bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevention of Type 2 Diabetes in Childhood
Authors: Cook V.V. , Hurley J.S.
Published: November 2007

The incidence of type 2 diabetes has increased dramatically in the past decade in Pima (Akimel O'odham) children, aged 5-17 years, living in the Gila River Indian Community (GRIC). As a result, a diabetes primary prevention program called Quest was implemented in 1996 at an elementary school in the GRIC for students in kindergarten and grades 1-2. The Quest program has four components: (1) biochemical and anthropometric assessments, (2) classroom instruction about diabetes, (3) increased daily physical activity at school, and (4) a structured school breakfast and lunch program. Preliminary results of the program indicate that the school provides a stable environment for behavior change and interventions that slow weight gain in early childhood. Clin Pediatr. 1998;37:123-130
Cranial Sonography in Very-Low-Birth-Weight Infants: Do All Infants Need to Be Screened?
Authors: Paul David A. , Pearlman Stephen A. , Finkelstein Mark S. , Stefano John L.
Published: November 2007

The objective of the study was to develop clinical screening criteria to diagnose infants with intraventricular hemorrhage (IVH) and cystic periventricular leukomalacia (PVL). We performed a case-control investigation of two cohorts of very-low-birth-weight infants (n=505, combined cohorts). Univariate and multivariate analyses were performed from data obtained in cohort 1 to develop screening criteria for IVH and cystic PVL. The screening criteria were then applied to cohort 2. The screening criteria for IVH had a sensitivity of only 51 %, a specificity of 62%, a positive predictive value of 31 %, and a negative predictive value of 79%. Screening criteria for cystic PVL had a sensitivity of only 22%, a specificity of 58% a positive predictive value of 2%, and a negative predictive value of 95%. These data suggest that using clinical criteria to determine which infants should receive screening cranial sonography for IVH and cystic PVL would miss a substantial number of infants with these conditions. Clin Pediatr. 1999;38:503-509
Comparative Study of Clinical Evaluation of Heart Murmurs by General Pediatricians and Pediatric Cardiologists
Authors: Rajakumar Kumaravel , Weisse Martin , Rosas Angela , Gunel Erdogan , Pyles Lee , Neal William A. , Balian Arpy , Einzig Stanley
Published: November 2007

In a study to compare the clinical diagnostic skills of academic general pediatricians and academic pediatric cardiologists in the evaluation of heart murmurs, a total of 128 patients (aged 1 month to 18 years) newly referred to a university pediatric cardiology clinic were evaluated by one of three general pediatricians and one of four pediatric cardiologists. The murmurs were clinically classified as innocent, pathologic, or possibly pathologic. The classification was revised after the review of electrocardiogram (EKG) and chest radiograph (CXR), if indicated. The definitive diagnosis was ascertained by echocardiography (94 normal, 34 abnormal). The general pediatricians identified as many pathologic heart murmurs as the pediatric cardiologists (27/34 vs. 29/34), with no difference in sensitivity, 79% vs. 85% (p=0.53). The similarity in sensitivity could be because the general pediatricians were more cautious in the classification of heart murmurs and had classified more innocent heart murmurs as pathologic than the pediatric cardiologists (13/39 vs. 3/23), 41% vs. 13% (p=0.02). The pediatric cardiologists correctly identified more innocent murmurs than general pediatricians (52/94 vs.72/94), with a better specificity, 55% vs. 76% (p=0.001); however, the accuracy of prediction of innocence was similar for both groups (52/59 vs. 72/77), 88% vs. 93% (p=0.36). The revision of diagnosis with review of EKG and CXR was more often misleading than helpful for either group. Academic general pediatricians would identify most of the pathologic murmurs and are no more likely than an academic pediatric cardiologist to misclassify a pathologic heart murmur as innocent. Clin Pediatr. 1999;38:511-518
Health Status of Children with Special Health Care Needs: Measurement Issues and Instruments
Authors: Kozinetz Claudia A. , Warren Robert W. , Berseth Carol Lynn , Aday Lu Ann , Sachdeva Ramesh , Kirkland Rebecca T.
Published: November 2007

The methods for measuring health care outcomes and monitoring the health status of the child with a chronic health condition must be available, accessible, and meaningful. This review was evoked by this need to identify reliable and valid instruments for measuring the health status of children with special health care needs. The objectives are as follows: (1) to review the methodologic and substantive issues related to the selection of instruments and (2) to identify those instruments available currently for collecting data regarding health status of children with special health care needs. A Medline search of the literature published since 1966 through 1998 and restricted to human subjects and the English language was conducted. Indexing terms included health status, quality of life, outcome assessment, functional status, and patient satisfaction. Multiple reviewers selected instruments based on their usefulness in clinical settings as generic, disease nonspecific, child health status instruments. Few instruments were identified that can be used by pediatricians for tracking and monitoring the health status of children with special health care needs. In conclusion, to progress in the field of outcomes measurement of children with special health care needs, it will be necessary to develop new measurement tools. These instruments must (1) provide valid and reliable information on health status; (2) be useful in guiding the management of patients; and (3) not be a burden for physicians, patients, or patients' families. Clin Pediatr. 1999;38:525-533
Pre-school project: an evaluation of group therapy
Authors: Watson Sarah
Published: November 2007

The Pre-school Project on group therapy arose from the perceived needs of therapists to evaluate this part of the service across the North West Hertfordshire Health Authority. Many of the Project's aims were achieved, although small sample sizes mean that results are subjective. The study has, however, given the District a number of useful indicators to help therapists improve the service to the pre-school population. Guidelines are being drawn up concerning methods of assessment and selection, parental involvement, efficient use of therapists' time, and structuring the service of group therapy.
Feasibility of real-time transcription in the clinical setting
Authors: Klee Thomas , Membrino Irene , May Susan
Published: November 2007

This study evaluated a computer-based approach to transcription in the clinical setting: transcription done in real time. Real-time transcription entails orthographically transcribing the language produced by a child, using a computer and a standard transcription format, while the child is engaged in a conversation. Twenty-minute language samples from 20 preschool children were transcribed both in real time and from au diotape and compared on several quantitative measures of language production. On average, 90% of the words and utterances transcribed from audiotape were captured in real time, with there being no significant differences in either intelligibility or MLU between the two transcription methods.
Comparing two methods of teaching single words in context
Authors: Houston Melanie , Bachor Dan G.
Published: November 2007

'John' (a pseudonym), a six-year-old boy, has been diagnosed as multiple-handicapped. His limited language production prior to the study was not functional; he imitated sounds and words. Two techniques (imitation and focused stimulation) were introduced to help John learn to name a list of objects and actions. Using a Multiple- Treatment Design with a control condition for practice effects, the efficacy of the two treatments was compared. Although treatment effects were not immedi ate and results continued to be variable throughout the study, imitation was more effective than focused stimulation or the control condition.
Language and early mathematics — ten years on
Authors: Grauberg Eva
Published: November 2007

During the last ten years some publications have appeared which may prove helpful in dealing with the difficulties encountered by language- impaired children in learning early mathematics. A brief account is given of these publications, and some general trends are identified: changed attitudes to Piaget; interest in crosscultural studies; debate on counting; emphasis on the problems of symbolic understanding; value given to informal methods; and awareness of the role of language in mathematics. Some implications for teaching are drawn, and three books from the mainstream literature on mathematics are recommended.
'What's in the box?': assessing physically disabled children's communication skills
Authors: McConachie Helen , Ciccognani Alexandra
Published: November 2007

The paper describes a scripted elicitation procedure for assessing the communication skills of nonspeaking physically disabled children. Preliminary data are reported for 16 children attending the Communica tion Aids Centre for children, London. Functions of communication, such as requests for clarification and expression of self, were more likely to be used by children during the scripted procedure with an unfamiliar adult than when they were observed in interaction with a parent.
Multimodal therapy for a child with developmental apraxia of speech: a case study
Authors: Watson Marie May , Leahy Jane
Published: November 2007

This case study describes the speech development of a child (Edward) between the ages of 3;1 and 4;10, diagnosed with Developmental Apraxia of Speech (DAS). During that time, Edward received intensive speech and language services to facilitate his development of intelligible speech. Treatment techniques and documentation of Edward's remark able progress will be discussed. Implications of this case study for other children will also be considered.
Teachers of pupils with speech and language difficulties: outcomes of specialist courses
Authors: Miller Carol , Wright Jannet
Published: November 2007

Opportunities for teachers to undertake professional development to work with pupils with language and communication difficulties have increased recently in the UK. It is suggested that the competence to work in this field is likely to be over and above what is generally expected of teachers. This paper describes the process of agreeing what the outcomes of these courses should be.
Collaborative working within a psycholinguistic framework
Authors: Popple Jill , Wellington Wendy
Published: November 2007

In this paper we aim to show the benefits we, as speech and language therapists, have found for children with phonological disorder, includ ing dyspraxia, through working within a psycholinguistic framework in an integrated way with teachers. We aim to do this by presenting two case studies. Working together in this way not only enables the child to develop speech skills, but also the phonological skills which are necessary for the development of reading and spelling.
A sedimentary record of the deposition of heavy metals and magnetic oxides in the Loch Dee basin, Galloway, Scotland, since c. AD 1500
Authors: Williams T.M.
Published: November 2007

Geochemical analyses of a 210Pb dated piston core from Loch Dee have highlighted trends of increased Pb and Cu deposition within the catchment as early as AD 1500, probably as a consequence of local mining and smelting activity. More marked atmospheric pollutant deposition appears to have occurred in association with European industrialization after c. 1840, causing a conspicuous enhancement of Pb, Zn, Cu and magnetically detectable Fe oxide concentrations in the uppermost 8 cm of sediment. The co-variability of these contaminants through the surficial sediment suggests that they emanate from a common industrial process and the presence of magnetic oxides in cenospheric particulates implicates thermal power generation plant as a principal pollutant source. This interpretation is further supported by the temporal comparability of trace metal/magnetic oxide influxes at Loch Dee and documented records regarding European fossil fuel combustion levels over the past 150 years. The reduced heavy metal concentrations recorded in sediments deposited during the last decade may accurately chronicle falling deposition during this period, but could also reflect an increase in the efficiency with which metals have been leached from the surficial sediment as the surface waters have acidified. The accordance between the post-industrial record of sedimentary pollutant incorpora tion at Loch Dee and temporal adjustments to the diatom flora of several Galloway lochs is consistent with claims that recent acidification in the region has been a direct response to hydrocarbon-derived atmospheric deposition.
Glacial limits, climate and uplift in the Mount Meylixueshan area of Yunnan Province, China: a simulation modelling approach
Authors: Aniya Masamu , Yokoyama Kotaro
Published: November 2007

Glacial landforms in the valleys of the Shenchenbao Glacier and the Lailogoru Glacier located on the eastern side of Mount Meylixueshan (6740 m), the highest mountain in Yunnan Province, China, were investigated in the field, and terminal and lateral moraines were identified in each valley. The lowest terminal moraines in these valleys indicate that even at the glacial maximum, the glaciers extended only 2-2.5 km from the present glacier snouts, with altitudes only about 300 m or so lower, despite a snowline lowering of about 600 m during the late Pleistocene. Examination of several possible reasons to account for this limited extension led us to postulate that altitudes were not high enough to nourish glaciers much larger than those of the present. Accordingly, former glacier and topographic conditions were simulated in three steps in order to test this hypothesis, utilizing as control values the climatological data recorded at a nearby station, elevations of the lowest terminal moraines recognized in these valleys (3260 m and 2360 m) and the estimated past equilibrium line altitude of around 4300 m. The results suggest that during the last glacial maximum the mountain was indeed not as high as today, uplift having been at most about 6-700 m during the late Pleistocene and Holocene. Assuming that the maximum glaciation occurred around 50 000 BP, the average annual rate of uplift must have been at most about 12-14 mm yr-1. Although the field data have limitations, the approach is a useful one for separating climate and orogenic effects on glacier variations.
A groundwater model to explain past lake levels at Parkers Prairie, Minnesota, USA
Authors: Almendinger James E.
Published: November 2007

The response of a lake level to a shift in climate depends on characteristics of surficial and groundwater hydrology that are unique to that lake. Determination of the past levels of several lakes, rather than just one, can help provide a more precise determination of past hydrology and climate for a given region. The levels of several closed-basin lakes in the Parkers Prairie sandplain in west-central Minnesota were lowest about 7 ka. A steady-state analytic-element groundwater model was used to quantify the effect of changing regional groundwater recharge (N) on the altitude of the water table surrounding these lakes. Because overland flow on the sandplain is limited, the surficial hydrology of the lakes can be simplified to the net quantity lake evaporation minus precipitation ( E-P) . Both N and E - P were manipulated to force the model water table to coincide with the palaeolake levels. Model results indicate that lake levels at 7 ka can be explained primarily by reducing N to about 50-60 mm yr-1 (40-50% of the modern value), coupled with an E - P of about 100-400 mm yr-1 (100-400% of the modem value).
Late Holocene environments at Lake Mitsinjo, northwestern Madagascar
Authors: Matsumotot Katsumi , Burneyt David A.
Published: November 2007

Two sediment cores from Lake Mitsinjo in northwestern Madagascar were analysed for evidence of past environmental changes. The unconformities in a 503 cm core from the centre of the lake and a 306 cm core from the shore were correlated to identify a hiatus in sedimentation that occurred just before ca. 1000 BP. The 3500-year stratigraphic record was analysed for fossil pollen, charcoal, algae, organic matter, and carbonate content. Pollen stratigraphy indicates the following vegetational changes: (1) a mosaic of dry forest and grassland from ca. 3500 BP until the time the lake dried up; (2) a savanna from ca. 1000-500 BP; and (3) a highly disturbed grassland with fire-adapted trees and ruderal herbs in the last 500 years. Pollen spectra and lithologic correlation indicate that prior to the hiatus the lake experienced a highstand, and after the hiatus lake levels were lower. The lake-level changes probably reflect the local effective moisture. Pollen evidence indicates a possible human disturbance of the surrounding landscape beginning ca. 1000 BP, with a major escalation in disturbance in the last 500 years. These events coincide with archaeologically derived evidence for herding and later cultivation in the region. Algal evidence suggests cultural eutrophication in the lake began about a century ago. It would appear that both natural desiccation and anthropogenic modification of the landscape overlap temporally with some of the much-debated megafaunal extinctions that have occurred on the island in recent millennia.
Pollen evidence from tropical Australia for the onset of an ENSO-dominated climate at c. 4000 BP
Authors: Shulmeister James , Lees Brian G.
Published: November 2007

The Holocene climatic history of tropical northern Australia is re-examined using the recently published pollen record from Groote Eylandt to corroborate and refine previous climatic inter pretations. We identify a four-stage Holocene comprising: (1) a continuous increase in effective precipitation (EP) from the beginning of the Holocene to about 5000 BP; (2) a mid-Holocene EP maximum from about 5000 to about 4000 BP; (3) a marked decline in EP somewhere between 4000-3500 Bp; and (4) an EP recovery in the last <2000 years. The mid-Holocene EP maximum is 1000 years later than Holocene EP maxima from temperate Southern Australia and suggests that the records are decoupled at this time.

We focus on pollen evidence of environmental change at c. 4000 BP, which marks a break between a continuously ameliorating (increasing EP) climate but with small mean variation in the earlier Holocene and a steady (no directional trend) but highly variable later Holocene. We believe that this break represents the first evidence from the monsoonal lowlands of northern Australia for the onset of 'modern' ENSO-dominated ocean-atmosphere interactions in the Holocene. A simple conceptual model of trans-Pacific teleconnections is presented to explain this onset and as an hypothesis for testing.
The 'segment length curse' in long tree-ring chronology development for palaeoclimatic studies
Authors: Cook Edward R. , Briffa Keith R. , Meko David M. , Graybill Donald A. , Funkhouser Gary
Published: November 2007

The problem of constructing millennia-long tree-ring chronologies from overlapping segments of cross-dated ring-width series is reviewed, with an emphasis on preserving very low-frequency signals potentially due to climate. In so doing, a fundamental statistical problem coined the 'segment length curse' is introduced. This 'curse' is related to the fact that the maximum wavelength of recoverable climatic information is ordinarily related to the lengths of the individual tree-ring series used to construct the millennia-long chronology. Simple experiments with sine waves are used to illustrate this fact. This is followed by more realistic experiments using a long bristlecone pine series that is randomly cut into a number of 1000-, 500- and 200-year segments and standardized using three very conservative methods. When compared against the original, uncut series, the resulting 'chronologies' show the effects of segment length even when the most conservative and noncommittal method of tree-ring standardiza tion is applied (i.e., a horizontal line through the mean). Alternative schemes of chronology development are described that seek to exorcise the segment length curse. While they show some promise, none is universal in its applicability and this problem still remains largely unsolved.
Holocene environmental change in the inner Severn estuary, UK: an example of the response of estuarine sedimentation to relative sea-level change
Authors: Hewlett R. , Bimie J.
Published: November 2007

Holocene sediments of the wetlands around the inner Severn estuary, UK, demonstrate a consistent stratigraphy of a single woody peat layer, up to at least 4.5 m thick, capped with a grey, silty clay. The peat directly overlies sand and gravel or bedrock. This differs from the multiple peat beds and sands and gravels described from the outer estuary. The contact between the peat and clay is sharp, and the altitude of that contact is around 5 m ODN throughout the area. Fifty-eight boreholes at three principal study sites suggest that the contact decreases in altitude inland, not seawards. Palaeoecology of the sediments around the contact shows a decline in alder and rise in sedge prior to the clay deposition. There are no salt-marsh indicators, and diatoms of the clay layer, although scarce, suggest nutrient-rich, fresh or only very slightly brackish conditions for the environment of clay deposition. The change from alder fen to sedge fen, and then to standing fresh water, indicates a rising water table. The silty clay does not show a fining upwards, nor away from the river, and the sediment source is thought to be estuarine, not fluvial. A rising relative sea level eventually allowed sediment-charged tidal waters to penetrate inland across former fenland. It is proposed that the inner Severn estuary acted as a series of basins, and the expansion of the tide into each basin led to a decrease in tide height. Flooding began after 3110 BP, and was later further inland. Each basin may have been flooded fairly suddenly, accounting for the sharp contact. The topographic controls make correlation with regional sea-level curves difficult. Above the silty clay there are distinct overbank deposits, suggesting that the phase of standing, tidal water was directly succeeded by fluvial sedimentation. Reclamation of the wetlands took place during this last phase.
Reassessment of supposed early 'Little Ice Age' and older Neoglacial moraines in the Sandane area of western Norway
Authors: Matthews John A. , Nesje Atle , Dahl Svein-Olaf
Published: November 2007

Neoglacial moraines that are substantially older than the conventional 'Little Ice Age' glacier maximum of the mid-eighteenth century have been recognized recently in the Sandane area of western Norway. This is important in the context of Scandinavian Holocene glacier variations because, in southern Scandinavia at least, it is widely accepted that glaciers were larger in the mid-eighteenth century than at any time since the Preboreal. In this report we question and test the age of supposed early 'Little Ice Age' and older Neoglacial moraines in two valleys in the Sandane area. Observations and data relating to moraine morphology, licheno metry and vegetation cover are reassessed and new lines of evidence based on boulder weathering (Schmidt hammer), soil development and glaciofluvial activity are introduced. Critical appraisal of the evidence leads to the conclusion that the existence of pre- or early 'Little Ice Age' moraines, dating from the thirteenth to seventeenth centuries (or, indeed, older Neoglacial moraines) cannot be supported. In Jardalen/Fagerdalen the evidence suggests only moraines of Younger Dryas and possibly Preboreal age; in Sørsendalen we recognize, in addition, a conventional 'Little Ice Age' moraine limit in front of Blåbreen.
The development of heathland in Orkney, Scotland: pollen records from Loch of Knitchen (Rousay) and Loch of Torness (Hoy)
Authors: Bunting M.J.
Published: November 2007

Pollen records from two lake sites located in areas of modern heathland were used to reconstruct the local development of this vegetation type. A pollen record obtained from Loch of Knitchen on Rousay covered the last 6000 radiocarbon years. Betula-Corylus scrub was once locally present, although never a dominant community. Heath vegetation began to develop around 5700 BP. At about 5400 BP woodland taxa declined, possibly in response to Neolithic human activity, and heathland expanded. Calluna vulgaris increas ingly dominated the record thereafter, reflecting local blanket peat development. Data from Loch of Torness on Hoy cover the period from 7700 BP to around 4800 BP. Initial tall herb-type vegetation was replaced by a mixture of trees and heath taxa at around 7000 BP. Arboreal taxa declined at about 6000 BP, and the sub sequent record showed the development of maritime-type heath. The data show that heathland vegetation has been present in Orkney since at least 7000 BP, and that a range of causal processes have been important.
Rethinking the prehistory of hunter-gatherers, fire and vegetation change in northern Australia
Authors: Head Lesley
Published: November 2007

Different types of evidence - palaeoecological, biogeographic and ethnographic - currently provide different perspectives on the question of hunter-gatherer impacts on fire-sensitive components of northern Australian vegetation. Here I analyze the apparent discrepancies, using evidence primarily from the Holocene. Using this more substantial body of evidence than is available for earlier periods, we can attempt to do justice to both ecological and social complexity. While dry rainforest patches and wet rainforest massifs need to be considered separately, each experienced more human alteration in the late Holocene than the early to mid-Holocene. In the former case, hunter-gatherer burning protected dry rainforest from climatically induced changes in fire regime; in the latter, it contributed to disturbance. Implications for future research into hunter-gatherer relations to land are discussed. This analysis does not preclude the possibility of analogous changes having occurred during the Pleistocene.
A 5500-year proxy-climate and vegetation record from blanket mire at Talla Moss, Borders, Scotland
Authors: Chambers F.M. , Barber K.E. , Maddy D. , Brew J.
Published: November 2007

A monolith of peat taken from an upland blanket mire at Talla Moss, southern Scotland, was sub jected to peat humification and pollen analyses to produce both a proxy-climate record and a vegetational history covering the last 5500 years. While the peat showed little visible stratigraphy, with no intimation of major peat humification changes, colorimetric data indicate a markedly oscillatory climate record, which is apparently largely independent of, or out of phase with, major vegetational changes. The raw data imply particular wet shifts in climate at c. 3455 BP, c. 2600 BP, c. 1930 BP, c. 1095 BP, with a markedly wet (or cool and wet) episode commencing at c. 540 BP. (These are central age estimates, and should not be regarded as precise dates for the inferred climate shifts.) Other wet shifts apparently date from c. 3070 BP, c. 2265 BP and c. 1700 BP, although the first of these corresponds with pollen evidence for significant prehistoric human activity in the locality. Spectral analysis of the peat humification data, when expressed on an interpolated calibrated age-scale, suggests a cycle of c. 210 years; this is dependent on the accuracy of the radiocarbon chronology and should be treated with caution. The upland site is amenable to tephrochronology, which, if also applied to ombrotrophic mire sites elsewhere, might then permit more precise correlation and comparisons of proxy-climate data between sites.
The application of multidimensional scaling methods to epidemiological data
Authors: Cliff AD , Haggett P. , Smallman-Raynor MR , Stroup DF , Williamson GD
Published: November 2007

This paper illustrates the use of multidimensional scaling methods (MDS) to examine space-time patterns in epidemic data. The paper begins by outlining the principles of MDS. The model is then formally specified and illustrated by application to two data sets. The first is partly a tutorial example. It uses monthly reported measles morbidity data for the 31-year period from January 1960 to December 1990, collected for the 50 states of the USA, plus New York City and the District of Columbia. These data are used to explore the various ways in which MDS may be used to identify changing spatial patterns in geographically-coded data. In addition to their tutorial use, the data are also employed to search for any substantive changes in the geographical structure of measles epidemics in the USA that may have followed the introduction of mass vaccination in 1965. New England appears to have developed an epidemic profile distinct from the rest of the USA, and there is tentative evidence of an urban-rural split in epidemic characteristics. The second data set takes annual reported measles mortality data for New Zealand and the states of Australia from 1860 to 1949. MDS is used to show how the spatial relationships among these geographical units have changed over time in response to changes in the sizes of local susceptible populations.
Mixture distributions in human genetics research
Authors: Schork Nicholas J , Allison David B , Thiel Bonnie
Published: November 2007

The use of mixture distributions in genetics research dates back to at least the late 1800s when Karl Pearson applied them in an analysis of crab morphometry. Pearson's use of normal mixture distributions to model the mixing of different species of crab (or 'families' of crab as he referred to them) within a defined geographic area motivated further use of mixture distributions in genetics research settings, and ultimately led to their development and recognition as intuitive modelling devices for the effects of underlying genes on quantitative phenotypic (i.e. trait) expression. In addition, mixture distributions are now used routinely to model or accommodate the genetic heterogeneity thought to underlie many human diseases. Specific applications of mixture distribution models in contemporary human genetics research are, in fact, too numerous to count. Despite this long, consistent and arguably illustrious history of use, little mention of mixture distributions in genetics research is made in many recent reviews on mixture models. This review attempts to rectify this by providing insight into the role that mixture distributions play in contemporary human genetics research. Tables providing examples from the litera ture that describe applications of mixture models in human genetics research are offered as a way of acquainting the interested reader with relevant studies. In addition, some of the more problematic aspects of the use of mixture models in genetics research are outlined and addressed.
Unusual Mesenchymoma With Prominent Chondro-osseous Elements
Authors: Hollingsworth Helen C. , Pogrebniak Helen , Baker Alan R. , Merino Maria J.
Published: November 2007

A 29-year-old woman presented with a right buttock mass of 5-year duration that had recently begun to increase in size. Physical examination revealed a large, hard, mobile mass in the right buttock that was calcified on radiograph. The mass was resected, revealing a lobulated, cartilaginous, and bony mass. Histologically, the lesion exhibited areas of mature cartilage, enchondral and membranous bone formation, mature fat, vascular proliferations, and skeletal muscle—features characteristic of be nign mesenchymoma. These lesions are rare, particularly in this location. This report describes the pathologic findings in this case and reviews the literature on benign cartilage-containing mesenchymomas of soft tissue. Int J Surg Pathol 1 (2):129-134, 1993
Fine-needle Aspiration Biopsy of the Thyroid
Authors: Palestini Nicola , Papotti Mauro , Sapino Anna , Macri Luigia , Durando Riccardo , Freddi Milena , Festini-Mira Ivano , Fortunato Maria Angela
Published: November 2007

Fine-needle aspiration biopsy is of primary importance in the screening of thyroid nodules. This report summarizes the results of a 7-year personal experience, compre hensive of 1,936 biopsies from 1,881 patients with single or multiple nodules. Ade quate material was obtained in 1,862 cases (96.2%) and interpreted as "negative," "suspicious," or "positive" for malignancy. Histological assessment in 311 operated cases revealed 6 false negatives and 3 false positives. The sensitivity, specificity, and accuracy of the test were 88.0%, 98.4%, and 96.2%, respectively. The predictive value was also high. These findings offer further evidence of the reliability of fine-needle aspiration biopsy in the evaluation of thyroid nodules, especially when the procedure is performed by experienced operators and close cooperation between clinicians and pathologists is established. Int J Surg Pathol 1 (3):171-176, 1994
Mucocele-like Lesions and Mucinous Carcinoma of the Breast
Authors: Fisher Edwin R. , Palekar Alka S. , Stoner Fred , Costantino Joseph
Published: November 2007

Clinical and pathologic features of 12 examples of so-called mucocele-like lesion, mucocele-like tumor, or intraductal carcinoma with mucous leakage are recounted. Similar alterations were noted in almost one half of the pure mucinous cancers and one fifth of mixed-mucinous cancers examined. This suggests that these lesions, particularly those characterized by mucinous intraductal cancer, may represent a histogenetic spec trum with overt mucinous cancers, even though all patients in this and other studies have remained disease-free for varying periods of observation. Although overall sur vival for pure mucinous cancers was only 58% at 15 years, it was still better than that (33%) found for women of the same cohort with not otherwise specified carcinomas. There are no contraindications to treat all mammary mucinous lesions conservatively. Int J Surg Pathol 1(4):213-220, 1994
Posttransplant Lymphoproliferative Disorders
Authors: Ritter Jon H. , Wick Mark R.
Published: November 2007

Posttransplant lymphoproliferative disorders (PTLD) are an acknowledged complica tion of transplantation and immunosuppression that may be difficult to distinguish from severe rejection in small biopsy specimens. In this study we compared 19 exam ples of PTLD with 20 cases of severe rejection. Antibodies to CD20, CD43, CD45, CD45RO, MB2, Epstein-Barr virus-latent membrane protein, bcl-2 , proliferating cell nuclear antigen, cytomegalovirus early antigen, and hepatitis B surface and core anti gens were employed. The results expressed as percentage of positive cases of PTLD/ rejection, were: CD20, 89/0; CD43, 63/100; CD45, 100/100; CD45RO, 5/85; MB2, 32/0; Epstein-Barr virus-latent membrane protein, 79/0. Aberrant coexpression of CD20 and CD43 was seen in 11 cases of PTLD and no cases of severe rejection. The proliferating cell nuclear antigen index was 58% in PTLD cases, and 20% in rejection; stains for bcl-2 protein were nondiscriminatory. No examples of either process were reactive for cytomegalovirus or hepatitis B antigens. These results indicate that PTLD usually has a B-cell phenotype, often with associated necrosis, while acute rejection is a T-cell process. Expression of Epstein-Barr virus-latent membrane protein, and coexpression of CD43 and CD20 are additional attributes of PTLD. Int J Surg Pathol 2(2):105-116, 1994
Verrucous Hemangioma
Authors: Chan John K. C. , Tsang William Y. W. , Calonje Eduardo , Fletcher Christopher D. M.
Published: November 2007

Verrucous hemangioma is an uncommon variant of cutaneous hemangioma, showing characteristic clinicopathologic features. Since its formal characterization in 1967, little has been written on this entity. This report describes 10 cases to draw wider attention to this distinct hemangioma. The patients, 5 males and 5 females, were aged 6-44 years at presentation. The lesions were usually noted at birth as flat or dome-shaped reddish or bluish lesions that enlarged slowly and became verrucous. All 10 cases were located in the lower extremities. Among the six cases with follow-up information, two have recurred. Histologically, beneath the warty epidermal surface, haphazardly distributed in the dermis were vascular spaces often of cavernous size, merging into capillaries in the subcutis. In the subcutaneous tissue, the lobules of capillaries com monly merged with the adipose cells in a pseudoinfiltrative pattern. The endothelial cells were flat and nondescript, and showed variable immunoreactivity for factor VIII related antigen but showed strong staining with CD34. All the vascular channels were surrounded by complete rims of muscle-specific actin-positive pericytes. The overlying epidermis lacked evidence of human papillomavirus infection either by immunohisto chemical studies or ultrastructural examination. Thus the warty change represented a reactive phenomenon rather than a result of human papillomavirus infection. Since the lateral and deep extent of the vascular proliferation is often greater than that of the exophytic epidermal component in verrucous hemangioma, the size of the lesion is often underestimated, leading to inadequate excision and recurrence. Awareness of this entity and obtaining a complete clinical history should permit recognition of the lesion as a vascular lesion and not a primary epidermal or melanocytic lesion. Int J Surg Pathol 2(3):171-176, 1995
Beneficial Effects of Vitamin E Treatment in Acute Myocardial Infarction
Authors: Sethi Rajat , Takeda Nobuakira , Nagano Makoto , Dhalla Naranjan S.
Published: November 2007

Background: Vitamin E (Vit E), an antioxidant, is considered to prolong survival in patients and animals after myocardial infarction. Because myocardial infarction is associated with arrhythmia and heart dysfunction, this study tested the hypothesis that early treatment with Vit E reduces mortality because of its protective effects against arrhythmia and cardiac dysfunction induced by acute myocardial infarction.

Methods: Rats were randomly divided into 4 groups: sham control, myocardial infarcted, Vit E-treated sham control, and Vit E-treated infarcted animals. Myocardial infarction was induced by ligation of the left anterior descending coronary artery. Treated animals received Vit E (25 mg/kg/d) through a gastric tube beginning 1 hour after the coronary occlusion, whereas control rats received tap water.

Results: Electrocardiograms (lead II) at 1, 3, 7, and 21 days after coronary occlusion in the untreated animals showed ST-segment elevation, abnormal Q waves, premature ventricular complex (PVC), and QTc prolongation. Conversely, Vit E-treated rats showed attenuated ST-segment changes, fewer abnormal Q waves, and decreased incidence of PVC after coro nary occlusion. Total mortality was reduced from 38% to 16%, whereas the infarct size was decreased from 44.2% to 22.3% in infarcted rats treated with Vit E. The depression in left ventricular function as well as elevation of malondialdehyde content and conjugated diene formation in the 21-day infarcted rat hearts were prevented by Vit E treatment.

Conclusion: These results indicate that Vit E may exert beneficial effects on the heart by reducing oxidative stress in acute myocardial infarction.
Cardiovascular Dysfunction in Hypercholesterolemia Associated With Enhanced Formation of ATI-Receptor and of Eicosanoids
Authors: Schwemmer Michael , Sommer Olaf , Koeckerbauer Reinhold , Bassenge Eberhard
Published: November 2007

Background: In hypercholesterolemia with or without atherosclerosis cardiovascular dys function and altered signalling of angiotensin (Ang II), nitric oxide (NO), or prostanoids are intimately related to enhanced oxidant stress and concomitant changes in gene expression. We analyzed cardiac angiotensin receptor (AT1) expression and metabolism of Ang II, eicosanoids, and NO in hypercholesterolemic animals.

Methods: Guinea pigs were fed a 1% cholesterol diet for 8 weeks (Chol). Hemodynamics were analyzed in Langendorff hearts. Spectrophotometric determination of plasma lipids and radioimmunological detection of eicosanoids/cyclic guanosine monophosphate (cGMP). Ac tivities of NO synthase III (NOS-III) or angiotensin converting enzyme (ACE) were deter mined by enzymatic assays. AT1 receptor density was assessed by radioligand binding assay. NOS-III mRNAs were quantitated by reverse transcription polymerase chain reaction.

Results: Hypercholesterolemia was associated with fatty degeneration of the liver and pro found myocardial and coronary (e.g., endothelial) dysfunction. In Chol Langendorff hearts we observed significant increases in coronary flow (26.0 ± 1.0 vs. 17.5 ± 0.5 mL/min/g tissue) but diminished coronary responses to bradykinin (Bk, 250 ng bolus) or adenosine (Ado, 250 μg bolus) (ΔCPPBk/Ado: 5 ± 0.5 vs. 7.2 ± 1/0.9 ± 0. 1 vs. 1.9 ± 0.3 cm2 (area under the curve)). AT1 receptor expression was significantly increased in Chol hearts (72 ± 6.8 vs. 45 ± 5.6 fmol/mg protein), whereas marked suppression of cardiac activities of ACE (1.96 ± 0.34 vs. 4.90 ± 0.20 nmol/min/mg tissue) and of the entire cardiac nitric oxide-cGMP axis (e.g., NOS-III activity: 1.9 ± 0.4 vs. 3.1 ± 0.1 pmol/min/mg tissue; NOS-III mRNA: 0.82 ± 0.16 vs. 1.20 ± 0.12 arbitrary units; cGMP release: 0.41 ± 0.02 vs. 0.54 ± 0.04 pmol/min/g tissue) were shown in Chol. Finally, cardiac release of eicosanoids prostacyclin (PGI2) and throm boxane (TxA2) were significantly enhanced (0.48 ± 0.05 vs. 0.38 ± 0.05 and 0.60 ± 0.10 vs. 0.24 ± 0. 10 ng/min/g tissue, respectively). Enhanced cardiac PGI2 release and suppression of cGMP synthesis in Chol were even more pronounced on stimulation with Bk (38.2 ± 3.0 vs. 28.2 ± 2.0 ng/min/g tissue and 1.9 ± 0.3 vs. 3.0 ± 0.3 pmol/min/g tissue, respectively).

Conclusions: Altered angiotensin-mediated signal transduction probably related to aug mented eicosanoid formation does not compensate for the limited endogenous NO production and for cardiovascular dysfunction in hypercholesterolemic guinea pigs. In this context, changes in redox-sensitive regulation of gene expression (ATI receptor, NOS-III—caused by enhanced oxidant stress—coutd play a pivotal role.
Use of Lipid-Lowering Drugs With Acute Myocardial Infarction Patients: An Examination of Physician Prescribing Behaviors
Authors: Khan Mubina , Mukkamala Aruna , Taylor D. Kay , Espinosa Aimee , Duff Jenny
Published: November 2007

Background : Clinical trials have shown that the use of lipid-lowering agents in postmyocar dial infarction (MI) patients reduces rates of subsequent coronary events, reduces coronary artery bypass surgery rates, and improves survival. Physician decisions to prescribe lipid- lowering drugs is influenced by a number of patient factors, including age, medical history, and serum cholesterol levels. The purpose of this study was to examine physician behaviors in prescribing lipid-lowering therapy in patients after acute MI.

Methods and Results: A retrospective study was conducted at a local community-based hospital. A total of 129 patients with validated acute MI, hospitalized between January 1996 and December 1996, was included in the study sample. Variables abstracted included patient age, sex, race, primary diagnosis, medical history, lipid-lowering interventions of the discharge plan, and other discharge instructions regarding smoking cessation, activity, and dietary modification. Descriptive analysis was performed. The study showed that only 7 sub jects (8.8%) were discharged on lipid-lowcring drugs. Several patients who did not undergo therapy had either a low-density lipoprotein concentration of < 130 (n = 13), a high-density lipoprotcin concentration of >50 (n = 6), or were on hormone replacement therapy (n = 3). Dietary modification was advised in 100% of subjects (n = 54) for whom the data were included in the charts.

Conclusions: The results of this descriptive study suggests that lipid-lowering drugs are being utilized at low rates in the secondary prevention of acute MI. However, additional risk-lowering factors may play a role in the decision to discharge without drugs. Because of potential side effects associated with their use, a prudent path appears to be the norm in prescription of lipid-lowering drug therapy for MI patients.
Adrenomedullin Does Not Inhibit Human Platelet Aggregation
Authors: Schiller N.K. , Champion Hunter C. , Hugghins S.Y. , Timothy A.M. , Murphy W.A. , Coy D.H. , Peter J.R. , Kadowitz Philip J. , McNamara D.B.
Published: November 2007

Background: Adrenomedullin (ADM) is a hypotensive peptide isolated from human pheo chromocytoma extracts discovered in 1993 using an assay system designed to monitor its ability to increase rat platelet adenosine 3',5'-cyclic monophosphate (cAMP) levels. Physio logical mediators that elevate cAMP levels, such as prostaglandin (PG)E1 and PGI2, have also been shown to inhibit platelet aggregation. Therefore, we have chosen to investigate the effect of ADM, a peptide shown to increase platelet cAMP levels, on human platelet aggregation.

Methods and Results: Platelet-rich plasma prepared from blood donors was incubated with ADM (10-9-10-6 M) for 1 min at 37°C before the addition of a submaximal dose of adeno sine 5'-diphosphate (ADP). ADM did not alter the platelet aggregatory response to ADP. PGE1, a substance known to inhihit ADP-induced human platelet aggregation (10-6 M), however, inhibited ADP-induced platelet aggregation. In addition, the ADM induced a dose-dependent relation in rings of human chorionic arteries.

Conclusions: These data may be interpreted to suggest that human platelets do not possess a functional ADM receptor couple with adenylate cyclase.
Pharmacokinetics of Catecholamines During Hemofiltration in Pediatric Patients
Authors: Freter Anne E. , Husayni Tarek S. , Reyes Gerardo
Published: November 2007

Background: Continuous hemofiltration is used in pediatric patients with acute renal fail ure. Many of these patients are treated with catecholamines for hemodynamic instability. The authors studied the pharmacokinetics of dopamine and dobutamine on patients under going continuous venovenous hemofiltration.

Methods and Results: Three critically ill pediatric patients with acute renal failure and car diovascular instability treated with hemofiltration and intravenous infusion of dopamine and/or dobutamine were entered into the study. Blood samples were drawn at steady-state levels from the arterial port (inflow) of the hemofilter, from the venous port (outflow) of the hemofilter, and from the ultrafilter. Sixteen (n = 16) pharmacokinetic measurements were made, six (n = 6) for dopamine and 10 (n = 10) for dobutamine. The clearance of dopamine by the hemofilter was 0.078 ± 0.011 mL/kg/min, and for dobutamine it was 0.036 ± 0.008 mL/kg/min. On the average, 0.56% of the dopamine dose and 0.13% of the dobutamine dose was removed by the hemofilter.

Conclusions: The pharmacokinetics of dopamine and dobutamine at the dosage range of 5- 25 μg/kg/min are not altered by continuous hemoliltration. Relative to total plasma clear ance. negligible amounts of the drug were removed. The dosage of these catecholamines need not hc adjusted during continuous hemofiltration.