bluuebunny/crossref_metadata_2025 huggingface dataset:
WHY DO PRICE SPREADS BETWEEN DOMESTIC SHARES AND THEIR ADRS VARY OVER TIME?
Authors: Hsu Junming , Wang Hsin‐Yi
Published: October 2008

Abstract.  The exchange translated price spreads between domestic stocks and their American depositary receipts (ADRs) are conventionally ascribed to market friction. However, price spreads vary over time and sometimes fluctuate dramatically, which is hardly explainable by friction costs and implies the existence of arbitrage opportunities. This study hypothesizes that changes in trading volume and macro events generate heterogeneous expectations between two markets, which augments price spreads. Using a sample of 37 dual‐listing firms of six Far Eastern countries, we confirm this hypothesis by showing that domestic volume and macro events shift price spreads. We also find that: (i) the liberalization of capital control in Korea and Taiwan slashed price spreads; and (ii) investors can profit by trading Hong Kong stocks and ADRs.
Siding with Euthyphro: Response‐Dependence and Conferred Properties
Authors: Sveinsdóttir Ásta Kristjana
Published: October 2008

Abstract:I argue that a response‐dependence account of a concept can yield metaphysical results, and not merely epistemological or semantical results, which has been a prevalent view in the literature on response‐dependence. In particular, I show how one can argue for a conferralist account of a certain property by arguing that the concept of the property is response‐dependent, if certain assumptions are made.
Science and Ethics: Demarcation, Holism and Logical Consequences
Authors: Zangwill Nick
Published: October 2008

Abstract: I argue that attempts to demarcation ethics from science are not jeopardized by the fact that conjunctions of moral claims may have empirically verifiable logical consequences
Cerebrospinal fluid antibodies to tubulin are elevated in the patients with multiple sclerosis
Authors: Švarcová J. , Fialová L. , Bartoš A. , Šteinbachová M. , Malbohan I.
Published: October 2008

Background and purpose:  The aim of this study was to compare the levels of anti‐tubulin antibodies (anti‐TU) in cerebrospinal fluid (CSF) and serum using bovine tubulin as the antigen in one enzyme‐linked immunosorbent assay (ELISA) method (anti‐TUb antibodies) and a synthetic neuron‐specific octapeptide of tubulin in a second ELISA method (anti‐TUs antibodies).

Methods:  Paired CSF and serum samples were obtained from 34 multiple sclerosis (MS) patients, 13 patients with various other neurological diseases (control diseases) and 17 normal control patients (CN).

Results:  CSF levels of anti‐TUs and anti‐TUb antibodies were significantly lower in the CN group when compared to those in the MS group. On the contrary, serum levels of anti‐TU antibodies did not differ among groups. The intrathecal synthesis of anti‐TUs antibodies in comparison with anti‐TUb was significantly increased in all groups. Significant correlations between anti‐TUb and anti‐TUs antibodies were observed in the CSF of all three groups. However, with regard to serum, a similar relationship was only found in the MS group.

Conclusions:  The estimation of anti‐TU in CSF can contribute to the overall assessment of axonal damage; on the contrary serum anti‐tubulin antibodies were not useful for differential purposes in MS. The antibodies to the neuron‐specific portion of tubulin seemed to be synthesised predominantly intrathecally.
Isobel’s images – one woman’s experience of art therapy
Authors: White Isobel , Bull Stephanie , Beavis Mary
Published: October 2008

Accessible summary

Isobel is a woman with a mild learning disability who had art therapy for four years.

She tells us how art therapy helped her to think about her feelings.

She also tells us why the relationship with the art therapist was important.

This paper matters because there may be other people with learning disabilities who would find art therapy helpful too.

This paper explores the aims and purpose of long term art therapy. This is done by focusing on the experience of a woman with learning disabilities whom we have called Isobel White (pseudonym). In this paper we set out a theoretical context and then consider key aspects of the therapy process. We have included excerpts from reflective discussions between the three authors.
An Empirical Investigation of the True and Fair Override in the United Kingdom
Authors: Livne Gilad , McNichols Maureen
Published: October 2008

Abstract:  The True and Fair View concept requires companies to depart from GAAP or the law if necessary to present a true and fair view of the corporation's financial affairs. We analyze UK public companies invoking a true and fair override to assess whether overrides are associated with weakened performance, earnings quality and informativeness. We find quantified overrides increase income and equity significantly, and firms that invoke more costly overrides report weaker performance. We also find that firms invoking the most costly overrides have less informative financial statements than control firms, and lower earnings quality. In contrast, firms invoking less costly overrides do not exhibit weaker performance, less informative financial statements or weaker earnings quality. These findings are relevant for the debate on principle‐ vs. rules‐based accounting.
National Release of the Nursing Home Quality Report Cards: Implications of Statistical Methodology for Risk Adjustment
Authors: Li Yue , Cai Xueya , Glance Laurent G. , Spector William D. , Mukamel Dana B.
Published: October 2008

Objective. To determine how alternative statistical risk‐adjustment methods may affect the quality measures (QMs) in nursing home (NH) report cards.

Data Sources/Study Settings. Secondary data from the national Minimum Data Set files of 2004 and 2005 that include 605,433 long‐term residents in 9,336 facilities.

Study Design. We estimated risk‐adjusted QMs of decline in activities of daily living (ADL) functioning using classical, fixed‐effects, and random‐effects logistic models. Risk‐adjusted QMs were compared with each other, and with the published QM (unadjusted) in identifying high‐ and low‐quality facilities by either the rankings or 95 percent confidence intervals of QMs.

Principal Findings. Risk‐adjusted QMs showed better overall agreement (or convergent validity) with each other than did the unadjusted versus each adjusted QM; the disagreement rate between unadjusted and adjusted QM can be as high as 48 percent. The risk‐adjusted QM derived from the random‐effects shrinkage estimator deviated nonrandomly from other risk‐adjusted estimates in identifying the best 10 percent facilities using rankings.

Conclusions. The extensively risk‐adjusted QMs of ADL decline, even when estimated by alternative statistical methods, show higher convergent validity and provide more robust NH comparisons than the unadjusted QM. Outcome rankings based on ADL decline tend to show lower convergent validity when estimated by the shrinkage estimator rather than other statistical methods.
Organizational Cost of Quality Improvement for Depression Care
Authors: Liu Chuan‐Fen , Rubenstein Lisa V. , Kirchner JoAnn E. , Fortney John C. , Perkins Mark W. , Ober Scott K. , Pyne Jeffrey M. , Chaney Edmund F.
Published: October 2008

Objective. We documented organizational costs for depression care quality improvement (QI) to develop an evidence‐based, Veterans Health Administration (VA) adapted depression care model for primary care practices that performed well for patients, was sustained over time, and could be spread nationally in VA.

Data Sources and Study Setting. Project records and surveys from three multistate VA administrative regions and seven of their primary care practices.

Study Design. Descriptive analysis.

Data Collection. We documented project time commitments and expenses for 86 clinical QI and 42 technical expert support team participants for 4 years from initial contact through care model design, Plan–Do–Study–Act cycles, and achievement of stable workloads in which models functioned as routine care. We assessed time, salary costs, and costs for conference calls, meetings, e‐mails, and other activities.

Principle Findings. Over an average of 27 months, all clinics began referring patients to care managers. Clinical participants spent 1,086 hours at a cost of $84,438. Technical experts spent 2,147 hours costing $197,787. Eighty‐five percent of costs derived from initial regional engagement activities and care model design.

Conclusions. Organizational costs of the QI process for depression care in a large health care system were significant, and should be accounted for when planning for implementation of evidence‐based depression care.
Placement of a Catheter through the Struts of a Previously Placed Stent for Maintenance Hemodialysis: A Case Report
Authors: Joseph Rajesh , Keshava Shyamkumar N. , Surendrababu Narayanam R. S. , John George T.
Published: October 2008

Venous accesses for hemodialysis are beset with thrombosis and stenosis, often resulting in loss of central venous access. We report a case in which an alternate access was created by placement of hemodialysis catheter into the central vasculature by penetrating a stent previously placed in the stenosed right brachio‐cephalic vein. To our knowledge, this is the first such report.
Anterior Chest Wall Arteriovenous Grafts: An Underutilized Form of Hemodialysis Access
Authors: Niyyar Vandana Dua
Published: October 2008

Vascular access dysfunction is a major cause of morbidity in hemodialysis (HD) patients and the maintenance of a functional vascular access is an ongoing challenge. An upper extremity autogenous arteriovenous fistula (AVF) that preferentially involves the cephalic vein is the access of choice for hemodialysis patients, followed by autogenous AVF utilizing the basilic vein and the use of prosthetic arteriovenous grafts (AVG). Unfortunately, upper extremity options for vascular access rapidly become exhausted in a sub‐group of patients and use of alternative sites for access becomes necessary. An anterior chest wall graft, in which the axillary artery is anastomosed to either the ipsilateral or contralateral axillary veins, is a reasonable option in patients who have exhausted their upper extremity as vascular access sites, but still have patent central veins. Major indications include patients predisposed to steal syndrome as well as those with stenotic outflow veins necessitating over the shoulder extension of a brachio‐axillary graft. Recent data suggest that primary and secondary patency rates in anterior chest wall grafts are equivalent to upper extremity AVGs, making them a reasonable alternative vascular access option. This review will discuss the anatomical variations, percutaneous interventions, patency and longevity of anterior chest wall AV grafts.
Functionally Similar Species Confer Greater Resistance to Invasion: Implications for Grassland Restoration
Authors: Young Stephen L. , Barney Jacob N. , Kyser Guy B. , Jones Tracy S. , DiTomaso Joseph M.
Published: October 2008

Plant community functional composition can be manipulated in restored ecosystems to reduce the establishment potential of invading species. This study was designed to compare invasion resistance among communities with species functionally similar or dissimilar to yellow starthistle (Centaurea solstitialis), a late‐season annual. A field experiment was conducted in the Central Valley of California with six experimental plant communities that included (1) six early‐season native annual forbs (AF); (2) five late‐season native perennials and one summer annual forb (NP); (3) a combination of three early‐season native annual forbs and three late‐season native perennials (FP); (4) six early‐season non‐native annual grasses (AG); (5) monoculture of the late‐season native perennial grassElymus glaucus(EG); and (6) monoculture of the late‐season native perennialGrindelia camporum(GC). Following establishment,C. solstitialisseed was added to half of the plots, and a monoculture ofC. solstitialis(CS) was established as a control. Over a 5‐year period, the AF and AG communities were ineffective at preventingC. solstitialisinvasion.Centaurea solstitialiscover remained less than 10% in the FP and NP communities, except in year 1. By the fourth year,E. glaucuscover was greater than 50% in NP and FP communities and had spread to all other communities (e.g., 27% cover in CS in year 5). Communities containingE. glaucus, which is functionally similar toC. solstitialis, better resisted invasion than communities lacking a functional analog. In contrast,G. camporum, which is also functionally similar toC. solstitialis, failed to survive. Consequently, species selection for restored communities must consider not only functional similarity to the invader but also establishment success, competitiveness, and survivorship.
Controls on Shumard Oak (Quercus shumardii) Establishment into the Cross Timbers Ecotone of Oklahoma: Implications for Restoration
Authors: Myster Randall W.
Published: October 2008

To better understand how the Cross Timbers ecotone between U.S. eastern deciduous forest and tallgrass prairie is organized and maintained, I set out seedlings of Shumard oak (Quercus shumardii) for 1 year with treatments of water addition, trenching in pots to reduce belowground competition, burning, and patch type. I found that (1) seedlings in pots survived twice as much as those without pots and seedlings in unburned areas survived up to four times as much as those in burned areas; (2) seedlings in pots grew twice as fast as those planted directly in the soil without a pot; and (3) whereas adding water, planting in a pot, and planting under shrubs all increased leaf chlorophyll absorption, it was when the seedling was watered, under a shrub, or in a pot that chlorophyll increases were 2‐fold. Results suggest these management and restoration strategies to increase Cross Timbers oak establishment: first reduce belowground competition by the resident grasses; second, do not burn; and third, use shrubs as a facilitating tool. Adding water to tree seedlings should be used as a management tool only after others have been tried and failed. Finally, an ecotone conceptual vegetation model is presented both to incorporate the results and to explain how ecotones may be managed, restored, and maintained.
A Method for Evaluating Outcomes of Restoration When No Reference Sites Exist
Authors: Brewer J. Stephen , Menzel Timothy
Published: October 2008

Ecological restoration typically seeks to shift species composition toward that of existing reference sites. Yet, comparing the assemblages in restored and reference habitats assumes that similarity to the reference habitat is the optimal outcome of restoration and does not provide a perspective on regionally rare off‐site species. When no such reference assemblages of species exist, an accurate assessment of the habitat affinities of species is crucial. We present a method for using a species by habitat data matrix generated by biodiversity surveys to evaluate community responses to habitat restoration treatments. Habitats within the region are rated on their community similarity to a hypothetical restored habitat, other habitats of conservation concern, and disturbed habitats. Similarity scores are reinserted into the species by habitat matrix to produce indicator (I) scores for each species in relation to these habitats. We apply this procedure to an open woodland restoration project in north Mississippi (U.S.A.) by evaluating initial plant community responses to restoration. Results showed a substantial increase in open woodland indicators, a modest decrease in generalists historically restricted to floodplain forests, and no significant change in disturbance indicators as a group. These responses can be interpreted as a desirable outcome, regardless of whether species composition approaches that of reference sites. The broader value of this approach is that it provides a flexible and objective means of predicting and evaluating the outcome of restoration projects involving any group of species in any region, provided there is a biodiversity database that includes habitat and location information.
Elevated CK‐MB mass and plasma brain‐type natriuretic peptide concentrations following convulsive seizures in children and adolescents: Possible evidence of subtle cardiac dysfunction
Authors: Alehan Füsun , Erol Ilknur , Cemil Tuba , Bayraktar Nilüfer , Ogüs Ersin , Tokel Kürsad
Published: October 2008

Purpose:  To evaluate the presence of myocardial injury during convulsive seizures in children and adolescents by determining serum concentrations of cardiac troponin I (cTnI), creatine kinase‐MB mass (CK‐MB mass), and plasma brain‐type natriuretic peptide (BNP).

Methods:  Thirty‐one children (20 boys; mean age, 6.6 ± 5.34 years) with convulsive seizures and 50 healthy children were enrolled. Serum cTnI, CK‐MB mass, and plasma BNP concentrations were analyzed 12 h after the seizure and repeated 7 days thereafter in the patient group and obtained one time in the control group.

Results:  The difference between serum concentrations of cTnI obtained 12 h and 7 days after the seizure was not statistically significant. cTnI levels 12 h postictal and those in control subjects also were not significantly different. CK‐MB mass and BNP at the 12th h were higher than those obtained on the 7th day (p < 0.05 and p < 0.001, respectively). Children with seizures had increased levels of CK‐MB mass and BNP 12 h after seizure than control subjects (p < 0.05 and p < 0.001, respectively). The results of electrocardiography (ECG) recordings, which were obtained up to 30 min after seizure activity, were completely normal in patients with seizure.

Conclusion:  Normal cTnI levels are not indicative of overt myocardial necrosis in patients with seizures. However, markedly elevated BNP concentrations together with elevated CK‐MB mass levels do suggest subtle cardiac dysfunction in patients with seizure, and further large‐scale studies are warranted.
Impact of nonadherence to antiepileptic drugs on health care utilization and costs: Findings from the RANSOM study
Authors: Faught R. Edward , Weiner Jennifer R. , Guérin Annie , Cunnington Marianne C. , Duh Mei Sheng
Published: October 2008

Purpose:  To study the impact of nonadherence to antiepileptic drugs (AEDs) on health care utilization and direct medical costs in a Medicaid population.

Methods:  A retrospective cohort design was employed using state Medicaid claims data from Florida, Iowa, and New Jersey during the period from January 1997 to June 2006. Patients aged ≥18 years with one or more neurologist visit with an epilepsy diagnosis and two or more pharmacy claims for AEDs were included. Medication possession ratio (MPR) was used to evaluate AED adherence with MPR ≥ 0.80 considered adherent and <0.80 considered nonadherent. The association of nonadherence with utilization outcomes [hospitalizations, inpatient days, emergency department (ED), and outpatient visits] was assessed with univariate and multivariate Poisson regressions. Quarterly per‐patient inpatient, outpatient, ED, and pharmacy costs were calculated across nonadherent and adherent quarters for the younger than 65 population (under‐65) and cost differences were computed. Adjusted incremental costs of nonadherence were estimated with multivariate Tobit regression models.

Results:  A total of 33,658 patients were included (28,470 under‐65), together contributing 388,564 treated quarters (26% nonadherent). In multivariate analyses, AED nonadherence was associated with significantly higher incidence of hospitalizations [incident rate ratio (IRR) = 1.39, 95% confidence interval (CI) = 1.37–1.41], inpatient days (IRR = 1.76, 95% CI = 1.75–1.78), and ED visits (IRR = 1.19, 95% CI = 1.18–1.21). Nonadherence was associated with cost increases related to serious outcomes, including inpatient ($4,320 additional cost per quarter, 95% CI = $4,077–$4,564) and ED services ($303 additional cost per quarter, 95% CI = $273–$334), but lower costs for outpatient and pharmacy services, likely because of nonadherent behavior.

Discussion:  Nonadherence to AEDs appears to be associated with serious outcomes, as evidenced by increased utilization and costs of inpatient and ED services.
Focal lesions in the splenium of the corpus callosum in patients with epilepsy
Authors: Gröppel Gudrun , Gallmetzer Paolo , Prayer Daniela , Serles Wolfgang , Baumgartner Christoph
Published: October 2008

Purpose:  A focal lesion in the splenium of the corpus callosum is a rare finding in patients with epilepsy. Intoxication with antiepileptic drugs, edema after generalized seizures, or a rapid change of antiepileptic drug levels have been proposed as possible mechanisms. The aim of the present study was to analyze the relationship between this lesion and possible etiologic factors.

Patients and methods:  We analyzed the magnetic resonance imaging (MRI) scans of 1,050 patients undergoing prolonged video‐EEG (electroencephalography) monitoring and identified 24 patients with a focal lesion in the splenium of the corpus callosum. Twenty‐four age‐ and gender‐matched temporal lobe epilepsy patients without such a lesion served as a control group. We evaluated the following parameters for their possible etiologic significance: epilepsy syndrome, seizure types in medical history, seizure frequency during the past year prior to admission for prolonged video‐EEG monitoring, localization of interictal spikes and ictal EEG patterns in patients with focal epilepsies as documented during prolonged video‐EEG‐monitoring, seizure types and seizure frequency during prolonged video‐EEG monitoring, past as well as current antiepileptic medication, withdrawal of antiepileptic drugs during monitoring including duration of medication withdrawal, and finally drug levels above the therapeutic range.

Results:  The parameters analyzed showed no significant difference between the group of patients with focal lesions in the splenium of the corpus callosum and the control group.

Conclusion:  We could not identify a single etiologic factor responsible for the lesion in the splenium of the corpus callosum.
Valproate‐induced metabolic changes in patients with epilepsy: Assessment with 1H‐MRS
Authors: Garcia Meritxell , Huppertz Hans‐Juergen , Ziyeh Sargon , Buechert Martin , Schumacher Martin , Mader Irina
Published: October 2008

Purpose:  Valproate (VPA) interferes with mitochondrial metabolism causing hyperammonemia, thereby shifting the balance reaction of glutamine (Gln)/glutamate (Glu) toward Gln. In this study we wanted to determine whether metabolic changes could be reproduced in VPA‐treated patients with epilepsy and whether the results differed from those known in chronic hepatic encephalopathy (CHE).

Methods:  Seven patients with epilepsy pretreated with VPA and seven healthy volunteers were investigated on a 3T‐scanner. We performed proton magnetic resonance spectroscopy (1H‐MRS) using a short echo time point‐resolved spectroscopy (PRESS) in the parietal and occipital lobe, respectively. Spectral analysis was performed by LCModel, allowing a separation of Glu and Gln at 3T. Absolute values of myo‐Inositol (mI), choline (Cho), creatine (Cr), N‐acetyl‐aspartate (NAA), glutamine (Gln), glutamate (Glu), and the sum of Gln and Glu (Glx) were calculated.

Results:  In the parietal lobe, mI was significantly decreased in the patients’ group compared to the healthy volunteers. After separation of the signals of Gln and Glu, a significant increase of Gln was observed in the parietal lobe in the patients’ group. No significant differences in the occipital spectra could be observed between the groups.

Discussion:  In VPA‐treated patients the alteration of the Glu/Gln ratio differs from that in patients with CHE, where Glx is markedly increased because of an increase in Gln. The expected shift from the biochemical balance reaction of Gln/Glu induced by VPA could be reproduced for the parietal lobe. Significantly reduced mI in the parietal lobe of VPA‐treated patients most likely reflects an osmolytic compensation for high Gln.
Morphine dependence increases the response to a brief pentylenetetrazol administration in rat hippocampal CA1 in vitro
Authors: Jafarzadeh Zakaria , Fathollahi Yaghoub , Semnanian Saeed , Omrani Azar , Salmanzadeh Feresteh , Salmani Mahmoud Elahdadi
Published: October 2008

Purpose: Herein we used electrophysiologic approaches in hippocampal area CA1 to estimate how morphine treatment alters the pentylenetetrazol (PTZ) effects.

Methods: Hippocampal slices taken from either control animals or animals made dependent via chronic morphine administration were examined. Changes in the population spike and epileptiform amplitudes were used as indices to quantify the effects of PTZ exposure in the control and morphine‐dependent slices. Hippocampal slices taken either from control animals or from animals made dependent upon morphine were exposed to PTZ, either with or without morphine, naloxone, or morphine + naloxone.

Results: Morphine dependence increased a PTZ‐induced long‐term potentiation (LTP) of the population spike in CA1 in vitro. This LTP was not found in rats that had spontaneously withdrawn morphine or withdrawn with naloxone in vivo after chronic morphine intake. Morphine or naloxone in vitro blocked the PTZ‐induced LTP changes in control and morphine‐dependent slices. However, PTZ‐induced multiple population spikes (epileptiform activity) in CA1 was not blocked by naloxone.

Discussion: It is concluded that dependence on morphine enhances PTZ‐induced plastic and epileptic changes in CA1 excitability. We suggest that this model of neuronal activity in dependent slices could present an opportunity for studying the mechanisms underlying the increased likelihood of seizures in morphine users.
The association between depression and epilepsy in a nationally representative sample
Authors: Fuller‐Thomson Esme , Brennenstuhl Sarah
Published: October 2008

Purpose:  To determine the: (1) national prevalence of epilepsy and depression; (2) prevalence of depression among those with epilepsy; (3) odds ratio of depression among those with epilepsy compared to those without, controlling for demographic characteristics; (4) demographic correlates of depression among those with epilepsy and those without; and, (5) health services utilization of those with epilepsy and depression.

Methods:  The full sample of the nationally representative 2000/2001 Canadian Community Health Survey (n = 130,880) was used to determine prevalence of epilepsy and depression. A subsample of 781 individuals reporting an epilepsy diagnosis and with complete depression data was used to determine prevalence and correlates of depression, and health service utilization patterns. Correlates of depression among those without epilepsy (n = 126,104) were also determined. Chi‐square analyses, t‐tests, prevalence ratios, and a logistic regression were conducted.

Results:  Thirteen percent of those with epilepsy were depressed, in comparison to 7% of those without (p < 0.001). Epilepsy was associated with 43% higher odds of depression when adjusting for demographic factors. The odds of depression among individuals with epilepsy were higher for females, visible minorities, older individuals, and individuals experiencing food insecurity. Visible minority and older age appear to be unique risk factors for depression in those with epilepsy as compared to those without. Thirty‐eight percent of depressed respondents with epilepsy had no consultations with a mental health professional in the previous year.

Discussion:  Medical professionals need to regularly assess levels of depression in their patients with epilepsy. This research helps guide which risk groups should be targeted.
Functional brain mapping of ictal activity in gelastic epilepsy associated with hypothalamic hamartoma: A case report
Authors: Leal Alberto J.R. , Monteiro José P. , Secca Mário Forjaz , Jordão Constança
Published: October 2008

Hypothalamic hamartomas (HHs) have been demonstrated as the cause of gelastic epilepsy, both by intracranial electrodes and functional imaging. The neocortex becomes secondarily involved, through poorly characterized propagation pathways. The detailed dynamics of seizure spread have not yet been demonstrated, owing to the limited spatial–temporal resolution of available functional mapping. We studied a patient with epilepsy associated with HH and gelastic epilepsy. Simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) of several seizure events were obtained, with blood oxygen level dependent (BOLD) activation of the hamartoma, and left hemisphere hypothalamus, hippocampus, parietal–occipital area, cingulate gyrus, and dorsal–lateral frontal area. Integration of regional BOLD kinetics and EEG power dynamics strongly suggests propagation of the epileptic activity from the HH through the left fornix to the temporal lobe, and later through the cingulate fasciculus to the left frontal lobe. The EEG/fMRI method has the spatial–temporal resolution to study the dynamics of seizure activity, with detailed demonstration of origin and propagation pathways.
Acute Interaction of Baclofen in Combination With Alcohol in Heavy Social Drinkers
Authors: Evans Suzette M. , Bisaga Adam
Published: October 2008

Background: There is growing evidence that gamma‐amino butyric acid‐B receptor agonists may be effective in the treatment of alcohol abuse or dependence. The primary goal of this study was to determine the safety of baclofen in combination with alcohol consumption in heavy drinkers. In addition, the effects of baclofen alone, and in combination with alcohol, on subjective effects, cognitive performance effects, as well as alcohol craving, were assessed.

Methods: Eighteen non‐treatment‐seeking heavy social drinkers (mean of 28 drinks per week), who did not meet the criteria for alcohol dependence participated. All individuals were tested using a double‐blind double‐dummy design with six 2‐day inpatient phases. Baclofen (0, 40, and 80 mg) was administered 2.5 hours before alcohol (1.5 g/l body water or approximately 0.75 g/kg) or placebo beverages, given in 4 divided doses every 20 minutes.

Results: Baclofen, either alone or in combination with alcohol, produced only modest increases in heart rate and blood pressure and no adverse effects were reported. Baclofen did not increase positive subjective effects (e.g., Stimulant effects, Drug Liking) but did increase sedation and impair performance. Even though both baclofen and alcohol impaired performance, for the most part performance was not impaired to a greater extent when baclofen was combined with alcohol. Among this population of nondependent drinkers, baclofen did not alter alcohol craving or alcohol‐induced positive subjective effects.

Conclusions: Baclofen alone has minimal abuse liability in heavy social drinkers, and baclofen is relatively well tolerated and safe when given in combination with intoxicating doses of alcohol.
Effects of in Utero Antiepileptic Drug Exposure
Authors: Meador Kimford J.
Published: October 2008

Recent studies demonstrate an increased teratogenic risk for valproate and a probable increased risk for phenobarbital. Carbamazepine and lamotrigine appear relatively safe; however, results are inconclusive concerning a specific risk for cleft lip/palate for both drugs as well as a dose-dependent effect for malformations associated with lamotrigine. Data regarding teratogenic risks for other antiepileptic drugs are inadequate. Additional studies are needed to delineate further the risks for all antiepileptic drugs and determine the underlying mechanisms.
When Should Clinicians Worry about Bone Density for Patients with Epilepsy?
Authors: Abou-Khalil Bassel W.
Published: October 2008

Progressive Bone Deficit in Epilepsy. Sheth RD, Binkley N, Hermann BP. Neurology 2008;70(3):170–176. OBJECTIVE: Chronic treatment with antiepileptic medication is associated with reduced bone mineral density (BMD), which may underlie the two-to sixfold increase in fracture rates observed in patients with epilepsy. The objective was to determine the timing of the BMD deficit in ambulatory children with epilepsy. METHODS: A cross-sectional evaluation was conducted in 82 ambulatory children aged 6 to 18 years (12.4 ± 3.3 years) with epilepsy for <1 year (n = 18), 1 to 5 years (n = 37), and 6 or more years (n = 27). Controls were 32 healthy children aged 12.8 ± 2.6 years. Age- and sex-corrected total body BMD Z-score was measured. RESULTS: Total BMD Z-score was lower in children with epilepsy (0.10 ± 0.96; CI = −0.08, 0.34) compared to controls (0.57 ± 0.74; CI = 0.3, 0.84; p = 0.03). Increasing duration of epilepsy was associated with a progressive reduction in BMD compared to controls (Spearman r = −0.197; p = 0.03). Compared to controls, those with epilepsy for 1 to 5 years had a mean BMD Z-score of 0.13 ± 0.78 (CI = −0.13, 0.39; p = 0.04) and in those treated for 6 or more years BMD was 0.06 ± 1.11 (CI = −0.38, 0.5; p = 0.04). For those with epilepsy for <1 year BMD was 0.23 ±1.1 (CI = −0.31, 0.77; p = 0.21). CONCLUSIONS: Children treated for epilepsy sustain significant bone mineral density (BMD) deficit compared to controls during the initial 1 to 5 years of treatment which progressively worsens thereafter. This progressive BMD deficit may be a contributing factor to the increased fracture risk observed in patients with epilepsy and may accelerate aging-related osteoporosis.
Is Seizure Surgery an Option for Patients with Very Low IQ?
Authors: Garcia Paul
Published: October 2008

Seizure Outcome after Resective Epilepsy Surgery in Patients with Low IQ. Malmgren K, Olsson I, Engman E, Flink R, Rydenhag B. Brain 2008;131(Pt 2):535–542. Epilepsy surgery has been questioned for patients with low IQ, since a low cognitive level is taken to indicate a widespread disturbance of cerebral function with unsatisfactory prognosis following resective surgery. The prevalence of epilepsy in patients with cognitive dysfunction is, however, higher than in the general population and the epilepsy is often more severe and difficult to treat. It is therefore important to try to clarify whether IQ predicts seizure outcome after resective epilepsy surgery. The Swedish National Epilepsy Surgery Register, which includes data on all epilepsy surgery procedures in Sweden since 1990, was analysed for all resective procedures performed 1990–99. Sustained seizure freedom with or without aura at the 2-year follow-up was analysed as a function of pre-operative IQ level categorized as IQ <50, IQ 50–69 and IQ ≥70 and was also adjusted for the following variables: age at epilepsy onset, age at surgery, pre-operative seizure frequency, pre-operative neurological impairment, resection type and histopathological diagnosis. Four hundred and forty-eight patients underwent resective epilepsy surgery in Sweden from 1990 to 1999 and completed the 2-year follow-up: 72 (16%) had IQ <70, (18 with IQ <50 and 54 with IQ 50–69) and 376 IQ ≥70. There were 313 adults and 135 children ≤18 years. Three hundred and twenty-five patients underwent temporal lobe resections (TLR) and 123 underwent various extratemporal resections (XTLR). At the 2-year follow-up, 56% (252/448) of the patients were seizure free: 22% (4/18) in the IQ <50 group, 37% (20/54) in the IQ 50–69 group and 61% (228β76) in the IQ ≥70 group. There was a significant relation between IQ category and seizure freedom [odds ratio (OR) 0.41, 95% confidence interval (CI) 0.27–0.62] and this held also when adjusting for clinical variables [OR 0.58 (95% CI 0.35–0.95)]. In this population-based epilepsy surgery series, IQ level was shown to be an independent predictor of seizure freedom at the 2-year follow-up. However, many of the low-IQ patients benefit from surgery, especially patients with lesions. Low IQ should not exclude patients from resective epilepsy surgery, but is an important prognostic factor to consider in the counselling process.
A Frontal Assault on the Generalized Nature of Juvenile Myoclonic Epilepsy
Authors: Fountain Nathan B.
Published: October 2008

Frontal Cognitive Dysfunction in Juvenile Myoclonic Epilepsy. Piazzini A, Turner K, Vignoli A, Canger R, Canevini M P. Epilepsia 2008;49(4):657–662. PURPOSE: The aim of the present study was to investigate the possible frontal cognitive dysfunction in patients with juvenile myoclonic epilepsy (JME) and to compare the results with those of patients with frontal lobe epilepsy (FLE) and temporal lobe epilepsy (TLE), as well as with controls. METHODS: A total of 50 patients with JME, 40 patients with FLE, 40 patients with TLE, and 40 normal controls, all matched for age, education, and IQ, were administered tests to assess frontal functions (the Word Fluency Test and the Wisconsin Card Sorting Test [WCST]). All participants had a normal intelligence level based on the Wechsler Adult Intelligence Scale, and did not take medications other than antiepileptics (AEDs) or have a psychiatric history. RESULTS: Patients with JME had severe impairment in all administered tasks, similar to that of patients with FLE; TLE patients and controls followed in order. Multiple regression analysis did not disclose any significant effect of clinical variables on the cognitive deficits. DISCUSSION: These results clearly suggest that JME patients can show some frontal dysfunction, which may affect both epileptogenic features and cognitive processes. Further studies are needed to confirm these findings.
Diagnosing Pseudoseizures: Don't Hold Your Breath
Authors: Bergen Donna C.
Published: October 2008

Postictal Breathing Pattern Distinguishes Epileptic from Nonepileptic Convulsive Seizures. Azar NJ, Tayah TF, Wang L, Song Y, Abou-Khalil BW. Epilepsia 2008;49(1):132–137. PURPOSE: To examine postictal breathing pattern in generalized convulsive nonepileptic seizures (GCNES) and generalized tonic–clonic seizures (GTCS) and evaluate this feature as a discriminating sign. METHODS: We reviewed the postictal breathing pattern seizures in 23 generalized tonic–clonic seizures in 15 consecutive patients with epilepsy and 24 convulsive nonepileptic seizures in 16 consecutive patients with pure psychogenic seizures. We also analyzed 21 frontal lobe hypermotor seizures (FLHS) in 9 patients with frontal lobe epilepsy. RESULTS: The breathing after GTCS was deep with prolonged inspiratory and expiratory phases, regular, and loud (except for two short seizures). The breathing after GCNES was characterized by increased respiratory rate or hyperpnea with short inspiratory and expiratory phases, as can be noted after exercise. The breathing was often irregular, with brief pauses. The altered breathing lasted longer after GTCS. The two groups differed significantly in loudness of postictal respiration, postictal snoring (only with GTCS), respiratory rate (faster for the GCNES group), and duration of altered breathing (longer after GTCS) (p < 0.00001 for all features). FLHS shared postictal breathing features of GCNES, but had other distinguishing features. CONCLUSIONS: The postictal breathing pattern can help differentiate generalized tonic–clonic seizures from nonepileptic psychogenic seizures with generalized motor activity and may be helpful to the practitioner obtaining a seizure history in the clinic setting or witnessing a seizure.
Name Calling in the Temporal Lobe
Authors: Blume Warren T. , Hayman-Abello Brent
Published: October 2008

Evidence for Cortical Reorganization of Language in Patients with Hippocampal Sclerosis. Hamberger MJ, Seidel WT, Goodman RR, Williams A, Perrine K, Devinsky O, McKhann GM 2nd. Brain 2007;130(Pt 11):2942–2950. Naming is mediated by perisylvian cortex in the left (language-dominant) hemisphere, and thus, left anterior temporal lobe resection for pharmacologically intractable temporal lobe epilepsy (TLE) carries risk for post-operative naming decline. Interestingly, this risk is lower in patients with hippocampal sclerosis (HS) relative to those without HS (non-HS). Although the hippocampus has traditionally been considered a critical structure for memory, without contribution to naming, this pattern might implicate direct hippocampal naming involvement. On the other hand, critical naming sites have been found in anterior, lateral temporal (i.e. extra-hippocampal) neocortex, the region typically removed with ‘standard’ TLE resection. We, therefore, speculated that the relative preservation of naming in post-operative HS patients might reflect cortical reorganization of language to areas outside this region. Using pre-resection electrical stimulation mapping, we compared the topography of auditory and visual naming sites in 12 patients with HS and 12 patients without structural brain pathology. Consistent with previous work, non-HS patients exhibited post-operative naming decline, whereas HS patients did not. As hypothesized, HS patients had proportionally fewer overall naming sites in anterior temporal cortex, the region typically removed with standard anterior temporal resection, whereas non-HS patients exhibited a more even distribution of naming sites in anterior and posterior temporal regions ( P = 0.03). Although both groups exhibited the previously reported pattern of auditory naming sites anterior to visual naming sites, auditory naming sites had a significantly more posterior distribution in HS patients ( P = 0.02). Additionally, non-HS patients exhibited a greater proportion of visual naming sites above the superior temporal sulcus, whereas visual naming sites in HS patients were scattered across superior and inferior temporal cortex. Results suggest that preserved naming ability in HS patients following anterior temporal resection might be attributable, at least in part, to intrahemispheric reorganization of language in response to the likely, early development of sclerosis in the medial temporal region. Furthermore, their more posterior distribution of naming sites is consistent with the more anterior propagation of EEG discharges in TLE. These results hold theoretical implications regarding the role of the dominant hippocampus in determining the cortical representation of semantic and lexical information, and raise questions regarding the specific roles of medial and lateral temporal cortex in targeted word retrieval. The different patterns of naming areas identified in patients with and without HS may also carry clinical implications, potentially improving efficiency during the time-constrained process of stimulation mapping.
Selective Changes in Hippocampal GABAA Receptors during Status Epilepticus
Authors: Mathews Gregory C.
Published: October 2008

Subunit-Specific Trafficking of >GABAA Receptors During Status Epilepticus. Goodkin HP, Joshi S, Mtchedlishvili Z, Brar J, Kapur J. J Neurosci 2008 5;28(10):2527–2538. It is proposed that a reduced surface expression of GABAA receptors (GABARs) contributes to the pathogenesis of status epilepticus (SE), a condition characterized by prolonged seizures. This hypothesis was based on the finding that prolonged epileptiform bursting (repetitive bursts of prolonged depolarizations with superimposed action potentials) in cultures of dissociated hippocampal pyramidal neurons (dissociated cultures) results in the increased intracellular accumulation of GABARs. However, it is not known whether this rapid modification in the surface-expressed GABAR pool results from selective, subunit-dependent or nonselective, subunit-independent internalization of GABARs. In hippocampal slices obtained from animals undergoing prolonged SE (SE-treated slices), we found that the surface expression of the GABAR β2/3 and γ2 subunits was reduced, whereas that of the δ subunit was not. Complementary electrophysiological recordings from dentate granule cells in SE-treated slices demonstrated a reduction in GABAR-mediated synaptic inhibition, but not tonic inhibition. A reduction in the surface expression of the γ2 subunit, but not the δ subunit was also observed in dissociated cultures and organotypic hippocampal slice cultures when incubated in an elevated KCl external medium or an elevated KCl external medium supplemented with NMDA, respectively. Additional studies demonstrated that the reduction in the surface expression of the γ2 subunit was independent of direct ligand binding of the GABAR. These findings demonstrate that the regulation of surface-expressed GABAR pool during SE is subunit-specific and occurs independent of ligand binding. The differential modulation of the surface expression of GABARs during SE has potential implications for the treatment of this neurological emergency.
Making Trash into Treasure: Struggles for Autonomy on a Brazilian Garbage Dump
Authors: Millar Kathleen
Published: October 2008

In recent years, the expansion of types of work that fall outside the category of formal waged employment challenge many of our anthropological conceptions of labor, class politics and contemporary capitalism. This paper addresses the need to rethink the meaning of work in the context of neoliberal capitalism by exploring the formation of new worker subjectivities and practices among catadores: informal workers who collect and sell recyclable materials on a garbage dump in Rio de Janeiro, Brazil. Based on ethnographic research conducted among catadores from June through August of 2005 and in January 2007, this paper provides an analysis of the labor conditions, social relations, and forms of political organizing that have emerged on the garbage dump and which differ in significant ways from those found in situations of formal wage labor. Ultimately, this paper argues that while neoliberal capitalism has led to increased unemployment and underemployment among vulnerable populations in cities worldwide, the practices of those struggling to earn a living in urban informal economies are creating new spaces for alternative economic practices, social relations, and class politics today.
The Pirate Media Economy and the Emergence of Quichua Language Media Spaces in Ecuador
Authors: Floyd Simeon
Published: October 2008

This paper gives an account of the pirate media economy of Ecuador and its role in the emergence of indigenous Quichua‐language media spaces, identifying the different parties involved in this economy, discussing their relationship to the parallel “legitimate” media economy, and considering the implications of this informal media market for Quichua linguistic and cultural reproduction. As digital recording and playback technology has become increasingly more affordable and widespread over recent years, black markets have grown up worldwide, based on cheap “illegal” reproduction of commercial media, today sold by informal entrepreneurs in rural markets, shops and street corners around Ecuador. Piggybacking on this pirate infrastructure, Quichua‐speaking media producers and consumers have begun to circulate indigenous‐language video at an unprecedented rate, helped by small‐scale merchants who themselves profit by supplying market demands for positive images of indigenous people. In a context of a national media that has tended to silence indigenous voices rather than amplify them, informal media producers, consumers and vendors are developing relationships that open meaningful media spaces within the particular social, economic and linguistic contexts of Ecuador.