bluuebunny/crossref_metadata_2025 huggingface dataset:
Reaction of lithium metal with benzil in THF. A kinetic study
Authors: Nudelman Norma Sbarbati , Velurtas Susana , Grela Maria A.
Published: September 2003

The kinetics of benzil reduction by lithium metal in THF were investigated under different reaction conditions. The main reaction products were phenylacetophenone and bibenzyl; 1,2‐diphenylethanol and diphenylethene were minor products. The first radical anion intermediate formed by electron transfer upon chemisorption of the benzyl on the metal surface was fully characterized and quantitatively determined by ESR spectroscopy. The kinetics of the benzil decay and of the formation of the two main products were followed by GC and ESR. A unique feature of this reaction is the presence of a well‐defined and reproducible induction period. A mechanism is proposed which accounts for the main experimental observations. Copyright © 2003 John Wiley & Sons, Ltd.
Synthesis and structural characterization of trans‐tactic vinylene–silylene(siloxylene) polymers
Authors: Marciniec Bogdan , Małecka Ewa
Published: September 2003

Divinyldimethylsilane (1), divinyldiphenylsilane (2), divinyltetramethyldisiloxane (3) and divinyltetraethoxydisiloxane (4) in the presence of [{RuCl2(CO)3}2] (I) as a catalyst undergo effective silylative coupling (SC) polycondensation giving stereoselectively trans‐tactic polymers (5–8) (Mw=3800–8500), yield 75–84%. The products isolated and characterized by 1H and 13C NMR and GPC methods cannot be synthesized via ADMET polymerization. Copyright © 2003 John Wiley & Sons, Ltd.
Application of source removal and natural attenuation remediation strategies at MGP sites in Wisconsin
Authors: Lingle James W. , Brehm Kevin L.
Published: September 2003

This article presents site closure strategies of source material removal and dissolved‐phase
groundwater natural attenuation that were applied at two manufactured gas plant (MGP) sites in
Wisconsin. The source removal actions were implemented in 1999 and 2000 with groundwater monitoring activities
preceding and following those actions. Both of these sites have unique geological and hydrogeological conditions.
The article briefly presents site background information and source removal activities at both of these sites and
focuses on groundwater analytical testing data that demonstrate remediation of dissolved‐phase
MGP‐related groundwater impacts by natural attenuation. A statistical evaluation of the data supports a
stable or declining MGP parameter concentration trend at each of the sites. A comparison of the site natural
attenuation evaluation is made to compare with the requirements for site closure under the Wisconsin Department
of Natural Resources regulations and guidance. © 2003 Wiley Periodicals, Inc.
Characterizing a Brownfields recreational reuse scenario using the Triad Approach–Assunpink Creek Greenways project
Authors: Mack James , Ellerbusch Fred , Librizzi William
Published: September 2003

Since the early 1990s the U.S. government has been developing and implementing public policies that advance the
redevelopment of brownfields, and the recent passage of the Small Business Liability Relief and Brownfields
Revitalization Act (SBLRBRA) will significantly advance efforts to integrate environmental contamination
mitigation and redevelopment. Experience has demonstrated that successful redevelopment requires the collection,
analysis, and interpretation of environmental data in a timely and cost‐effective manner in order to allow
developers and lenders to efficiently use cleanup resources, develop response strategies that integrate cleanup
with redevelopment, and support meaningful outreach to involved stakeholders. Recent advances in the science and
technology of site characterization hold the promise of improved site characterization outcomes while saving time
and money. One such advancement, the Triad Approach, combines systematic up‐front planning with the use of
a dynamic field investigation process and the generation of real time data to allow in‐field decision
making on sample location selection.

This article describes an application of the Triad Approach to redevelopment of an urban greenway in Trenton,
New Jersey. The Triad Approach, initiated through a partnership between the City of Trenton, New Jersey Department
of Environmental Protection, New Jersey Institute of Technology, and the U.S. Environmental Protection Agency,
demonstrated that this approach could accelerate the characterization of the 60‐acre, 11‐parcel
project area. Environmental issues that were solved using the Triad Approach included the delineation of the
extent of historic fill, determination of no further action for several areas of concern, detailed investigation
of specific impacted areas and the acquisition of sufficient data to allow the city to make important decisions
regarding remediation costs and property acquisition. © 2003 Wiley Periodicals, Inc.
Injecting remediation compounds—How you inject is equally as important as what you inject
Authors: Livadas Alan
Published: September 2003

The injection of remediation compounds has rapidly become a widely accepted approach for addressing
contaminated sites. One of the most fundamental questions surrounding the use of in situ
remediation has been “What compound are you injecting at your site?” With the advances in the
industry's understanding and acceptance of the in situ remediation process remediation
professionals are now asking a follow‐up question that has become equally important to the success of a
project: “How are you injecting a compound at your site?” This article discusses advances in
field applications for in situ remediation and injecting remediation compounds. © 2003
Wiley Periodicals, Inc.
Effect of chronic “binge cocaine” on basal levels and cocaine‐induced increases of dopamine in the caudate putamen and nucleus accumbens of C57BL/6J and 129/J mice
Authors: Zhang Yong , Schlussman Stefan D. , Ho Ann , Kreek Mary Jeanne
Published: September 2003

In vivo microdialysis was used to measure the effect of chronic “binge” pattern cocaine administration on basal and cocaine‐induced dopamine levels in the caudate putamen and nucleus accumbens of C57BL/6J and 129/J mice. Mice were implanted with a guide cannula in the caudate putamen or nucleus accumbens and after 4 days recovery, one group received “binge” pattern cocaine administration for 13 days (15 mg/kg × 3, i.p. at hourly intervals) while another group received saline in the same pattern. On the day before microdialysis, dialysis probes were lowered into the caudate putamen and nucleus accumbens. The next morning, after baseline dopamine collection, all animals received “binge” cocaine administration. Dialysates were collected every 20 min and dopamine content was determined by HPLC with electrochemical detection. In the basal condition, the mean level of dopamine in the dialysate from both brain regions of mice pretreated with “binge” pattern cocaine administration was significantly lower than that of the mice pretreated with saline administration. The absolute levels of dopamine achieved following “binge” pattern cocaine challenge were lower in the mice that had received chronic cocaine administration. However, when expressed as percent increase over baseline, the dopamine response to cocaine in the nucleus accumbens was significantly higher in mice that received chronic than in mice that received acute cocaine administration. Chronic cocaine administration led to a lowering of both basal dopamine and the absolute levels of cocaine‐induced increases of dopamine in the two brain regions, but enhanced the percent increases over the baseline in response to cocaine in the nucleus accumbens of both mouse strains. Synapse 50:191–199, 2003. © 2003 Wiley‐Liss, Inc.
Acute and chronic administration of the selective 5‐HT1A receptor antagonist WAY‐405 significantly alters the activity of midbrain dopamine neurons in rats: An in vivo electrophysiological study
Authors: Minabe Yoshio , Schechter Lee , Hashimoto Kenji , Shirayama Yuhiko , Ashby Charles R.
Published: September 2003

In this study, we examined the effect of the acute and chronic administration of WAY‐405, a selective 5‐HT1A receptor antagonist, on the number and firing pattern of spontaneously active substantia nigra pars compacta (A9) and ventral tegmental area (A10) dopamine (DA) neurons in anesthetized rats. This was accomplished using in vivo, extracellular single unit recording. The i.v. administration of WAY‐405 (5–640 μg/kg) did not significantly alter the basal firing rate or pattern of spontaneously active A9 and A10 DA neurons. A single injection of 10 μg/kg of WAY‐405 decreased the number of spontaneously active A10 DA neurons and the 100 μg/kg dose significantly decreased the number of spontaneously active A9 and A10 DA neurons compared to vehicle‐treated animals. A single injection of 1, 10, or 100 μg/kg of WAY‐405 significantly decreased the degree of bursting of A10 DA neurons. In contrast, 1 μg/kg i.p. of WAY‐405 significantly increased the percent of A9 DA neurons exhibiting a bursting pattern. The repeated administration of 10 or 100 μg/kg i.p. of WAY‐405 (21 days) significantly decreased the number of spontaneously active DA neurons in both the A9 and A10 compared to vehicle‐treated animals and this decrease was not reversed by i.v. (+)‐apomorphine. The repeated administration of WAY‐405 significantly altered the firing pattern of DA neurons, particularly those in the A10 area. Overall, these results indicate that the antagonism of the 5‐HT1A receptor significantly alters the activity of midbrain DA neurons in anesthetized rats. Synapse 50:181–190, 2003. © 2003 Wiley‐Liss, Inc.
Acute and chronic effects of nicotine on serotonin uptake in prefrontal cortex and hippocampus of rats
Authors: Awtry Tammy L. , Werling Linda L.
Published: September 2003

We sought to investigate the effect of nicotine exposure (chronic and acute) on serotonin transporter (SERT) activity in two regions of the brain important for behavioral effects of nicotine. We first looked at the effects of chronic nicotine exposure (0.7 mg/kg nicotine, twice a day for 10 days) on [3H]5‐HT uptake in prefrontal cortex (PFC) and hippocampus of rats. A significant increase in [3H]5‐HT uptake was observed in synaptosomes prepared from both regions. To rule out the possibility that the increases were due to the last injection given, in a separate set of experiments a single injection of nicotine was administered the evening before sacrifice. No change in uptake occurred in either region, suggesting that the increases in uptake caused by nicotine was an effect of chronic exposure and not to an acute treatment. SERT binding studies, using prefrontocortical or hippocampal membrane preparations, revealed that chronic nicotine exposure significantly increased Bmax which correlated to an increase in SERT density. Lastly, we looked at the short‐term effect of nicotine on [3H]5‐HT uptake. Rats received a single nicotine injection 15–75 min before sacrifice. PFC synaptosomes displayed a time‐dependent increase in uptake, whereas hippocampal synaptosomes showed an increase at only one time point. Synapse 50:206–211, 2003. © 2003 Wiley‐Liss, Inc.
Is there empirical evidence for the dynamic nature of communication systems?: The role of synchronization and inferential communication
Authors: Grammer Karl
Published: September 2003

Communication is a multichannel, multiunit process that works on different levels. It is sequential with specific information carriers on a cognitive accessible level, and dynamic for the regulation of relationships at the same time. One function of communication is the broadcasting of internal states that can be assessed by inferential communication.
Language, consciousness, and cross-modular thought
Authors: Frankish Keith
Published: September 2003

Carruthers suggests that natural language, in the form of inner speech, may be the vehicle of conscious propositional thought, but he argues that its fundamental cognitive role is as the medium of cross-modular thinking, both conscious and nonconscious. I argue that there is no evidence for nonconscious cross-modular thinking and that the most plausible view is that cross-modular thinking, like conscious propositional thinking, occurs only in inner speech.
Weak evidence for a strong case against modularity in developmental disorders
Authors: Müller Ralph-Axel
Published: September 2003

Thomas & Karmiloff-Smith (T&K-S) provide evidence from computational modeling against modular assumptions of “Residual Normality” (RN) in developmental disorders. Even though I agree with their criticism, I find their choice of empirical evidence disappointing. Cognitive neuroscience cannot as yet provide a complete understanding of most developmental disorders, but what is known is more than enough to debunk the idea of RN.
Neurophysiology, neuropsychiatry and neurophilosophy of catatonia
Authors: Northoff Georg
Published: September 2003

The excellent and highly interesting commentaries address the following concerns: (1) neuroanatomy and neurophysiology of catatonia; (2) cognitive-motor deficits in catatonia; (3) conceptual issues; (4) general methodology in neuropsychiatric research; and (5) neurophilosophical implications. The specific problems, issues, and aspects raised by the different commentators are grouped under these categories in Table R1 presented below. These five areas of concern are then discussed in the order listed in the five sections of the Response.
Residual normality: Friend or foe?
Authors: Thomas Michael , Karmiloff-Smith Annette
Published: September 2003

In response to our target article, many of the commentators concentrated on our notion of Residual Normality. In our response, we focus on the questions raised by this idea. However, we also examine broader issues concerning the importance of incorporating a realistic theory of the process of development into explanations of developmental deficits.
Cyclosporin A-Sensitive Cytochrome c Release and Activation of External Pathway of NADH Oxidation in Liver Mitochondria Due to Pore Opening by Acidification of Phosphate-Containing Incubation Medium
Authors: Knorre D.A. , Dedukhova V.I. , Vyssokikh M. Yu. , Mokhova E.N.
Published: September 2003

Acidification of a high phosphate incubation medium from pH 7.4 to 6.5 promotes increase in rates of succinate oxidation and exogenous NADH oxidation via external (rotenone- and myxothiazol-resistant) pathway by factors 2 and 2.3 respectively. Cyclosporin A prevents these effects. To measure the cytochrome c release, mitochondrial cytochrome c concentration was calculated from absorption spectrum of α-band of cytochromes c+c1. The cytochrome c release is shown to be equal to 27±4%, 40±12%, 70±5% at pH 7.4, 7.0, 6.5, respectively, the last value being reduced by cyclosporin A to 10±3%. Immunoblot method gives the similar results. It is concluded that acidification of the high phosphate medium induces release of a large part of the cytochrome c pool from liver mitochondria due to opening the Ca2+-dependent cyclosporin A-sensitive permeability transition pore and subsequent high amplitude swelling.
Participation of Chloroplasts in Plant Apoptosis
Authors: Samuilov Vitaly D. , Lagunova Elena M. , Kiselevsky Dmitry B. , Dzyubinskaya Elena V. , Makarova Yana V. , Gusev Mikhail V.
Published: September 2003

Mitochondria are known to participate in the initiation of programmed cell death (PCD) in animals and in plants. The role of chloroplasts in PCD is still unknown. We describe a new system to study PCD in plants; namely, leaf epidermal peels. The peel represents a monolayer consisting of cells of two types: phototrophic (guard cells) and chemotrophic (epidermal cells). The peels from pea (Pisum sativum L.) leaves were treated by cyanide as an inducer of PCD. We found an apoptosis-enhancing effect of illumination on chloroplast-containing guard cells, but not on chloroplastless epidermal cells. Antioxidants and anaerobiosis prevented the CN--induced apoptosis of cells of both types in the dark and in the light. On the other hand, methyl viologen and menadione known as ROS-generating reagents as well as the Hill reaction electron acceptors (BQ, DAD, TMPD, or DPIP) that are not oxidized spontaneously by O2 were shown to prevent the CN--induced nucleus destruction in guard cells. Apoptosis of epidermal cells was potentiated by these reagents, and they had no influence on the CN- effect. The light-dependent activation of CN--induced apoptosis of guard cells was suppressed by DCMU, stigmatellin or DNP-INT, by a protein kinase inhibitor staurosporine as well as by cysteine and serine protease inhibitors. The above data suggest that apoptosis of guard cells is initiated upon a combined action of two factors, i.e., ROS and reduced plastoquinone of the photosynthetic electron transfer chain. As to reduction of ubiquinone in the mitochondrial respiratory chain, it seems to be antiapoptotic for the guard cell.
American Psychology and Schools: A Critique
Authors: Sarason Seymour B.
Published: September 2003

No one denies that the Boulder Conference on Clinical Psychology marked a turning point on American psychology. This paper by one of the three or four living participants lists the conference as one in which psychology was at a choice point, went in one and only one direction, without examining the possible consequences or the possibility of going in more than 1 direction. A second theme is that the APA has to be faulted for a lack of searching self‐scrutiny of its past. Organizations, like individuals, resist such self‐scrutiny.
Inner‐City African American Parental Involvement in Children's Schooling: Racial Socialization and Social Support from the Parent Community
Authors: McKay Mary McKernan , Atkins Marc S. , Hawkins Tracie , Brown Catherine , Lynn Cynthia J.
Published: September 2003

Parents (n = 161) and teachers (n = 18) from an urban elementary school serving primarily African American children completed questionnaires regarding racial socialization, social support, and involvement in activities that support youth educational achievement at home and school. Parental reports of racism awareness, and contact with school staff were significantly correlated with parent reports of at‐home involvement and at‐school involvement. Parent reports of social support from the parent community were significantly related to at‐home involvement only. Relative to teacher reports, parents reported more formal contacts with school staff, and higher levels of racism awareness, religiosity, and African American cultural pride. Teachers and parents agreed on school climate and parental levels of at‐home and at‐school involvement. The results suggest that racial socialization processes are related to parent involvement in children's schooling and that increased efforts are needed to bridge a cultural gap between parents and teachers in inner‐city communities.
Long‐Term Unemployment Among Young People: The Risk of Social Exclusion
Authors: Kieselbach Thomas
Published: September 2003

The European Union considers long‐term unemployment among youth an impediment to their full integration into society. The Commission of the European Union has, therefore, supported research into the mechanisms by which youth unemployment leads to “social exclusion.” This paper provides a brief summary of the project's findings. These imply that theories and previous research concerning social exclusion and social support can help explain the effects of youth unemployment although the phenomena vary from country to country. Results also suggest that the construct of social exclusion leads to interventions that reduce the personal and societal costs of youth unemployment.
Cancer Risk Counseling: How Is It Different?
Authors: Schneider Katherine A. , Marnane Daragh
Published: September 2003

Fifty‐six of 80 (70%) full members of the National Society of Genetic Counselors with interest in cancer genetics responded to a 1994 survey regarding their cancer risk counseling practices. This study was undertaken to describe cancer risk counselors and the services they provide and to identify possible differences from general genetic counseling that warrant further study. Of 56 respondents, 41 (75%) were providing CRC. The components of CRC programs are described. Our results found significant differences between CRC and general genetic counseling in terms of training and experience of genetic counselors providing CRC and length and number of counseling sessions per consultand. 51% of respondents had 1–2 years of working in CRC, compared to 17% with 1–2 years experience in genetic counseling (p<0.05). Over one‐third had 10 or more years genetic counseling experience. Counselors were more likely to see individuals at risk for cancer for longer counseling sessions (p<0.05) and for additional sessions (p<0.05).
Hall current system around the magnetic neutral line in the magnetotail: Statistical study
Authors: Ueno Genta , Ohtani Shin‐ichi , Mukai Toshifumi , Saito Yoshifumi , Hayakawa Hajime
Published: September 2003

Recent magnetotail observations clarified the ion‐electron decoupling processes for the magnetic reconnection. One of the decoupling processes is the Hall current system generated around the magnetic neutral line. In this paper we study the current structure on the magnetotail meridian plane when Geotail observed a simultaneous reversal of north‐south magnetic field Bz and earthward‐tailward ion flows. The currents are evaluated by examining the cross‐tail magnetic field By′ variation. Two case studies of reversal events indicate that the By′ component varied consistently with the quadrupolar magnetic field structure induced by the Hall current loops. This tendency is confirmed statistically on the basis of all reversal events defined by the simultaneous reversal of Bz and ion bulk velocity Vx and also by the negatively correlated number densities of earthward flow (NEarth) and tailward flow (Ntail). Here NEarth and Ntail are calculated from the ion velocity distribution within earthward and tailward flowing parts of the velocity space, respectively. The number of selected reversal events are 4022 in the region of 0 ≥ XGSM ≥ −50 RE and −20 ≤ YGSM ≤ 20 RE from 1993 to 2001. The mean By′ variation is found to make a quadrupole structure consistent with the Hall generated magnetic field. The amplitude of By′ becomes larger for increasing the magnitude of Bz. It also increases with the electric field Ey component. These characteristics also can be interpreted in terms of the Hall current system created around the neutral line.
Uptake of nitrate and sulfate on dust aerosols during TRACE‐P
Authors: Jordan C. E. , Dibb J. E. , Anderson B. E. , Fuelberg H. E.
Published: September 2003

Aerosol data collected near Asia on the DC‐8 aircraft platform during TRACE‐P has been examined for evidence of uptake of NO3− and SO4= on dust surfaces. Data is compared between a sector where dust was predominant and a sector where dust was less of an influence. Coincident with dust were higher mixing ratios of anthropogenic pollutants. HNO3, SO2, and CO were higher in the dust sector than the nondust sector by factors of 2.7, 6.2, and 1.5, respectively. The colocation of dust and pollution sources allowed for the uptake of NO3− and nss‐SO4= on the coarse dust aerosols, increasing the mixing ratios of these particulates by factors of 5.7 and 2.6 on average. There was sufficient nss‐SO4= to take up all of the NH4+ present, with enough excess nss‐SO4= to also react with dust CaCO3. This suggests that the enhanced NO3− was not in fine mode NH4NO3. Particulate NO3− (p‐NO3−) constituted 54% of the total NO3− (t‐NO3−) on average, reaching a maximum of 72% in the dust sector. In the nondust sector, p‐NO3− contributed 37% to t‐NO3−, likely due to the abundance of sea salts there. In two other sectors where the influence of dust and sea salt were minimal, p‐NO3− accounted for <15% of t‐NO3−.
Observations of downgoing velocity dispersed O+ and He+ in the cusp during magnetic storms
Authors: McFadden J. P. , Carlson C. W. , Strangeway R. , Moebius E.
Published: September 2003

Downgoing, velocity‐dispersed (<1 keV to 25 keV) O+ and He+ ions accelerated at the magnetopause have been observed by the FAST satellite in the polar cusp. These ions, together with H+ ions, were observed during 24 magnetic storms. In comparison, only H+ was observed during >300 cusp crossings during low activity periods. During the largest storm, the O+ energy flux was an order of magnitude larger than the H+ energy flux. Velocity dispersed H+, with a signature of decreasing energy with increasing latitude during southward IMF, are normally observed in the low altitude cusp. These ions originate in the magnetosheath and, during dayside reconnection, are accelerated along the magnetopause with some ions funneled into the cusp. Poleward convection of the plasma leads to the latitude‐velocity dispersion signature. Magnetospheric plasma can also be accelerated at the magnetopause, however the magnetosheath plasma density is much larger and magnetospheric composition is normally dominated by H+, so that distinguishing magnetospheric and magnetosheath plasma becomes difficult. During magnetic storms, auroral ionospheric outflow of O+ and He+ can be large enough to produce a significant, non‐hydrogen component in the plasma sheet. These ions are convected through the inner magnetosphere and ring current, eventually appearing at the dayside magnetopause where they are accelerated and form this atypical cusp signature.
Effect of enamel matrix proteins (Emdogain®) on healing after re‐implantation of “periodontally compromised” roots
Authors: Araújo M. , Hayacibara R. , Sonohara M. , Cardaropoli G. , Lindhe J.
Published: September 2003

Objective: The present experiment was performed to assess whether Emdogain® applied on the root surface of extracted teeth or teeth previously exposed to root planning can protect the tooth from ankylosis following re‐implantation.

Material and Methods: The experiment included two groups of dogs, including five animals each. The root canals of all mandibular third premolars (3 P 3) were reamed and filled with gutta‐percha. A crestal incision was placed from the area of the second to the fourth premolar. Buccal and lingual full thickness flaps were elevated. With the use of a fissure bur, the crown and furcation area of 3 P 3 were severed in an apico‐coronal cut. The distal and mesial tooth segments were luxated with an elevator and extracted with forceps. Group A: The mesial and distal segments of 3 P 3 were air dried on a glass surface for 60 min. The roots from the right side were conditioned and exposed to Emdogain® application. The roots from the left side received the same treatment with the exception of Emdogain® application.

The mesial and distal tooth segments were re‐implanted and the crown portions were severed with a horizontal cut and removed. The buccal and lingual flaps were mobilized and sutured to obtain complete coverage of the submerged roots. Group B: A notch was prepared in each root, 4–5 mm apical of the cemento‐enamel junction. The area of the root that was located coronal to the notch was scaled and planned. The roots in the right side of the mandible were treated with Emdogain®, while the roots in the left side served as controls.

After 6 months of healing, the dogs were killed and blocks containing one root with surrounding tissues were harvested, and prepared for histological examination, which also included morphometric assessments. Thus, the proportions of the roots that exhibited signs of (i) replacement (ii) inflammatory and (iii) surface resorption were calculated.

Results and Conclusion: It was demonstrated that healing of a re‐implanted root that had been extracted and deprived of vital cementoblasts was characterized by processes that included root resorption, ankylosis and new attachment formation. It was also demonstrated that Emdogain® treatment, i.e. conditioning with EDTA and placement of enamel matrix proteins on the detached root surface, failed to interfere with the healing process.
Psychiatric Hospitalization: Reasons for Admission and Alternatives to Admission in South Auckland, New Zealand
Authors: Abas Melanie , Vanderpyl Jane , Le Prou Trix , Kydd Rob , Emery Brian , Alo Foliaki Siale
Published: September 2003

Objective: To describe reasons for admission and alternatives to admission in a government funded acute inpatient unit.

Method: Reasons for admission and alternatives to admission were rated for a consecutive sample of 255 admissions to an acute psychiatric unit in Auckland, using interviews with staff and case note review.

Result: Most patients had a functional psychosis and were admitted involuntarily. Forty percent came from areas of marked social deprivation. The major reasons for admission were for reinstatement of medication (mainly linked to non-concordance with prescribed medication), intensive observation, risk to self and risk to others. Only 12% of admissions could have been diverted, of whom most would have required daily home treatment. For those still admitted at 5 weeks, 26% could have been discharged, mainly to 24 h nurse-staffed accommodation. If the alternatives had all been available, simulated bed-day savings were 11 bed years per year. Simulated bed day savings were greater through implementing early discharge than by diverting new admissions.

Conclusion: Greater availability of assertive community treatment and of interventions to improve medication concordance may have prevented a small number of admissions. For patients admitted longer than 5 weeks, it appeared that greater availability of 24 h nursestaffed accommodation would have allowed considerable bed-day savings.
Preference, Need and Utilization of Mental Health Services, Singapore National Mental Health Survey
Authors: Pin Ng Tze , Pin Ng Tze , Soon Leng Fones Calvin , Heok Kua Ee
Published: September 2003

Objective: To ascertain the extent of the community's preference, needs for and utilization of mental health services, and their socio-demographic determinants in the multi-ethnic Asian community in Singapore. The extent to which need, enabling and predisposing factors determine the likelihood to seek professional help was also examined.

Method: Data were analyzed from the Singapore National Mental Health Survey of 1996, based on a stratified random sample of 2947 Chinese, Malay and Indian subjects of the general population aged 13–64 years.

Results: An estimated 37% of the general population indicated they would seek professional help if they experienced a serious emotional or mental problem. Although 16.9% were determined by their high general health questionnaire (GHQ) score to need mental health services, only 2.6% in the population used the services of any professional caregiver. Among persons with high GHQ scores, only 5.9% sought any professional help. Among those with a high GHQ score and who were receptive to professional help, only 10.4% actually sought professional help. General practitioners were the most commonly preferred caregiver (49.3%), and were used by 41.1% of those who sought help. Those who sought professional help were more likely to have a high GHQ score and to be inclined to seek professional help. Malays used mental health services more than Chinese, but they did not show a significantly greater prevalence of high GHQ scores, or a greater preference to seek professional help. Receptivity to professional help, high GHQ score, and Malay ethnicity were independent significant predictors of use of mental health service.

Conclusion: Need and attitudinal factors predict mental health service utilization, but they still do not explain why a large majority of the population chose not to use mental health services.
T‐lymphocyte populations in hepatitis C and HIV co‐infected patients treated with interferon‐alfa‐2a and ribavirin
Authors: Neau D , Galpérine T , Legrand E , Pitard V , Neau‐Cransac M , Moreau JF , Ragnaud JM , Dupon M , Fleury H , Lafon ME
Published: September 2003

Objective

The effects on T‐lymphocyte populations of two interferon‐alfa‐2a (IFN) regimens associated with ribavirin were evaluated in 36 HCV‐HIV co‐infected patients with chronic hepatitis C, T‐CD4 cell count > 250 cells/µL and a plasma viral load of < 10 000 HIV RNA copies/mL.

Methods

Patients were given IFN for 48 weeks. Group A (18 patients) received 6 mega units (MU) subcutaneously three times a week for 24 weeks, then 3 MU three times a week for the last 24 weeks. Group B (18 patients) received 9 MU daily for 2 weeks, 3 MU daily for 22 weeks, then 3 MU three times a week for the last 24 weeks. Serum HCV RNA was evaluated at weeks 12 and 72. Ribavirin was added at week 16 for virologic nonresponders at week 12. CD3, CD3 CD4, CD3 CD8, CD3 CD4 human leucocyte antigen (HLA)‐DR and CD3 CD8 HLA‐DR lymphocyte subsets were evaluated before, during and after treatment by cytofluorometry. Controls were healthy and HCV mono‐infected patients.

Results

CD3 CD4 and CD3 CD8 T‐cells counts were both impaired during anti‐HCV therapy, but returned to baseline value after treatment completion. Lymphopenia concerned mainly CD8 T‐cells, the percentage of which decreased, whereas that of CD4 increased. Three patients displayed reversible CD4 lymphopenia < 200 cells/µL. HIV infection at inclusion was responsible for higher CD3 CD8 HLA‐DR T‐cell percentages in co‐infected patients than in healthy and HCV mono‐infected subjects. T‐cell sequestration in lymphoid tissues and enhanced apoptosis may account for lymphopenia.

Conclusion

High‐dosed IFN anti‐HCV therapy induced only moderate and transient CD4 lymphopenia in HIV co‐infected patients.
Pharmacokinetic and tolerability profile of twice‐daily saquinavir hard gelatin capsules and saquinavir soft gelatin capsules boosted with ritonavir in healthy volunteers
Authors: Kurowski M , Sternfeld T , Sawyer A , Hill A , Möcklinghoff C
Published: September 2003

Objective

To evaluate the pharmacokinetics and safety of a boosted saquinavir (SQV)/ritonavir (RTV) combination, administered as either the hard gelatin capsule (HGC) or soft gelatin capsule (SGC) formulation of SQV, in 24 healthy volunteers.

Methods

This was a single‐centre, open‐label, randomized, 2 × 2 crossover study. Twelve subjects were randomized to receive SQV/RTV 1000 mg/100 mg twice daily (BID) orally for 10 days, as either the HGC or SGC formulation. The pharmacokinetic profile of SQV was determined on day 10. Subjects then crossed over to the opposite SQV formulation, and the pharmacokinetic profile was determined again on day 20. The primary analysis was the assessment of bioequivalence based on logarithmically transformed values for AUC(0−24 h) and Cmax for the two formulations.

Results

There was a statistically significant increase in the geometric means of all the pharmacokinetic variables evaluated for SQV‐HGC/RTV compared with SQV‐SGC/RTV. A mean AUC0−24 h‐value of 15.798 µg/mL/h was reported for the HGC formulation compared with 11.655 µg/mL/h for the SGC formulation (P = 0.0043). The SQV‐HGC/RTV combination was better tolerated in terms of gastrointestinal system disorders. Furthermore, no elevations in triglycerides or total cholesterol were reported with SQV/RTV during the entire study period.

Conclusion

In healthy volunteers, RTV boosting of SQV‐HGC produces plasma exposures at least comparable to SQV‐SGC, which is accompanied by an improvement in gastrointestinal system disorders.
Walking and Talking as Predictors of Falls in the General Population: The Leiden 85‐Plus Study
Authors: Bootsma‐van der Wiel Annetje , Gussekloo Jacobijn , De Craen Anton J.M. , Van Exel Eric , Bloem Bastiaan R. , Westendorp Rudi G. J.
Published: September 2003

Objectives: To compare the value of dual tasking in predicting falling in the general population of oldest old with that of easy‐to‐administer single tasks.

Design: Prospective population‐based follow‐up study.

Setting: Municipality of Leiden, the Netherlands.

Participants: Representative cohort of 380 individuals, all aged 85 at baseline.

Measurements: During enrollment, walking time over a 12‐meter distance was measured, as well as the verbal fluency to recite names of animals or professions during a 30‐second period. In the dual task, performance was assessed when participants combined walking with reciting names. Incidence of falls and fractures was assessed by interviewing participants and checking their medical histories.

Results: After 1 year of follow‐up, 42% of the participants reported one or more falls, and 4% suffered a fracture. Total walking time, number of steps, and verbal fluency were all strongly related to incident falls (P for trend for all <.01), but dual‐task performance was not a better predictor for incident falls than single‐task performance.

Conclusion: The dual‐task test in this study had no predictive value above that of a single‐task test to predict falling. Dual tasks with more‐sensitive measures of impaired dual‐task execution might have better test characteristics. In this study, history of falls and performance on an easy‐to‐administer single walking task identified old persons at higher risk for falling who could benefit from fall preventive strategies.
Sympathetic Nervous System Inhibition Increases Hepatic Progenitors and Reduces Liver Injury
Authors: Oben Jude A. , Roskams Tania , Yang Shiqi , Lin Huizhi , Sinelli Nicoletta , Li Zhiping , Torbenson Michael , Huang Jiawen , Guarino Paul , Kafrouni Michel , Diehl Anna Mae
Published: September 2003

Recovery from liver damage might be enhanced by encouraging repopulation of the liver by endogenous hepatic progenitor cells. Oval cells are resident hepatic stem cells that promote liver regeneration and repair. Little is known about the mediators that regulate the accumulation of these cells in the liver. Parasympathetic nervous system inhibition reduces the number of oval cells in injured livers. The effect of sympathetic nervous system (SNS) inhibition on oval cell number is not known. Adrenergic inhibition mobilizes hematopoietic precursors into the circulation and has also been shown to promote liver regeneration. Thus, we hypothesized that SNS inhibition would promote hepatic accumulation of oval cells and reduce liver damage in mice fed antioxidant–depleted diets to induce liver injury. Our results confirm this hypothesis. Compared with control mice that were fed only the antioxidant–depleted diets, mice fed the same diets with prazosin (PRZ, an α–1 adrenoceptor antagonist) or 6–hydroxydopamine (6–OHDA, an agent that induces chemical sympathectomy) had significantly increased numbers of oval cells. Increased oval cell accumulation was accompanied by less hepatic necrosis and steatosis, lower serum aminotransferases, and greater liver and whole body weights. Neither PRZ nor 6–OHDA affected the expression of cytokines, growth factors, or growth factor receptors that are known to regulate progenitor cells. In conclusion, stress–related sympathetic activity modulates progenitor cell accumulation in damaged livers and SNS blockade with α–adrenoceptor antagonists enhances hepatic progenitor cell accumulation.
Surgical treatment of Budd-Chiari syndrome
Authors: Klein Andrew S. , Molmenti Ernesto P.
Published: September 2003

Shunting and transplantation are satisfactory methods of treating Budd-Chiari syndrome (BCS). Selection of treatment is based on the degree of hepatic injury (clinical settings), liver biopsy results, potential for parenchymal recovery, and pressure measurements. Shunting is recommended in cases of preserved hepatic function and architecture. In the presence of fulminant forms of BCS, in cases of established cirrhosis or frank fibrosis, or for patients with defined hepatic metabolic defects (e.g., protein C or protein S deficiency), liver transplantation is the treatment of choice. Nonsurgical alternatives, although encouraging, have limited long-term outcome results at the present time. In most cases of BCS, a thrombophilic disorder can be identified. However, it is important to note that postoperative vascular thrombosis has been identified in patients with BCS who do not have a definable hypercoagulable predisposition. It therefore is our practice to recommend early (<24 hours postoperatively) initiation of intravenous heparin therapy in all patients with BCS, who then undergo life-long anticoagulation with coumadin. (Liver Transpl 2003;9:891-896.)
Effect of coadministered lopinavir and ritonavir (Kaletra) on tacrolimus blood concentration in liver transplantation patients
Authors: Jain Ashokkumar B. , Venkataramanan Raman , Eghtesad Bijan , Marcos Amadeo , Ragni Margaret , Shapiro Ron , Rafail Ann B. , Fung John J.
Published: September 2003

With the advent of highly active antiretroviral therapy (HAART), HIV positivity is no longer a contraindication for liver transplantation. Some of the antiretroviral agents, particularly protease inhibitors (e.g., ritonavir, indinavir, and nelfinavir) have been described as potent inhibitors of the metabolism of certain immunosuppressive drugs. In this article we describe a profound interaction between tacrolimus and Kaletra (Abbott Laboratories, Chicago, IL) (a combination of lopinavir and ritonavir) in 3 liver transplantation patients. Patient 1, who was maintained on a 5 mg twice daily dose of tacrolimus with a trough blood concentration around 10.6 ng/mL, required only 0.5 mg of tacrolimus per week after addition of Kaletra to achieve similar tacrolimus blood concentrations, with a half-life of 10.6 days. In patient 2, the area under the blood concentration versus time curve for tacrolimus increased from 31 ng/mL/h to 301 ng/mL/h after addition of Kaletra, with a corresponding half-life of 20 days. When the patient was subsequently switched to nelfinavir, the half-life decreased to 10.3 days. Patient 3, who was maintained with 4 to 8 mg/d of tacrolimus and a corresponding blood concentration of 10 ng/mL before Kaletra, required a tacrolimus dose of 1 mg/wk and tacrolimus concentrations of 5 ng/mL with Kaletra. In conclusion, a combination of lopinavir and ritonavir led to a much more profound increase in tacrolimus blood concentrations than use of single protease inhibitor, nelfinavir. A tacrolimus dose of less than 1 mg/wk may be sufficient to maintain adequate blood tacrolimus concentrations in patients on Kaletra. Patients may not need a further dose of tacrolimus for 3 to 5 weeks depending on liver function when therapy with Kaletra is initiated. Great caution is required in the management of tacrolimus dosage when Kaletra is introduced or withdrawn in HIV-positive patients after liver transplantation, particularly in the presence of hepatic dysfunction.
Retransplantation of liver: Primary graft nonfunction and hepatitis C virus are associated with worse outcome
Authors: Yoo Hwan Y. , Maheshwari Anurag , Thuluvath Paul J.
Published: September 2003

It is not known whether the outcome of liver retransplantation (re-LT) is dependent on the indication for re-LT or cause of liver disease. In this study, our aim is to compare the outcome of re-LT in adults with that of primary liver transplantation (PLT) and determine whether the outcome of re-LT is dependent on its indication. United Network for Organ Sharing data from 1988 to 2001 were used for the study. Of 34,267 patients who met our inclusion criteria, 761 patients underwent re-LT for primary graft nonfunction (PGNF; group 1), 3,428 patients underwent re-LT for other reasons (group 2), and 30,078 patients underwent PLT (group 3). There was a greater incidence of PGNF (9.4% v 4.0%; P < .001) and regrafting (23.1% v 7.4%; P < .001) in the re-LT groups compared with the PLT group. Kaplan-Meier analysis and Cox regression analysis, after adjusting for confounding risk factors, showed significantly lower short- and long-term patient and graft survival in the re-LT groups compared with the PLT group. Kaplan-Meier survival showed lower patient and graft survival in group 1 compared with group 2. However, only graft, not patient, survival was lower in group 1 by Cox regression analysis when adjusted for other risk factors. Patients with hepatitis C virus (HCV) infection who underwent re-LT had lower patient and graft survival compared with those without HCV infection, and HCV was an independent predictor of mortality after re-LT. Re-LT was associated with a greater rate of complications and lower patient and graft survival compared with PLT. Re-LT for PGNF and HCV infection was associated with lower patient and graft survival compared with re-LT for other causes
The small remnant liver after major liver resection: How common and how relevant?
Authors: Yigitler Cengizhan , Farges Olivier , Kianmanesh Reza , Regimbeau Jean-Marc , Abdalla Eddie K. , Belghiti Jacques
Published: September 2003

The maximum extent of hepatic resection compatible with a safe postoperative outcome is unknown. The study goal was to determine the incidence and impact of a small remnant liver volume after major liver resection in patients with normal liver parenchyma. Among 265 major hepatectomies performed at our institution (1998 to 2000), 138 patients with normal liver and a remnant liver volume (RLV) systematically calculated from the ratio of RLV to functional liver volume (FLV) were studied. Patients were divided into five groups based on RLV-FLV ratio from ≤30% to ≥60%. Kinetics of postoperative liver function tests were correlated with RLV. Postoperative complications were stratified by RLV-FLV ratios. Ninety patients (65%) underwent resection of up to four Couinaud segments. The RLV-FLV ratio was ≤60% in 94 patients (68%) including only 13 (9%) with RLV-FLV ≤30%. There was no linear correlation between the number of resected segments and the RLV-FLV. Postoperative serum bilirubin but not prothrombin time correlated with extent of resection. The incidence of complications including liver failure was not different among groups. Analysis of the four groups with a RLV-FLV ratio <60% showed a trend toward more complications and a longer intensive care unit stay in patients with the smallest RLVs. After major hepatectomy in patients with normal livers, the proportion of patients with a small remnant liver is low and not directly related to the number of segments resected. Although the rate of postoperative complications, including liver failure, did not directly correlate with the volume of remaining liver, the postoperative course was more difficult for patients with smaller remnants. Therefore preoperative portal vein embolization should be considered in patients who will undergo extended liver resection who have (1) injured liver or (2) normal liver when the planned procedure will be complex or when the anticipated RLV-FLV will be <30%. (Liver Transpl 2003;9:S18-S25.)
Geometric aspects of Sturm-Liouville problems II. Space of boundary conditions for left-definiteness
Authors: Haertzen Kevin , Kong Qingkai , Wu Hongyou , Zettl Anton
Published: September 2003

For a given regular Sturm-Liouville equation with an indefinite weight function, we explicitly describe the space of left-definite selfadjoint boundary conditions. The description only uses one value of a fundamental solution of the matrix form of the equation. As a consequence we show that this space has the shape of a solid consisting of two cones sharing a common base.