bluuebunny/crossref_metadata_2025 huggingface dataset:
R&D AND REGIONAL NETWORKS DYNAMICS IN DUTCH PHARMACEUTICAL INDUSTRY
Authors: GEENHUIZEN MARINA VAN , KNAAP BERT VAN DER
Published: March 2008

National conditions, particularly regulation, have been an important factor in the competitiveness of the Dutch pharmaceutical industry in the past decades. Regulation had no uniform impact on the sector, as witnessed by a loss of strength in the innovative segment and a gain in strength in the segment producing generic drugs. New product technology is the major basis for competition in the innovative segment. This knowledge is highly specialized and often protected against a free flow. Consequently, regional networking between companies can only be relevant for related companies within the same corporation. Since the late 1980s, there has been a trend for out‐sourcing of R&D to universities, associated with different needs in the various stages of R&D. In some respects, there is a poor match between demand and supply of knowledge. Both at the national and regional level attempts are now being made in order to improve the economic use of knowledge.
VAL, THE FUNCTIONAL AND SPATIAL ORGANIZA TION OF BUSINESSES
Authors: HOEK REMKO VAN
Published: March 2008

In the business environment of global competition, the pendulum between centralization and decentralization of activities may swing differently. With value‐added logistics (VAL), activities previously relocated to global manufacturing plants in low‐cost countries may be shifted back to the Western world. The explanation behind these spatial evolutions requires an analysis of the link between the functional and the spatial organizations. In modern network organizations, companies try to achieve such capabilities as global efficiency and local responsiveness simultaneously. In two case studies, a theoretical framework will be used that integrates market and producer transactions and links the functional organization of value‐adding processes with the spatial organization. By studying past, present and projected organizations, the spatial impact of VAL, resulting from the integration or disintegration of activities, can be assessed. These studies show how the spatial organization is becoming of increasing importance to the success of a company's strategy.
EXPANDING THE THEORETICAL FOUNDATION OF DIFFERENTIAL URBANIZATION
Authors: GEYER HERMANUS
Published: March 2008

Recently, the concept of differential urbanization was introduced. It conceptually links the processes of urbanization, polarization reversal, and counter‐urbanization across the development spectrum in the First and Third Worlds. Based on supporting evidence in developed and less developed countries, this study expands the theoretical foundation of the concept by first focusing on a graphical analysis of the processes of urbanization, polarization reversal, and counterurbanization. Secondly, it looks into the explanations given for counterurbanization. Thirdly, factors likely to influence post‐counterurban migration trends are discussed, and finally, the relevance of certain causes of differential urbanization given in the literature are explored.
NORTH‐SOUTH ENERGY RESOURCE TRANSFERS IN CHINA AND THE PORT INTERMEDIARY
Authors: TODD DANIEL
Published: March 2008

A pressing problem confronting China is that of energy supply. Despite a huge endowment of energy minerals, the country must tackle the thorny issue of an alarming divide between the regions replete with energy and those devoid of it. Exacerbating die mismatch is die fact that the energy‐deficient regions are precisely die ones experiencing the most dramatic growth. Only a diorough revamping of transport infrastructure, in which ports and north‐soudi coastwise shipping play a seminal role, can hope to eliminate the energy imbalance existing between supplying and consuming regions. Bodi types of regions are expected to benefit in consequence: die former on die strength of interregional energy exports; die latter on die basis of international product exports. The part played by ports and associated land transport facilities is aired in this article.
REGIONAL LABOUR MARKET RESEARCH ON PARTICIPATION RATES
Authors: ELHORST J. PAUL
Published: March 2008

This article reviews the methodology of 17 empirical studies in which the participation rate has been estimated with the help of regional data. After defining and pointing out the orientation of regional labour market research on participation rates, three methodological issues dominate the discussion and eventually the conclusions: the extent to which the participation rate of the population of working age should be disaggregated to subpopulations; the theoretical foundation of the independent variables of the regional participation rate; and the spatial dimension of a participation rate equation being estimated from a regional perspective, the latter covering the delineation of regions, the modelling of regional interdependencies and spatial heterogeneity.
SOCIAL INTEGRATION IN THE ITALO‐SLOVENE GORIZIA TRANSBORDER REGION
Authors: BUFON MILAN
Published: March 2008

This article provides a survey of the local dimensions of a particular, but at the same time emblematic, Central European border landscape; the problems caused by the dividing of a consolidated historical region after World War II; and the phenomenon of its persistence in the field of human relations; thereby providing a basis for a gradual reintegration of the two border areas. The analysis of the regional structure and cross‐border behaviour leads to the conclusion that social and functional cross‐border integration is determined less by the proximity of the border than by a common social, cultural and territorial background of the border population. In fact, a lower degree of cultural affinity between the two sides of the border has a clearly negative influence on the intensity of cross‐border relations, even if the two sides have a similar or functionally complementary socio‐economic structure.
ANALYSING THE REGIONAL IMPACT OF FOREIGN MANUFA CTURING FIRMS
Authors: WILLIAMS DAVID
Published: March 2008

This article has been written in response to Pigozzi and Bagchi‐Sen's (1995) work on the impact which affiliates of foreign manufacturing firms make upon employment in the US economy. It will be argued that their analysis is incomplete because of inadequacies in their conceptual framework. In order to assess the impact of multinational subsidiaries it is necessary to use a framework which includes a more extensive range of modes of entry and subsidiary types. It is also necessary to consider, more extensively, the indirect employment effects brought about by the linkages which are created by the foreign‐owned subsidiary as well as the dynamic effects which influence the competitive environment including the capabilities of indigenous firms.
SEXUAL MORES, ETHICAL THEORIES, AND THE OVERPOPULATION MYTH
Authors: KAINZ HOWARD P.
Published: March 2008

Some of the causes of the ‘sexual revolution’ during the past few decades are widely known: The development of relatively safe and reliable contraceptives, especially the birth‐control pill; the ‘morning after’ pill; antibiotics to relieve or cure sexually transmitted diseases such as gonorrhea, herpes, and syphilis; the increased social acceptance of pre‐marital sex, homosexuality, and other behaviors that formerly were considered deviant; and the legalization of abortion as the ultimate ‘contraceptive’. But little attention has been paid to two rather cerebral factors relevant to these developments – namely, ethical theories, and theories of overpopulation. In this paper I will argue that these two less well‐known and more subtle factors have been at least as powerful as the more obvious factors mentioned above, in bringing about sea‐changes in sexual mores. More specifically, I will argue that some implicit approaches to ethical theory are more conducive than others to bringing about the present status quo in sexual mores, and that the widespread belief in world overpopulation has not only changed the moral climate regarding sexuality, but has helped to redefine what is moral and what is immoral.
THE RETURN OF THE NATURALISTIC FALLACY: A DIALOGUE ON HUMAN FLOURISHING
Authors: WALSH FRANCIS MICHAEL
Published: March 2008

In response to the proposal justifying the morality of homosexual acts offered by Todd A. Salzman and Michael G. Lawler, this paper seeks to make intelligible the reasoning used by the New Natural Law Theory and others that arrives at the opposite conclusion. This article proposes to explore the weaknesses in the arguments offered in justification. By proposing an expanded notion of human nature so as to include sexual orientation as one of the factors from which to draw moral norms, the authors have adopted the central proposition of the Old Natural Law Theory defended by Francisco Suarez and others, viz., that human nature as such was a fit source from which to draw moral norms. Thus the New Natural Law Theory, formulated by Germain Grisez to answer the charge of the naturalistic fallacy, has curiously found itself being refuted by a reformulation of the Old Natural Law Theory. This article seeks to show how the proportionalistic reasoning used by Salzman and Lawler leads inevitably to a revival of the naturalistic fallacy.
PUNITIVE JUSTICE AND RESTORATIVE JUSTICE AS SOCIAL RECONCILIATION
Authors: SZABLOWINSKI ZENON
Published: March 2008

The notion of justice is broad and complex. When we pursue justice too harshly after a conflict, we create new injustice and more victims; when we do not, the offenders usually keep hurting others and the violence is prolonged. As a matter of fact, only a few perpetrators can be punished. On the other hand, does punishment of the offender alone heal the victim or restore peace and harmony in society? Moreover, when the victim forgives, should the society still punish the offender? What role do truth recovery, state tribute (paid to the victims) and monetary compensation play in finding the balance between punitive justice and restorative justice? This paper takes up these issues of justice and, while discussing certain aspects of the relationship between punitive justice and restorative justice in some processes of social (national) reconciliation, tries to present some answers.
Anhydrobiosis in tardigrades and its effects on longevity traits
Authors: Hengherr S. , Brümmer F. , Schill R. O.
Published: March 2008

Living in harsh and variable environments that are prone to periodic desiccation, tardigrades exhibit remarkable tolerance against physical extremes through a state known as anhydrobiosis. To study the effect of this state on the longevity and hence the lifecycle in the taxon Tardigrada for the first time, we exposed a tardigrade species, Milnesium tardigradum, to alternating periods of drying and active feeding periods in a hydrated state. Compared with a hydrated control, the periodically dried animals showed a similar longevity, indicating that the time spent in anhydrobiosis was ignored by the internal clock. Thus, desiccation can produce a time shift in the age of tardigrades similar to the model described for rotifers that has been termed ‘Sleeping Beauty’.
Lipidomic analysis and electron transport chain activities in C57BL/6J mouse brain mitochondria
Authors: Kiebish Michael A. , Han Xianlin , Cheng Hua , Lunceford Adam , Clarke Catherine F. , Moon Hwi , Chuang Jeffrey H. , Seyfried Thomas N.
Published: March 2008

The objective of this study was to characterize the lipidome and electron transport chain activities in purified non‐synaptic (NS) and synaptic (Syn) mitochondria from C57BL/6J mouse cerebral cortex. Contamination from subcellular membranes, especially myelin, has hindered past attempts to accurately characterize the lipid composition of brain mitochondria. An improved Ficoll and sucrose discontinuous gradient method was employed that yielded highly enriched mitochondrial populations free of myelin contamination. The activities of Complexes I, II, III, and II/III were lower in Syn than in NS mitochondria, while Complexes I/III and IV activities were similar in both populations. Shotgun lipidomics showed that levels of cardiolipin (Ptd2Gro) were lower, whereas levels of ceramide and phosphatidylserine were higher in Syn than in NS mitochondria. Coenzyme Q9 and Q10 was also lower in Syn than in NS mitochondria. Gangliosides, phosphatidic acid, sulfatides, and cerebrosides were undetectable in brain mitochondria. The distribution of Ptd2Gro molecular species was similar in both populations and formed a unique pattern, consisting of seven major molecular species groups, when arranged according to mass to charge ratios. Remodeling involving choline and ethanolamine phosphoglycerides could explain Ptd2Gro heterogeneity. NS and Syn mitochondrial lipidomic heterogeneity could influence energy metabolism, which may contribute to metabolic compartmentation of the brain.
Individual acoustic monitoring of the European Eagle OwlBubo bubo
Authors: GRAVA THIBAULT , MATHEVON NICOLAS , PLACE EMELYNE , BALLUET PATRICK
Published: March 2008

The Eagle OwlBubo bubois cited in Annex I of the Birds Directive of the European Union. Europe's biggest owl is extremely sensitive to human presence and needs special conservation measures. The present paper aims to show that monitoring of individuals by bioacoustic methods can be relevant to understanding population dynamics. Our study investigates the possibility of identifying a vocal signature in the wild‐recorded calls of male and female Eagle Owls, and assesses the potential use of these signatures for long‐term monitoring of individuals in the field. We show that both males and females of a given population can be identified individually on the basis of their calls. Our results also show that, regardless of the sex, most of the individuals recorded in the first year of the investigation may be identical to those recorded in the same places the year after. This bioacoustic approach could thus be used in studies of site fidelity.
Resolving the population status of Ascension FrigatebirdFregata aquilausing a ‘virtual ecologist’ model
Authors: RATCLIFFE NORMAN , PELEMBE TARA , WHITE RICHARD
Published: March 2008

The Ascension Frigatebird is an island endemic whose conservation status was subject to confusion owing to difficulties in counting and misinterpretation of data. Accurate nest counts for this species are problematic owing to their extremely prolonged breeding seasons, high nest failure rates, turnover of individuals at nest‐sites, replacement laying and biennial breeding. We conducted repeated complete censuses of Ascension Frigatebird eggs at the species’ sole colony of Boatswainbird Island, and collected data on laying phenology and nest survival rates within sample quadrats, throughout the 2001 and 2002 breeding seasons. We used these data to develop an individual‐based model that predicted the number of Frigatebird nests present on each day an actual census occurred assuming an arbitrary 1000 breeding females bred there. We then divided the number of nests counted in these virtual censuses by 1000 to quantify bias, and used this figure to correct real census totals. The model revealed that the population numberedc.6250 breeding females andc. 9350 mature females in 2001–2, and that numbers have not changed significantly since the late 1950s. Productivity, at 0.34 chicks/pair, was high compared to previous studies of Ascension Frigatebirds and most of those of congeners elsewhere.
A portable integrated rainfall and overland flow simulator
Authors: Alves Sobrinho T. , Gómez‐Macpherson H. , Gómez J. A.
Published: March 2008

This paper describes a prototype of a portable rainfall simulator that can simulate a wide range of rainfall intensities with a kinetic energy similar to that of natural rainfall and, more innovatively, provide simultaneous or independent simulations of rainfall and overland flow at the microplot scale (0.70 m2). The design of the rotating shutter disc makes possible a wide range of rainfall intensities, from 30 to 155 mm/h without changing nozzle type or working pressure. Overland flow intensity can be adjusted from 94 to 573 mm/h depending on nozzle type and working pressure. The flow is applied on the upper side of the experimental plot. The Christiansen coefficient of uniformity of the simulated rainfall varied between 81.4 and 85.1%, and the calculated kinetic energy was >90% the kinetic energy of corresponding natural rain. Special attention was paid to portability. Stainless steel was used whenever possible and the equipment was constructed in modules so that it could easily be dismantled and carried by two people. A telescopic‐type frame allows operation on sloping ground.
THE AMINOCHRONOLOGY OF MAN‐INDUCED SHELL MIDDENS IN CAVES IN NORTHERN SPAIN*
Authors: ORTIZ J. E. , TORRES T. , GONZÁLEZ‐MORALES M. R. , ABAD J. , ARRIBAS I. , FORTEA F. J. , GARCÍA‐BELENGUER F. , GUTIÉRREZ‐ZUGASTI I.
Published: March 2008

Here, we provide the first report on the ages of 54 archaeological levels in 38 caves in northern Spain by means of the aspartic acid d/l ratio measurements in Patella shells, with good results. For this purpose, we developed an age calculation algorithm that allows the numerical dating of deposits from other archaeological localities in the area and nearby regions. We conclude that the sample size—that is, the number of shells analysed within a single level—reinforces the importance of analysing numerous specimens per horizon and the understanding of the time‐averaging concept. The ultrastructure of different species of Patella shells was also studied, showing calcite in their apexes and aragonite at their margins.
Variability and management patterns of range resources in the Baro River plain, Ethiopia
Authors: Kassahun Daniel , Afsaw Soloman
Published: March 2008

The biophysical environment of rangelands in the arid and semi‐arid lowland parts of Africa is customarily viewed as a homogenous entity. Such notion has encouraged employing a blanket management approach. However, there are perceptible variations within them which necessitate site‐specific range management. This study has attempted to identify the variability of soil and forage attributes and assess the existing management practices of those resources in the Baro River plain, Ethiopia. Sample transects, representing pre‐ and post‐fire conditions, were used to collect composite soil samples and vegetation attributes. Alongside the physical survey, a household survey was undertaken to validate the laboratory‐generated information. The result showed significant differences of soil and forage attributes among different management regimes, distances from river course and dominant cover types. In general, the distribution of soil nutrients showed a ‘distance decay effect’, while the distribution of pH showed the reverse pattern. Application of heavy fire load and congested grazing are the principal range management related factors. About 80 per cent of sample pastoralists employ heavy fire without due consideration for the sustainability of the range resource and without considering the local variability. Recognition of site‐specific information is the key to effective management of range resources in the study area.
From salvage to recycling – new agendas or same old rubbish?
Authors: Riley Mark
Published: March 2008

Recent years have seen increased attention paid by geographers to the phenomenon of household waste recycling. Much of this attention by geographers has focused on contemporary recycling, especially contemporary policy and behaviour. This article takes a wider temporal perspective and considers the antecedent ‘National Salvage Campaign’ of the Second World War. It considers the conceptual lessons from this recycling campaign, drawing out the importance of themes of scale, relatedness, civic duty and positive identity. The article explores the socially constructed boundaries that attempt to find an ‘appropriate’ place for waste and how such boundaries are constantly reconsidered and redefined.
Distance, power and ideology: diplomatic representation in a world of nation‐states
Authors: Neumayer Eric
Published: March 2008

Sending diplomatic missions abroad and receiving foreign missions at home is in the political and economic interests of countries. But such missions depend on domestic and foreign political will and they also cost scarce resources. This article demonstrates that the global pattern of diplomatic representation is significantly determined by geographical distance between countries, by the power of both sending and recipient countries and by the degree of their ideological affinity. The pattern of diplomatic representation is both a reflection of and a contributor to a world of nation‐states dominated by geographical distance, unequal power and ideological division.
By northern lights: on the making of geography in Sweden– by Anne Buttimer and Tom Mels
Authors: Abrahamsson Christian
Published: March 2008

Statement The Editors do not necessarily agree with the statements contained in the book reviews, and neither they nor the RGS‐IBG assume responsibility for the reviewers’ assessments of the books that they evaluate.
Unlocking the time capsule of historic aerial photography to measure changes in antarctic peninsula glaciers
Authors: Fox Adrian J. , Cziferszky Andreas
Published: March 2008

Recent studies have reported widespread retreat and acceleration of glaciers on the Antarctic Peninsula, attributed to regional warming. The loss of ice is a contributor to sea level rise, but its volume and impact on sea level is poorly known. There are few ground measurements of ice thickness change and existing satellite altimeters are ineffective over the mountainous terrain. An accurate assessment of changes in surface height, and hence ice volume, of glaciers on the Antarctic Peninsula over past decades is needed to aid better estimates of their past impact on sea level rise and predictions of their future contribution.

There is an archive of over 30 000 aerial photographs going back to the 1940s for parts of the Antarctic Peninsula. Photogrammetry of time series of these historic photographs is now the only way to reconstruct changes in glacier surface height over the past 60 years. However, the historic aerial photographs are difficult to employ for detailed measurements owing to inadequate ground control, unfavourable sortie characteristics, incomplete calibration data and the unavoidable use of paper prints only.

This paper describes a method of providing control for historic photos without fieldwork on the ground, by linking them to a newly acquired, highly accurate photogrammetric model adjusted through direct kinematic GPS positioning of the camera. It assesses the achievable accuracy through a worked example using a glacier on the Antarctic Peninsula with typical aerial photography at five dates from 1947 to 2005. Overall measurement accuracy of better than 2 m rmse in X, Y and Z was achieved for all the photography types, which is accurate enough to allow meaningful measurement of changes in ice thickness for the glacier over periods of the order of decades. The principal constraints are image quality of the historic photographs and the availability of paper prints only.
A convergent image configuration for DEM extraction that minimises the systematic effects caused by an inaccurate lens model
Authors: Wackrow Rene , Chandler Jim H.
Published: March 2008

The internal geometry of consumer‐grade digital cameras is generally considered unstable. Research conducted recently at Loughborough University indicated the potential of these sensors to maintain their internal geometry. It also identified residual systematic error surfaces or “domes”, discernible in digital elevation models (DEMs), caused by slightly inaccurate estimated lens distortion parameters. This paper investigates these systematic error surfaces and establishes a methodology to minimise them. Initially, simulated data was used to ascertain the effect of changing the interior orientation parameters on extracted DEMs, specifically the lens model. Results presented demonstrate the relationship between “domes” and inaccurately specified lens distortion parameters. The stereopair remains important for data extraction in photogrammetry, often using automated DEM extraction software. The photogrammetric normal case is widely used, in which the camera base is parallel to the object plane and the optical axes of the cameras intersect the object plane orthogonally. During simulation, the error surfaces derived from extracted DEMs using the normal case were compared with error surfaces created using a mildly convergent geometry. In contrast to the normal case, the optical camera axes intersect the object plane at the same point. Results of the simulation process clearly demonstrate that a mildly convergent camera configuration eradicates the systematic error surfaces. This result was confirmed through practical tests and demonstrates that mildly convergent imagery effectively improves the accuracies of DEMs derived with this class of sensor.
Time to reconsider our approach to echogenic intracardiac focus and choroid plexus cysts
Authors: BETHUNE Michael
Published: March 2008

Ultrasound soft markers are commonly reported at mid‐trimester ultrasounds. Soft markers frequently arouse anxiety in the patient, her family, and the referring clinician. Recent publications have raised concerns that this anxiety may be unfounded. The significance of an echogenic intracardiac focus or choroid plexus cyst in particular is no longer certain. It may be time to discard these two markers; especially if they are reported in isolation and in a patient who is otherwise at low risk for aneuploidy.
Diagnostic accuracy of IOTA ultrasound morphology in the hands of less experienced sonographers
Authors: GRAMELLINI Dandolo , FIENI Stefania , SANAPO Laura , CASILLA Giovanna , VERROTTI Carla , NARDELLI Giovanni B.
Published: March 2008

Aim:   The purpose of our study was to evaluate the ability of the International Ovarian Tumor Analysis (IOTA) classification and its impact on the identification of benign and malignant adnexal masses by less experienced sonographers.

Methods:  One hundred and five patients undergoing elective surgical treatment for single adnexal masses at the University of Parma were enrolled. After the final diagnosis, we had the ultrasound recordings reviewed retrospectively by a group of three residents, and the features of each adnexal mass were evaluated according to the morphological score reported by the IOTA Group.

Results:  Based solely on the qualitative classification of the IOTA Group unilocular cysts were associated with a high, significant probability of a benign lesion (odds ratio (OR) = 12.6 (95% CI, 1.61–99.10), P < 0.001). This probability remained high also with multilocular cysts (OR = 7.9 (95% CI, 1.00–62.38), P < 0.05). By contrast, multilocular‐solid cysts were significantly associated with the probability of malignancy (OR = 6.4 (95% CI, 1.81–22.70), P < 0.001), as were solid masses (OR = 5.5 (95% CI, 1.48–20.92), P < 0.05). None of the five ultrasound categories of lesions could be significantly correlated with borderline masses.

Conclusions:  A simple qualitative classification based solely on the recognition of five different ultrasound categories may be enough to guide the physician to an accurate identification of the nature of the mass. Our findings confirm the diagnostic reliability of the IOTA Group classification by less experienced sonographers. This system is especially helpful because it is capable of discriminating between ovarian masses without further tests and clinical examinations.
Prediction of small for gestational age newborns using ultrasound estimated and actual amniotic fluid volume: Published data revisited
Authors: CHAUHAN Suneet P. , MAGANN Everett F. , DOHERTY Dorota A. , ENNEN Christopher S. , NIEDERHAUSER Amy , MORRISON John C.
Published: March 2008

Background:  Intrauterine growth restriction (IUGR) is a complex problem in modern obstetrics. The presence of oligohydramnios is reported as an important diagnostic and prognostic factor in the management of a pregnancy complicated by IUGR.

Aim:  To determine the predictive accuracy of sonographic and actual amniotic fluid volume (AFV) to identify small for gestational age (SGA; birthweight < 10%).

Methods:  Before amniocentesis, the single deepest pocket (SDP) and amniotic fluid index (AFI) were obtained. The AFV was determined using a diazo‐dye reaction. Thresholds for AFI, SDP and AFV were estimated using receiver‐operating curves analysis and areas under the curves were used to assess predictive accuracy of these indices. Likelihood ratios (LR) were obtained.

Results:  Among the 175 newborns, 16% had SGA. Compared to newborns with birthweight > 10%, all AFV indices were significantly lower (P= 0.001, P= 0.001 and P= 0.009 for AFI, SDP and AFV respectively) for SGA. The areas under the curves for all curves < 0.65 and the LR for all thresholds were < 5.0, reflecting poor diagnostic capabilities.

Conclusions:  Despite observed lower AFV indices in SGA, neither sonographic examination nor determination of AFV is a reliable predictor of suboptimal growth.
A randomised comparative study on sublingual versus vaginal administration of misoprostol for termination of pregnancy between 13 to 20 weeks
Authors: BHATTACHARJEE Nabendu , SAHA Shyama Prasad , GHOSHROY Samir Chandra , BHOWMIK Sabyasachi , BARUI Gangotri
Published: March 2008

Background:  Misoprostol is the drug of choice for medical abortion worldwide but consensus is yet to be reached regarding its preferred route of administration.

Aims:  To compare the outcome of sublingual with vaginal administrations of misoprostol for induction of second trimester abortion.

Methods:  A randomised comparative trial where 300 women at 13–20 weeks gestation, requiring medical abortion, were randomly assigned to sublingual or vaginal route for misoprostol administration with a dose schedule of 400 µg three‐hourly, up to a maximum five doses over 24 h. The same doses were repeated for another 24 h in non‐responders.

Primary outcome measure was complete abortion rate at 24 and 48 h, and the secondary outcome measures were induction–abortion interval, failure rate, side‐effects and patients’ preference to the route.

Results:  No statistically significant differences in the complete abortion rates were observed at 24 h (64.03% vs 61.59%, P = 0.767) and at 48 h (79.14% vs 82.01%, P = 0.651) when sublingual and vaginal groups were compared. Mean induction–abortion intervals in sublingual and vaginal groups were 14.1 and 14.5 h, respectively (P = 0.066). Other outcome measures were also more or less similar in both groups. Differences in the incidence of side‐effects were also statistically insignificant when both groups were compared. Sublingual administration of the drug was preferred by most of the women as compared to vaginal administration (P < 0.0001).

Conclusion:  Both sublingual and vaginal administrations of misoprostol are equally effective in inducing medical abortion during second trimester but sublingual route was preferred by the patients.
Current caesarean delivery rates and indications in a major public hospital in northern Greece
Authors: DINAS Konstantinos , MAVROMATIDIS Georgios , DOVAS Dimitrios , GIANNOULIS Charalambos , TANTANASIS Theocharis , LOUFOPOULOS Aristoteles , TZAFETTAS John
Published: March 2008

Background:  Over the past 25 years, there has been a sustained increase in caesarean section (CS) rates around the world. However, there is a paucity of data regarding the current CS rates and particularly the trends of CS indications in Greece.

Aim:  To assess the overall CS rates and indications in a major Greek teaching hospital over the last five years.

Methods:  All deliveries that took place in our Department between January of 2002 and December of 2006 were retrospectively analysed through manual medical chart review to record CS rates and indications.

Results:  During the study period, 4964 deliveries took place in our department; among them, 1831 were CS (36.9%). The overall caesarean delivery rate has remained stable during these five years (36.7% during 2002 vs 35.5% during 2006; P = 0.633). The primary indications were previous caesarean delivery (30.9%), non‐reassuring or pathological fetal heart rate trace by cardiotocography (12.3%) and dystocia (10.4%). The only indication whose rate significantly increased was previous caesarean delivery (+47.3%; P = 0.002), whereas a significant decrease was found for non‐reassuring or pathological fetal heart rate trace by cardiotocography (–39.1%; P = 0.008).

Conclusions:  It is quite difficult to reduce the proportion of caesarean deliveries, particularly in a teaching hospital with a considerable number of high‐risk pregnancies. The dominant role of previous caesarean delivery among CS indications stresses the importance of performing more vaginal birth after CS if we are to avoid the self‐perpetuation of the CS epidemic.
Antithrombogenic Polynitrosated Polyester/Poly(methyl methacrylate) Blend for the Coating of Blood‐Contacting Surfaces
Authors: Seabra Amedea B. , Da Silva Regiane , De Souza Gabriela F.P. , De Oliveira Marcelo G.
Published: March 2008

Abstract:  A nitric oxide (NO) donor polyester containing multiple S‐nitrosothiol (S‐NO) groups covalently attached to the polymer backbone was synthesized through the esterification of poly(ethylene glycol) with mercaptosuccinic acid, followed by the nitrosation of the –SH moieties. The polynitrosated polyester (PNPE) obtained was blended with poly(methyl methacrylate) (PMMA), yielding solid films capable of releasing NO. Scanning electron microscopy analysis showed that acrylic plates and stainless steel intracoronary stents can be coated with continuous and adherent PNPE/PMMA films. After an initial NO burst, these films release NO spontaneously in dry condition or immersed in aqueous solution at constant rates of 1.8 and 180 nmol/g/h, respectively, for more than 24 h at physiological temperature. PNPE/PMMA coated surfaces were shown to inhibit platelet adhesion when in contact with whole blood. These results show that PNPE/PMMA blend can be used for the coating of blood‐contacting surfaces, with potential to inhibit thrombosis and restenosis after stenting.
Histological Evaluation of Biocompatibility of Lyophilized Bovine Pericardium Implanted Subcutaneously in Rats
Authors: Maizato Marina J.S. , Pires Mara D. , Canzian Mauro , Higa Olga Z. , Pitombo Ronaldo N.M. , Leirner Adolfo A.
Published: March 2008

Abstract:  This article aims at investigating in vivo evaluation of lyophilization procedure on the biocompatibility of bovine pericardium treated with glutaraldehyde (GA). The bovine pericardium was fixed with 0.5% glutaraldehyde during 10 days and preserved in 4% formaldehyde (FA). Two groups of samples were prepared from treated membranes: Group 1, nonlyophilized samples and Group 2, lyophilized samples. Male Sprague‐Dawley rats (4 weeks after birth) were anesthetized (pentobarbital sodium 25 mg/kg of body weight) and in each one were implanted subcutaneously in the dorsal region a sample from Group 1 and another from Group 2. These samples were explanted after 30 days for histological analysis. No intercurrences took place after the surgery. No differences (P > 0.05) in the calcification, granulomatous reaction, mononuclear infiltration, and granulation tissue development was observed between both groups. The implanted lyophilized samples presented a trend for a reduced inflammatory reaction. Lyophilization of the bovine pericardium does not seem to increase the above listed tissue reaction.
Bioactive Porous Titanium: An Alternative to Surgical Implants
Authors: De Medeiros Waléria Silva , De Oliveira Marize Varella , Pereira Luiz Carlos , De Andrade Mônica Calixto
Published: March 2008

Abstract:  Porous titanium implants have been used to improve implant–bone attachment by the ingrowth of bone tissue within the porous structure. Despite the efficient bone adhesion of porous titanium implants, chemical bonds are required at bone–implant interface. These implants can become bioactive by a biomimetic precipitation process. The aim of this work was to enhance the bioactivity of pure porous titanium implants by biomimetic process. The samples immersed in a simulated body fluid promoted the nucleation and growth of calcium phosphate (Ca‐P) crystals, such as hydroxyapatite (Hap), on the material surface. Scanning electron microscopy, energy dispersive spectroscopy, and Fourier transform infrared spectroscopy analyses revealed that a Ca‐P deposition occurred without the need of pretreatments to improve the surface bioactivity. This present study indicates the potential for growing a bone‐like Hap layer on porous titanium implants by biomimetic processes.
Influence of Surface Sub‐micropattern on the Adhesion of Pioneer Bacteria on Metals
Authors: Díaz Carolina , Schilardi Patricia , De Mele Mónica Fernández Lorenzo
Published: March 2008

Abstract:  Most of the implantable medical devices are prone to infection caused by microorganisms that form biofilms. Pseudomonads are frequently used as model species for studying bacterial adhesion. The initial stages of biofilm formation are influenced by different factors including, among others, the chemistry of the surface, the roughness, and topography. The aim of this work was to assess the early stages of Pseudomonas fluorescens biofilm formation on sub‐microstructured surfaces (SMS) that are in tune with bacterial size. Copper and gold were used as the substrata. It was concluded that SMS influenced bacterial length, alignment, and distribution, whereas the chemistry of the surfaces affected bacterial length and distribution. However, the effect of the SMS was the most significant. The shape of the bacterial colonies and the polymeric substances production were also influenced by SMS and the chemistry of the surface and both factors may be considered to reduce the susceptibility of a surface to biofilm formation.
Effect of Roughness of Zirconia and Titanium on Fibroblast Adhesion
Authors: Takamori Esther Rieko , Cruz Renato , Gonçalvez Fábio , Zanetti Raquel Virgínia , Zanetti Artemio , Granjeiro José Mauro
Published: March 2008

Abstract:  The aim of this study was to investigate the adhesion (4 and 24 h) and the morphology of fibroblast Balb/c 3T3 seeded onto polystyrene, partially stabilized (ZrO2Y2O3), stabilized zirconia ceramic (3YTZP), and pure titanium (Ti, grade 2). Initial cell adhesion (4 h) was greater (P < 0.05, analysis of variance and Tukey's Multiple Comparisons Test) onto ZrO2Y2O3 and polystyrene than in Ti and 3YTZ. After 24 h, the number of adhered cells was similar between the biomaterials tested, but smaller than onto polystyrene (P < 0.05). Cells were more spread onto glass surface after 4 h, but after 24 h, the morphology and density of the cells were similar in all groups (SEM). Profilometry showed distinct Ra values for each material: glass coverslips and ZrO2Y2O3 (0.09 µm), Ti (0.88 µm), and 3YTZP (30.93 µm). It was concluded that ZrO2Y2O3 promoted the best initial adhesion, thus indicating that surfaces with Ra values smaller than 0.1 µm could be more favorable to initial adhesion.
Computational Fluid Dynamics Investigation of a Centrifugal Blood Pump
Authors: Legendre Daniel , Antunes Pedro , Bock Eduardo , Andrade Aron , Biscegli José F. , Ortiz Jayme Pinto
Published: March 2008

Abstract:  In the development of a ventricular assist device, computational fluid dynamics (CFD) analysis is an efficient tool to obtain the best design before making the final prototype. In this study, different designs of a centrifugal blood pump were developed to investigate flow characteristics and performance. This study assumed the blood flow as being an incompressible homogeneous Newtonian fluid. A constant velocity was applied at the inlet; no slip boundary conditions were applied at device wall; and pressure boundary conditions were applied at the outlet. The CFD code used in this work was based on the finite volume method. In the future, the results of CFD analysis can be compared with flow visualization and hemolysis tests.
Fibromyalgia: Nosography and Therapeutic Perspectives
Authors: Coaccioli Stefano , Varrassi Giustino , Sabatini Chiara , Marinangeli Franco , Giuliani Marco , Puxeddu Adolfo
Published: March 2008

▪ Abstract:  Fibromyalgia (FM) is an important cause of morbidity and health expenditure. Severe widespread extra‐articular chronic pain, along with nonrestorative sleep, dominates the clinical syndrome. The pathogenesis of FM remains unclear. While dysfunction in serotoninergic neurotransmission is believed to play an important role, several neurologic and immuno‐endocrine mechanisms may also be relevant. A theory is advanced based on an inherited imbalance in neuro‐vegetative systems resulting from increased sympathetic tone because of a metabolic deficiency in the serotoninergic system that, when exposed to a precipitating event, leads to the development of the clinical manifestations of FM. The importance of both nonpharmacological treatments and multimodal medication management is stressed. ▪
Full‐Motion Two‐ and Three‐Dimensional Pulmonary Vein Imaging by Intracardiac Echocardiography After Pulmonary Vein Isolation
Authors: OKUMURA YASUO , WATANABE ICHIRO , OHKUBO KIMIE , YAMADA TAKESHI , KAWAUCHI KAZUNORI , TAKAGI YASUHIRO , ASHINO SONOKO , KOFUNE MASAYOSHI , KOFUNE TATSUYA , HASHIMOTO KENICHI , SHINDO ATSUSHI , SUGIMURA HIDEZOU , NAKAI TOSHIKO , KUNIMOTO SATOSHI , SAITO SATOSHI , HIRAYAMA ATSUSHI
Published: March 2008

Background:

The pulmonary veins (PVs) are topographically complex and motile, so angiographic visualization of the PVs anatomy is limited. An imaging technique that accurately portrays the pulmonary vein (PV) anatomy would be valuable during and after catheter ablation procedures.

Purpose:

We investigated whether three‐dimensional (3D) intracardiac echocardiography (ICE) can visualize radiofrequency (RF)‐induced tissue changes after PV isolation.

Methods:

We performed 3D ICE studies with a 9F, 9‐MHz ICE catheter after segmental or extended PV isolation. The ICE catheter was placed 3–4 cm inside the PV ostium and mounted onto a pullback device. Sequential two‐dimensional (2D) images of the full length of the vein were obtained in 0.3 mm steps with cardiac and respiratory cycle gating. Each image was fed into a computer, and the aggregate data set was reconstructed into a 3D, full‐motion image. RF lesion location and lesion size were studied on 67 pullback images from 29 patients.

Results:

The 2D and 3D reconstruction was possible for 27 left superior PVs, 13 left inferior PVs, 26 right superior PVs, and one right inferior PV. The ablation site was identified 3–7 mm inside the PV ostium, and a 1/2 – 4/5 circumferential area was ablated with no clinically relevant stenosis. No significant differences were found on the ablated area or ablation site between segmental and extensive PV isolation.

Conclusion:

The 2D and 3D ICE of the PVs provides detailed anatomical information of the proximal PVs, and RF‐induced tissue changes in the PV wall can be visualized by ICE.
Anatomic and Electrophysiologic Differences between Chronic and Paroxysmal Atrial Flutter: Intracardiac Echocardiographic Analysis
Authors: OHKUBO KIMIE , WATANABE ICHIRO , OKUMURA YASUO , ASHINO SONOKO , KOFUNE MASAYOSHI , KAWAUCHI KAZUNORI , YAMADA TAKESHI , KOFUNE TATSUYA , HASHIMOTO KENICHI , SHINDO ATSUSHI , SUGIMURA HIDEZOU , NAKAI TOSHIKO , KUNIMOTO SATOSHI , SAITO SATOSHI , HIRAYAMA ATSUSHI
Published: March 2008

Background

: It remains unknown why atrial flutter (AFL) occurs as either a chronic or paroxysmal arrhythmia.

Purpose

: The aim of the study was to compare intracardiac echocardiographic (ICE) images of the crista terminalis (CT) and transverse conduction properties of the CT between chronic and paroxysmal forms of common AFL.

Methods

: Chronic AFL (n = 7) was defined as non‐self‐terminating AFL lasting >1 month, and paroxysmal AFL (n = 8) was defined as an intermittent arrhythmia with symptomatic episodes of 24 hours maximum duration. ICE images of the right atrium were recorded with a 9 F 9‐MHz intracardiac ultrasound catheter during pullback at 0.5‐mm intervals from the superior vena cava to the inferior vena cava triggered by electrocardiogram and respiration. The two‐dimensional image of the right atrium was reconstructed into a three‐dimensional (3‐D) image.

Results

: Three‐dimensional images from patients with chronic AFL showed the CT to be thick and continuous, and conduction across the CT was blocked at a pacing rate just above sinus rhythm in all seven patients. In contrast, 3D images from paroxysmal AFL showed the CT to be thin and discontinuous, and conduction across the CT during midseptal pacing was observed in five of the eight patients.

Conclusion

: The nature of AFL is determined, at least in part, by anatomic and electrophysiologic characteristics of the CT.
Electrophysiological Abnormalities Occur Prior to the Development of Clinical Episodes of Atrial Fibrillation: Observations from Human Epicardial Mapping
Authors: KANAGARATNAM PRAPA , KOJODJOJO PIPIN , PETERS NICHOLAS S
Published: March 2008

Background: Atrial fibrillation (AF) is characterized by irregular atrial activation maintained by an arrhythmogenic substrate. We addressed the hypothesis that the substrate of human AF includes changes in atrial conduction properties.

Methods: Patients in sinus rhythm (SR) and permanent AF undergoing cardiac surgery underwent right atrial epicardial mapping. AF was induced by burst pacing in patients in SR and was defined as sustained at >30 seconds. Epicardial maps were analyzed to determine conduction properties, AF activation patterns, and refractoriness. Patients in SR underwent postoperative Holter monitoring.

Results: Thirty‐seven subjects were recruited. (27 in SR and 10 in permanent AF). Sustained AF was induced in 17 patients in SR. Only patients with sustained AF developed any episodes of postoperative AF (P < 0.05), indicating the preexistence of an arrhythmogenic substrate, which was characterized by prolonged unipolar electrograms (37.0 ± 9.4 ms vs 27.5 ± 6.4 ms, P = 0.03), particularly in the region of the crista terminalis (41.2 ms ± 12.1 vs 26.7 ms ± 5.8, P = 0.004) compared with the nonsustaining group. However, these differences in electrogram characteristics were not associated with changes in wavefront propagation velocity (WPV) during SR or pacing. Activation mapping of acutely induced AF was compared with permanent AF and although there were shorter mean fibrillation intervals in permanent AF (171 ± 16 ms vs 229 ± 51 ms, P < 0.001), there was no difference in fibrillatory activation pattern (complexity scores: 2.21 ± 0.52 vs 2.02 ± 0.61) or WPV (46.9 ± 15.4 cm/s vs 53.5 ± 17.6 cm/s, P = 0.37). Fibrillatory activation pattern was associated with both WPV (P = 0.03) and wavelength (P = 0.03) in both pacing‐induced and permanent AF.

Conclusions: Patients in SR capable of sustaining pacing‐induced AF have differences in electrogram duration, which are apparent before clinical episodes of AF. Although patients with permanent AF had shortening of refractoriness, there was no evidence of further changes in fibrillatory activation pattern or macroscopic wavefront propagation velocity in permanent AF. These results imply that changes occur before the onset of AF and indicate the presence of a substrate capable of maintaining AF with only alterations in refractoriness required for the development of permanent AF.