bluuebunny/crossref_metadata_2025 huggingface dataset:
Technology Spillovers, Agglomeration, and Regional Economic Development
Authors: Koo Jun
Published: October 2005

Technology spillovers and agglomeration are critical issues in regional economic development. The presence of geographically localized spillovers in a region attracts firms and thereby leads to a higher level of agglomeration. On the other hand, the agglomeration of firms facilitates localized spillovers through local innovation networks. The endogenous nature of the relationship between spillovers and agglomeration, however, has been rarely acknowledged in the existing literature. This article critically reviews a wide range of issues related to technology spillovers and agglomeration and proposes a comprehensive conceptual framework to understand the mechanism of regional economic development.
A Review of Qualitative Research on the Childhood Cancer Experience From the Perspective of Siblings: A Need to Give Them a Voice
Authors: Wilkins Krista L. , Woodgate Roberta L.
Published: October 2005

Researchers are increasingly adopting the qualitative research paradigm to study the world of siblings of children with cancer. The purpose of this review article is to identify the contributions of qualitative research in advancing the understanding of the childhood cancer experience from the perspective of siblings. Articles were selected for inclusion if (1) written in English; (2) published in a peer-reviewed journal between 1979 and present or, if a doctoral dissertation, easily accessible to the authors; (4) cited a specific qualitative research design or some type of qualitative research method of data collection and analysis; and (4) involved siblings of children with cancer as sole research participants or as research participants within the context of the family. Twenty-seven qualitative research studies were reviewed. Three themes emerged from an analysis of the primary findings: (1) changing lives, (2) intense feelings, and (3) unmet needs. Limitations in the conceptualization, research design, and research methods of the qualitative studies are discussed. Suggestions that will help researchers in conducting qualitative research with siblings are also presented.
Treatment Approaches for Metastatic Ewing’s Sarcoma: A Review of the Literature
Authors: Hendershot Eleanor
Published: October 2005

The Ewing’s sarcoma family of tumors (ESFT) is an aggressive group of neoplasms that represent approximately 3% of all pediatric malignancies. The overall survival rates in patients with localized disease are approaching 75%. The outcome for the 25% of patients who present with metastatic disease, however, remains poor, with long-term survival rates of less than 30%. This review will explore the natural history of ESFT including clinical presentation, molecular pathology, and high-risk features of the disease. Outcomes of metastatic treatment protocols to date will be examined as well as the rationale for current and future therapies. Nursing considerations in caring for patients with metastatic ESFT will be discussed. A case scenario will be reviewed to highlight treatment and supportive care issues in the management of the disease. Cancer therapy in general is becoming more complex; treatment approaches involve different ways of targeting tumor cells. It is crucial that nurses caring for these patients understand the rationale behind treatment strategies so that appropriate patient education and support may be given.
Having a Child Diagnosed With Cancer: An Assessment of Values From the Mother's Viewpoint
Authors: Ward-Smith Peggy , Kirk Sarah , Hetherington Maxine , Hubble Christopher L.
Published: October 2005

The purpose of this qualitative study was to explore the mother's experience of having a child diagnosed with cancer. Semistructured interview questions, focused specifically on values, provided the foundation for the study. Each of the 9 participants was a mother of a child diagnosed with cancer 30 days prior to participation. Subsequent data were collected from each participant 6 months after the original interview. Using a phenomenological approach for data collection and analyses, themes were uncovered from each interview data set. The initial interviews identified 3 themes: (1) problems accessing the health care system, (2) challenges of family dynamics, and (3) support structures. Each theme persisted in the second interview, with an additional theme, (4) future plans, uncovered. Data from this study may provide guidance for health care professionals who provide care to these children and their families. The importance of maintaining communication and keeping promises cannot be overstated.
Bone Mineral Density Decrements and Children Diagnosed With Cancer
Authors: Pagano-Therrien Jesica , Santacroce Sheila Judge
Published: October 2005

This integrative literature review is focused on (1) the prevalence of bone mineral density (BMD) decrements in children treated for acute lymphoblastic leukemia (ALL), and when these decrements are observed; (2) the risk factors associated with the development of decreased BMD and resultant complications in children treated for ALL; (3) the role, if any, that corticosteroids play in decreasing BMD in children treated for ALL; (4) interventions that can potentially manage bone loss in people treated for ALL during childhood or adolescence. The results showed that people who have been diagnosed with ALL can have decrements in BMD. The etiology of BMD decrements can be attributed to multiple factors including genetic endowment, lifestyle behaviors, the leukemia disease process, and treatment exposures especially to corticosteroids and cranial radiotherapy. Male gender, age greater than 10 years, and physical inactivity are associated with BMD decrements in ALL survivors. The role of pediatric oncology nurses in the management of bone disease in children with cancer across the illness trajectory is discussed.
An Innovative Approach to the Care of Patients on Phase I and Phase II Clinical Trials: The Role of the Experimental Therapeutics Nurse
Authors: Carlson Claire , Reilly Maureen , Hitchens Anne
Published: October 2005

The tremendous strides in survival rates for childhood malignancies in large part can be attributed to the clinical trial mechanism. New and innovative therapies are being developed in the laboratory in an attempt to find a cure for those children who have relapsed or have refractory disease. Phase I and phase II clinical trials move this science from the laboratory to the patient’s bedside. With increasing frequency, the oncology staff nurse may be managing the care of a patient receiving a phase I or phase II study drug. Administration of these agents goes beyond what is familiar, requires specialized knowledge, and demands a skill set beyond what is required for standard oncology care. At The Children’s Hospital of Philadelphia, the role of the experimental therapeutics nurse was created in an effort to improve the process for identification, treatment, and follow-up of patients receiving these therapies. The broader role of nursing in clinical trials, the multidisciplinary challenges of experimental therapies, and the development of an innovative approach to caring for patients on phase I/II studies are discussed.
Mothers’ Home Health Care Work When Their Children Have Cancer
Authors: Clarke Juanne N. , Fletcher Paula C. , Schneider Margaret A.
Published: October 2005

The lack of research devoted to understanding the specific home health care work that mothers of children with cancer perform necessitates research in the area. This study examines the health care activities that mothers of children with cancer must assume in the home (eg, nursing care such as the administration of medicines, protecting the immune-suppressed child from concurrent illness, watching for side effects, record keeping, scheduling checkups and treatments). The implications for public policy of the extent and nature of home and lay health care in the hospital, clinic, and home are discussed.!
Comparing the Geriatric Depression Scale, Minimum Data Set, and Primary Care Provider Diagnosis for Depression in Rural Nursing Home Residents
Authors: Kerber Cindy Sullivan , Dyck Mary J. , Culp Kennith R. , Buckwalter Kathleen
Published: October 2005

BACKGROUND: Depression has a substantial negative impact on quality of life. Underdiagnosis and undertreatment of depression are major problems in nursing home residents. OBJECTIVES: This study sought to determine the prevalence of depression among older adults in nursing homes in rural Iowa using the Geriatric Depression Scale (GDS), Minimum Data Set (MDS), and primary care provider (PCP) depression diagnosis. DESIGN: This is a secondary analysis of data collected from 279 randomly selected residents of nursing homes in rural Iowa. RESULTS: The prevalence of depression based on the GDS (score of 6 or greater) was 37.3%, the MDS was 21.3%, and the PCP depression diagnosis was 39.1%. CONCLUSION: There was only chance agreement in identifying depression among the measures. The overall prevalence of depression (as indicated by a positive depression marker in any group) was 67.1%, suggesting depression continues to be a problematic clinical and quality-of-life issue in rural nursing homes.
Signs of Silent Suicide Among Depressed Hospitalized Geriatric Patients
Authors: Fitzpatrick Joyce J.
Published: October 2005

BACKGROUND: The overall suicide rate increases both with age and illness. Older hospitalized persons may be most at risk for silent suicide. OBJECTIVE: This study sought to determine whether nurses noted the signs of silent suicide in the medical records of elderly depressed hospitalized patients. STUDY DESIGN: This exploratory study included a retrospective chart review of geriatric patients who were identified as clinically depressed. Review of the charts was limited to the nursing documentation to determine signs related to silent suicide, evidence of psychiatric medications used to intervene, and notation of psychiatric referrals. RESULTS: Fifty of 200 patients had Geriatric Depression Scale scores reflective of depression; 41 of the 50 charts of these patients were retrievable and reviewed. Of the six signs of silent suicide, most charts (82.9%) had nurses’ notations of five to six of the signs. Only two of these patients were referred for any psychiatric consultation. CONCLUSIONS: There is a need for more awareness of the signs of silent suicide among depressed hospitalized elders.
“Politics Makes Strange Bedfellows”
Authors: Lusoli Wainer , Ward Janelle
Published: October 2005

This article examines the use of the Internet by a range of political actors in the 2004 European Parliament election in Britain—candidates, citizens, parties, government, pressure groups, and the media. Specifically, it surveys the structure of online political communications and the amount and nature of electoral information and engagement opportunities available to citizens in the framework of recent theories of “third age of political communications.” Methodologically, the article builds on the identification ( n= 571), sampling ( n= 100), qualitative annotation, and quantitative content analysis of U.K.campaignWeb sites between mid-April and Election Day,June 10,2004. Evidence provides qualified support for previous findings that the online campaign, or the lack thereof,largely reflects the apathy and disillusionment of the press,national politicians, and the media with a distinctly second-order election.However,there are two important qualifications to this “politics as usual” scenario.First,political parties,candidates, and government agencies provided a considerably wider variety of political information and engagement opportunities than in the past. As only 7 percent of British adults used the Internet for electoral information, one might wonder why online contents were provided at all.Second,online information and engagement opportunities were structured on two underlying dimensions, of which one is overtly political—a public communication versus political communication cleavage—while the other—replication versus innovation of techno-political practice—touches upon the political economy of Web production in the “third media age.”
Mutable Influences on Intimate Partner Abuse Screening in Health Care Settings
Authors: Stayton Catherine D. , Duncan Mary M.
Published: October 2005

For more than a decade, professional medical and nursing associations have recommended universal screening for intimate partner abuse (IPA). This review of 44 studies examines IPA screening during this period. The purposes of the review are to (a) identify mutable influences on IPA screening, (b) summarize what is known about altering these influences, and (c) outline an agenda for improving IPA screening. Evidence to date indicates that screening is not universal. Promising approaches to improvement start with provider training and relatively simple environmental adjustments. Unanswered empirical questions include “What are the essential components of effective training? Which health care providers are best positioned to screen under which circumstances? Which of the untested mutable influences will further improve IPA screening practice?” The review leads to the following practice recommendations: (a) Interventions should focus on clinicians in training (e.g., medical residents), and (b) screening approaches must be tailored to various practice settings.
The Effectiveness of Sexual Assault Nurse Examiner (SANE) Programs
Authors: Campbell Rebecca , Patterson Debra , Lichty Lauren F.
Published: October 2005

In sexual assault nurse examiner (SANE) programs, specially trained forensic nurses provide 24-hour-a-day, first-response medical care and crisis intervention to rape survivors in either hospitals or clinic settings. This article reviews the empirical literature regarding the effectiveness of SANE programs in five domains:(a) promoting the psychological recovery of survivors, (b) providing comprehensive and consistent postrape medical care (e.g., emergency contraception, sexually transmitted disease [STD] prophylaxis), (c) documenting the forensic evidence of the crime completely and accurately, (d) improving the prosecution of sexual assault cases by providing better forensics and expert testimony, and (e) creating community change by bringing multiple service providers together to provide comprehensive care to rape survivors. Preliminary evidence suggests that SANE programs are effective in all domains, but such conclusions are tentative because most published studies have not included adequate methodological controls to rigorously test the effectiveness of SANE programs. Implications for practice and future research are discussed.
Responsivity Issues in the Treatment of Sexual Offenders
Authors: Looman Jan , Dickie Ida , Abracen Jeffrey
Published: October 2005

Andrews and Bonta (2003) have presented a model of effective correctional programming focusing on risk, need, and responsivity factors for a general criminal population. When applied to sexual offenders, the first two issues (risk assessment and treatment targets such as cognitive distortions) have received a great deal of research attention. However, little attention has been paid to responsivity issues: those factors that influence the extent to which clients benefit, or fail to benefit, from treatment programs. This article presents a review of several potential responsivity factors related to sexual offender treatment and outlines areas that require further research attention.
The Transnationalization of the Telenovela Industry, Territorial References, and the Production of Markets and Representations of Transnational Identities
Authors: Mato Daniel
Published: October 2005

This article examines the process of the transnationalization of the telenovela industry from a perspective that seeks to articulate economic and cultural analysis. Several objectives guide this analysis: first, studying an industry of great importance in the daily life of hundreds of millions of human beings; second, criticizing through a case study the a priori assumptions that globalization processes are both “homogenizing” and “deterritorialized.” The case of the telenovela industry shows that while certain differences are erased from the productions, new ones appear, and that not only do old territorial references continue to be meaningful but that new territorial references emerge (e.g., the city of Miami); third, discussing some tensions underlying the production of telenovelas as a sector of television and other entertainment industries, with particular attention to the tensions related to the production of markets and of representations of identities, especially to the construction of a transnational “Hispanic” identity.
Coronation Street, Neighbours, Shortland Street
Authors: Dunleavy Trisha
Published: October 2005

The pressure on television soap operas to strike an effective balance between the often conflicting demands of localness and universality has been underlined by the genre’s post-1990 environment of aggressive competition, ratings anxiety, and continuing expectations that TV drama address export as well as domestic markets. Particularly given soap opera’s stripped, continuing nature and channel “flagship” role, new primetime soap concepts require artful trade-offs between national quirks and international conventions. This article uses examples from Britain, Australia, and New Zealand to examine the ways in which universality has been important to the primetime soap’s appeal in domestic as well as foreign markets while localness has worked to extend the genre’s diversity—particularly in the areas of concept, representation, and production approach.
Engaging the Audience
Authors: Clifford Reginald
Published: October 2005

The use of social imaginary as a research methodology and analysis technique was developed from a qualitative methodology called ASBI (análisis semántico basado en imagenes). Here, the application of this methodology is described with respect to TV Azteca and its offerings. The analysis is used to underwrite analysis that involves information from ratings, quantitative analysis, focus group and panel research, genre theory, and research about what I call the “social imaginary.” This model has been pioneered and applied to the production and broadcast of telenovelas. It is now being developed for use in news programs and in entertainment. The study reports work done for the TV Azteca chain in Mexico.
Political Controversies in Brazilian TV Fiction
Authors: Porto Mauro P.
Published: October 2005

This article discusses the Brazilian telenovela Terra Nostra, a prime-time production of TV Globo. The telenovela presented a complex picture of nineteenth-century Brazilian politics and of the saga of Italian immigrants, with a plurality of perspectives about these themes. A series of focus group discussions with viewers of different social backgrounds, concentrating on the political messages of the telenovela, reveals the complexity of audience responses. The author finds that the telenovela played an “orientation role,” providing interpretive frames that were often applied by viewers to current political issues. Even though they are frequently looked at with disdain, telenovelas have become key to understanding the dilemmas and perspectives of democratic politics in Brazil.
The role of pro- and anti-inflammatory responses in silica-induced lung fibrosis
Authors: Barbarin Virginie , Nihoul Aurélie , Misson Pierre , Arras Mohammed , Delos Monique , Leclercq Isabelle , Lison Dominique , Huaux Francois
Published: October 2005

Background

It has been generally well accepted that chronic inflammation is a necessary component of lung fibrosis but this concept has recently been challenged.

Methods

Using biochemical, histological, immunohistochemistry, and cellular analyses, we compared the lung responses (inflammation and fibrosis) to fibrogenic silica particles (2.5 and 25 mg/g lung) in Sprague-Dawley rats and NMRI mice.

Results

Rats treated with silica particles developed chronic and progressive inflammation accompanied by an overproduction of TNF-α as well as an intense lung fibrosis. Dexamethasone or pioglitazone limited the amplitude of the lung fibrotic reaction to silica in rats, supporting the paradigm that inflammation drives lung fibrosis.

In striking contrast, in mice, silica induced only a limited and transient inflammation without TNF-α overproduction. However, mice developed lung fibrosis of a similar intensity than rats. The fibrotic response in mice was accompanied by a high expression of the anti-inflammatory and fibrotic cytokine IL-10 by silica-activated lung macrophages. In mice, IL-10 was induced only by fibrotic particles and significantly expressed in the lung of silica-sensitive but not silica-resistant strains of mice. Anti-inflammatory treatments did not control lung fibrosis in mice.

Conclusion

These results indicate that, beside chronic lung inflammation, a pronounced anti-inflammatory reaction may also contribute to the extension of silica-induced lung fibrosis and represents an alternative pathway leading to lung fibrosis.
The key role for local base order in the generation of multiple forms of China HIV-1 B'/C intersubtype recombinants
Authors: Zhang Chi-Yu , Wei Ji-Fu , He Shao-Heng
Published: October 2005

Background

HIV-1 is a retrovirus with high rate of recombination. Increasing experimental studies in vitro indicated that local hairpin structure of RNA was associated with recombination by favoring RT pausing and promoting strand transfer. A method to estimate the potential to form stem-loop structure by calculating the folding of randomized sequence difference (FORS-D) has been used to investigate the relationship between secondary structure and evolutionary pressure in some genome. It showed that gene regions under strong positive "Darwinian" selection were associated with positive FORS-D values. In the present study, the sequences of HIV-1 subtypes B' and C, both of which represent the parent strains of CRF07_BC, CRF08_BC and China URFs, were selected to investigate the relationship between natural recombination and secondary structure by calculating the FORS-D values.

Results

The apparent higher negative FORS-D value region appeared in the gag-pol gene region (nucleotide 0–3000) of HIV-1 subtypes B' and C. Thirteen (86.7 %) of 15 mosaic fragments and 17 (81 %) of 21 recombination breakpoints occurred in this higher negative FORS-D region. This strongly suggested that natural recombination did not occur randomly throughout the HIV genome, and that there might be preferred (or hot) regions or sites for recombination. The FORS-D analysis of breakpoints showed that most breakpoints of recombinants were located in regions with higher negative FORS-D values (P = 0.0053), and appeared to have a higher negative average FORS-D value than the whole genome (P = 0.0007). The regression analysis also indicated that FORS-D values correlated negatively with breakpoint overlap.

Conclusion

High negative FORS-D values represent high, base order determined stem-loop potentials and influence mainly the formation of stem-loop structures. Therefore, the present results suggested for the first time that occurrence of natural recombination was associated with high base order-determined stem-loop potential, and that local base order might play a key role in the initiation of natural recombination by favoring the formation of stable stem-loop structures.
Two previously proposed P1/P2-differentiating and nine novel polymorphisms at the A4GALT (P
k
) locus do not correlate with the presence of the P1 blood group antigen
Authors: Hellberg Åsa , Chester M Alan , Olsson Martin L
Published: October 2005

Background

The molecular genetics of the P blood group system and the absence of P1 antigen in the p phenotype are still enigmatic. One theory proposes that the same gene encodes for both the P1 and Pk glycosyltransferases, but no polymorphisms in the coding region of the P

k
gene explain the P1/P2 phenotypes. We investigated the potential regulatory regions up- and downstream of the A4GALT (P

k
) gene exons.

Results

P1 (n = 18) and P2 (n = 9) samples from donors of mainly Swedish descent were analysed by direct sequencing of PCR-amplified 5'- and 3'-fragments surrounding the P

k
coding region. Seventy-eight P1 and P2 samples were investigated with PCR using allele-specific primers (ASP) for two polymorphisms previously proposed as P2-related genetic markers (-551_-550insC, -160A>G). Haplotype analysis of single nucleotide polymorphisms was also performed with PCR-ASP. In ~1.5 kbp of the 3'-untranslated region one new insertion and four new substitutions compared to a GenBank sequence (AL049757) were found. In addition to the polymorphisms at positions -550 and -160, one insertion, two deletions and one substitution were found in ~1.0 kbp of the 5'-upstream region. All 20 P2 samples investigated with PCR-ASP were homozygous for -550insC. However, so were 18 of the 58 P1 samples investigated. Both the 20 P2 and the 18 P1 samples were also homozygous for -160G.

Conclusion

The proposed P2-specific polymorphisms, -551_-550insC and -160G, found in P2 samples in a Japanese study were found here in homozygous form in both P1 and P2 donors. Since P

2
is the null allele in the P blood group system it is difficult to envision how these mutations would cause the P2 phenotype. None of the novel polymorphisms reported in this study correlated with P1/P2 status and the P1/p mystery remains unsolved.
Callose (β-1,3 glucan) is essential for Arabidopsispollen wall patterning, but not tube growth
Authors: Nishikawa Shuh-ichi , Zinkl Gregory M , Swanson Robert J , Maruyama Daisuke , Preuss Daphne
Published: October 2005

Background

Callose (β-1,3 glucan) separates developing pollen grains, preventing their underlying walls (exine) from fusing. The pollen tubes that transport sperm to female gametes also contain callose, both in their walls as well as in the plugs that segment growing tubes. Mutations in CalS5, one of several Arabidopsis β-1,3 glucan synthases, were previously shown to disrupt callose formation around developing microspores, causing aberrations in exine patterning, degeneration of developing microspores, and pollen sterility.

Results

Here, we describe three additional cals5 alleles that similarly alter exine patterns, but instead produce fertile pollen. Moreover, one of these alleles (cals5-3) resulted in the formation of pollen tubes that lacked callose walls and plugs. In self-pollinated plants, these tubes led to successful fertilization, but they were at a slight disadvantage when competing with wild type.

Conclusion

Contrary to a previous report, these results demonstrate that a structured exine layer is not required for pollen development, viability or fertility. In addition, despite the presence of callose-enriched walls and callose plugs in pollen tubes, the results presented here indicate that callose is not required for pollen tube functions.
Serous borderline tumor of the fallopian tube presented as hematosalpinx: a case report
Authors: Krasevic Maja , Stankovic Teodora , Petrovic Oleg , Smiljan-Severinski Neda
Published: October 2005

Background

Compared with their ovarian counterparts, serous borderline tumors of the fallopian tube are uncommon, with limited experience about their clinical behaviour. We present a case of serous borderline tumor of the fallopian tube with unusual presentation and summarise all the published cases to date.

Case presentation

A case of serous borderline tumor of the fallopian tube in a 34-year old patient is presented, incidentally found during routine gynecologic examination. At laparoscopy the tumor was unusualy presented as hematosalpinx and was treated by salpingectomy. Cell-cycle analysis of the tumor tissue revealed a diploid DNA content and a low S-phase fraction. There was no evidence of the disease during the follow-up period of 4.6 years.

Conclusion

The current case and review of the literature suggest salpingectomy as the optimal treatment for patients with serous borderline tumor of the fallopian tube.
Modeling the effect of age in T1-2 breast cancer using the SEER database
Authors: Tai Patricia , Cserni Gábor , Van De Steene Jan , Vlastos Georges , Voordeckers Mia , Royce Melanie , Lee Sang-Joon , Vinh-Hung Vincent , Storme Guy
Published: October 2005

Background

Modeling the relationship between age and mortality for breast cancer patients may have important prognostic and therapeutic implications.

Methods

Data from 9 registries of the Surveillance, Epidemiology, and End Results Program (SEER) of the United States were used. This study employed proportional hazards to model mortality in women with T1-2 breast cancers. The residuals of the model were used to examine the effect of age on mortality. This procedure was applied to node-negative (N0) and node-positive (N+) patients. All causes mortality and breast cancer specific mortality were evaluated.

Results

The relationship between age and mortality is biphasic. For both N0 and N+ patients among the T1-2 group, the analysis suggested two age components. One component is linear and corresponds to a natural increase of mortality with each year of age. The other component is quasi-quadratic and is centered around age 50. This component contributes to an increased risk of mortality as age increases beyond 50. It suggests a hormonally related process: the farther from menopause in either direction, the more prognosis is adversely influenced by the quasi-quadratic component. There is a complex relationship between hormone receptor status and other prognostic factors, like age.

Conclusion

The present analysis confirms the findings of many epidemiological and clinical trials that the relationship between age and mortality is biphasic. Compared with older patients, young women experience an abnormally high risk of death. Among elderly patients, the risk of death from breast cancer does not decrease with increasing age. These facts are important in the discussion of options for adjuvant treatment with breast cancer patients.
Postoperative IOP prophylaxis practice following uncomplicated cataract surgery: a UK-wide consultant survey
Authors: Zamvar Usha , Dhillon Baljean
Published: October 2005

Background

In order to minimise postoperative intraocular pressure (IOP) rise, after routine uncomplicated cataract surgery, prophylaxis may be adopted. Currently, there are no specific guidelines in this regard resulting in wide variation in practice across the UK. We sought to document these variations through a questionnaire survey.

Methods

A questionnaire was sent to all consultant ophthalmic surgeons in the UK.

Results

62.6% of surgeons did not use any IOP lowering agents. 37.4% surgeons routinely prescribed some form of medication. The majority (86.8%) used oral diamox. 20.6% of surgeons said they based their practice on evidence, 43.3% on personal experience, and 17.6% on unit policy. Surprisingly, among the two groups of surgeons (those who gave routine prophylaxis, and those who did not) the percentages of surgeons quoting personal experience, unit policy, or presence of evidence was strikingly similar. The timing of the first postoperative IOP check varied from the same day to beyond 2 weeks. Only 20.2% of surgeons had ever seen an adverse event related to IOP rise; this complication is thus very rare.

Conclusion

This survey highlights a wide variation in the practice and postoperative management of phacoemulsification cataract surgery. What is very striking is that there is a similar proportion of surgeons in the diametrically opposite groups (those who give or do not give routine IOP lowering prophylaxis) who believe that there practice is evidence based. The merits of this study suggests that consideration must be given to drafting a uniform guideline in this area of practice.
Differing mental health practice among general practitioners, private psychiatrists and public psychiatrists
Authors: Younès N , Hardy-Bayle MC , Falissard B , Kovess V , Chaillet MP , Gasquet I
Published: October 2005

Background

Providing care for mental health problems concerns General Practitioners (GPs), Private Psychiatrists (PrPs) and Public Psychiatrists (PuPs). As patient distribution and patterns of practice among these professionals are not well known, a survey was planned prior to a re-organisation of mental health services in an area close to Paris

Methods

All GPs (n = 492), PrPs (n = 82) and PuPs (n = 78) in the South-Yvelines area in France were informed of the implementation of a local mental health program. Practitioners interested in taking part were invited to include prospectively all patients with mental health problem they saw over an 8-day period and to complete a 6-month retrospective questionnaire on their mental health practice. 180 GPs (36.6%), 45 PrPs (54.9%) and 63 PuPs (84.0%) responded.

Results

GPs and PrPs were very similar but very different from PuPs for the proportion of patients with anxious or depressive disorders (70% v. 65% v. 38%, p < .001), psychotic disorders (5% v. 7% v. 30%, p < .001), previous psychiatric hospitalization (22% v. 26 v. 61%, p < .001) and receiving disability allowance (16% v. 18% v. 52%, p < .001). GPs had fewer patients with long-standing psychiatric disorders than PrPs and PuPs (52%, 64% v. 63%, p < .001). Time-lapse between consultations was longest for GPs, intermediate for PuPs and shortest for PrPs (36 days v. 26 v. 18, p < .001). Access to care had been delayed longer for Psychiatrists (PrPs, PuPs) than for GPs (61% v. 53% v. 25%, p < .001). GPs and PuPs frequently felt a need for collaboration for their patients, PrPs rarely (42% v. 61%. v. 10%, p < .001).

Satisfaction with mental health practice was low for all categories of physicians (42.6% encountered difficulties hospitalizing patients and 61.4% had patients they would prefer not to cater for). GPs more often reported unsatisfactory relationships with mental health professionals than did PrPs and PuPs (54% v. 15% v. 8%, p < .001).

Conclusion

GP patients with mental health problems are very similar to patients of private psychiatrists; there is a lack of the collaboration felt to be necessary, because of psychiatrists' workload, and because GPs have specific needs in this respect. The "Yvelines-Sud Mental Health Network" has been created to enhance collaboration.
Evaluation of school absenteeism data for early outbreak detection, New York City
Authors: Besculides Melanie , Heffernan Richard , Mostashari Farzad , Weiss Don
Published: October 2005

Background

School absenteeism data may have utility as an early indicator of disease outbreaks, however their value should be critically examined. This paper describes an evaluation of the utility of school absenteeism data for early outbreak detection in New York City (NYC).

Methods

To assess citywide temporal trends in absenteeism, we downloaded three years (2001–02, 2002–03, 2003–04) of daily school attendance data from the NYC Department of Education (DOE) website. We applied the CuSum method to identify aberrations in the adjusted daily percent absent. A spatial scan statistic was used to assess geographic clustering in absenteeism for the 2001–02 academic year.

Results

Moderate increases in absenteeism were observed among children during peak influenza season. Spatial analysis detected 790 significant clusters of absenteeism among elementary school children (p < 0.01), two of which occurred during a previously reported outbreak.

Conclusion

Monitoring school absenteeism may be moderately useful for detecting large citywide epidemics, however, school-level data were noisy and we were unable to demonstrate any practical value in using cluster analysis to detect localized outbreaks. Based on these results, we will not implement prospective monitoring of school absenteeism data, but are evaluating the utility of more specific school-based data for outbreak detection.
Directed evolution strategies for improved enzymatic performance
Authors: Hibbert Edward G , Dalby Paul A
Published: October 2005

The engineering of enzymes with altered activity, specificity and stability, using directed evolution techniques that mimic evolution on a laboratory timescale, is now well established. However, the general acceptance of these methods as a route to new biocatalysts for organic synthesis requires further improvement of the methods for both ease-of-use and also for obtaining more significant changes in enzyme properties than is currently possible. Recent advances in library design, and methods of random mutagenesis, combined with new screening and selection tools, continue to push forward the potential of directed evolution. For example, protein engineers are now beginning to apply the vast body of knowledge and understanding of protein structure and function, to the design of focussed directed evolution libraries, with striking results compared to the previously favoured random mutagenesis and recombination of entire genes. Significant progress in computational design techniques which mimic the experimental process of library screening is also now enabling searches of much greater regions of sequence-space for those catalytic reactions that are broadly understood and, therefore, possible to model.

Biocatalysis for organic synthesis frequently makes use of whole-cells, in addition to isolated enzymes, either for a single reaction or for transformations via entire metabolic pathways. As many new whole-cell biocatalysts are being developed by metabolic engineering, the potential of directed evolution to improve these initial designs is also beginning to be realised.
Patients' perspectives on how idiopathic pulmonary fibrosis affects the quality of their lives
Authors: Swigris Jeffrey J , Stewart Anita L , Gould Michael K , Wilson Sandra R
Published: October 2005

Background

Idiopathic pulmonary fibrosis (IPF) is a debilitating lung disease with a survival of only three to five years from the time of diagnosis. Due to a paucity of studies, large gaps remain in our understanding of how IPF affects the quality of patients' lives. In only one other study did investigators ask patients directly for their perspectives on this topic. Further, currently there is no disease-specific instrument to measure health-related quality of life (HRQL) in patients with IPF. A carefully constructed measurement instrument, sensitive to underlying change, is needed for use in clinical trials and longitudinal studies of patients with IPF. Before developing such an instrument, researchers must improve their understanding of the relevant effects of IPF on patients' lives. On a broader scale, to provide the best care for people with IPF, clinicians must appreciate – from patients' perspectives – how this disease affects various aspects of their lives.

Methods

We used focus groups and individual in-depth interviews with 20 IPF patients to collect their perspectives on how IPF affects their lives (with a focus on the quality of their lives). We then analyzed these perspectives and organized them into a conceptual framework for describing HRQL in patients with IPF. Next, we examined how well certain existing measurement instruments – which have been administered to IPF patients in prior studies – covered the domains and topics our patients identified.

Results

In our framework, we identified 12 primary domains: symptoms, IPF therapy, sleep, exhaustion, forethought, employment and finances, dependence, family, sexual relations, social participation, mental and spiritual well-being, mortality. Each domain is composed of several topics, which describe how IPF affects patients' lives. When we compared the content of our conceptual framework with the existing instruments, we found the coverage of the existing instruments to be inadequate for several reasons, including they may tap general areas of QOL or HRQL but not some areas that appear to be most directly affected by IPF, and they include items that are relevant to symptoms and effects of other respiratory diseases but not IPF.

Conclusion

Collecting patients' perspectives and developing an organized inventory of the relevant effects of IPF on patients' lives provides valuable information for improving our understanding of the impact of this disease on patients and their loved ones. We believe our findings will help alert clinicians and researchers to IPF patients' experiences and concerns. Based on the comparison or our conceptual framework with the content of four existing instruments, it would appear that developing an IPF-specific measurement instrument is justified. Our conceptual framework for describing health-related quality of life in patients with IPF lays a solid foundation for constructing such an instrument.
Retroperitoneal inflammatory myofibroblastic tumor
Authors: Attili Suresh VS , Chandra C Rama , Hemant Dadhich K , Bapsy Poonamalle P , RamaRao Clementeena , Anupama G
Published: October 2005

Background

Inflammatory myofibroblastic tumor (IMT) is a neoplasm of unknown etiology occurring at various sites. By definition, it is composed of spindle cells (myofibroblasts) with variable inflammatory component, hence the name is IMT.

Case presentation

The present case is of a 46 years old woman presented with a history of flank pain, abdominal mass and intermittent hematuria for last 6 months. The initial diagnosis was kept as renal cell carcinoma. Finally, it turned out to be a case of retroperitoneal IMT. The patient was managed by complete surgical resection of the tumor.

Conclusion

IMT is a rare neoplasm of uncertain biological potential. Complete surgical resection remains the mainstay of the treatment.
Focal glial activation coincides with increased BACE1 activation and precedes amyloid plaque deposition in APP[V717I] transgenic mice
Authors: Heneka Michael T , Sastre Magdalena , Dumitrescu-Ozimek Lucia , Dewachter Ilse , Walter Jochen , Klockgether Thomas , Van Leuven Fred
Published: October 2005

Background

Inflammation is suspected to contribute to the progression and severity of neurodegeneration in Alzheimer's disease (AD). Transgenic mice overexpressing the london mutant of amyloid precursor protein, APP [V717I], robustly recapitulate the amyloid pathology of AD.

Methods

Early and late, temporal and spatial characteristics of inflammation were studied in APP [V717I] mice at 3 and 16 month of age. Glial activation and expression of inflammatory markers were determined by immunohistochemistry and RT-PCR. Amyloid deposition was assessed by immunohistochemistry, thioflavine S staining and western blot experiments. BACE1 activity was detected in brain lysates and in situ using the BACE1 activity kit from R&D Systems, Wiesbaden, Germany.

Results

Foci of activated micro- and astroglia were already detected at age 3 months, before any amyloid deposition. Inflammation parameters comprised increased mRNA levels coding for interleukin-1β, interleukin-6, major histocompatibility complex II and macrophage-colony-stimulating-factor-receptor. Foci of CD11b-positive microglia expressed these cytokines and were neighbored by activated astrocytes. Remarkably, β-secretase (BACE1) mRNA, neuronal BACE1 protein at sites of focal inflammation and total BACE1 enzyme activity were increased in 3 month old APP transgenic mice, relative to age-matched non-transgenic mice. In aged APP transgenic mice, the mRNA of all inflammatory markers analysed was increased, accompanied by astroglial iNOS expression and NO-dependent peroxynitrite release, and with glial activation near almost all diffuse and senile Aβ deposits.

Conclusion

The early and focal glial activation, in conjunction with upregulated BACE1 mRNA, protein and activity in the presence of its substrate APP, is proposed to represent the earliest sites of amyloid deposition, likely evolving into amyloid plaques.
Branching projections of ventrolateral reticular neurons to the medial preoptic area and lumbo-sacral spinal cord
Authors: Russo Antonella , Pellitteri Rosalia , Romeo Rosa , Stanzani Stefania , Jean André
Published: October 2005

Different findings indicate that rostral ventrolateral reticular nucleus (RVL) is neuronal substrate of integration and regulation of the cardiovascular functions. Some efferent RVL neurons project to the thoraco-lumbar spinal cord and excite preganglionic sympathetic neurons, to the spinal phrenic motor neurons involved in inspiratory function and increase the activity of vasoconstrictor fibres innervating blood vessels in the skin and skeletal muscle. Our study was aimed at revealing presence of neurons within RVL supplying branching collateral input to the medial preoptic area (MPA) and to the lumbo-sacral spinal cord (SC-L) in the rat. All animal experiments were carried out in accordance with current institutional guidelines for the care and use of experimental animals. We have employed double fluorescent-labelling procedure: the projections were defined by injections of two retrograde tracers: Rhodamine Labelled Bead (RBL) and Fluoro Gold (FG) in the MPA and SC-L, respectively. Our results showed the presence of few single FG neurons and single RBL neurons in the RVL. The size of FG-neurons and RBL-neurons was medium (25–30 μm) and large (50 μm).

Few double-projecting neurons were distributed in the middle third of RVL nucleus, their size was 30–40 μm. The results demonstrate that pools of neurons in the RVL have collateral projections to the MPA and SC-L and they are involved in ascending and descending pathway. These data suggest that these neurons could play a role in maintaining activity of central and peripheral blood flow.
25-Hydroxyvitamin D31α-hydroxylase expression in breast cancer and use of non-1α-hydroxylated vitamin D analogue
Authors: Segersten Ulrika , Holm Pernille Kaae , Björklund Peyman , Hessman Ola , Nordgren Hans , Binderup Lise , Åkerström Göran , Hellman Per , Westin Gunnar
Published: October 2005

Introduction

The cytochrome P450 mitochondrial enzyme 25-hydroxyvitamin D3 1α-hydroxylase (1α-hydroxylase) of renal tubule cells hydroxylates the major circulating form of vitamin D (25(OH)D3) to the active systemic hormone 1,25(OH)2D3. Local production of 1,25(OH)2D3 appears to occur also at other sites where 1α-hydroxylase is expressed for autocrine/paracrine regulation. To reduce risks of hypercalcemia during treatment with vitamin D, we have previously suggested use of non-1α-hydroxylated vitamin D analogues to target tissues where 1α-hydroxylase is expressed, including the parathyroid glands in secondary hyperparathyroidism. The present study was undertaken to examine expression of 1α-hydroxylase in breast cancer and to investigate whether a non-1α-hydroxylated vitamin D analogue displayed biological function. In addition, expression of the 25-hydroxyvitamin D3 24-hydroxylase (24-hydroxylase) and the vitamin D receptor (VDR) was investigated.

Methods

The expression of 1α-hydroxylase, 24-hydroxylase and VDR was investigated in breast cancer specimens (n = 19) and normal breast tissues (n = 10) by immunohistochemistry and/or RT-PCR. Consecutive cryosections of 6 μm essentially free of immune cells were used in the analyses. The effect of vitamin D analogues on transcriptional activation was analyzed in transiently transfected MCF-7 breast cancer cells.

Results

1α-hydroxylase protein was demonstrated in 79% and 100% of breast cancer specimens and normal breast, respectively. The overall relative mRNA levels of 1α-hydroxylase and 24-hydroxylase in normal breast compared to breast tumors were: 1α-hydroxylase, 1 ± 0.07 versus 0.7 ± 0.05, respectively (p < 0.001); 24-hydroxylase, 1 ± 0.08 verus 2.1 ± 0.2, respectively (p < 0.001). The VDR was expressed in 95% of the tumors as expected, with mRNA levels of 1 ± 0.09 and 1.4 ± 0.12 (p < 0.05) in breast cancer and normal breast, respectively. The ketoconazole-sensitive transcription activation potential of the non-1α-hydroxylated vitamin D analogue prodrug of EB1089 (EB1285) was demonstrated in MCF-7 cells, which express 1α-hydroxylase. The activity of EB1285 was about 20% of 1,25(OH)2D3.

Conclusion

These results demonstrate nearly normal expression levels of 1α-hydroxylase, 24-hydroxylase and VDR in the majority of investigated breast cancer specimens. A non-1α-hydroxylated vitamin D analogue displayed activity in breast cancer cells. Such analogues may present future therapeutic options for proliferative disorders where 1α-hydroxylase is expressed.