bluuebunny/crossref_metadata_2025 huggingface dataset:
Original article: Nasal nitric oxide: longitudinal reproducibility and the effects of a nasal allergen challenge in patients with allergic rhinitis
Authors: Boot J. D. , De Kam M. L. , Mascelli M. A. , Miller B. , Van Wijk R. Gerth , De Groot H. , Cohen A. F. , Diamant Z.
Published: March 2007

Background:  Exhaled nitric oxide (eNO) is a validated noninvasive marker of airway inflammation in asthma. In patients with allergic rhinitis (AR), increased levels of nasal nitric oxide (nNO) have also been measured. However, the applicability of nNO as a marker of upper airway inflammation awaits validation.

Aim:  To test the longitudinal reproducibility of standardized nNO measurements in patients with AR and the effects of nasal allergen challenge.

Methods:  Twenty patients with clinically stable, untreated AR participated in a combined study design. First, reproducibility of nNO was tested over 1, 7, and 14–21 days. Subsequently, the effect of nasal allergen challenge on nNO was studied in a placebo‐controlled, parallel design. Nasal NO was measured with a chemoluminescence analyzer. Ten subjects randomly underwent a standardized nasal allergen challenge; 10 subjects received placebo. Response to nasal challenge was monitored by composite symptom scores.

Results:  There was a good reproducibility of nNO up to 7 days [coefficient of variation (CV) over 1 (16.45%) and 7 days (21.5%)], decreasing over time [CV (14–21 days): 38.3%]. As compared with placebo, allergen challenge caused a significant increase in symptom scores (P < 0.001), accompanied by a decrease in nNO at 20 min postchallenge (P = 0.001). Furthermore, there was a gradual increase in nNO at 7 h, reaching significance at 24‐h postallergen (P = 0.04).

Conclusions:  Similar to eNO in asthma, nNO is a noninvasive marker, potentially suitable to monitor upper airway inflammation following allergen‐induced late response. Present data show a good reproducibility of nNO measurements, decreasing over time, probably because of subclinical seasonal influences.
Original article: Predictors of response to bronchial allergen challenge in 5‐ to 6‐year‐old atopic children
Authors: Douglas T. A. , Kusel M. , Pascoe E. M. , Loh R. K. S. , Holt P. G. , Sly P. D.
Published: March 2007

Background:  The relationship between atopy and bronchial allergy in young children is not completely understood.

Objective:  To examine the association between response to bronchial allergen challenge, immune markers of atopy and other clinical characteristics in 5‐ to 6‐year‐old children.

Methods:  Children with positive skin test (SPT) to aeroallergen, together with a proportion of SPT negative children (as controls), were recruited from a birth cohort of 198 children at high risk of developing atopic disease and underwent allergen challenge.

Results:  Thirty‐seven children (26 atopic and 11 SPT negative), median age 74.5 months, were challenged: 31 with house dust mite and six with grass allergen. Only atopic children responded to challenge: n = 12/26 (46%). Wheal size [odds ratio (OR) 2.5 (1.2–5.3), P = 0.01], allergen‐specific immunoglobulin E (IgE) [OR 3.4 (1.23–9.61), P = 0.02], total IgE [OR 8.6 (1.1–68.7), P = 0.04], current wheeze [OR 12 (1.7–81.7), P = 0.006] and persistent eczema [OR 11.0 (1.7–68.3), P = 0.006] emerged as the strongest independent predictors of response to allergen challenge. Prediction of response to allergen challenge was significantly improved when immune markers of atopy, and in particular wheal size, were combined with clinical characteristics.

Conclusion:  The relationship between atopy and bronchial allergy is quantitative at this age. There may be potential to create more powerful indicators of the presence of respiratory allergy in young children when immunological markers of atopy are considered quantitatively and when combined with clinical history of coexistent allergic disease.
Original article: Atopy and asthma in rural Poland: a paradigm for the emergence of childhood respiratory allergies in Europe
Authors: Sozanska B. , MacNeill S. J. , Kajderowicz‐Kowalik M. , Danielewicz H. , Wheatley M. , Newman Taylor A. J. , Boznanski A. , Cullinan P.
Published: March 2007

Background:  We hypothesized that, in south‐west Poland, a ‘rural’ protective effect on atopy and respiratory allergies would be most pronounced among children but that at all ages would be stronger among those with a rural background.

Methods:  A cross‐sectional survey of the inhabitants (age >5 years, n = 1657) of Sobotka, a town of 4000 people in south‐west Poland: and seven neighbouring villages. We measured and analysed responses to skin prick tests (atopy) and to a standard questionnaire (asthma and hayfever).

Results:  Atopy was very uncommon (7%) among villagers at all ages but not among townspeople (20%, P < 0.001); the differences were most marked among those aged under 40 years. Asthma and hayfever were similarly distributed, both being very rare among villagers. The differences appear to be explained by the cohort effect of a communal move away from rural life. This interpretation is supported by an ecological correlation (ρ = −0.59) between rural populations and childhood wheeze in 22 European countries.

Conclusion:  The very striking differences in the prevalence of allergy between these two neighbouring communities of central Europe reflect the pan‐continental population movements that may have been responsible for the emergence of childhood allergies in Europe.
Volatile organic compounds emissions in Norway spruce (Picea abies) in response to temperature changes
Authors: Filella Iolanda , Wilkinson Michael J , Llusià Joan , Hewitt C. Nicholas , Peñuelas Josep
Published: March 2007

Volatile organic compound (VOC) emissions from Norway spruce (Picea abies) saplings were monitored in response to a temperature ramp. Online measurements were made with a proton transfer reaction – mass spectrometer under controlled conditions, together with plant physiological variables. Masses corresponding to acetic acid and acetone were the most emitted VOCs. The emission rates of m137 (monoterpenes), m59 (acetone), m33 (methanol), m83 (hexanal, hexenals), m85 (hexanol) and m153 (methyl salicylate, MeSa) increased exponentially with temperature. The emission of m61 (acetic acid) and m45 (acetaldehyde), however, increased with temperature only until saturation around 30°C, closely following the pattern of transpiration rates. These results indicate that algorithms that use only incident irradiance and leaf temperature as drivers to predict VOC emission rates may be inadequate for VOCs with lower H, and consequently higher sensitivity to stomatal conductance.
Water uptake and distribution in germinating lupine seeds studied by magnetic resonance imaging and NMR spectroscopy
Authors: Garnczarska Małgorzata , Zalewski Tomasz , Kempka Marek
Published: March 2007

Magnetic resonance imaging (MRI) was used to study temporal and spatial water uptake and distribution in germinating lupine (Lupinus luteusL.) seeds. During 24 h of imbibition, water was unevenly distributed within the seed and some anatomical parts were more hydrated than others. Water entered the seed through the hilum and micropyle. The embryonic axis was the first to show hydration followed by seed coat and later cotyledons. The changes in water status were characterized by NMR spectroscopy. Analyses of T2relaxation times revealed a three‐component water proton system (structural, intracellular and extracellular water) in germinating lupine seeds. The data on the components of transverse relaxation time studies indicated the complex exchange processes taking place between water components inside lupine seed over first 2.5 h of hydration, with a distinguished increase in structural water and decrease in other components. This speaks in favor of the high water‐absorbing capacity of lupine seeds as related to high protein content. Germination was accompanied by swelling of protein bodies and changes in the organization of stored reserves with gradual disappearance of protein from the cells.
Invasion and fixation of sex‐reversal genes
Authors: VUILLEUMIER S. , LANDE R. , VAN ALPHEN J. J. M. , SEEHAUSEN O.
Published: March 2007

We simulated a meta‐population with random dispersal among demes but local mating within demes to investigate conditions under which a dominant female‐determining gene W, with no individual selection advantage, can invade and become fixed in females, changing the population from male to female heterogamety. Starting with one mutant W in a single deme, the interaction of sex ratio selection and random genetic drift causes W to be fixed among females more often than a comparable neutral mutation with no influence on sex determination, even when YY males have slightly reduced viability. Meta‐population structure and interdeme selection can also favour the fixation of W. The reverse transition from female to male heterogamety can also occur with higher probability than for a comparable neutral mutation. These results help to explain the involvement of sex‐determining genes in the evolution of sex chromosomes and in sexual selection and speciation.
Embryonic Loss in Sows with Repeated Propensity for Small Litter Size
Authors: Geisert RD , Sasakia S , Clutter AC
Published: March 2007

Contents

Information is lacking as to the timing and cause of sows that repeatedly have low litter size over several parities. Sows evaluated for the present study had at least two parities either small ≤7 (SL) or normal ≥12 (NL) litter size. Following breeding of sows with contemporary boars, reproductive tracts were obtained on day 30 of gestation. There was no difference (p > 0.10) between SL and NL sows in the number of CL, embryo weight or placental length. The total number of embryos and embryonic survival tended to be lower (p < 0.10) in SL sows compared with NL sows, but there were 5.1 less viable embryos (p < 0.03) in SL. Results indicate that time of conceptus loss in SL sows was variable throughout gestation.
Secondary obsessive‐compulsive disorder related to diaschisis after pontine infarction, successfully treated with paroxetine
Authors: MATSUI TOKUZO , SAXENA SANJAYA , KAWABE JOJI , MATSUNAGA HISATO , KOHAGURA KAORU , HIGASHIYAMA SHIGEAKI , KIRIIKE NOBUO
Published: March 2007

Abstract  This report describes a case of secondary obsessive‐compulsive disorder related to diaschisis after pontine infarction. A 71‐year‐old male developed obsessive images, after a pontine infarction. A brain magnetic resonance imaging scan showed a low intensity area in the right pons on T1‐weighted image, while brain single photon emission computed tomography showed low cerebral blood flow in the temporal lobe as well as the pons. In this case, infarction in the pons appeared to cause dysfunction in the temporal lobe via the neural projection network, an example of so‐called ‘diaschisis’. This case suggests that brainstem infarction and decreased temporal lobe perfusion can lead to secondary obsessive‐compulsive disorder.
Long‐term study of dry matter allocation and rhizome growth in Anemone nemorosa
Authors: PHILIPP MARIANNE , PETERSEN PETER MILAN
Published: March 2007

The rhizome system of Anemone nemorosa in a beech forest in Denmark was studied to determine how resources (dry matter) are allocated to segments of different age, and how rhizome growth is influenced by temperature and precipitation in the spring. The allocation pattern was studied by regular sampling and by experiments. In early spring, almost all movable resources in 1–4‐year‐old rhizome segments are used for development of leaves and flowers. Later, photosynthetic products from the above‐ground parts are used for the growth of new segments (one‐third to one‐quarter of the resources allocated to the rhizome) or stored in segments from previous years (two‐thirds to three‐quarters of the resources). Thus, A. nemorosa uses the rhizome tissue for storage several times. Maximum and minimum dry weight per unit length (DWUL) was remarkably constant in 1–4‐year‐old rhizome segments. The DWUL of the current year’s segments was half as high as that of the older segments. The differences in dry matter production across years were expressed in differences in segment length and branching, not in the DWUL of rhizomes. Unusually severe drought in the spring had a negative effect on rhizome growth, although a significant correlation between spring precipitation and rhizome growth was not detected. We found a negative correlation between the length of the growing period in spring and segment length, suggesting that a future increase in winter temperatures may cause an increase in rhizome growth.
Amplified fragment length polymorphism analysis of the genetic variation of an endangered plant Lysimachia tashiroi (Myrsinaceae)
Authors: NAKAZAWA MIYUKI , YAHARA TETSUKAZU
Published: March 2007

Lysimachia tashiroi Makino (Myrsinaceae) is an endangered perennial herb growing in moist places along riverbanks in restricted localities of Kyushu, Japan. The largest population known to date is located in Gokayama and is under threat of extinction because of the planned construction of a dam. To develop a conservation plan of the riverbank population of L. tashiroi in Gokayama, we examined genetic variation in the population using amplified fragment length polymorphisms (AFLPs). A related and widespread species, L. japonica, was included in the analysis. A total of 733 AFLP fragments were obtained from 73 accessions. An amova for L. tashiroi showed that within‐population and between‐population variability were 62% and 38%, respectively. In addition, genetic variability was higher in L. tashiroi than in L. japonica. These results are unexpected because plants of L. tashiroi propagate vegetatively and seed fertility is very low in the Gokayama population. Based on our findings, we suggest that as many genets as possible should be transplanted to appropriate habitats neighboring the dam construction area.
11C‐Choline positron‐emission tomography/computed tomography and transrectal ultrasonography for staging localized prostate cancer
Authors: Rinnab Ludwig , Blumstein Norbert M. , Mottaghy Felix M. , Hautmann Richard E. , Küfer Rainer , Hohl Kathrin , Reske Sven N.
Published: March 2007

OBJECTIVE

To evaluate and compare the role of 11C‐choline positron emission tomography (PET) and transrectal ultrasonography (TRUS) in the preoperative staging of clinically localized prostate cancer.

PATIENTS AND METHODS

Fifty‐five consecutive patients with biopsy‐confirmed prostate cancer had TRUS and 11C‐choline PET as a part of their clinical staging programme before radical retropubic prostatectomy (RP). The PET images were prospectively interpreted by a consensus decision of two nuclear medicine physicians and one radiologist with special expertise in the field. The TRUS was done by one experienced urologist. The criteria evaluated prospectively in each patient were extracapsular extension (ECE), seminal vesicle invasion (SVI) and bladder neck invasion (BNI). The results were compared with the histopathological findings after RP.

RESULTS

At pathology, 32 patients were classified pT2, 16 as pT3a and three had pT3b lesions. In four patients the histopathological examination showed pT4 with BNI. The overall accuracy of PET in defining local tumour stage (pT2 and pT3a−4) was 70%; the overall accuracy by TRUS was 26%. PET was more sensitive than TRUS for detecting ECE (pT3a) and SVI (pT3b) in advanced stages, and in pT4 stages. The sensitivity and positive predictive value (PPV) (95% confidence interval) in stages pT3a–pT4 for PET were 36 (17–59)% and 73 (39–89)%. The sensitivity and PPV in stages pT3a–pT4 for TRUS were 14 (3–35)% and 100 (29–100)%.

CONCLUSIONS

11C‐choline PET and TRUS tended to understage prostate cancer. This series shows the current limited value of TRUS and PET for making treatment decisions in patients with clinically localized prostate cancer, especially if a nerve‐sparing RP is considered. Treatment decisions should not be based on TRUS and 11C‐choline PET findings alone. In future studies, the combination of metabolic and anatomical information of PET and endorectal magnetic resonance imaging should be evaluated, as this might optimize the preoperative staging in prostate cancer.
Dysregulation of cGMP‐dependent protein kinase 1 (PKG‐1) impairs erectile function in diabetic rats: influence of in vivo gene therapy of PKG1α
Authors: Bivalacqua Trinity J. , Kendirci Muammer , Champion Hunter C. , Hellstrom Wayne J.G. , Andersson Karl‐Erik , Hedlund Petter
Published: March 2007

OBJECTIVES

To investigate the expression of cGMP‐dependent protein kinase 1 (PKG1)α and PKG1β in the corpus cavernosum, and to evaluate the effect of adenoviral gene transfer of PKG1α to the erectile compartment on erectile function in a rat model of diabetes.

MATERIALS AND METHODS

Diabetic (DM; induced by streptozotocin) male Sprague Dawley rats were transfected with adenoviruses (AdCMVβgal or AdCMVPKG1α, in 10 rats each) 2 months after the induction of DM. Intracavernosal pressure (ICP) during stimulation of the cavernosal nerve (CN) was assessed, and compared with mean arterial pressure (MAP). Erectile tissue was harvested for Western blot analysis, immunohistochemistry and total PKG activity. Ten age‐matched rats without DM served as the control.

RESULTS

Compared to controls, AdCMVβgal‐transfected DM rats had significantly lower peak ICP responses, ICP/MAP ratios, and filling rates during CN stimulation. In DM rats transfected with AdCMVPKG1α, peak ICP, ICP/MAP ratios and filling rates were significantly better than in DM rats transfected with the reporter gene. As assessed by Western blot and immunohistochemistry, expression of PKG1α and PKG1β was lower in corporal tissue from DM AdCMVβgal‐transfected rats than in controls. PKG1α expression was improved after AdCMVPKG1α gene therapy. Total PKG activity was lower in DM rat corporal tissue than in controls, and PKG1α gene transfer significantly improved DM corporal PKG activity to a value greater than in the control.

CONCLUSION

PKG1α and PKG1β activities are reduced in the erectile tissue of the diabetic rat, and gene transfer of PKG1α to the penis restored PKG activity and erectile function in vivo in diabetic rats. Gene therapy procedures targeting PKG1α might be an interesting future therapeutic approach to overcome diabetic erectile dysfunction resistant to oral pharmacotherapy.
Contrast‐enhanced ultrasonography in the follow‐up of cryoablation of renal tumours: a feasibility study
Authors: Wink Margot H. , Laguna M. Pilar , Lagerveld Brunolf W. , De La Rosette Jean J.M.C.H. , Wijkstra Hessel
Published: March 2007

OBJECTIVE

To determine whether evaluating perfusion patterns with contrast‐enhanced ultrasonography using contrast‐pulse sequence imaging (CPS; a new imaging method that enables selective visualization of perfusion) is possible at different times after cryoablation of renal tumours, and to describe the characteristics of CPS in a small group of patients.

PATIENTS AND METHODS

The efficacy of renal cryoablation is mainly judged using imaging. Seven randomly selected patients, each at a different time after laparoscopically assisted cryoablation of a renal tumour, were investigated with CPS and a microbubble‐contrast agent. The perfusion characteristics in the lesions were scored by two investigators and described, and the lesions were measured.

RESULTS

In the seven patients treated with cryoablation for small renal tumours, eight CPS studies were performed. Five lesions showed no enhancement and one lesion, investigated 18 months after treatment was not recognized. In one patient, no enhancement was seen after 1 month but 7 months later, there were minimal contrast signals inside the treated area. The lesions could be measured with a mean standard deviation of 1.1 mm and a mean difference between the two investigators of 0.7 mm.

CONCLUSION

Our first experiences with CPS imaging for the follow‐up of renal cryoablation show that this technique can be used to characterize perfusion defects at different times after cryoablation.
Radiotelemetered urodynamics of obstructed ovine fetal bladders: correlations with ex vivo cystometry and renal histopathology
Authors: Farrugia Marie‐Klaire , Woolf Adrian S. , Fry Christopher H. , Peebles Donald M. , Cuckow Peter M. , Godley Margaret L.
Published: March 2007

OBJECTIVE

To test the hypothesis that fetal bladder outlet obstruction (BOO) in sheep causes abnormal urodynamics correlating with the initiation of renal pathology, as most boys with posterior urethral valves (PUV) have bladder dysfunction when assessed after birth.

MATERIALS AND METHODS

Male ovine fetuses at 94 days of gestation were assigned to BOO (four) or sham control (five) groups. In BOO fetuses, radiotelemetry catheters were inserted transurachally and intraperitoneally, and the urethra was partly occluded. In two sham controls catheters were inserted directly through the bladder wall; the remaining three had sham surgery only. Radiotelemetered cystometry was recorded daily where possible. At the end of the experiment (9 days), ex vivo cystometry, bladder contractility studies and renal tract histology were assessed.

RESULTS

Ultrasonography showed dilated renal tracts only in BOO fetuses; three of four BOO fetuses had renal cortical cysts. The control fetuses with bladder catheters died in utero, so urodynamics were recorded only in fetuses with BOO. The baseline filling/storage detrusor pressures increased slightly (by a mean of 5 mmHg) during the first 4 days of BOO, thereafter returning to those at the outset. There were marked changes in the patterns of bladder activity from 1 to 9 days. The frequency and duration of ‘voiding’ increased; as such the higher sustained pressures of emptying activity were progressively extended and the periods of low pressure filling/storage accordingly shortened. The patterns among individual fetuses with BOO were not substantially different, except that the one with the non‐cystic kidneys had a more moderate frequency and duration of voiding. Ex vivo compliance and contractility showed no consistent differences in detrusor compliance or contractility between BOO and sham bladders.

CONCLUSION

In this fetal model of PUV, there was a progressive increase in the duration and frequency of sustained elevated ‘voiding’ pressures, with no change in bladder compliance. Fetal kidneys were sensitive to these altered dynamics, with the formation of cortical cysts by 9 days after initiating BOO.
Different prostate‐specific antigen assays give different results on the same blood sample: an obstacle to recommending uniform limits for prostate biopsies
Authors: Stephan Carsten , Kramer Jürgen , Meyer Hellmuth‐Alexander , Kristiansen Glen , Ziemer Sabine , Deger Serdar , Lein Michael , Loening Stefan A. , Jung Klaus
Published: March 2007

OBJECTIVE

To show the effect of different results for total prostate specific antigen (tPSA) and percentage free/total PSA (%fPSA) obtained with different assays for differentiating between benign and malignant prostate diseases.

PATIENTS AND METHODS

Data were used for tPSA and fPSA levels from 596 patients with prostate cancer (314) or no evidence of cancer (282) within the PSA range 0.5–10 ng/mL, analysed with assays from Abbott (AxSYM), Beckman Coulter (Access), DPC (Immulite 2000), and Roche (Elecsys 2010), and with tPSA and complexed PSA (cPSA) assays from Bayer (ADVIA Centaur), as already reported. Receiver operating characteristics (ROC), specificities at assay‐dependent and fixed thresholds, and the percentages of correct classification rates of patients were calculated.

RESULTS

Whereas the areas under the ROC curves were no different among all tPSA assays, the assay‐specific thresholds at 90% sensitivity were 2.5–3.1 ng/mL. When using fixed 2.5 or 4 ng/mL tPSA thresholds there was a wide sensitivity range, with significant differences among almost all assays, resulting in significantly different classification rates of patients. These differences were even larger when using fixed %fPSA thresholds.

CONCLUSIONS

The current situation of differences among PSA values measured with different assays do not allow the recommendation of uniform PSA limits as biopsy criteria. For that purpose, better harmonization of PSA values between the different PSA test systems must be realized.
Penile size and the ‘small penis syndrome’
Authors: Wylie Kevan R. , Eardley Ian
Published: March 2007

The male is often troubled by concerns that his penis is not large enough to satisfy his partner or himself. He is ashamed to have others view his penis, especially in the flaccid state. Such concerns might be unfounded in reality and might be a presentation of social anxiety or some other clinical problem, such as erectile dysfunction. Concern over the size of the penis, when such concern becomes excessive, might present as the ‘small penis syndrome’, an obsessive rumination with compulsive checking rituals, body dysmorphic disorder, or as part of a psychosis. However, it is often a worry that can be described as within the normal experience of many men. Various potential causal factors are considered. A thorough assessment, normalizing the worry and then exploring the treatment options in detail with the man, is essential to allow the matter to be consolidated satisfactorily within the male ego.
Economic conditions and marriage quality of men with prostate cancer
Authors: Sunny Lizzy , Hopfgarten Thomas , Adolfsson Jan , Steineck Gunnar
Published: March 2007

OBJECTIVE

To explore the predictors of the quality of marriage of men with prostate cancer, as being diagnosed with prostate cancer affects the quality of life of the man and his partner, and while some aspects are known about the impact of the disease and its treatments on the man’s quality of life, less is known about the marriage quality (MQ) in this new situation.

PATIENTS AND METHODS

We followed 591 men from Stockholm County (Sweden) who had been diagnosed with prostate cancer in 1999, and who were 50–80‐years old and alive on 1 October 2002. The men completed a questionnaire asking about their MQ, and several other sociodemographic, medical and economic characteristics.

RESULTS

Of 426 men who provided information and who had a spouse or partner, 168 (39.4%) reported having a lower MQ due to their disease. Increased expenditure (46.2% vs 30.9%; relative risk, 1.5; 95% confidence interval, 1.1–2.0) and decreased income (55.4% vs 36.5%; 1.5, 1.1–2.0) as a consequence of prostate cancer reduced their MQ. Patients who had erectile dysfunction had a lower MQ (46.3% vs 11.8%; 3.9; 2.0–7.6). There was also a lower MQ in men who were depressed or had urinary leakage as a consequence of prostate cancer. Younger men (50–69 years old) with prostate cancer had a lower MQ than older men (70–80 years; 51.9% vs 33.1%; 1.6; 1.2–2.0).

CONCLUSIONS

Men whose economic situation is worsened by prostate cancer reported having a reduced MQ. There was also such an effect for men with erectile dysfunction, urinary leakage and depression, and among men diagnosed with prostate cancer when young.
Accelerating progress on salt iodisation in Sudan: time for action
Authors: Bani Ibrahim
Published: March 2007

This paper uses a public health approach to examine briefly: (a) the progress of universal salt iodisation (USI) in Sudan; (b) the roles of the main actors involved; and (c) the main issues around accelerating USI. The literature, especially that coming from the UN agencies, is analysed and experiences from the recently revitalised USI programme, and related relevant meetings, are distilled. In Sudan the prevalence of goitre is 22 per cent. It is assumed that productivity among the people affected is reduced by 5–25 per cent. Little apparent progress has been made with USI. The Government of Sudan, UN multilateral agencies, international consultative groups, bilateral agencies, global and national non‐governmental organisations and, increasingly, the private sector must work together to find innovative approaches to increase awareness of the broader social, public health and nutritional contexts, and to advocate for increased national nd international funding.
Numerical Model for Biaxial Earthquake Response of Reinforced Concrete
Authors: Dönmez Cemalettin , Sözen Mete A.
Published: March 2007

Abstract:  A numerical constitutive model is developed to simulate the biaxial nonlinear flexural response of slender reinforced concrete members subjected to earthquake excitation. The model is tested using data from two types of experiments with reinforced concrete elements: (1) elements subjected to varying pseudo‐static biaxial lateral loads and (2) elements that responded biaxially to simulated earthquake motions. The goal for the model was not only to help determine the absolute maxima for earthquake response but also to enable calculation of the entire waveform, including the ranges of low‐ and moderate‐amplitude response. The comparisons of measured and calculated results and sensitivity of the proposed model to variations in the input parameters are discussed. The output was found to be insensitive to the changes in input parameters related to concrete and sensitive to input parameters related to reinforcing steel. The results of the calculations were tested using experimental data.
Numerical Treatment of Seismic Accelerograms and of Inelastic Seismic Structural Responses Using Harmonic Wavelets
Authors: Spanos Pol D. , Giaralis Agathoklis , Politis Nikolaos P. , Roesset Jose M.
Published: March 2007

Abstract:  The harmonic wavelet transform is employed to analyze various kinds of nonstationary signals common in aseismic design. The effectiveness of the harmonic wavelets for capturing the temporal evolution of the frequency content of strong ground motions is demonstrated. In this regard, a detailed study of important earthquake accelerograms is undertaken and smooth joint time‐frequency spectra are provided for two near‐field and two far‐field records; inherent in this analysis is the concept of the mean instantaneous frequency. Furthermore, as a paradigm of usefulness for aseismic structural purposes, a similar analysis is conducted for the response of a 20‐story steel frame benchmark building considering one of the four accelerograms scaled by appropriate factors as the excitation to simulate undamaged and severely damaged conditions for the structure. The resulting joint time‐frequency representation of the response time histories captures the influence of nonlinearity on the variation of the effective natural frequencies of a structural system during the evolution of a seismic event. In this context, the potential of the harmonic wavelet transform as a detection tool for global structural damage is explored in conjunction with the concept of monitoring the mean instantaneous frequency of records of critical structural responses.
Dynamic Stiffness Matrices for Analyses in the Frequency Domain
Authors: Dai Wentao , Yu Chih Peng , Roesset Jose M.
Published: March 2007

Abstract:  A number of studies conducted after the Northridge and the Kobe earthquakes suggested the existence of important axial dynamic effects in the piers due to the vertical accelerations and indicated that these effects could not be properly reproduced with the usual models of Structural Dynamics, requiring instead wave propagation analyses. Although it is true that lumped mass models with a limited number of masses, or even consistent mass formulations with a small number of members, will not be able to reproduce correctly wave propagation effects, particularly for high frequencies (short wavelengths), these effects can be accurately reproduced when using a large number of masses or members, or more conveniently using a frequency domain formulation and the dynamic stiffness matrices for members with distributed mass. This article presents the detailed derivation of the dynamic stiffness matrix of a prismatic member with distributed masses (continuous mass distribution), and its application to the linear dynamic analysis of structures in the frequency domain. The formulation is then verified with a series of simple examples.
Reliability‐Based Optimal Design of Electrical Transmission Towers Using Multi‐Objective Genetic Algorithms
Authors: Mathakari Sachin , Gardoni Paolo , Agarwal Pranab , Raich Anne , Haukaas Terje
Published: March 2007

Abstract: A hybrid methodology for performing reliability‐based structural optimization of three‐dimensional trusses is presented. This hybrid methodology links the search and optimization capabilities of multi‐objective genetic algorithms (MOGA) with structural performance information provided by finite element reliability analysis. To highlight the strengths of the proposed methodology, a practical example is presented that concerns optimizing the topology, geometry, and member sizes of electrical transmission towers. The weight and reliability index of a tower are defined as the two objectives used by MOGA to perform Pareto ranking of tower designs. The truss deformation and the member stresses are compared to threshold values to assess the reliability of each tower under wind loading. Importance sampling is used for the reliability analysis. Both the wind pressure and the wind direction are considered as random variables in the analysis. The research results presented demonstrate the benefit of implementing MOGA optimization as an integral part of a reliability‐based optimization procedure for three‐dimensional trusses.
Nonlinear Static Procedure for Seismic Vulnerability Assessment of Bridges
Authors: Banerjee S. , Shinozuka M.
Published: March 2007

Abstract:  The impact of an earthquake event on the performance of a highway transportation network depends on the extent of damage sustained by its individual components, particularly bridges. Seismic damageability of bridges expressed in the form of fragility curves can easily be incorporated into the scheme of risk analysis of a highway network under the seismic hazard. In this context, this article focuses on a nonlinear static method of developing fragility curves for a typical type of concrete bridge in California. The method makes use of the capacity spectrum method (CSM) for identification of spectral displacement, which is converted to rotations at bridge column ends. To check the reliability of this current analytical procedure, developed fragility curves are compared with those obtained by nonlinear time history analysis. Results indicate that analytically developed fragility curves obtained from nonlinear static and time history analyses are consistent.
An Integrated Fuzzy Control System for Structural Vibration
Authors: Nomura Yasutoshi , Furuta Hitoshi , Hirokane Michiyuki
Published: March 2007

Abstract: Recently, numerous studies of structural control systems of civil structures and infrastructure have been carried out. To develop structural control systems, it is necessary to consider their special features such as complexity, uncertainty, and size. To consider these features, fuzzy theory has been applied to structural control systems. This study proposes an integrated fuzzy active control system based on fuzzy ensemble learning. It combines several fuzzy active control systems and improves structural vibrations caused by earthquakes. The proposed method includes two fuzzy active control systems, a fuzzy ensemble system, and a gating network. In this study, two fuzzy active control systems are constructed by applying particle–swarm optimization. The fuzzy ensemble system assigns a performance grade to each fuzzy active control system according to control effects from input patterns. The gating network determines the final control force based on the weight of their performance grade. By introducing fuzzy ensemble learning, the structural response is reduced more than when the response is controlled by individual fuzzy active control systems.
The Impacts of Home‐Based Early Behavioural Intervention Programmes on Families of Children with Autism
Authors: Trudgeon Clare , Carr Deborah
Published: March 2007

Background  In the UK, Early Intensive Behavioural Intervention [EIBI] programmes typically are conducted within the homes of children with autism. Despite evidence for their effectiveness in producing appreciable developmental gains in children with autism, a concern expressed about EIBI programmes is that stressful effects from the high levels of demand they place on family resources could undermine their effectiveness [The Effectiveness of Early Interventions for Children with Autistic Spectrum Disorders (ASD). A report for the DfES South East Regional Special Educational Needs Partnership. SERSEN Website, 2004]. This study investigates the positive impacts and the stressors experienced by families running EIBI programmes.

Method  Sixteen parents from nine different families participated in semi‐structured qualitative interviews on their experiences of running a home‐based EIBI programme. Data were analysed using the Grounded Theory process.

Results  Positive and negative impacts of the programmes were reported. Analysis indicated that sources of support obtained through the programmes’ benefits offset sources of stress through the programmes’ demands.

Conclusions  The interaction between programme demands and benefits and the resources available to each family strongly influences the impact of running a home‐based EIBI programme.
Modified Overt Aggression Scale (MOAS) for People with Intellectual Disability and Aggressive Challenging Behaviour: A Reliability Study
Authors: Oliver P. C. , Crawford M. J. , Rao B. , Reece B. , Tyrer P.
Published: March 2007

Background  Reliable measures of aggressive challenging behaviour are required if interventions aimed at reducing this behaviour among people with intellectual disability (ID) are to be formally evaluated. The present authors examined the reliability of the Modified Overt Aggression Scale (MOAS), an instrument not yet formally tested in those with ID, in a sample of people who participated in a randomized trial of neuroleptic medication for aggressive challenging behaviour.

Method  Sixty interviews using the MOAS were carried out by two interviewers 2–5 days apart with 23 carers of 14 people who had shown aggressive challenging behaviour. Level of agreement between these two ratings was examined for four subscales of aggression and for total MOAS score.

Results  The level of agreement between the raters was high for verbal aggression (intraclass correlation coefficient, ICC = 0.90), physical aggression against others (ICC = 0.90) and for total MOAS score (ICC = 0.93). Levels of agreement on the other two subscales were lower but still in the good/moderate range.

Conclusion  The MOAS provides a reliable measure of verbal and physical aggression among people with ID who reside in community settings and is suitable for use in studies evaluating the effectiveness of interventions aimed at reducing aggressive challenging behaviour in this group.
Effects of aneuploidy on skull growth in a mouse model of Down syndrome
Authors: Hill Cheryl A. , Reeves Roger H. , Richtsmeier Joan T.
Published: March 2007

Adult craniofacial morphology results from complex interactions among genetic, epigenetic and environmental factors. Trisomy causes perturbations in the genetic programmes that control development and these are reflected in morphology that can either ameliorate or worsen with time and growth. Many of the specific changes that occur in Down syndrome can be studied in the Ts65Dn trisomic mouse, which shows direct parallels with specific aspects of adult craniofacial dysmorphology associated with trisomy 21. This study investigates patterns of craniofacial growth in Ts65Dn mice and their euploid littermates to assess how the adult dysmorphology develops. Three‐dimensional coordinate data were collected from microcomputed tomography scans of the face, cranial base, palate and mandible of newborn (P0) and adult trisomic and euploid mice. Growth patterns were analysed using Euclidean distance matrix analysis. P0 trisomic mice show significant differences in craniofacial shape. Growth is reduced along the rostro‐caudal axis of the Ts65Dn face and palate relative to euploid littermates and Ts65Dn mandibles demonstrate reduced growth local to the mandibular processes. Thus, the features of Down syndrome that are reflected in the mature Ts65Dn skull are established early in development and growth does not appear to ameliorate them. Differences in growth may in fact contribute to many of the morphological differences that are evident at birth in trisomic mice and humans.
Monitoring obstetricians’ performance with statistical process control charts
Authors: Lane S , Weeks A , Scholefield H , Alfirevic Z
Published: March 2007

Objective  The main objective of this study was to pave the way towards proactive, continuous assessment of individuals and hospitals by demonstrating the application of evidence‐based competency standards in maternity care using statistical performance monitoring.

Design  Retrospective study using data routinely collected by a large maternity hospital.

Setting  A large teaching hospital.

Population  Clinicians who routinely perform either amniocentesis or ventouse deliveries.

Method  As a ‘proof of principle’, we have used statistical process control (SPC) charts to compare the observed complication rates for amniocentesis and ventouse delivery with the expected complication rates based on published data.

Main outcome measures  The recorded complication rates for aminocentesis and ventouse delivery.

Results  The SPC charts identified significant variation in complication rates within the team and showed the ways in which prospective data can be used to provide continuous feedback to individuals on their performance.

Conclusion  The study shows that statistical performance monitoring and, in particular, the use of control charts can be a valuable tool in the continuous assessment of individuals and the healthcare service being provided. The control charts provide a more immediate indication of current performance and provide an alternative to performance‐based league tables for the presentation of yearly performance data.
Short communication: The complications of external cephalic version: results from 805 consecutive attempts
Authors: Collins S , Ellaway P , Harrington D , Pandit M , Impey LWM
Published: March 2007

Most breech babies at term are now delivered by caesarean section. Although external cephalic version reduces the number of term breech presentations, its uptake has not been as wide as is recommended by professional bodies. This may be because of fears over safety. Pooled safety data do exist, largely from case series. However, the possibility of reporting and publication biases in such studies maybe preventing both women and obstetricians from being adequately reassured. In this series of 805 consecutive version attempts, we report an extremely low complication rate and 0.5% risk of emergency caesarean section after the procedure.
Short communication: Termination of pregnancy for fetal anomaly: a population‐based study 1995 to 2004
Authors: Wyldes MP , Tonks AM
Published: March 2007

Terminations of pregnancy for fetal anomaly (TOPFAs) were analysed over a 10‐year period from a population‐based congenital anomaly register covering 646 342 births. A total of 3189 cases of TOPFA were identified, prevalence of 49.3 per 10 000 registerable births. The rate of TOPFA at all gestations and at less than 16 weeks increased significantly. There were 102 cases of liveborn TOPFAs (3.2%). The proportion of liveborn TOPFAs after 22 weeks of gestation decreased significantly but below 22 weeks remains unchanged. TOPFA is increasing in frequency, occurring earlier in pregnancy. Live birth is a possible important outcome.
Does hormone replacement therapy affect the use of prescription medicines in postmenopausal women: experience from the Estonian Postmenopausal Hormone Therapy Trial [ISRCTN35338757]
Authors: Veerus P , Fischer K , Hovi S‐L , Karro H , Hemminki E
Published: March 2007

Objective  To determine how postmenopausal hormone therapy (HRT) is related to the use of other prescription medication.

Design  Follow up of a randomised controlled trial with a blind subtrial of hormone therapy versus placebo and a nonblind subtrial of open label hormone therapy versus nontreatment.

Population  A total of 1823 postmenopausal women aged 50–64 at the time of sampling participated in the trial from 1999 to 2004.

Methods  Use of prescription medication was identified by records in the central computerised database of the Estonian Health Insurance Fund.

Main outcome measures  The use of 21 classes of prescription medication was compared in the hormone therapy arms and placebo or nontreatment trial arms. The influence of women’s socio‐economic characteristics on the intensity of concomitant medication use was also examined.

Results  The proportion of women using any prescription medication besides hormone therapy did not differ between the arms. However, the type of prescribed drugs varied between the arms. After combining data from both hormone therapy arms, for women using HRT the combined hazard ratio was 1.26 (95% CI: 1.05–1.53) for the use of calcium channel blockers, 1.48 (95% CI: 1.10–1.99) for local vaginal treatment, 0.70 (95% CI: 0.50–0.99) for hypnotics and sedatives and 0.77 (95% CI: 0.60–0.99) for selective serotonin reuptake inhibitors (SSRIs). Women who were older, who had a higher body mass index, who were unemployed and who lived outside the capital used more prescription drugs in comparison with others.

Conclusions  Hormone therapy did not increase the overall use of prescription medication other than hormone therapy, but the types of drugs used in hormone therapy and nontherapy arms varied, with increased use of calcium channel blockers for hypertension and local vaginal treatments for vaginal candidiasis and decreased use of hypnotics, sedatives and SSRIs in the HRT arms.
Association of caesarean delivery for first birth with placenta praevia and placental abruption in second pregnancy
Authors: Yang Q , Wen SW , Oppenheimer L , Chen XK , Black D , Gao J , Walker MC
Published: March 2007

Objective  To quantify the risk of placenta praevia and placental abruption in singleton, second pregnancies after a caesarean delivery of the first pregnancy.

Design  Retrospective cohort study.

Setting  Linked birth and infant mortality database of the USA between 1995 and 2000.

Population  A total of 5 146 742 singleton second pregnancies were available for the final analysis after excluding missing information.

Methods  Multiple logistic regressions were used to describe the relationship between caesarean section at first birth and placenta praevia and placental abruption in second‐birth singletons.

Main outcome measures  Placenta praevia and placental abruption.

Results  Placenta praevia was recorded in 4.4 per 1000 second‐birth singletons whose first births delivered by caesarean section and 2.7 per 1000 second‐birth singletons whose first births delivered vaginally. About 6.8 per 1000 births were complicated with placental abruption in second‐birth singletons whose first births delivered by caesarean section and 4.8 per 1000 birth in second‐birth singletons whose first births delivered vaginally. The adjusted odds ratio (95% CIs) of previous caesarean section for placenta praevia in following second pregnancies was 1.47 (1.41, 1.52) after controlling for maternal age, race, education, marital status, maternal drinking and smoking during pregnancy, adequacy of prenatal care, and fetal gender. The corresponding figure for placental abruption was 1.40 (1.36, 1.45).

Conclusion  Caesarean section for first live birth is associated with a 47% increased risk of placenta praevia and 40% increased risk of placental abruption in second pregnancy with a singleton.