bluuebunny/crossref_metadata_2025 huggingface dataset:
Collagenous colitis: Oral low‐dose methotrexate for patients with difficult symptoms: Long‐term outcomes
Authors: Riddell James , Hillman Lybus , Chiragakis Louise , Clarke Anthony
Published: September 2007

Aim:  To perform a qualitative retrospective review of identified cases of collagenous colitis within the patient databases of local clinicians, with particular attention to the use and effectiveness of oral low‐dose methotrexate.

Methods:  Gastroenterologists in the referral area were invited to identify collagenous colitis cases from their own databases for inclusion in the study. Patients were considered eligible if they had a symptom history and colonic mucosal histology consistent with collagenous colitis. The retrospective analysis identified age at diagnosis, previous therapies, date of commencement and duration and effectiveness of methotrexate, side‐effects, and repeat colonic mucosal histology (if available) after a period of treatment.

Results:  Between 1986 and 2003, 43 eligible patients were identified, ranging in age from 32 years to 88 years at the time of diagnosis. Nineteen of the 43 received methotrexate over varying periods, and in 16 of these the clinical response was considered either ‘Good’ (14) or ‘Partial’ (2). In the methotrexate group 10 of the 19 underwent repeat colonoscopy and mucosal biopsy at some stage after commencing methotrexate. Of these, five had normal histology in comparison with pretreatment abnormal histology, two had improvement but not normalization of histology, and three had unchanged abnormal histology.

Conclusion:  The data from this retrospective review suggest that methotrexate may have a beneficial effect on symptoms of collagenous colitis and may improve the underlying histological abnormality. A controlled trial of adequate power and duration is needed to further clarify the usefulness of methotrexate in this condition.
Personality, treatment choice and satisfaction in patients with localized prostate cancer
Authors: Block Craig A , Erickson Brad , Carney‐Doebbling Caroline , Gordon Susanna , Fallon Bernard , Konety Badrinath R
Published: September 2007

Objectives:  Radical prostatectomy (RP), external beam radiation (XRT) and brachytherapy (BTX) are the most commonly used treatments for localized prostate cancer. We studied whether patient personality influences treatment choice and overall treatment satisfaction.

Methods:  From 1998 to 2002, 219 consecutive patients treated with RP (n = 74), XRT (n = 73), or BTX (n = 72) at our institution who remained free of biochemical recurrence were sent the Big Five Inventory (BFI) and a satisfaction/treatment participation questionnaire. We compared personality, satisfaction and participation scores between the three groups. Correlation between personality and satisfaction was determined. Multivariate regression was used to determine association between personality and satisfaction/participation after controlling for patient‐ and disease‐related factors.

Results:  Higher mean satisfaction and participation scores were observed within the RP and XRT groups, respectively (P = NS). No significant differences in personality were observed between groups. XRT patients tended to have higher extroversion, openness and agreeability scores, while RP patients tended to be more neurotic and conscientious (all P = NS). After controlling for other factors, a negative correlation was found between openness scores and satisfaction and a positive correlation between conscientiousness scores and satisfaction. Specific personality traits were associated with interest in participation in care for both RP and BTX patients but not for XRT patients.

Conclusions:  There are mild variations in personality as measured by the BFI between patients undergoing treatment for localized prostate cancer. Certain BFI‐measured personality traits may be associated with levels of satisfaction following therapy. Disease concerns and provider recommendations may override the influence of personality in the decision‐making process.
Next of kin's conceptions of the quality of care in the psychiatric setting: A phenomenographic study
Authors: Schröder Agneta , Wilde Larsson Bodil , Ahlström Gerd
Published: September 2007

ABSTRACT:  The next of kin play a decisive role in the care provided for patients. This and their unique experience of psychiatric care make it important to include them when defining quality of care. The aim of the present study was to describe how next of kin perceive the concept of quality of care in the case of psychiatric care. Twelve next of kin were included in a qualitative interview study and a phenomenographic approach was used for the analysis of the interviews. The next of kin described quality of care mainly from their own perspective but also to a large extent from the patient's perspective as well. Five descriptive categories resulted: dignity, security, participation, recovery, and health‐promoting surroundings. Good relations and communication between staff, patients, and next of kin emerged as the central factors regarding the quality of psychiatric care. The next of kin asked for information about psychiatric illnesses and wanted to cooperate in the care. They avoid telling others about their family member's psychiatric illness because of a feeling of shame and guilt. Staff education regarding such feelings and stigmatization could be useful in furthering the understanding of the next of kin's distress and developing interventions to alleviate it. Clinical practice can be improved by guidelines and instruments developed on the basis of this study.
Consumer–clinician co‐taught borderline personality disorder training: A pilot evaluation
Authors: Krawitz Roy , Jackson Wendy
Published: September 2007

ABSTRACT:  This paper describes a consumer–clinician co‐taught borderline personality disorder training programme for clinicians, of whom the largest group were nurses, working in mental health and substance use fields. A pilot evaluation of 73 participants attending the training rated the training as superior to evaluations of an earlier clinician‐only‐taught training. This study of a novel co‐taught training programme found that the consumer input added substantial value. Findings indicate that consumer input into education programmes can make a significant positive contribution to the delivery of mental health services training with likely impacts on mental health service delivery. The potential importance of the findings warrants a comprehensive multicentre study. Confirming the findings would have implications for future borderline personality disorder training programmes.
Effect of kihito extract granules on cognitive function in patients with Alzheimer's‐type dementia
Authors: Higashi Keiko , Rakugi Hiromi , Yu Hisahiro , Moriguchi Atsushi , Shintani Takahiro , Ogihara Toshio
Published: September 2007

Background:  It has been recently suggested that Japanese herbal (kampo) medicines, such as kami‐untan‐to, may improve cognitive function in elderly subjects with Alzheimer's disease. Polygalae radix is thought to be a useful component of kami‐untan‐to because it enhances the activity of choline acetyltransferase in cultured neuronal cells. The purpose of the present study was to investigate the safety and usefulness of kihito extract granules, a commercially available Japanese herbal medicine that contains P. radix, for elderly patients with senile dementia.

Methods:  Seventy‐five elderly subjects (84.4 ± 6.4 years) with senile dementia of Alzheimer type according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria were randomly assigned to the non‐treatment, goshajinkigan (control kampo medicine) or kihito groups. Each medicine was given three times a day for 3 months.

Results:  There was no severe adverse event in any of the groups. We examined the Mini‐Mental State Examination (MMSE), the activities of daily living (ADL) scale and cerebrovascular single photon emission computed tomography (SPECT) before and after treatment. MMSE scores were significantly improved only in the kihito group (+1.65 ± 0.53) but not in the non‐treatment (−0.3 ± 0.67) and goshajinkigan (−0.58 ± 0.49) groups. ADL scores remained unchanged in all groups. Treatment with kihito was not associated with an increase in cerebral blood flow.

Conclusion:  These results propose that kihito may be useful and has potential to be tested as a medicine for Alzheimer's‐type senile dementia, although further examination is required to clarify the mechanism of the improving effect of kihito on cognitive function.
Dyslipidemia is a major determinant of systemic atherosclerosis in the elderly: An autopsy study
Authors: Naito Takahiro , Sawabe Motoji , Arai Tomio , Chida Kouji , Hamamatsu Akihiko , Harada Kazumasa , Ozawa Toshio , Murayama Shigeo , Muramatsu Masaaki
Published: September 2007

Background:  Assessment of the pathobiological determinants of atherosclerosis is crucial for a better understanding of cardiovascular events.

Methods:  The study was conducted in 178 autopsy cases of in‐hospital death (104 men and 74 women; mean age, 81 years), for whom serum lipid values recorded during outpatient follow ups for chronic diseases were available. Severity of the atherosclerosis was semiquantitatively assessed in 10 arteries, and the correlations with age, sex, serum levels of total cholesterol and high‐density lipoprotein cholesterol (HDL‐C), and the history of hypertension, diabetes mellitus and/or smoking were evaluated.

Results:  The statistically significant risk factors differed between the genders and among the arterial systems. The effect of total cholesterol and HDL‐C was more prominent in women than in men. The odds ratio of an elevated total cholesterol value (per 0.1 g/L) for coronary atherosclerosis was 1.56 (95% confidence interval, 1.25–1.95, P < 0.001) in women and 1.19 (1.07–1.33, P = 0.002) in men. Hypertension, but not serum lipid profiles, was significantly associated with cerebral atherosclerosis in both genders (P < 0.05). Diabetes mellitus and smoking were associated with atherosclerosis in selected arteries.

Conclusion:  Dyslipidemia is a major determinant of atherosclerosis in the elderly, and control of dyslipidemia is still necessary in the elderly population.
Non‐medical palliative care and education to improve end‐of‐life care at geriatric health services facilities: A nationwide questionnaire survey of chief nurses
Authors: Hirakawa Yoshihisa , Masuda Yuichiro , Kuzuya Masafumi , Iguchi Akihisa , Uemura Kazumasa
Published: September 2007

Background:  Geriatric health services facilities (GHSF) are expected to assume a growing role in caring for the dying elderly. However, research in this area has so far been scant. The purpose of the present study is to reveal the status of non‐medical palliative care and staff education aiming at improving and enhancing end‐of‐life care at GHSF.

Methods:  The subjects were 2876 chief nurses of GHSF. Data was collected through a mailed questionnaire in 2003. The questionnaire covered the following: (i) staff perception of end‐of‐life care policies; (ii) staff education; and (iii) available non‐medical care. To evaluate the factors correlated with end‐of‐life care policies at GHSF, we divided the facilities into two groups.

Results:  We analyzed the answers collected from 313 facilities with a progressive policy toward end‐of‐life care (PP group) and 818 with a regressive policy toward it (RP group). It was found that staff training was conducted more frequently among PP facilities. Generally, nurses in the PP facilities were more confident that they could provide comprehensive on‐site end‐of‐life care and grieving support, but did not feel so sure about their ability to provide better end‐of‐life environments for dying residents and family by organizing outside support from voluntary and/or governmental organizations and religious organization for healing and to pursue appropriately a written follow‐up communication with the bereaved family.

Conclusions:  Our results suggest that providing GHSF staff with education about end‐of‐life issues or setting up collaboration with the outside is an important factor to enhance overall end‐of‐life care at these facilities.
Hospital care of people living in residential care facilities: Profile, utilization patterns and factors impacting on quality and safety of care
Authors: Jayasinghe Sanjay , Young Lis , Santiano Nancy , Bauman Adrian , Dickson Hugh G , Rowland Jeffrey , Anderson Teresa
Published: September 2007

Background:  Residents in residential care facilities (RCF) are frequent users of acute hospital services. However, the interface between the two sectors remains relatively unexplored. Our objective was to determine the patterns of utilization, characteristics and experiences of RCF residents accessing a tertiary referral center (TRC).

Methods:  An observational study of RCF residents presenting to the TRC emergency department (ED). The experiences of acute care services were explored for more than one‐quarter of this group 2–3 days postdischarge. The carer within the RCF acted as the proxy respondent.

Results:  During the study period, RCF residents accounted for 2.3% of all ED presentations. These presentations involved 526 residents. The dimension “continuity of care” for the Picker Patient Experience questionnaire had the highest proportion (53.1%) reporting a problem. The likelihood of reporting a problem for “continuity of care” (odds ratio [OR], 3.58; confidence interval [CI], 1.72–7.45) and “information and education” (OR, 2.62; CI, 1.14–3.01) were higher if the resident was admitted to a ward compared to ED only. If the resident had a low level care status the likelihood of reporting a problem for “continuity of care” (OR, 2.8; CI, 1.02–7.72) also increased. The odds of RCF staff reporting a problem for “ambulance service” were significantly higher if the resident's presentation was related to a fall. (OR, 3.35; CI, 1.28–8.8).

Conclusion:  The utilization rates for acute hospital care in our study were similar to the two previous Australian studies. Factors at the patient and organizational level impacted significantly on problems relating to the quality and safety of care being reported.
Three‐dimensional sonographic volume measurement of the fetal spleen
Authors: Hata Toshiyuki , Kuno Atsushi , Dai Shu‐Yan , Inubashiri Eisuke , Hanaoka Uiko , Kanenishi Kenji , Yamashiro Chizu , Tanaka Hirokazu , Yanagihara Toshihiro
Published: September 2007

Aim:  The objective of this longitudinal study was to evaluate the growth of the fetal spleen in normal pregnancies, using three‐dimensional ultrasound.

Methods:  Three‐dimensional sonographic examinations were performed on 14 appropriate‐for‐gestational‐age fetuses. Fetal splenic volume was measured every 2–3 weeks after 20 weeks of gestational age until delivery.

Results:  Curvilinear relationships were found between the gestational age and splenic volume (R2 = 80.2%, P < 0.0001), and normal ranges of splenic volume measurements for estimating the growth of the fetal spleen during normal pregnancy were generated. We found that the splenic volume calculation based on the equation for the volume of the ellipsoid by conventional two‐dimensional ultrasound in previous investigations is about twice as large as that using three‐dimensional ultrasound in our study, whereas the present data described in this study is quite comparable with previous data from an autopsy series.

Conclusion:  Our findings suggest that the standard curve for the fetal splenic volume using three‐dimensional ultrasound provides a superior means for evaluating the normal splenic growth in the fetus and for identifying splenic abnormalities in utero. However, the data and its interpretation in our study should be taken with some degree of caution because of the small number of subjects studied. Further studies involving a larger sample size would be needed to confirm these findings.
Placenta previa increta/percreta in Japan: A retrospective study of ultrasound findings, management and clinical course
Authors: Sumigama Seiji , Itakura Atsuo , Ota Toyohiro , Okada Mayumi , Kotani Tomomi , Hayakawa Hiromi , Yoshida Kana , Ishikawa Kaoru , Hayashi Kazumasa , Kurauchi Osamu , Yamada Satoru , Nakamura Hiromi , Matsusawa Katsuji , Sakakibara Katsumi , Ito Mitsuaki , Kawai Michiyasu , Kikkawa Fumitaka
Published: September 2007

Aim:  Placenta accreta is an abnormally firm attachment of placental villi to the uterine wall, which may cause postpartum hemorrhage resulting in maternal morbidity and mortality. The purpose of the present study was to clarify the incidence, clinical background and prognosis of placenta previa increta/percreta treated with different modalities in Japan.

Methods:  Medical records of cases with placenta previa increta/percreta in eight tertiary centers between January 1994 and December 2004 were reviewed. Placenta accreta without actual invasion into the myometrium confirmed by pathology was not included in placenta increta/percreta. Details of obstetric history, maternal background, ultrasonographical findings, the course of delivery, subsequent complications and management were noted.

Results:  Among the total of 59 008 deliveries, 45 261 were by the vaginal route (76.7%) and 13 747 by cesarean section (23.3%). In this study, 408 cases were diagnosed as placenta previa (0.69%), 18 of these being placenta increta and 5 placenta percreta. Only 1.1% of cases of placenta previa without prior cesarean section were increta/percreta, in contrast to 37% of placenta previa after prior cesarean sections. Mean intraoperation blood loss was 3630 ± 2216 g (increta) and 12 140 ± 8343 g (percreta). One patient with placenta previa percreta died of hemorrhage. Stepwise treatment (cesarean section without separation of the placenta, arterial embolization and hysterectomy) was applied for 4 cases, which had the least blood loss.

Conclusions:  Placenta previa increta/percreta is a life‐threatening disease. Patients who undergo hysterectomy after uterine arterial embolization demonstrate reduced intraoperation blood loss, and this treatment should be incorporated to reduce maternal morbidity.
Ultrasound‐determined fetal subcutaneous tissue thickness for a birthweight prediction model
Authors: Larciprete Giovanni , Valensise Herbert , Barbati Giulia , Di Pierro Giuseppe , Jarvis Sheba , Deaibess Therese , Gioia Stefano , Giacomello Francesco , Cirese Elio , Arduini Domenico
Published: September 2007

Aim:  The aim of this study was to explore a birthweight prediction model using ultrasound determined tissue thickness (SCTT) parameters.

Methods:  We measured routine ultrasonographic biometric parameters and in addition, fetal SCTT in 201 healthy singleton pregnancies. Mid‐arm fat and lean mass, mid‐thigh fat and lean mass, subscapular fat mass and abdominal fat mass (AFM) were measured in order to calculate a birthweight prediction model. Ultrasound measurements were analyzed using an ‘anovarepeated measures model’. The growth rate (β‐slope) of the selected parameters was computed and the correlation coefficient with the birthweight and the Kendall rank correlation tau, were calculated.

Results:  From the ultrasound determined SCTT parameters, only abdominal circumference (AC), AFM, and MTLM showed a statistically significant trend. The β‐slope of mid‐thigh lean mass was excluded since it exhibited significant correlation with the β‐slope of AFM. The final regression model could be calculated as: birthweight (gr.) = intercept +α1(AFM β‐slope) + α2(AC β‐slope), where α1, α2 represent regression coefficients.

Conclusions:  We provide a graphical birthweight prediction model for clinical practice using conventional and specific ultrasound measurements of fetal subcutaneous tissue thickness. This model is based upon an overall analysis of the ultrasound estimated body components.
Length of the third stage of labor at term pregnancies is shorter if placenta is located at fundus: Prospective study
Authors: Altay M. Metin , İlhan Ali Kemal , Haberal Ali
Published: September 2007

Aim:  To investigate how the location of the placenta at term pregnancies affects the duration of the third stage of labor and to discuss the possible mechanisms affecting the duration of the third stage. We believe that this is the first prospective study comparing the duration of the third stage of labor according to placental location.

Methods:  The placental implantation was determined as anterior (n = 78), posterior (n = 59), or fundal (n = 64) by ultrasound, in 201 women with singleton pregnancies. After delivery of the newborn, oxytocin infusion was routinely given. Duration of the third stage of labor was compared by anova. P < 0.05 was determined as significant.

Results:  The duration of the third stage of labor was 10.36 ± 5.94 min, 10.44 ± 5.35 min, and 8.12 ± 4.25 min with placentas located anteriorly, posteriorly, and fundal, respectively. The length of the third stage was significantly shorter in the fundal placenta group.

Conclusion:  In this study, the length of the third stage of labor was approximately 2 min shorter with placentas located at the fundus compared to the other two groups. The mechanism responsible for shorter duration may be the bipolar separation of fundal placentas in contrast to usual unipolar down‐up separation of anterior or posterior placentas. Another contributing factor may be the use of oxytocin infusion for the management of the third stage, however this should be investigated by further studies by using real time ultrasonography.
Evaluation of pregnant women with scarred uterus in a low resource setting
Authors: Agarwal Anjoo , Chowdhary Poonam , Das Vinita , Srivastava Aarti , Pandey Amita , Sahu Meenakshi T.
Published: September 2007

Aim:  Management of post cesarean pregnancy continues to be a dilemma. The present study was undertaken to evaluate the outcome of such pregnancies in a resource constrained setting so that an appropriate management protocol can be decided.

Methods:  An observational study was conducted in the Department Of Obstetrics And Gynecology, King George's Medical University, Lucknow, India. The outcome of all of the women admitted with pregnancy with a previous cesarean section was noted.

Results:  A total number of 447 women with a post cesarean pregnancy underwent delivery. These comprised 13.7% of total deliveries over the same period. 124 women (27.7%) had successful vaginal delivery while 323 (72.3%) had a repeat cesarean section. Maternal morbidity and perinatal mortality were both significantly higher in the vaginal delivery group (P = 0.00211 and P = 0.0426, respectively).

Conclusions:  Vaginal birth after cesarean (VBAC) is associated with higher maternal morbidity and perinatal mortality. Therefore the decision for VBAC must be taken only after proper consideration and counseling of the couple.
Impact of laparoscopic cystectomy on fecundity of infertility patients with ovarian endometrioma
Authors: Nakagawa Koji , Ohgi Shirei , Kojima Rieko , Sugawara Kana , Ito Megumu , Horikawa Takashi , Irahara Minoru , Saito Hidekazu
Published: September 2007

Aim:  To clarify the effect of laparoscopic cystectomy for ovarian endometrioma in infertility patients, the pregnancy outcome was evaluated.

Methods:  This was a retrospective study. From August 2002 to February 2006, 33 infertility patients with ovarian endometrioma underwent laparoscopic cystectomy at our center. According to the laparoscopic findings 33 were divided into two groups; 10 were evaluated as the patients who need assisted reproductive technologies (ART) treatment (IVF subgroup) and 23 were evaluated as the patients who do not need ART treatment but conventional infertility treatment (non‐IVF subgroup). During the same period, 70 patients who were age‐matched and received ART treatment without laparoscopy were defined as control (control group). Following up to 12 months after laparoscopy, the cumulative pregnancy rate in the non‐IVF subgroup was calculated.

Results:  The patients age, duration of infertility and size of endometrioma were equal in the IVF and the non‐IVF subgroups. The revised‐American Society of Reproductive Medicine (r‐ASRM) score in the IVF subgroup was significantly higher than that in the non‐IVF group (P < 0.05). The pregnancy rates after laparoscopic cystectomy in IVF and non‐IVF subgroups were 50.0% and 60.9%, respectively. These rates in the IVF and the non‐IVF groups were slightly higher than that in control group (41.4%), but these differences were not significant. The cumulative pregnancy rate in the non‐IVF group reached 52.2%, 12 months after laparoscopic surgery.

Conclusions:  Laparoscopic surgery should be performed prior to ART treatment not only for making a decision about the treatment course but also for establishing a good pelvic condition to induce a pregnancy during ART treatment in infertility treatment with ovarian endometrioma.
Efficacy and outcome of anterior vaginal wall repair using polypropylene mesh (Gynemesh)
Authors: Jo Hoenil , Kim Jae Weon , Park Noh Hyun , Kang Soon Beom , Lee Hyo Pyo , Song Yong‐Sang
Published: September 2007

Aim:  The aim of the present study was to assess the safety and efficacy of anterior vaginal wall repair using polypropylene mesh for the correction of anterior vaginal wall prolapse.

Methods:  From May 2001 to March 2005, 38 patients with cystoceles or uterine prolapse underwent transvaginal repair with implantation of polypropylene mesh. In all 38 patients anterior vaginal wall repair was done concurrently with other procedures: vaginal hysterectomy, n = 18 (47.4%) and tension‐free vaginal tapes n = 22 (57.9%).

Results:  Preoperatively 26 patients (68.4%) had stage III/IV prolapse on pelvic organ prolapse quantification examination. After mean follow up of 23.4 months, the objective cure rate at 12 and 18 months was 94.5% and 94.3%, respectively. As for complications associated with placement of the polypropylene mesh, no tissue erosion or infection was found.

Conclusions:  Transvaginal implantation of polypropylene mesh is an effective and safe technique for the correction of anterior vaginal wall prolapse.
Sudden fetal hemorrhage from umbilical cord ulcer associated with congenital intestinal atresia
Authors: Miyachi Keiko , Kikuchi Akihiko , Kitsunezaki Masako , Sunagawa Sorahiro , Hiroma Takehiko , Takagi Kimiyo , Ogiso Yoshifumi , Nakamura Tomohiko
Published: September 2007

There have been several reports of umbilical cord ulcer (UCU) associated with congenital intestinal atresia, many cases of which have been reported with fetal or neonatal death. Herein is described the case of a fetus with jejunal atresia complicated by acute massive intrauterine hemorrhage due to the perforation of UCU resulting in an intact survival. Although the onset of critical condition in the present case was noted due to continuous fetal heart rate (FHR) monitoring, it is necessary to establish the management of congenital intestinal atresia to prevent this life‐threatening fetal hemorrhage.
Abundant proteorhodopsin genes in the North Atlantic Ocean
Authors: Campbell Barbara J. , Waidner Lisa A. , Cottrell Matthew T. , Kirchman David L.
Published: September 2007

Proteorhodopsin (PR) is a light‐driven proton pump that has been found in a variety of marine bacteria, including Pelagibacter ubique, a member of the ubiquitous SAR11 clade. The goals of this study were to explore the diversity of PR genes and to estimate their abundance in the North Atlantic Ocean using quantitative polymerase chain reaction (QPCR). We found that PR genes in the western portion of the Sargasso Sea could be grouped into 27 clusters, but five clades had the most sequences. Sets of specific QPCR primers were designed to examine the abundance of PR genes in the following four of the five clades: SAR11 (P. ubique and other SAR11 Alphaproteobacteria), BACRED17H8 (Alphaproteobacteria), HOT2C01 (Alphaproteobacteria) and an uncultured subgroup of the Flavobacteria. Two groups (SAR11 and HOT2C01) dominated PR gene abundance in oligotrophic waters, but were significantly less abundant in nutrient‐ and chlorophyll‐rich waters. The other two groups (BACRED17H8 and Flavobacteria subgroup NASB) were less abundant in all waters. Together, these four PR gene types were found in 50% of all bacteria in the Sargasso Sea. We found a significant negative correlation between total PR gene abundance and nutrients and chlorophyll but no significant correlation with light intensity for three of the four PR types in the depth profiles north of the Sargasso Sea. Our data suggest that PR is common in the North Atlantic Ocean, especially in SAR11 bacteria and another marine alphaproteobacterial group (HOT2C01), and that these PR‐bearing bacteria are most abundant in oligotrophic waters.
Preconditioning and postconditioning: new strategies for cardioprotection
Authors: Hausenloy D. J. , Yellon D. M.
Published: September 2007

Despite optimal therapy, the morbidity and mortality of coronary heart disease (CHD) remains significant, particularly in patients with diabetes or the metabolic syndrome. New strategies for cardioprotection are therefore required to improve the clinical outcomes in patients with CHD. Ischaemic preconditioning (IPC) as a cardioprotective strategy has not fulfilled it clinical potential, primarily because of the need to intervene before the index ischaemic event, which is impossible to predict in patients presenting with an acute myocardial infarction (AMI). However, emerging studies suggest that IPC‐induced protection is mediated in part by signalling transduction pathways recruited at time of myocardial reperfusion, creating the possibility of harnessing its cardioprotective potential by intervening at time of reperfusion. In this regard, the recently described phenomenon of ischaemic postconditioning (IPost) has attracted great interest, particularly as it represents an intervention, which can be applied at time of myocardial reperfusion for patients presenting with an AMI. Interestingly, the signal transduction pathways, which underlie its protection, are similar to those recruited by IPC, creating a potential common cardioprotective pathway, which can be recruited at time of myocardial reperfusion, through the use of appropriate pharmacological agents given as adjuvant therapy to current myocardial reperfusion strategies such as thrombolysis and primary percutaneous coronary intervention for patients presenting with an AMI. This article provides a brief overview of IPC and IPost and describes the common signal transduction pathway they both appear to recruit at time of myocardial reperfusion, the pharmacological manipulation of which has the potential to generate new strategies for cardioprotection.
When the blind lead
Authors: Cohan Peter S.
Published: September 2007

It's called confirmation bias. When facing a major decision, one exhibits an unwillingness to admit conflicting data – no matter how salient – to influence a closed point of view. Peter S. Cohan examines the disease and offers a cure.
Leveraging levees
Authors: Kochikar V.P. , Ravindra M.P.
Published: September 2007

Is your business benefiting from – or being restrained by – a levee?V.P. Kochikar and M.P. Ravindra studied a seldom‐examined concept and explain how walls, or “levees”, can be potential disruptors as well as bases for innovation.
THE GEOGRAPHICAL IMPRINT OF LAND RESTITUTION WITH REFERENCE TO LIMPOPO PROVINCE, SOUTH AFRICA
Authors: RAMUTSINDELA MAANO
Published: September 2007

This paper analyses the geographical imprint of land restitution against earlier views that land reform in South Africa will result in the enlargement of former bantustans (homelands), and that it will give black people marginal land. Those views, and their underlying assumptions not only suggest that it would be difficult to dismantle apartheid geography, but also imply that land reform has the potential to reinforce that geography. This begs the question of the manner in which South Africa's land reform programme might contribute to the consolidation of the spatial legacy of apartheid. In this paper Limpopo Province is referred to to conclude that the government's approach to land restitution, together with the pattern and resolution of land claims, largely account for the emerging spatial consolidation of the geography of the former bantustans. It also demonstrates that the resolution of land claims has moved from ‘a case‐by‐case’ to ‘a policy‐oriented’ approach between 1994 and 2004.
THE COMMERCE CLAUSE AS A CONSTRAINT ON WASTEFUL BUSINESS INCENTIVES: ROADBLOCK OR BUMP IN THE ROAD IN THE ‘RACE TO THE BOTTOM?’
Authors: MCCARTHY LINDA
Published: September 2007

State and local economic development efforts have grown during the last three decades in the United States. Some public incentives for companies may be effective, including those for high unemployment areas; others may be wasteful, especially if they retain corporations that merely threaten to leave. As companies increasingly expect incentives, however, governments find themselves in a ‘race to the bottom’– the only way to remain competitive is to offer more. Having identified arguments for and against incentives, this paper considers the prospects for addressing wasteful competition, including, in the absence of Congressional action, the US Supreme Court's application of the Commerce Clause to strike down incentives that discriminate against interstate commerce. A review of a lawsuit challenging the constitutionality of incentives for the DaimlerChrysler Toledo Jeep plant finds that the Commerce Clause is not a solution for wasteful competition. Another model to consider is the European Union's regulation of incentives.
FLOOD RISK, UNCERTAINTY AND CHANGING RIVER PROTECTION POLICY IN THE NETHERLANDS: THE CASE OF ‘CALAMITY POLDERS’
Authors: ROTH DIK , WARNER JEROEN
Published: September 2007

Extreme river discharges, floods and debates about climate change triggered a shift in flood protection policy in the Netherlands from infrastructural to spatial measures. The new policy directive of ‘Room for the River’, details of which were introduced in 2000, should prepare the country for future peak discharges. In order to deal with ‘residual risk’, the concept of ‘calamity polders’ for ‘controlled flooding’ was launched in the same year. In this contribution we discuss the local protests against these plans against the backdrop of changed thinking about flood protection. We analyse the emergence of the concept, the commission established to inquire into the calamity polder plans, as well as local resistance and the counter‐expertise it mobilised. We conclude that the choice to limit public participation in the debates about calamity polders has backfired. It has contributed to the shelving of the plans while increasing public distrust of flood policy. At the same time this episode has created some awareness among policy‐makers of the importance of dialogue with the inhabitants of areas affected by flood policy measures.
Transnational community enterprises for social welfare in global civil society
Authors: Poole Dennis L. , Negi Nalini
Published: September 2007

Considerable attention has been devoted thus far to transnational economic and political enterprises in globalisation. This article focuses on the phenomenon of social globalisation. Specifically, we call attention to the need for research and development on transnational enterprises to support and maintain individuals and families that are members of transnational communities in the USA and Mexico. The social fallout of transmigration on the health and social wellbeing of sending and receiving communities is enormous and costly, and far beyond the capacity of transmigrants to handle merely through self‐help, mutual aid or small voluntary clubs and associations. This article raises questions about whether it is possible, or desirable, for civil society organisations to expand the scope of their vision to include social welfare activities that promote and enhance the health and social wellbeing of host and home communities simultaneously.
Gap junction protein expression and cellularity: comparison of immature and adult equine digital tendons
Authors: Stanley Rachael L. , Fleck Roland A. , Becker David L. , Goodship Allen E. , Ralphs Jim R. , Patterson‐Kane Janet C.
Published: September 2007

Injury to the energy‐storing superficial digital flexor tendon is common in equine athletes and is age‐related. Tenocytes in the superficial digital flexor tendon of adult horses appear to have limited ability to respond adaptively to exercise or prevent the accumulation of strain‐induced microdamage. It has been suggested that conditioning exercise should be introduced during the growth period, when tenocytes may be more responsive to increased quantities or intensities of mechanical strain. Tenocytes are linked into networks by gap junctions that allow coordination of synthetic activity and facilitate strain‐induced collagen synthesis. We hypothesised that there are reductions in cellular expression of the gap junction proteins connexin (Cx) 43 and 32 during maturation and ageing of the superficial digital flexor tendon that do not occur in the non‐injury‐prone common digital extensor tendon. Cryosections from the superficial digital flexor tendon and common digital extensor tendon of 5 fetuses, 5 foals (1–6 months), 5 young adults (2–7 years) and 5 old horses (18–33 years) were immunofluorescently labelled and quantitative confocal laser microscopy was performed. Expression of Cx43 and Cx32 protein per tenocyte was significantly higher in the fetal group compared with all other age groups in both tendons. The density of tenocytes was found to be highest in immature tissue. Higher levels of cellularity and connexin protein expression in immature tendons are likely to relate to requirements for tissue remodelling and growth. However, if further studies demonstrate that this correlates with greater gap junctional communication efficiency and synthetic responsiveness to mechanical strain in immature compared with adult tendons, it could support the concept of early introduction of controlled exercise as a means of increasing resistance to later injury.
Klippel‐Feil syndrome with other associated anomalies in a medieval Portuguese skeleton (13th–15th century)
Authors: Fernandes Teresa , Costa Catarina
Published: September 2007

Klippel‐Feil syndrome, or synostosis of the cervical spine, is the result of an abnormal division of somites during embryonic development. This report analyses an adult male (exhumed from a Portuguese graveyard dating from the 13th to the 15th century) with malformations in the cranium and vertebral column. Besides the lesions that are typical of Klippel‐Feil syndrome type II, other defects usually linked to this pathology are described (occipito‐atlantal fusion, hemivertebrae, butterfly vertebrae, cervical rib, changes in normal number of vertebral segments and a possible Sprengel deformity).
Do delay aversion and executive function deficits make distinct contributions to the functional impact of ADHD symptoms? A study of early academic skill deficits
Authors: Thorell Lisa B.
Published: September 2007

Background:  The present study examined the distinct properties of executive functioning in relation to ADHD symptoms, as well as functional outcomes associated with ADHD. In line with the dual‐pathway model of ADHD, executive functioning and delay aversion were expected to show independent effects on ADHD symptoms. Furthermore, relations to early academic skills were examined, and it was hypothesized that the two processes of the dual‐pathway model can be differentiated in terms of their effect on academic skill deficits, such that EF deficits, but not delay aversion, mediate the link between ADHD and academic functioning.

Results:  As hypothesized, both EF deficits and delay aversion were independently related to ADHD symptoms. However, when conducting separate analyses for the two ADHD symptom domains, only the effect of EF deficits was independently related to symptoms of inattention, whereas only the effect of delay aversion was independently related to symptoms of hyperactivity/impulsivity. The mediation analysis showed that EF deficits, but not delay aversion, act as a mediator in the relation between symptoms of inattention and both mathematics and language skills. In addition, there was also a significant direct effect of inattention on early academic skills.

Conclusions:  The findings of the present study are of importance for current models of heterogeneity in ADHD as they 1) provide further support for the notion that EF deficits and delay aversion are two possible pathways to ADHD, 2) add new interesting knowledge by showing that EF deficits and delay aversion can be differentiated in terms of their relations to the two ADHD symptom domains, and 3) indicate that the two processes of the dual‐pathway model can also be differentiated in terms of their effect on functional impairments associated with ADHD.
MICRO‐RAMAN SPECTROSCOPY CHARACTERIZATION OF DELLA ROBBIA GLAZES*
Authors: SENDOVA M. , ZHELYASKOV V. , SCALERA M. , GULLIFORD C.
Published: September 2007

Micro‐Raman spectroscopy and the laser‐induced transformation technique were used for systematic study of five coloured glazes on Saint John the Baptist (29 inch tondo), a majolica terracotta relief attributed to Luca Della Robbia and on permanent exhibit in The John and Mable Ringling Museum of Art. We suggest that ions in a lead silicate matrix, called ‘lead ultramarine’, could contribute to the famous Della Robbia blue colour, in addition to the effect of Co atoms as suggested previously by Pappalardo et al. (2004). The original yellow glaze contains lead(II) antimonate. The green is a mixture of the yellow and blue pigments, the brown contains hematite, and the white glaze contains tin dioxide as an opacifier. The use of lead oxide as a main fluxing agent is confirmed by laser‐induced micro‐crystallization.
MULTIVARIATE MIXTURE OF NORMALS WITH UNKNOWN NUMBER OF COMPONENTS: AN APPLICATION TO CLUSTER NEOLITHIC CERAMICS FROM AEGEAN AND ASIA MINOR USING PORTABLE XRF*
Authors: PAPAGEORGIOU IOULIA , LIRITZIS IOANNIS
Published: September 2007

Multivariate techniques and especially cluster analysis have been commonly used in archaeometry. Exploratory and model‐based techniques of clustering have been applied to geochemical (continuous) data of archaeological artefacts for provenance studies. Model‐based clustering techniques such as classification maximum likelihood and mixture maximum likelihood have been used to a lesser extent in this context and, although they seem to be suitable for such data, they either present practical difficulties—such as high dimensionality of the data—or their performance gives no evidence that they are superior to standard methods. In this paper standard statistical methods (hierarchical clustering, principal components analysis) and the recently developed model‐based multivariate mixture of normals with an unknown number of components, are applied and compared. The data set provides chemical compositions of 188 ceramic samples derived from the Aegean islands and surrounding areas.
METHODOLOGICAL DEVELOPMENTS IN THE LUMINESCENCE DATING OF BRICK FROM ENGLISH LATE‐MEDIEVAL AND POST‐MEDIEVAL BUILDINGS*
Authors: BAILIFF I. K.
Published: September 2007

Fired clay brick samples, obtained from a group of seven high‐status late‐medieval and post‐medieval buildings in England ranging in age fromc.ad1390 to 1740, were dated by the luminescence method using an optically stimulated luminescence (OSL) technique. The results obtained indicate that, when applied to quartz extracted from brick, the technique is capable of producing dates that are in consistently good agreement with independent dating evidence for the buildings. For six samples taken from a group of four dating ‘control’ buildings the mean difference between the central values of luminescence and assigned ages was 5 ± 10 years (SD, n = 6). The methodology used is appropriate for application to other standing buildings in other temporal and geographic regions, and may be used with confidence where conventional dating methods are less certain. The study also examines the luminescence characteristics of quartz and the characteristics of the lithogenic radionuclides in brick samples and identifies various aspects related to the assessment of experimental uncertainty in testing the reliability of the method.
Successful management of chylous ascites after living donor liver transplantation with somatostatin
Authors: Ijichi Hideki , Soejima Yuji , Taketomi Akinobu , Yoshizumi Tomoharu , Uchiyama Hideaki , Harada Noboru , Yonemura Yusuke , Maehara Yoshihiko
Published: September 2007

Chylous ascites is a rare complication following liver transplantation. A variety of treatment options have been proposed for the management of chylous ascites; however, their effectiveness following a liver transplant is unknown. A 40‐year‐old woman who underwent living donor liver transplantation for primary biliary cirrhosis developed chylous ascites 21 days after the transplant. A conventional treatment consisting of a low‐fat diet with total parenteral nutrition failed to treat the complication for 104 days. However, the use of somatostatin in combination with total parenteral nutrition resulted in a rapid falloff in chyle output without any adverse effects. Somatostatin and total parenteral nutrition are an effective option for the treatment of chylous ascites after living donor liver transplantation.
The effect of polyhydroxyurethane on dyeing of cellulosic fabrics with direct and reactive dyes
Authors: Oprea Stefan
Published: September 2007

Dye yields and fastness properties are reported for direct and reactive dyes using a modified dyeing solution with polyhydroxyurethane. Excellent dye yields and colour fastness properties were obtained without the use of electrolytes, multiple rinsing or fixation agents, which are normally employed in cotton dyeing. From the results, it was found that polyhydroxyurethane media exhibit better dyeability and fastness than the normal aqueous media. Dye adsorption in polyhydroxyurethane media was much higher than in other aqueous systems. The dyed samples showed good hot pressing and washing colour fastness properties within the color change range. The excellent solubility of these dyes in the polyhydroxyurethane aqueous solution makes them ideal for use in exhaustion dyeing.
The Influence of Atopic Status and Potential Risk Factors for Sensitization on Histamine Skin Reactivity in Unselected Belgian Children
Authors: Van Gysel Dirk , Govaere Elke , Verhamme Katia , Doli Erenik , De Baets Frans
Published: September 2007

Abstract:  The histamine skin response is widely used as a standardized positive control in the performance of skin prick testing. As a part of the Aalst Allergy Study, we investigated whether histamine skin reactivity, using histamine 10 mg/mL, was influenced by age, gender, ethnic origin, environmental exposure, specific sensitization patterns, or other factors. The parents of 2021 nonselected children aged 3.4–14.8 years completed a baseline questionnaire and gave written informed consent for skin prick testing with seven common aeroallergens on their child. Sensitized children had significantly larger histamine wheal sizes than nonsensitized children (mean 4.3 vs 4.0 mm, p < 0.05). A significant difference was found in histamine wheal size between nonsensitized versus multiply sensitized children (p < 0.001), but not between mono‐sensitized versus multiply sensitized children (p = 0.105). The only other factors associated with significantly larger histamine wheal sizes were a history of eczema and a history suggestive for asthma on the Brief Pediatric Asthma Screen Plus. The histamine wheal was absent in 8.9% of children. In conclusion, sensitization and some other clinical indicators of atopy were associated with a larger histamine skin wheal. Other conditions including gender and environmental exposure did not have an influence on histamine skin reactivity, which strengthens the use of histamine as a reference in skin prick testing in this age group.