with several previous studies, amplify the need for further investigation to determine if these higher levels are in actuality a consequence of the disease or a factor in the formation of cataract.
Stroke-in-Evolution: Infarct-Inherent Mechanisms versus Systemic Causes
Authors: Karepov Vadim G. , Gur Alexander Y. , Bova Irina , Aronovich Boris D. , Bornstein Natan M.
Published: November 2005

Background: It is uncertain whether deterioration after acute ischemic stroke is neurological and/or systemic (somatic) in origin. Methods: 442 consecutive patients admitted with first-ever ischemic stroke (FIS) were assessed by the Unified Neurological Stroke Scale (UNSS) at admission, on hospitalization days 1, 2 and 3 and before discharge. Results: Among 71/442 (16.1%) patients deteriorated during hospitalization, the worsening from stroke onset was early (≤72 h) in 67 (94.4%) of them. The majority (57/71, 80.3%) had CT-confirmed cerebral causes and 14/71 (19.7%) had systemic causes. The causes of late deterioration were exclusively systemic. In the logistic regression analysis the initial mean UNSS score was the only significant independent predictor of stroke deterioration (p < 0.0001). Conclusions: Early clinical deterioration in FIS patients results from infarct-inherent mechanisms while late stroke deterioration is due primarily to systemic factors. An initially severe neurological deficit might predict further decline.
Potential Value of Poststroke Extracranial Arterial Blood Flow Volume in the Prediction of Stroke Functional Outcome
Authors: Ho Stella S.Y. , Lam Wynnie W.M. , Wong K.S. , Leung Cecilia S.F. , Metreweli C.
Published: November 2005

Background and Purpose: Cerebral vasoreactivity and collateral circulation are important protective mechanisms against cerebral ischemia. Previous studies suggest that the efficiency of these mechanisms can be reflected by extracranial arterial blood flow volume. Brain damage leading to neurological impairments can influence patients’ functional recovery after stroke. This study attempted to explore the potential value of poststroke extracranial arterial blood flow volume in the prediction of stroke patients’ functional outcome. Methods: We prospectively studied 362 consecutive patients who were hospitalized for recent acute strokes. All patients underwent extracranial arterial blood flow volume measurement of the carotid and vertebral arteries by color velocity imaging quantification within 3 days after admission. Their functional recovery was assessed 6 months after stroke. The effect of poststroke extracranial arterial blood flow volume on patients’ functional outcome was tested by multivariate ordinal regression after controlling for other independent variables. Significance was at p < 0.05. Results: Poststroke extracranial arterial blood flow volume together with age, prestroke modified Rankin scale, the National Institutes of Health Stroke Scale and diabetes mellitus had significant effects on the patients’ 6-month functional outcome as measured by the modified Rankin scale after controlling for other independent variables (p < 0.05). Conclusions: Poststroke extracranial arterial blood flow volume is an independent outcome predictor. The graded predictive power of this parameter is potentially more superior than other outcome predictors by allowing classification of stroke outcome according to the degree of severity. A large prospective study is thus warranted to investigate its clinical value in the management of stroke patients.
Characteristics of (+)-Catechin and (–)-Epicatechin Transport across Pig Intestinal Brush Border Membranes
Authors: Starp Christiane , Alteheld Birgit , Stehle Peter
Published: November 2005

Background/Aims: (+)-Catechin and (–)-epicatechin are considered as disease preventive flavan-3-ols of foods like fruits, beverages and chocolate. We investigated mechanisms and kinetics of (+)-catechin and (–)-epicatechin uptake employing a validated in vitro model with isolated pig brush border membrane vesicles. Methods: Vesicles were isolated from pig small intestine employing the divalent cation method. Characterization (marker enzymes, electron microscopy) confirmed their purity and function. Transport studies with (+)-catechin and (–)-epicatechin under predefined conditions [presence/absence of sodium, pH gradient, temperature (8–37°C), various initial substrate concentrations (2–20 mmol/l)] revealed a measurable transport (HPLC analyses) across the brush border membrane for both substrates. Re sults: Catechin transport was stimulated by an outwardly directed H+ gradient (pHi 5.5/pHo 7.5). The presence of an inwardly directed Na+ gradient did not result in a transient overshoot in (+)-catechin and (–)-epicatechin uptake. At 37°C, subtraction of diffusion from the total transport rate showed saturation kinetics. Conclusion: Our in vitro study indicate that both (+)-catechin and (–)-epicatechin are transported across the basolateral membrane using a dual transport system consisting of free diffusion (dominant at low concentrations) and carrier-mediated facilitated diffusion.
Intrathoracic Tracheal Obstruction Caused by a Carotid Mycotic Aneurysm in a Patient with Deep Neck Infection – A Case Report
Authors: Lee Shih-Yi , Wu Kun-Ming , Chen Pei-Jan , Sheu Chin-Yin , Kuo Chiu-Ping , Wang Tao-Yeuan , Wu Chien-Liang
Published: November 2005

Upper airway obstruction secondary to a carotid mycotic aneurysm has not been previously reported. We describe a patient with a mycotic aneurysm associated with a deep neck infection and presenting with acute tracheal obstruction. Recognition of this condition is important to avoid inadvertent rupture of the aneurysm in the course of diagnostic aspiration or surgical drainage. Physical findings, including a pulsating mass and an arterial bruit, in addition to appropriate imaging studies, may be helpful in suggesting the diagnosis. In particular, both neck and chest contrast-enhanced computed tomography scans may give important clues to the presence of a vascular lesion. In a patient with an infected neck mass and tracheal compression, a common carotid mycotic aneurysm should be considered in the differential diagnosis.
Functional Predictors of Exertional Dyspnea, 6-min Walking Distance and HRCT Fibrosis Score in Idiopathic Pulmonary Fibrosis
Authors: Mura Marco , Ferretti Anna , Ferro Orazio , Zompatori Maurizio , Cavalli Alberto , Schiavina Mario , Fabbri Mario
Published: November 2005

Background: Exertional dyspnea and exercise incapacity are the most prominent and disabling symptoms and the main contributors to health-related quality of life in patients with idiopathic pulmonary fibrosis (IPF). Objectives: There are no comprehensive studies on pulmonary function tests (PFTs), dyspnea, exercise capacity and radiographic scores in IPF. We therefore sought to investigate the functional variables that can predict dyspnea, exercise capacity and disease extent in IPF. Methods: Thirty-four patients with IPF according to the ATS/ERS criteria underwent PFTs, Medical Research Council (MRC) dyspnea scoring, 6-min walking distance (6-MWD) and radiographic evaluation of fibrosis (HRCT score). Results: The 6-MWD (% pred.) was more impaired than PFTs. Residual volume (RV) showed the best correlation with the extent of fibrosis (r = –0.67, p = 0.0001) and, together with the alveolar-arterial gradient for O2 [ΔP(A – a)O2], was an independent predictor of disease extent (R2 = 0.44). PFTs showed significant though weak correlations with MRC score and 6-MWD. According to the regression analysis, DLCO and the HRCT fibrosis score were independent predictors of dyspnea, though they explained only 28% of the overall variance. FEV1 and ΔP(A – a)O2 were independent predictors of 6-MWD (R2 = 0.31). Conclusions: PFTs and lung volumes in particular are closely related to the HRCT score, a measure of the extent of IPF. The correlation of dyspnea score and 6-MWD to PFTs is limited, due to the complexity of mechanisms leading to exercise limitation in IPF. Therefore dyspnea and exercise performance are largely independent indices and should be followed together with PFTs and HRCT score in order to better assess the status and progress of IPF patients.
The Water Budget of the Kuparuk River Basin, Alaska*
Authors: Déry Stephen J. , Stieglitz Marc , Rennermalm Åsa K. , Wood Eric F.
Published: November 2005

A water budget study that considers precipitation, river runoff, evapotranspiration, and soil moisture for the Kuparuk River basin on the North Slope of Alaska is presented. Numerical simulations of hydrologic processes using the NASA Catchment-based Land Surface Model are conducted for the period 1991–2001 and provide the partitioning of the observed precipitation input (292 mm yr−1) onto the basin into river discharge (169 mm yr−1), evapotranspiration (127 mm yr−1), and an increase in soil moisture (1 mm yr−1). Discharge attains its annual peak during snowmelt and disposes 58% of the annual precipitation. Evapotranspiration contributes another 43% to the water budget and is mainly associated with warm summertime conditions and a snow-free surface. Combined, surface-snow and blowing-snow sublimation contribute only 5% of the total annual evaporative fluxes. Soil moisture recharge is associated with snowmelt during spring and rainfall during late summer and early fall, whereas soil drying accompanies high evapotranspiration rates during summer. An analysis of interannual variability in the water budget shows that warm, dry years favor a relatively more intense response of river discharge and evapotranspiration to the precipitation input, whereas cool, wet years tend to augment soil moisture.
Hydrometeorology of the Amazon in ERA-40
Authors: Betts Alan K. , Ball John H. , Viterbo Pedro , Dai Aiguo , Marengo José
Published: November 2005

The hydrometeorology of the Amazon basin in the ERA-40 reanalysis for 1958–2001 is compared with observations of precipitation, temperature, and streamflow. After 1979, the reanalysis over the Amazon has a small cool bias of the order of −0.35 K, and a small low bias of precipitation of the order of −0.3 mm day−1. In the early years (1958–72), there is a large upward drift in reanalysis precipitation and runoff associated with an upward drift in the atmospheric water vapor in the analysis, and a somewhat smaller downward drift of temperature as precipitation increases. In the presatellite data, there are inhomogeneities in the radiosonde and surface synoptic data, and there were problems with the variational analysis of humidity once satellite radiances were introduced. Approximate bias corrections can be made for precipitation and runoff on an annual basis, but this also removes some of the interannual variability. The reanalysis runoff–precipitation relationship is similar to the observed streamflow–precipitation relation, on an annual water-year basis. Compared to observations, ERA-40 precipitation for the Amazon is low by about 1.3 mm day−1 in the rainy season, and high by a smaller amount in the dry season. The precipitation bias produces a temperature bias in ERA-40 of the opposite sign on the annual time scale. The reanalysis has a small cold temperature bias after 1967, but on an annual time scale it reproduces the interannual variability of the observations. Although the biases in temperature and precipitation in recent decades are small, the difficulties with the analysis of atmospheric water vapor lead to large uncertainty in long-term trends of the water cycle.
Uncertainties in Estimating Moisture Fluxes over the Intra-Americas Sea
Authors: Mestas-Nuñez Alberto M. , Zhang Chidong , Enfield David B.
Published: November 2005

This study estimates discrepancies in moisture flux divergence in the Intra-Americas Sea (IAS; including the Gulf of Mexico and the Caribbean Sea) calculated using sounding observations, the NCEP Eta high-resolution regional analysis, and the NCEP–NCAR coarse-resolution global reanalysis. The main purpose of this exercise is to quantify the uncertainties in the global reanalysis when it is used to calculate annual and interannual variability of moisture flux divergence in the region. An accurate estimate of moisture flux divergence is crucial to evaluate whether the IAS serves as a water vapor source for rainfall over the adjacent land. Using the three datasets, the uncertainties of calculated moisture flux divergence due to the design of the boundary of the area, mathematical algorithms, and spatial and temporal resolutions are quantified. The results show that the large seasonal and interannual variability in moisture flux divergence estimated using the NCEP–NCAR reanalysis is not compromised by these uncertainties. Therefore, NCEP–NCAR reanalysis, with its global coverage and long-term record, can be used to provide the best estimate of short climate variability of moisture flux divergence available to date. Further comparisons are made of the moisture flux divergence based on the NCEP–NCAR reanalysis with previous estimates using single-year sounding observations, as well as with multiyear estimates based on global datasets of surface evaporation and precipitation. It is shown that the previous estimates using single-year sounding observations bear large uncertainties because of interannual variability. Large uncertainties also exist in datasets of surface global evaporation and precipitation.
Comparison between Two Extreme NAO Winters and Consequences on the Thermal Regime of Lake Vendyurskoe, Karelia
Authors: Maher Osama Ali , Uvo Cintia Bertacchi , Bengtsson Lars
Published: November 2005

For 10 consecutive winters, measurements were carried out in Lake Vendyurskoe, Karelia, Russia. The aim of these measurements was to investigate some of the physical processes in this small shallow lake during its ice-covered period. Detailed measurements of ice thickness and condition, snow thickness, water temperature, salt content, and currents were developed into a database. Within this database are the winters 1994/95 and 1995/96, which are characterized by a very sharp change between positive and negative phases of the North Atlantic Oscillation (NAO). This note investigates and compares the effects of these two NAO phases on the regional climate and their relation to the thermal regime of Lake Vendyurskoe.

It became clear that the ice-covered period length did not vary much from one winter to the other; however, a large difference was observed in the maximum average ice cover thickness and in the average water temperature at ice formation (e.g., larger thickness and colder water temperature during the 1995/96 winter).
Obesity - an epidemic of the twenty-first century: an update for psychiatrists
Authors: Holt Richard I. G.
Published: November 2005

Obesity is a chronic relapsing condition associated with significant morbidity and premature mortality. The prevalence of obesity has increased dramatically over the last 20 years and continues to do so, primarily as a result of changes in dietary intake and exercise patterns. There are considerable challenges associated with the management of the obesity epidemic involving both public health policies and individual treatment. Management of the obese individual involves lifelong lifestyle change for all, drugs for some, and surgery for a few. Appropriate selection of patients and the setting of realistic goals are crucial to the success of any weight-reducing programme. The aim of obesity management is to reduce associated morbidity and mortality, not necessarily to restore normal body weight. While the current trends in obesity are depressing, a better understanding of the pathophysiology and treatment of the condition should allow the clinician to be more optimistic for the future.
Weight change with atypical antipsychotics in the treatment of schizophrenia
Authors: Haddad Peter
Published: November 2005

Weight gain is a common complication of antipsychotic treatment. Its consequences include decreased self-esteem, reduced quality of life, reduced adherence with medication and increased morbidity and mortality. Most studies that assess weight change are short term. Among the atypicals mean weight gain is greatest with olanzapine and clozapine and least with aripiprazole and ziprasidone. Mean weight change obscures the marked individual variation in weight change that occurs during antipsychotic treatment i.e. irrespective of the antipsychotic, some subjects lose weight, some maintain their weight and some gain weight. In several long-term naturalistic studies (>6 months) mean weight gain is less marked than in randomised controlled trials of a shorter or comparable duration. This may reflect selective prescribing, the effect of weight management interventions and differences in the statistical analysis employed. With most antipsychotics weight stabilizes in the short to medium term but with clozapine it may continue beyond the first year. With some drugs clinical improvement is associated with short-term weight gain. Predictors of long-term weight gain include lower body mass index, increased appetite and rapid initial weight increase. Weight gain is greater in first onset patients due to the lack of prior antipsychotic exposure and associated weight gain. The potential for weight gain should be discussed with patients before starting antipsychotic treatment and weight monitored regularly during treatment. It may be possible to predict weight gain before an antipsychotic is started or early on in treatment enabling high-risk patients to receive more intensive strategies to reduce weight gain.
An overview of the central control of weight regulation and the effect of antipsychotic medication
Authors: Tighe Sheila , Dinan Timothy
Published: November 2005

Weight regulation is a complex system necessary for maintaining health. Obesity and cachexia are consequences of dysregulation and cause significant physical morbidity and mortality. In the developed world, obesity is a growing epidemic. A greater understanding of the neuroanatomy of weight regulation has been gained through advances in imaging and neural mapping techniques. The neural connections between key hypothalamic and other central nuclei have been elucidated. Advances in molecular biology have led to the identification and cloning of important peripheral and central weight regulating peptides. Weight gain as a consequence of antipsychotic use is increasingly being recognized as a serious clinical issue. The weight regulation system provides a framework upon which antipsychotics exert their weight-inducing effects. Some studies have sought, with inconsistent results, to establish associations between antipsychotic use and levels of weight regulating mediators. The receptor pharmacology of antipsychotics known to increase weight can be studied with a view to establishing genetic variants contributing to the risk. To date, the 5-HT2C receptor 759C/T polymorphism shows most promise. Further studies are required to replicate previous findings and establish new associations.
Do guidelines for severe mental illness promote physical health and well-being?
Authors: Citrome Leslie , Yeomans David
Published: November 2005

The effective management of individuals with severe mental illnesses (SMIs) requires an holistic approach that offers reliable symptom control, but also addresses other clinical, emotional and social needs. The physical health of individuals with an SMI is often poor, with many being overweight or obese, having hypertension, diabetes or dyslipidaemia, and at significant risk of developing cardiovascular disease or other comorbidities. We have recently reviewed current UK and US guidelines for the management of individuals with schizophrenia and bipolar disorder, and found very different approaches to the holistic care of people with SMIs, especially in relation to the management of physical health and cardiovascular risk. UK guidelines acknowledge the high risk of physical morbidity and mortality in individuals with an SMI, but fail to address in detail the specifics of physical health monitoring and lifestyle management. US guidelines are more descriptive in terms of the type and extent of monitoring recommended, but there are inconsistencies between the guidelines produced by different organizations, and studies in the field suggest that none of them is being adequately implemented. Clear and consistent recommendations on how and when to monitor weight, cardiovascular function, and metabolic parameters and, importantly, what to do with the results, would support clinicians wishing to integrate physical and mental healthcare. Publication of specific recommendations on evidence-based physical health interventions that can work for people with SMIs would also help primary care and mental health services improve general well-being in their patients with severe mental illnesses.
Cure Me Even If It Kills Me: Preferences for Invasive Cancer Treatment
Authors: Fagerlin Angela , Zikmund-Fisher Brian J. , Ubel Peter A.
Published: November 2005

Purpose . When making medical decisions, people often care not only about what happens but also about whether the outcome was a result of actions voluntarily taken or a result of inaction. This study assessed the proportion of people choosing nonoptimal treatments (treatments which reduced survival chances) when presented with hypothetical cancer scenarios which varied by outcome cause. Methods . A randomized survey experiment tested preferences for curing an existent cancer with 2 possible treatments (medication or surgery) and 2 effects of treatment (beneficial or harmful). Participants were 112 prospective jurors in the Philadelphia County Courthouse and 218 visitors to the Detroit-Wayne County Metropolitan Airport. Results . When treatment was beneficial, 27% of participants rejected medication, whereas only 10% rejected surgery with identical outcomes ( 2 = 5.87, P < 0.02). When treatment was harmful, participants offered surgery were significantly more inclined to take action (65% v. 38%, 2 = 11.40, P = 0.001), even though doing so reduced overall survival chances. Conclusions . Faced with hypothetical cancer diagnoses, many people say they would pursue treatment even if doing so would increase their chance of death. This tendency toward active treatment is notably stronger when the treatment offered is surgery instead of medication. Our study suggests that few people can imagine standing by and doing nothing after being diagnosed with cancer, and it should serve to remind clinicians that, for many patients, the best treatment alternative may not only depend on the medical outcomes they can expect to experience but also on whether those outcomes are achieved actively or passively.
Use of Admission Troponin in Critically Ill Medical Patients
Authors: Minkin Ruth , Cotiga Delia , Noack Sigrid , Dobrescu Andrei , Homel Peter , Shapiro Janet M.
Published: November 2005

Serum troponin I (TnI) is a sensitive marker of cardiac injury. A relation between elevated TnI and mortality has been suggested. In this retrospective chart review of 221 patients admitted to the medical intensive care unit (MICU) during a 6-month period, the authors studied the use of admission TnI levels in predicting mortality in MICU-admitted patients. Data retrieved included demographics, admission diagnosis, troponin, electrocardiogram, Acute Physiology and Chronic Health Evaluation (APACHE) II score, echocardiogram, requirements for mechanical ventilation and vasopressor support, development of multiorgan failure, mortality, and discharge disposition. There were 132 patients for whom TnI level was sent within 24 hours of admission; these patients comprised the study group. The median age was 70 years; 59% were female. The mean APACHE II score was 22. Troponin I was positive in 31% of patients (median level, 0.4 Ug/L; range 0-358 Ug/L). The hospital mortality was 39%. Positive TnI showed a weak association with intensive care unit (ICU) mortality ( P= .049) but not with overall mortality. There was no significant correlation between admission TnI concentration and APACHE II score ( P= .33), administration of vasopressor medications ( P= .115), or development of multiorgan failure ( P= .64). The authors concluded that there is no benefit in obtaining a routine admission troponin level in MICU patients when an acute coronary event is not suspected.
Drotrecogin Alfa (Activated) in Sepsis: Initial Experience With Patient Selection, Cost, and Clinical Outcomes
Authors: Higgins Thomas L. , Steingrub Jay S. , Tereso Gary J. , Tidswell Mark A. , Mcgee William T.
Published: November 2005

During a 1-year period, the authors examined clinical experience with drotrecogin alfa, activated for sepsis in a 24-bed medical-surgical intensive care unit. Drotrecogin alfa, activated was administered 46 times to 44 patients (3% of all intensive care unit admissions). Eighty-six percent of patients were on vasopressors; 95% were mechanically ventilated. Mean Acute Physiology and Chronic Health Evaluation II score was 22.0 at admission and 21.9 during the 24 hours before drug administration. The 28-day all-cause mortality was 36.4% and hospital mortality was 43.2%, trending higher ( P= .10) than in the PROWESS study, which can be attributed to clinical use in patients who would not have met PROWESS study inclusion criteria. Failure to complete a 96-hour infusion of drotrecogin alfa, activated and transfer from another hospital or nursing home before treatment were associated with poor outcome. Total cost of hospital care, including mean drotrecogin alfa, activated drug cost of $7312, exceeded reimbursement by a mean of $18 227.
Breastfeeding Mothers’ Experiences Using a Supplemental Feeding Tube Device: Finding an Alternative
Authors: Borucki Lynne C.
Published: November 2005

Strategies promoting initiation and successful continuation of breastfeeding are important in facilitating the breastfeeding experience. However, unique difficulties with breastfeeding may occur that necessitate specific interventions, to prevent early weaning and promote satisfaction with the breastfeeding experience. Special devices have been recommended and used to help women overcome various breastfeeding problems. A supplemental feeding tube device (SFTD) is a device that permits supplemental nourishment for infants while still preserving the breastfeeding goals of the mother. The purpose of this naturalistic study was to describe the experiences of breastfeeding mothers who used SFTDs to establish, reestablish, or supplement infant feeding at the breast. From the findings, 3 groups of themes emerged: seeking a solution, managing the challenges, and forming opinions. The underlying theme identified by all of the participants in the study was “finding an alternative.” Women found the SFTD to be an acceptable alternative that facilitated their breastfeeding experience.
Immunologic Factors in Human Milk: The Effects of Gestational Age and Pasteurization
Authors: Koenig Álvaro , Diniz Edna Maria de Albuquerque , Barbosa Sonia França Correia , Vaz Flávio Adolfo Costa
Published: November 2005

This study compared concentrations of total protein, lysozyme, and immunoglobulins (IgA, IgG, IgM) in samples of colostrum (n = 101) obtained from mothers of infants < 32 weeks, 32 to 366 7 weeks, and ≥ 37 weeks gestational age, both before and after pasteurization. Total protein was measured by refraction index, lysozyme by the lysoplate method, and immunoglobulins through the radial immunodiffusion technique. The total protein concentration was greater in colostrum of the < 32 weeks and 32 to 366 7 weeks categories compared to full-term ( P < .001), while concentrations of lysozyme and IgM were similar. IgA concentrations were higher in the < 32 weeks group compared to the full-term and similar to the 32 to 366 7 weeks group ( P < .05). The IgG was higher in the < 32 weeks category compared to 32 to 366 7 weeks, and both were similar to the full-term ( P < .05). Pasteurization significantly decreased all of the factors analyzed.
Human Milk Pumping Rates of Mothers of Singletons and Mothers of Multiples
Authors: Geraghty Sheela R. , Khoury Jane C. , Kalkwarf Heidi J.
Published: November 2005

Rates of breastfeeding are increasing, but the methods by which human milk is fed to infants is not well described. Using a retrospective survey design, the authors collected information about infant feeding from mothers of term, preterm, singleton, and multiple-gestation infants (n = 346). Human milk feeding methods were characterized as solely at the breast, pumped only, or a combination. Sixty-eight percent of mothers in the study fed their infants at least some human milk; 77% of these mothers reported pumping milk. There was no difference in the percentage of pumping based on multiple gestation or length of pregnancy. Feeding human milk solely at the breast at early postpartum time points was associated with longer durations of human milk feeding overall. More research is needed to better understand why mothers choose pumping over direct human milk feedings and to evaluate the health outcomes associated with this practice. J Hum Lact. 21(4):413-420.
In-Hospital Formula Supplementation of Healthy Breastfeeding Newborns
Authors: Gagnon Anita J. , Leduc Guylaine , Waghorn Kathy , Yang Hong , Platt Robert W.
Published: November 2005

The UNICEF/WHO Baby-Friendly Hospital Initiative suggests that breastfeeding activities in hospital are important to later breastfeeding. Understanding reasons for in-hospital supplementation may help to optimize the successful implementation of this initiative. The objective was to identify predictors of in-hospital initial formula supplementation of healthy, breastfeeding newborns. The authors analyzed 564 Canadian mother-infant pairs and interviewed nurses. Half of the study infants (47.9%) received formula in hospital; the median age at first supplementation was 8.4 hours. Risk for supplementation was affected by birth occurring between 7 PM and 9 AM (hazard ratio [HR] varied with time) and high maternal trait anxiety (HR = 1.61, 95% confidence interval [CI] = 1.01, 2.59). The following variables were protective against supplementation: planning to exclusively breastfeed (HR = 0.46, 95% CI = 0.33, 0.64), planning to breastfeed for ≥ 3 months (HR = 0.56, 95% CI = 0.37-0.86), childbirth education (HR = 0.61, 95% CI = 0.43, 0.86), mother born in Canada (HR = 0.68, 95% CI = 0.53, 0.87), completion of community college (HR = 0.76, 95% CI = 0.59, 0.98), male infant (HR = 0.78, 95% CI = 0.61, 0.99), and breastfeeding at delivery (HR varied with time). Nurses reported breastfeeding problems, infant behavior, and maternal fatigue as reasons for supplementing. Reassessing patterns of night feeds and encouraging breastfeeding at delivery may decrease supplementation. Trait anxiety reduction and the role of infant gender in supplementation merit further study.
Symptoms of Postpartum Depression and Breastfeeding
Authors: Hatton Daniel C. , Harrison-Hohner Jane , Coste Sarah , Dorato Veronica , Curet Luis B. , McCarron David A.
Published: November 2005

Despite important health benefits, the presence of depressive symptoms may decrease the prevalence of breastfeeding. The current study assessed the relationship between depressive symptoms and breastfeeding at 6 and 12 weeks postpartum. Participants were recruited from a cohort completing a clinical trial of calcium for prevention of preeclampsia. At 6 weeks postpartum, the Edinburgh Postnatal Depression Scale (EPDS) was completed by mail. At 12 weeks postpartum, the EPDS was completed at an outpatient visit. There was an inverse relationship between depressive symptoms and breastfeeding at 6 weeks postpartum ( P < .001) but not at 12 weeks. This relationship persisted even after controlling for prior history of depression, increased life stress, and current psychoactive medication. The results suggest that depressive symptoms early in the postpartum period may lower the prevalence of breastfeeding.
Should Oral Contraceptives Be Sold Without a Prescription? An Analysis of Women’s Risk and Benefit Perceptions Regarding Nonprescription Birth Control Pills
Authors: Nayak Rajesh , Brushwood David , Kimberlin Carole
Published: November 2005

Despite expert opinions favoring a switch of oral contracepwho were surveyed, 37% favored the acquisition of OCs with-tives (OCs) from prescription to over-the-counter (OTC) staout a prescription. Women associated the OTC system for obtus, limited empirical evidence currently exists for indicating taining OCs with increased likelihood of adverse medical a consumer preference for nonprescription OCs. The objec-consequences and the prescription-only system with an intive of this study was to measure perceptions of women re-creased likelihood of pregnancy avoidance. Women who pregarding nonprescription OCs and to assess their preference ferred nonprescription pills reported more favorable attifor acquiring OCs without a prescription. A cross-sectional tudes toward their use and stronger intentions to buy them survey research design employing a combination of mail and without a prescription. Perceptions of OC benefits seem to telephone survey methodologies was used to measure per-play a more significant role in decisions to favor nonprescripceptions, beliefs, and attitudes of a randomly selected sample tion pills than the perceptions of OC risks for those women of university women (N = 500) regarding the consequences of who preferred OTC pills. Currently, the support for nonpre-using OCs with and without a prescription. Of the women scription OCs among women is only moderate.
Pharmacokinetics and Pharmacodynamics of the New Quinolones
Authors: Noreddin Ayman M. , Haynes Virginia L. , Zhanel George G.
Published: November 2005

In this review, the authors describe the pharmacokinetic (PK) and pharmacodynamic (PD) characteristics of the new quinolones (levofloxacin, gatifloxacin, moxifloxacin, gemifloxacin, and garenoxacin) and discuss their implications on adequate therapy of patients with respiratory infections. The newer quinolones display excellent bioavailability and have longer serum half-lives than ciprofloxacin. In addition, they have the ability to concentrate in respiratory tract tissues and fluids at levels that exceed serum-drug concentrations. Also, the newer quinolones exhibit broad-spectrum activity against both susceptible and resistant organisms. Those favorable PK/PD properties make the new quinolones an attractive therapeutic alternative to traditional agents for common respiratory infections. Understanding the PK/PD of quinolone antibiotics can facilitate selection of optimal regimens to hasten response, prevent treatment failures, and minimize the development of resistance.
Hematopoiesis and stem cell renewal in long-term bone marrow cultures containing catalase
Authors: Gupta Rashmi , Karpatkin Simon , Basch Ross S.
Published: November 2005

Culturing mouse bone marrow in the presence of catalase dramatically alters hematopoiesis. Granulocyte output is initially increased 4- to 5-fold. This increase is transient and granulocyte production declines as immature (Sca-1+/LIN-) cells accumulate. One third of these immature cells have a phenotype (Sca-1+/c-Kit+) characteristic of hematopoietic stem cells. At 2 to 3 weeks there are greater than 200-fold more Sca-1+/c-Kit+/LIN- cells in treated cultures than in controls. This population contains functional stem cells with both short-term and long-term bone marrow repopulating activity. In addition to myeloid progenitors, this Sca-1+/LIN- population contains a large number of cells that express CD31 and CD34 and have an active Tie-2 promoter, indicating that they are in the endothelial lineage. After 3 to 4 weeks hematopoiesis in treated cultures wanes but if catalase is removed, hematopoiesis resumes. After 7 to 10 days the cultures are indistinguishable from untreated controls. Thus, protected from H2O2, hematopoietic progenitors multiply and become quiescent. This sequence resembles in vivo development in normal marrow. These results make it clear that peroxide-sensitive regulatory mechanisms play an important role in controlling hematopoiesis ex vivo and presumably in vivo as well. They also indicate that manipulation of the peroxide levels can be used to enhance the growth of hematopoietic stem cells in culture.
Beta-agonists modulate T-cell functions via direct actions on type 1 and type 2 cells
Authors: Loza Matthew J. , Foster Susan , Peters Stephen P. , Penn Raymond B.
Published: November 2005

Although the β2-adrenergic receptor (β2AR) is the most extensively characterized G-protein-coupled receptor (GPCR), the effects of β-agonists on T-cell subtype function remain poorly understood. In contrast to studies suggesting lack of β2AR expression on type 2 T cells, we demonstrate that type 2 interleukin-13+ (IL-13+) T cells (CD4+ or CD8+) in human peripheral blood lymphocytes (PBLs) can respond directly to β-agonist, with effects including induction of protein kinase A (PKA) activity and associated inhibition of CD3-stimulated CD25 expression; CD3-stimulated IL-13, interferon-γ (IFN-γ), and IL-2 production; and p38 mitogen-activated protein kinase (MAPK) phosphorylation. PGE2 was more efficacious than β-agonist in activating PKA and inhibiting cytokine production. β-agonist and PGE2 also inhibited phorbol myristate acetate (PMA) + calcimycin-stimulated IFN-γ and IL-2 (but not IL-13) production, suggesting that upstream CD3-initiated signaling is not the sole locus of PKA actions. Differential regulation of PMA-stimulated p38, p42/p44, and NF-κB explained the capacity of PGE2 and β-agonist to inhibit IFN-γ but not IL-13 production. The inhibition of CD3 + CD28-stimulated IL-13 production by both β-agonist and PGE2 was reversed at low agonist concentrations, resulting in enhanced IL-13, but not IFN-γ or IL-2, production. These findings identify direct effects of β2AR activation on T-cell subtypes and suggest a complex role for GPCRs and PKA activity in modulating T-cell functions.
The insulin-PI3K/TOR pathway induces a HIF-dependent transcriptional response in Drosophila by promoting nuclear localization of HIF-α/Sima
Authors: Dekanty Andrés , Lavista-Llanos Sofía , Irisarri Maximiliano , Oldham Sean , Wappner Pablo
Published: November 2005

The hypoxia-inducible factor (HIF) is a heterodimeric transcription factor composed of a constitutively expressed HIF-β subunit and an oxygen-regulated HIF-α subunit. We have previously defined a hypoxia-inducible transcriptional response in Drosophila melanogaster that is homologous to the mammalian HIF-dependent response. In Drosophila, the bHLH-PAS proteins Similar (Sima) and Tango (Tgo) are the functional homologues of the mammalian HIF-α and HIF-β subunits, respectively. HIF-α/Sima is regulated by oxygen at several different levels that include protein stability and subcellular localization. We show here for the first time that insulin can activate HIF-dependent transcription, both in Drosophila S2 cells and in living Drosophila embryos. Using a pharmacological approach as well as RNA interference, we determined that the effect of insulin on HIF-dependent transcriptional induction is mediated by PI3K-AKT and TOR pathways. We demonstrate that stimulation of the transcriptional response involves upregulation of Sima protein but not sima mRNA. Finally, we have analyzed in vivo the effect of the activation of the PI3K-AKT pathway on the subcellular localization of Sima protein. Overexpression of dAKT and dPDK1 in normoxic embryos provoked a major increase in Sima nuclear localization, mimicking the effect of a hypoxic treatment. A similar increase in Sima nuclear localization was observed in dPTEN homozygous mutant embryos, confirming that activation of the PI3K-AKT pathway promotes nuclear accumulation of Sima protein. We conclude that regulation of HIF-α/Sima by the PI3K-AKT-TOR pathway is a major conserved mode of regulation of the HIF-dependent transcriptional response in Drosophila.
Tum/RacGAP50C provides a critical link between anaphase microtubules and the assembly of the contractile ring inDrosophila melanogaster
Authors: Zavortink Michael , Contreras Nelida , Addy Tracie , Bejsovec Amy , Saint Robert
Published: November 2005

A central question in understanding cytokinesis is how the cleavage plane is positioned. Although the positioning signal is likely to be transmitted via the anaphase microtubule array to the cell cortex, exactly how the microtubule array determines the site of contractile ring formation remains unresolved. By analysing tum/RacGAP50C mutant Drosophila embryos we show that cells lacking Tum do not form furrows and fail to localise the key cytokinetic components Pebble (a RhoGEF), Aurora B kinase, Diaphanous, Pav-KLP and Anillin. The GAP activity of Tum is required for cytokinesis: in its absence cytokinesis fails early even though Tum is present on microtubules at the cell equator where the furrow should form. Disruption of the Pebble-interacting domain leaves Tum localised to the cell equator on cortically associated microtubules, again with no evidence of furrowing. These data support a model in which Tum/RacGAP, via its interaction with Pbl, provides a critical link between the anaphase microtubule spindle and cytokinetic furrow formation in Drosophila cells.
Three distinct chromatin domains in telomere ends of polytene chromosomes inDrosophila melanogaster Telmutants
Authors: Andreyeva Evgenia N. , Belyaeva Elena S. , Semeshin Valerii F. , Pokholkova Galina V. , Zhimulev Igor F.
Published: November 2005

Drosophila melanogaster telomeric DNA is known to comprise two domains: the terminal tract of retrotransposons (HeT-A, TART and TAHRE) and telomere-associated sequences (TAS). Chromosome tips are capped by a protein complex, which is assembled on the chromosome ends independently of the underlying terminal DNA sequences. To investigate the properties of these domains in salivary gland polytene chromosomes, we made use of Tel mutants. Telomeres in this background are elongated owing to the amplification of a block of terminal retroelements. Supercompact heterochromatin is absent from the telomeres of polytene chromosomes: electron microscopy analysis identifies the telomeric cap and the tract of retroelements as a reticular material, having no discernible banding pattern, whereas TAS repeats appear as faint bands. According to the pattern of bound proteins, the cap, tract of retroelements and TAS constitute distinct and non-overlapping domains in telomeres. SUUR, HP2, SU(VAR)3-7 and H3Me3K27 localize to the cap region, as has been demonstrated for HP1. All these proteins are also found in pericentric heterochromatin. The tract of retroelements is associated with proteins characteristic for both heterochromatin (H3Me3K9) and euchromatin (H3Me3K4, JIL-1, Z4). The TAS region is enriched for H3Me3K27. PC and E(Z) are detected both in TAS and many intercalary heterochromatin regions. Telomeres complete replication earlier than heterochromatic regions. The frequency of telomeric associations in salivary gland polytene chromosomes does not depend on the SuUR gene dosage, rather it appears to be defined by the telomere length.
The Parkin co-regulated gene product, PACRG, is an evolutionarily conserved axonemal protein that functions in outer-doublet microtubule morphogenesis
Authors: Dawe Helen R. , Farr Helen , Portman Neil , Shaw Michael K. , Gull Keith
Published: November 2005

Eukaryotic cilia and flagella are highly conserved structures composed of a canonical 9+2 microtubule axoneme. Comparative genomics of flagellated and non-flagellated eukaryotes provides one way to identify new putative flagellar proteins. We identified the Parkin co-regulated gene, or PACRG, from such a screen. Male mice deficient in PACRG are sterile, but its function has been little explored. The flagellated protozoan parasite Trypanosoma brucei possesses two homologues of PACRG. We performed RNA interference knockdown experiments of the two genes independently and both together. Simultaneous ablation of both proteins produced slow growth and paralysis of the flagellum with consequent effects on organelle segregation. Moreover, using transmission electron microscopy, structural defects were seen in the axoneme, with microtubule doublets missing from the canonical 9+2 formation. The occurrence of missing doublets increased toward the distal end of the flagellum and sequential loss of doublets was observed along individual axonemes. GFP fusion proteins of both PACRG homologues localised along the full length of the axoneme. Our results provide the first evidence for PACRG function within the axoneme, where we suggest that PACRG acts to maintain functional stability of the axonemal outer doublets of both motile and sensory cilia and flagella.
Reduce-and-Split Cuts: Improving the Performance of Mixed-Integer Gomory Cuts
Authors: Andersen Kent , Cornuéjols Gérard , Li Yanjun
Published: November 2005

Mixed-integer Gomory cuts have become an integral part of state-of-the-art software for solving mixed-integer linear programming problems. Therefore, improvements in the performance of these cutting planes can be of great practical value. In this paper, we present a simple and fast heuristic for improving the coefficients on the continuous variables in the mixed-integer Gomory cuts. This is motivated by the fact that in a mixed-integer Gomory cut, the coefficient of an integer variable lies between 0 and 1, whereas for a continuous variable, there is no upper bound. The heuristic tries to reduce the coefficients of the continuous variables. We call the resulting cuts reduce-and-split cuts. We found that on several test problems, reduce-and-split cuts can substantially enhance the performance of a branch-and-bound algorithm.