bluuebunny/crossref_metadata_2025 huggingface dataset:
Helicobacter pylori Infection: Treatment Options
Authors: Calvet Xavier
Published: February 2006

After two decades of progress the best current approach to treatment of Helicobacter pylori infection is a strategy that combines two consecutive complementary treatments. Current guidelines recommend a first-line triple therapy – 7–10 days of a proton-pump inhibitor (PPI), clarithromycin and amoxicillin – followed by a quadruple therapy combining a PPI, metronidazole, tetracycline and a bismuth salt for treatment failures. Regrettably, present cure rates for first-line triple therapy are below 80%, and many patients require second-line treatment with further testing and control visits. Although most compliant patients are cured by the second-line treatment, patients often do not complete the full process and, as a result, final cure rates for the whole strategy often fall below 90%. This means that more effective first-line therapies are required. Promising recent developments include using quadruple therapy as first-line therapy, the use of adjuvant lactoferrin with triple therapy and a newly devised combination of a PPI, clarithromycin, amoxicillin and metronidazole, known as sequential treatment. Additional future developments will re quire the incorporation of new antibiotic weapons in the anti-H. pylori arsenal. The new quinolones and rifamycin derivates have recently demonstrated their efficacy in the treatment of H. pylori infection.
Eradication of Helicobacter pylori: Are Rifaximin-Based Regimens Effective?
Authors: Gasbarrini Antonio , Gasbarrini Giovanni , Pelosini Iva , Scarpignato Carmelo
Published: February 2006

Rifaximin is a non-absorbed semisynthetic rifamycin derivative with a broad spectrum of antibacterial activity including Gram-positive and Gram-negative bacteria, both aerobes and anaerobes. Although originally developed for the treatment of infectious diarrhea, the appreciation of the pathogenic role of gut bacteria in several organic and functional gastrointestinal diseases has increasingly broadened its clinical use. Being the antibiotic active against Helicobacter pylori, even towards clarithromycin-resistant strain, and being the primary resistance very rare, several investigations explored its potential use for eradication of the microorganism. Rifaximin alone proved to be effective, but even the highest dose (1,200 mg daily) gave a cure rate of only 30%. Dual and triple therapies were also studied, with the better results obtained with rifaximin-clarithromycin and rifaximin-clarithromycin-esomeprazole combinations. However, the eradication rates (60–70%) obtained with these regimens were still below the standard set by the Maastricht Consensus guidelines. Although rifaximin-based eradication therapies are promising, new antimicrobial combinations (with and without proton pump inhibitors) need to be explored in well-designed clinical trials including a large cohort of H. pylori-infected patients. The remarkable safety of rifaximin will allow high-dose regimens of longer duration (e.g. 10 or 14 days) to be tested with confidence in the hope of achieving better eradication rates. A drawback of rifaximin could be its inability to reach sufficiently high concentrations in the gastric mucus layer under and within which H. pylori is commonly located and this would likely affect eradication rate. Taking these considerations into account, bioadhesive rifaximin formulations able to better and persistently cover gastric mucosa, or combination with mucolytic agents, such as pronase or acetylcysteine, need to be evaluated in order to better define the place of this antibiotic in our therapeutic armamentarium.
Accessory Mitral Valve Tissue: Report of Two Asymptomatic Cases
Authors: Uslu Nevzat , Gorgulu Sevket , Yildirim Aydin , Eren Mehmet
Published: February 2006

Accessory mitral valve tissue is a rare anomaly of embryologic development of the endocardial cushion and may cause substantial and progressive obstruction of the left ventricular outflow tract. Subaortic obstruction resulting from accessory mitral tissue is most likely due to systolic ballooning of the tissue into the outflow tract. The obstruction can occur in the early period of life as a result of mass effect or it can develop gradually due to the continued deposition of fibrous tissues within the left ventricular outflow tract. In patients with accessory mitral valve tissue, surgery is mandatory if there is a significant obstruction in the left ventricular outflow tract. We report two cases with accessory mitral valve tissue causing mild subaortic stenoses which did not require surgery.
Identification of Factorial Structure of MMSE Based on Elderly Cognitive Destiny: The Italian Longitudinal Study on Aging
Authors: Noale M. , Limongi F. , Minicuci N.
Published: February 2006

The Mini-Mental State Examination (MMSE) is one of the most commonly used instruments in the evaluation of global cognitive status, but only few studies have investigated the relationship among its components in terms of factorial structure. We have considered data from the Italian Longitudinal Study on Aging (ILSA), carried out in Italy in 1992 on a sample of 5,632 subjects aged 65–84 years, and followed up in 1996. The aim of our study was to investigate static factorial structure in three groups of elderly (subjects with a diagnosis of dementia at baseline; subjects free of dementia at baseline, but incident cases at follow-up; subjects who never developed dementia during the 4-year follow-up). Considering our results, we could hypothesize that MMSE static structure reflects the cognitive profile of elderly, and is thus influenced by subjects’ potential to develop dementia.
Fatty Acid Cytotoxicity to Organ-Cultured Bovine Lenses
Authors: Glanz Dagobert , Lennarz Birgit , Glaesser Dietmar
Published: February 2006

High sensitivity of cultured bovine and human lens epithelial cells to unsaturated free fatty acids has been reported in previous papers. Here we show that micromolar concentrations of unsaturated free fatty acids also impair lens cells during organ culturing, a system which resembles the in vivo situation much better than cell cultures do. This added weight to the assumption that fatty acid cytotoxicity might be causally related to senile cataract as well as to cataracts associated with systemic diseases.
Topical Application of Mitomycin C in Combination with Dexamethasone: Effective Delay of Myringotomy Closure
Authors: Kaftan Holger , Hosemann Werner
Published: February 2006

The object of this study was to investigate the efficacy of topical mitomycin C (MMC) in combination with subsequent topical dexamethasone to prolong the patency of myringotomies. Bilateral instrumental myringotomies were performed in 12 rats. On both sides, a solution of MMC (2 mg/ml) was applied to the intact tympanic membrane for ten minutes before myringotomy. Dexamethasone (4 mg/ml) was applied to one tympanic membrane of each animal at days 3, 6, 9 and 14. Tympanic membranes were observed weekly for a total of 9 weeks. The mean healing period was found to be 17.5 days (range 4.5–45.5 days) in the group with MMC alone, and 32 days (range 17.5–59.5 days) in the group MMC + dexamethasone. The difference was significant. A combination of topical MMC and subsequent dexamethasone did delay the healing rate of myringotomies in rat tympanic membranes longer than MMC alone.
Molecular Assessment of Neck Dissections Supports Preserving Level IIB Lymph Nodes in Selective Neck Dissection for Laryngeal Squamous Cell Carcinoma with a Clinically Negative Neck
Authors: Elsheikh Mohamed Nasser , Mahfouz Magdy ElSayed , Salim ElSayed I. , Elsheikh Ehab A.
Published: February 2006

Objectives: It was the aim of this study to determine whether level IIB lymph nodes can be saved in elective neck dissection as a treatment for patients with squamous cell carcinoma (SCC) of the larynx. We present a prospective analysis of a case series. Methods: Thirty-one patients with SCC of the larynx and without palpable lymph nodes at the neck who underwent an elective neck dissection were prospectively studied. The incidence of micrometastasis to level IIB lymph nodes after performing elective neck dissection was evaluated by nested reverse transcription polymerase chain reaction for cytokeratin (CK)19 and CK20 as well as by pathological examination. Results: Nested reverse transcription polymerase chain reaction for CK19 and CK20 mRNA presented similar results but differed from the pathological examination. Of the 31 patients, 6 (19%) by pathological analysis and 9 (29%) by molecular analysis had lymph nodes positive for metastatic SCC. By molecular analysis, only 1 of the 31 patients had involvement of level IIB lymph nodes. Conclusions: This region may be preserved in elective neck dissection in patients with SCC of the larynx, so that accessory nerve dysfunction can be minimized and operative time can be saved.
Endometrial Adenocarcinoma Presenting with an Osseous Metastasis
Authors: Uharček Peter , Mlynček Miloš , Ravinger Jozef
Published: February 2006

Background: Gynecologic cancers metastatic to bone are rare. Endometrial carcinoma usually presents with vaginal bleeding. Case Report: A 67-year-old woman presented with pain, erythema and swelling of the right foot and no history of postmenopausal bleeding. Biopsy revealed primary endometrioid carcinoma metastatic to the calcaneus, talus and metatarsal bones. Lower leg amputation, total abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node sampling were performed. Postoperatively the patient received cisplatin with adriamycin and megestrol acetate and is alive with no evidence of disease 20 months after the diagnosis. Conclusion: Endometrial carcinoma can present as a metastatic lesion of bone.
Dynamics and Plasticity of Weibel-Palade Bodies in Endothelial Cells
Authors: Rondaij Mariska G. , Bierings Ruben , Kragt Astrid , van Mourik Jan A. , Voorberg Jan
Published: February 2006

Agonist-induced release of endothelial cell specific storage granules, designated Weibel-Palade bodies (WPBs), provides the endothelium with the ability to rapidly respond to changes in its micro-environment. Originally being defined as an intracellular storage pool for von Willebrand factor (VWF), it has recently been shown that an increasing number of other components, including P-selectin, interleukin (IL)-8, eotaxin-3, endothelin-1, and angiopoietin-2, is present within this subcellular organelle, implicating a role for WPB exocytosis in inflammation, hemostasis, regulation of vascular tone and angiogenesis. Recent studies emphasize that WPBs provide a dynamic storage compartment whose contents can be regulated depending on the presence of inflammatory mediators in the vascular micro-environment. Additionally, release of WPBs is tightly regulated and feedback mechanisms have been identified that prevent excessive release of bioactive components from this subcellular organelle. The ability to regulate both contents and exocytosis of WPBs endows these endothelial cell specific organelles with a remarkable plasticity. This is most likely needed to allow for controlled delivery of bioactive components into the circulation on vascular perturbation.
Decreased High-Density Lipoprotein (HDL) Particle Size, Preβ-, and Large HDL Subspecies Concentration in Finnish Low-HDL Families
Authors: Watanabe Hiroshi , Söderlund Sanni , Soro-Paavonen Aino , Hiukka Anne , Leinonen Eeva , Alagona Corradina , Salonen Riitta , Tuomainen Tomi-Pekka , Ehnholm Christian , Jauhiainen Matti , Taskinen Marja-Riitta
Published: February 2006

Objective—

High-density lipoprotein (HDL) cholesterol correlates inversely with the risk of coronary heart disease (CHD). The precise antiatherogenic mechanisms of HDL subspecies are not thoroughly elucidated. We studied the relationship between carotid intima-media thickness (IMT) and HDL subspecies distribution in Finnish families with low HDL cholesterol and premature CHD.

Methods and Results—

Altogether, 148 members of Finnish low-HDL families and 133 healthy control subjects participated in our study. HDL particle size was significantly smaller in affected family members (HDL ≤10th Finnish age-sex specific percentile) compared with unaffected family members and control subjects (9.1±0.04 nm versus 9.5±0.05 nm,
P
<0.0001, versus 9.8±0.03 nm,
P
<0.0001 [mean±SE]). Large HDL
2b
particles as well as preβ-HDL concentration were significantly decreased among the affected family members. Mean IMT was significantly higher in the affected family members than in the control subjects (0.85±0.01 mm versus 0.79±0.01 mm;
P
<0.0001). Age, HDL
2b
, systolic blood pressure, and preβ-HDL were significant independent determinants of mean IMT.

Conclusions—

The decreased levels of HDL
2b
and preβ-HDL reflect the potentially efflux-deficient HDL subspecies profile in the affected low-HDL family members. Decreased HDL particle size caused by the decrease of plasma concentration of HDL
2b
and decreased preβ-HDL levels correlate with increased IMT.
Persistent High Levels of Plasma Oxidized Low-Density Lipoprotein After Acute Myocardial Infarction Predict Stent Restenosis
Authors: Naruko Takahiko , Ueda Makiko , Ehara Shoichi , Itoh Akira , Haze Kazuo , Shirai Nobuyuki , Ikura Yoshihiro , Ohsawa Masahiko , Itabe Hiroyuki , Kobayashi Yoshiki , Yamagishi Hiroyuki , Yoshiyama Minoru , Yoshikawa Junichi , Becker Anton E.
Published: February 2006

Objective—

Recently, elevated levels of plasma oxidized low-density lipoprotein (LDL) have been shown to relate to plaque instability in human atherosclerotic lesions. We investigated prospectively patients admitted with acute myocardial infarction (AMI) who underwent primary coronary stenting to evaluate whether the 6-month outcome could be predicted by measuring plasma oxidized LDL (ox-LDL) levels at the time of hospital discharge.

Methods and Results—

Plasma ox-LDL levels were measured in 102 patients with AMI undergoing primary coronary stenting using a highly sensitive ELISA method. Measurements were taken on admission and at discharge, and the findings related to the clinical outcome. At 6-month follow-up, angiographic stent restenosis occurred in 25 (25%) of the 102 AMI patients. Plasma ox-LDL levels at discharge were significantly (
P
=0.0074) higher in the restenosis group than those in the no-restenosis group (1.03±0.65 versus 0.61±0.34 ng/5 μg LDL protein). Multiple regression analysis showed that only plasma ox-LDL levels at discharge were a statistically significant independent predictor for late lumen loss after stenting (β=0.645;
P
<0.0001).

Conclusions—

This prospective study demonstrates that persistence of an increased level of plasma ox-LDL at discharge is a strong independent predictor of stent restenosis at 6-month follow-up in AMI patients.
Pulsatile Cardiac Tissue Grafts Using a Novel Three-Dimensional Cell Sheet Manipulation Technique Functionally Integrates With the Host Heart, In Vivo
Authors: Furuta Akira , Miyoshi Shunichiro , Itabashi Yuji , Shimizu Tatsuya , Kira Shinichiro , Hayakawa Keiko , Nishiyama Nobuhiro , Tanimoto Kojiro , Hagiwara Yoko , Satoh Toshiaki , Fukuda Keiichi , Okano Teruo , Ogawa Satoshi
Published: February 2006

We devised a method of fabricating easily transplantable scaffoldless 3D heart tissue, made with a novel cell-sheet (CS) technology from cultured cardiomyocytes using a fibrin polymer coated dish. In the present study, we tested in vivo electrical communication which is essential for improving heart function between the host heart and the grafted CS. The epicardial surface of the ventricle of an anesthetized open-chest nude rat was ablated by applying a heated metal. Bilayered CS was obtained from neonatal rat primary culture. CS was transplanted onto the injured myocardial surface (sMI) (sMI+sheet group). The rats were allowed to recover for 1 to 4 weeks, to stabilize the grafts. Action potentials (APs) from the excised perfused heart were monitored by the fluorescence signal of di-4ANEPPS with a high speed charge-coupled device camera. The APs were observed under epicardial pacing of the host heart or the CS grafts. The pacing threshold of the current output was measured in the sMI+sheet group and in the nongrafted sMI group at the center of the sMI and in the normal zone (Nz). Bidirectional AP propagation between the sMI and Nz was observed in the sMI+sheet group (n=14), but was blocked at the marginal area of the sMI in the sMI group (n=9). The ratio of the pacing threshold (sMI/Nz) was significantly lower in the sMI+sheet than in the sMI group (3.0±0.7, 19.0±6.1 respectively
P
<0.05). There were neither spontaneous nor pacing-induced arrhythmias in these two groups. Bidirectional smooth AP propagation between the host heart and the grafted CS was observed. This finding suggested functional integration of this CS graft with the host heart without serious arrhythmia.
Locating Nganiyo: Divination as Intentional Space
Authors: Graw Knut
Published: February 2006

In Senegal and Gambia, the main reason for divinatory consultation is seen not in misfortune or uncertainty but in the client's intention, longing and desire (nganiyo). To locate this intention is the diviner's first task. Successfully executed, it is the proof of his/her divinatory capacities. Drawing on the phenomenological and semantic analysis of Senegambian divinatory praxis, especially among Mandinka speakers, it is argued that Senegambian divination should not be seen as an abstract search for knowledge but as a performative praxis constituting an intentional and empowering cultural space that allows the subject to engage actively with his current situation. In a parallel analysis, it is shown that the notions and concepts underlying the divinatory process form in themselves a highly instructive theory of intentionality and affliction.
Coexistence and/or Confrontation?: Towards a Reappraisal of Christian-Muslim Encounter in Contemporary Ethiopia
Authors: Ahmed Hussein
Published: February 2006

This article deals with the genesis and development of Christian-Muslim relations in Ethiopia from the earliest times to the present, with an emphasis on the post-1974 developments in the country. It seeks to demonstrate that these relations were both consensual and conflictual, and that the conventional over-emphasis on the former has obscured—and marginalized and distorted—the occasional confrontational aspects of the relations that also need to be historicized, contextualized and assessed. Examples of both aspects of relations are presented and discussed, and their relevance to the contemporary situation analyzed. In summary, the paper challenges the validity of the concept of peaceful coexistence as the only defining feature of the relations between the Christian and Muslim communities of Ethiopia.
The Hidden Order of Preformation: Plans, Functions, and Hierarchies in the Organic Systems of Louis Bourguet, Charles Bonnet and Georges Cuvier
Authors: Cheung Tobias
Published: February 2006

In eighteenth-century French natural history, the notion of preformation was not only a model for a small preexisting embryo that gradually extended its shape through the influx of particles, but also for an order that coordinated the dynamic relation between organic parts. Preformation depended therefore also on a hidden order behind the continuity of visible forms. Louis Bourguet, Charles Bonnet, and Georges Cuvier distinguished three organizational levels: First, the synchronic or functional order of organic systems; second, the diachronic order of the initiation of mechanical processes; and third, the hierarchical order that regulates the interaction of organic parts. In this essay, I reconstruct and compare the three organizational levels in the writings of Bourguet, Bonnet and Cuvier, relate their models of organic unity to the principle of perfection, and contrast these models with Georges Buffon's critique of system theories.
Who Invented 'Avicenna's Gilded Pills'?
Authors: Bela Zbigniew
Published: February 2006

This article questions the belief expressed in various histories of pharmacy that the tenth-century Arab physician Avicenna introduced the tradition of coating pills with gold and silver. Although an examination of his Canon documents Avicenna's interest in the medicinal application of gold and silver, no mention is made of coating pills. Nor do other Islamic physicians seem to have been familiar with this practice, any more than such medieval European authors as Arnaldus of Villanova, Raymund Lull or Johannes de Rupescissa. The same is true of medicinal compendia representative of later periods, such as the Ortus sanitatis, Valerius Cordus' Dispensatorium or the Secrets of Alessio Piemontese. The earliest known mention of coating pills with precious metals occurs in a non-medical book, The Golden Fleece (London, 1626), and the earliest mention in the professional literature seems to appear only in the second half of the seventeenth century. The practice of coating pills with gold and silver was to be practiced in Europe into the first half of the twentieth century.
Ludwig Edelstein at the Crossroads of 1933. On the Inseparability of Life, Work, and Their Reverberations
Authors: Rütten Thomas
Published: February 2006

This article takes some first steps towards the establishment of the intellectual biography of the medical historian, classicist, and moral philosopher Ludwig Edelstein (1902-1965). Based on scattered archival records, it sheds light on Edelstein's early career in Germany, the decisions he was forced to make in 1933 when he left Germany and the events that led to his appointment as associate professor at Baltimore's Johns Hopkins University in the autumn of 1934. The representative nature of Edelstein's case will be highlighted in terms of both the history of exile and the history of the academic disciplines involved (medical history and classics); in doing so, the article attempts to reinscribe Edelstein's achievements and influence back into their respective discourses.
A Mechanism for Abrupt Climate Change Associated with Tropical Pacific SSTs*
Authors: Vavrus Steve , Notaro Michael , Liu Zhengyu
Published: February 2006

The tropical Pacific’s response to transiently increasing atmospheric CO2 is investigated using three ensemble members from a numerically efficient, coupled atmosphere–ocean GCM. The model is forced with a 1% yr−1 increase in CO2 for 110 yr, when the concentration reaches 3 times the modern concentration. The transient greenhouse forcing causes a regionally enhanced warming of the equatorial Pacific, particularly in the far west. This accentuated equatorial heating, which is slow to arise but emerges abruptly during the last half of the simulations, results from both atmospheric and oceanic processes. The key atmospheric mechanism is a rapid local increase in the super–greenhouse effect, whose emergence coincides with enhanced convection and greater high cloud amount once the SST exceeds an apparent threshold around 27°C. The primary oceanic feedback is greater Ekman heat convergence near the equator, due to an anomalous near-equatorial westerly wind stress created by increased rising (sinking) air to the east (west) of Indonesia. The potential dependence of these results on the specific model used is discussed.

The suddenness and far-ranging impact of the enhanced, near-equatorial warming during these simulations suggests a mechanism by which abrupt climate changes may be triggered within the Tropics. The extratropical atmospheric response in the Pacific resembles anomalies during present-day El Niño events, while the timing and rapidity of the midlatitude changes are similar to those in the Tropics. In particular, a strengthening of the Pacific jet stream and a spinup of the wintertime Aleutian low seem to be forced by the changes in the tropical Pacific, much as they are in the modern climate.
Dipole Anomaly in the Winter Arctic Atmosphere and Its Association with Sea Ice Motion
Authors: Wu Bingyi , Wang Jia , Walsh John E.
Published: February 2006

This paper identified an atmospheric circulation anomaly–dipole structure anomaly in the Arctic atmosphere and its relationship with winter sea ice motion, based on the International Arctic Buoy Program (IABP) dataset (1979–98) and datasets from the National Centers for Environmental Prediction (NCEP) and the National Center for Atmospheric Research (NCAR) for the period 1960–2002. The dipole anomaly corresponds to the second-leading mode of EOF of monthly mean sea level pressure (SLP) north of 70°N during the winter season (October–March) and accounts for 13% of the variance. One of its two anomalous centers is stably occupied between the Kara Sea and Laptev Sea; the other is situated from the Canadian Archipelago through Greenland extending southeastward to the Nordic seas. The dipole anomaly differs from one described in other papers that can be attributed to an eastward shift of the center of action of the North Atlantic Oscillation. The finding shows that the dipole anomaly also differs from the “Barents Oscillation” revealed in a study by Skeie. Since the dipole anomaly shows a strong meridionality, it becomes an important mechanism to drive both anomalous sea ice exports out of the Arctic Basin and cold air outbreaks into the Barents Sea, the Nordic seas, and northern Europe.

When the dipole anomaly remains in its positive phase, that is, negative SLP anomalies appear between the Kara Sea and the Laptev Sea with concurrent positive SLP over from the Canadian Archipelago extending southeastward to Greenland, there are large-scale changes in the intensity and character of sea ice transport in the Arctic basin. The significant changes include a weakening of the Beaufort gyre, an increase in sea ice export out of the Arctic basin through Fram Strait and the northern Barents Sea, and enhanced sea ice import from the Laptev Sea and the East Siberian Sea into the Arctic basin. Consequently, more sea ice appears in the Greenland and the Barents Seas during the positive phase of the dipole anomaly. During the negative phase of the dipole anomaly, SLP anomalies show an opposite scenario in the Arctic Ocean and its marginal seas when compared to the positive phase, with the center of negative SLP anomalies over the Nordic seas. Correspondingly, sea ice exports decrease from the Arctic basin flowing into the Nordic seas and the northern Barents Sea because of the strengthened Beaufort gyre.

The finding indicates that influences of the dipole anomaly on winter sea ice motion are greater than that of the winter AO, particularly in the central Arctic basin and northward to Fram Strait, implying that effects of the dipole anomaly on sea ice export out of the Arctic basin become robust. The dipole anomaly is closely related to atmosphere–ice–ocean interactions that influence the Barents Sea sector.
Environmental Justice and the New Regionalism
Authors: Rast Joel
Published: February 2006

During the past decade, renewed calls for central city revitalization have come from scholars and practitioners working within a new regionalist perspective. Such arguments have provided much of the ideological underpinning for coalitions around the country promoting smart growth and other regional reforms. Smart growth policies seek to curb urban sprawl by channeling investment into already developed areas, including inner-city communities. Given the attention paid to urban policy among advocates of the new regionalism, one would expect inner-city minorities to be well represented in the dialogue. However, the dialogue over smart growth and regionalism has largely failed to engage inner-city African Americans, Latinos, and other minorities. This article asks why that is the case, examines the consequences, and proposes a strategy for reframing the new regionalist debate in a way that may resonate more with minority stakeholders.
Technology, Culture, and Environmental Uncertainty
Authors: Umemoto Karen , Suryanata Krisnawati
Published: February 2006

Natural resource planning is often riddled with uncertainty, especially when new technologies are introduced. While an “adaptive management” approach is attractive in such situations, it is difficult to implement where there is a real or perceived decline of the state. Based on a case study of mariculture development in Hawaii, the authors suggest that planners and policy makers consider informal social contracts as complements to formal regulatory frameworks to increase the viability of adaptive management regimes. Discussion includes the benefits as well as potential pitfalls of social contracts where formal regulations may be necessary.
Alternative Modified Infant-Feeding Practices to Prevent Postnatal Transmission of Human Immunodeficiency Virus Type 1 Through Breast Milk: Past, Present, and Future
Authors: Hartmann Sandra Urdaneta , Berlin Cheston M. , Howett Mary K.
Published: February 2006

Preventing mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV-1) through breastfeeding is important to reduce the number of infected children. Research on making breastfeeding safer is a high priority. The authors reviewed the attempts to develop alternative methods, other than antiretroviral (ARV) therapy of mothers and/or babies, to decontaminate breast milk of infectious HIV-1 (free and associated with lymphocytes). They also review how these methods affect milk constituents, as well as their current and prospective status. A PubMed search for English publications on methods to prevent MTCT through breast milk was completed. Methods that have been tested, other than systemicuse or ARV or immunoprophylaxis, to reduce or prevent MTCT of HIV-1 through breast milk were broadly classified into 5 groups: (1) modified feeding practices, (2) heat treatment of milk, (3) lipolysis, (4) antimicrobial treatment of the breastfeeding mother, and (5) microbicidal treatment of infected milk. Their advantages and disadvantages are discussed, as well as future directions in the prevention of MTCT through breastfeeding.
How to Integrate a Lactation Consultant in an Outpatient Clinic Environment
Authors: Lukac Marta , Riley Joann K. , Humphrey Angela D.
Published: February 2006

Successful efforts in improving breastfeeding initiation rates at an urban teaching hospital prompted the hospital to create a lactation consultant (LC) position in the outpatient setting to focus on breastfeeding duration. This article reviews the complexity of the clinic setting, with the challenges and benefits of the consultant’s first year in one of the hospital’s outpatient clinics. Preliminary data collected by the consultant suggest that patients counseled by the LC in the outpatient clinic setting have longer breastfeeding duration rates.
Intragroup Differences in Risk Factors for Breastfeeding Outcomes in a Multicultural Community
Authors: Al Tajir Ghada K. , Sulieman Hana , Badrinath Padmanabhan
Published: February 2006

A sample of 221 women who delivered at Al Qassimi Hospital, Sharjah, United Arab Emirates, were included in this prospective study to identify breastfeeding patterns at day 1, 1 month, and 6 months postpartum. The exclusive breastfeeding rate was 76.5% on day 1, 48.4% at 1 month, and 13.3% at 6 months. At 6 months, 16.1% had stopped breastfeeding. Simple and multivariable binary logistic regression analyses were used to identify factors associated with better breastfeeding outcomes. Nationality significantly affected exclusive breastfeeding at day 1 and 1 month. Pethidine use was associated with lower levels of exclusive breastfeeding at 1 month. Education was the most significant determinant of breastfeeding behavior at 6 months. Effects of the interrelationships between factors were examined and shown to influence breastfeeding outcomes in different population subgroups. The findings of this study suggest that strategies to improve breastfeeding should focus on risk factors specific to the population subgroup.
Unplanned Exposure to Genetically Modified Organisms
Authors: Clapp Jennifer
Published: February 2006

This article examines the divergent political responses to unplanned exposure to genetically modified organisms (GMOs) in the Global South. Although scientific and domestic political considerations have some relevance to explaining different positions among developing countries, trade considerations appear to be a principal driver of GMO policy. This consideration is strikingly clear when we compare the different responses to unplanned GMO imports in Mexico/Central America with that in Africa. When trade and environment interests converge, as was the case in Africa, the strong policy stance, in this case against the import of GMOs, was clear and swift. In the cases of Mexico and Central America, the trade and environment interests did not overlap, and this has resulted in a weak government response and incremental policy shifts, in this case toward a pro-GMO stance.
Household Income and Pollution
Authors: Plassmann Florenz , Khanna Neha
Published: February 2006

Country-level analyses of global Environmental Kuznets Curve (EKC) relationships that use multicountry panel data sets are likely to suffer from several types of aggregation bias that may explain why previous studies have yielded conflicting results. The authors analyze 1990 cross-sectional data for the United States for three pollutants and test the general EKC relationship as well as the pure income effect. Their results suggest that the income level at which households reduce their exposure to pollution depends on the nature of the pollutant. They find consistent evidence for such a relationship for coarse particulate matter but little evidence for nonmonotonic relationships for carbon monoxide and ground-level ozone.
Interpreting Estimated Environmental Kuznets Curves for Greenhouse Gases
Authors: Kolstad Charles D.
Published: February 2006

This article examines the question of how to interpret a relationship between income and carbon emissions in a country (the environmental kuznets curve [EKC] for carbon). A very simple and graphical structural model of an EKC is developed, and the problems of applying the concept to carbon are discussed. A major issue is the weak link between demand to avoid damage from climate change and regulations limiting greenhouse gas emissions at the country level. The article goes on to interpret three recent papers in this journal in the context of this structural model.
What Future for the Global Environment Facility?
Authors: Clémençon Raymond
Published: February 2006

For more than a decade, the Global Environment Facility (GEF) has provided critical support to developing countries for fighting global environmental problems such as climate change and the loss of biodiversity. But recent developments do not bode well for the ability of the GEF to continue playing its pivotal role in support of implementing multilateral environmental agreements. Its already modest resource base has been declining in real terms, and a December 2005 deadline for the conclusion of the fourth replenishment of the GEF (GEF4) passed without a compromise between major donors. The adoption of a resource allocation framework in September 2005 is likely to complicate how the GEF can program its resources in the future, even if replenishment negotiations can be completed by June 2006. Current events reinforce the need for a close look at what the future role of the GEF should be and how resources for addressing global environmental problems in developing countries should be raised.1
UNFCCC COP 11 and COP/MOP 1
Authors: Schipper E. Lisa F. , Boyd Emily
Published: February 2006

Since entry into force of the UN Framework Convention on Climate Change (UNFCCC) in 1994, negotiations on controlling future greenhouse gas emissions have turned into one of the largest development issues of our time. In February 2005, the Kyoto Protocol entered into force and 9 months later a historical first meeting of the Kyoto Protocol (COP/MOP 1) was held in Montreal side-by-side with the 11th Conference of the Parties to the UNFCCC (COP 11). After several years of stalemate, the Montreal meeting has resulted somewhat unexpectedly in a constructive outcome that has opened the door for new momentum in climate talks. Along with several key technical decisions, an agreement was reached to hold separate talks to discuss the futures of the UNFCCC and the Kyoto Protocol. This paper discusses the main outcomes of the conference and explores possible ways forward. It concludes that success in the UNFCCC process is imperative to address climate change in both developing and developed countries, even if the most effective actions are taken outside the immediate context of the legal process.
Neuroimaging Patterns Associated with Motor Control in Traumatic Brain Injury
Authors: Lotze M. , Grodd W. , Rodden F. A. , Gut E. , Schönle P. W. , Kardatzki B. , Cohen L. G.
Published: February 2006

Objective. To determine if patients with traumatic brain injury (TBI) and motor deficits show differences in functional activation maps during repetitive hand movements relative to healthy controls. Are there predictors for motor outcome in the functional maps of these patients? Methods. In an exploratory cross-sectional study, functional magnetic resonance imaging (fMRI) was used to study the blood-oxygenation-level-dependent (BOLD) response in cortical motor areas of 34 patients suffering from moderate motor deficits after TBI as they performed unilateral fist-clenching motions. Twelve of these patients with unilateral motor deficits were studied 3 months after TBI and a 2nd time approximately 4 months later. Results. Compared to age-matched, healthy controls performing the same task, TBI patients showed diminished fMRI-signal change in the primary sensorimotor cortex contralateral to the moving hand (cSM1), the contralateral dorsal premotor cortex, and bilaterally in the supplementary motor areas (SMAs). Clinical impairment and the magnitude of the fMRI-signal change in cSM1 and SMA were negatively correlated. Patients with poor and good motor recovery showed comparable motor impairment at baseline. Only patients who evolved to “poor clinical outcome” had decreased fMRI-signal change in the cSM1 during baseline. Conclusions. These observations raise the hypothesis that the magnitude of the fMRI-signal change in the cSM1 region could have prognostic value in the evaluation of patients with TBI.
Evolution of Brain Activation with Good and Poor Motor Recovery after Stroke
Authors: Carey Leeanne M. , Abbott David F. , Egan Gary F. , O’Keefe Graham J. , Jackson Graham D. , Bernhardt Julie , Donnan Geoffrey A.
Published: February 2006

Objective. To characterize the evolution of brain activation in stroke patients with variable motor recovery and quantify changes relative to healthy controls. Methods. Serial PET activation studies, using a simple finger-tapping task, and quantitative measures of motor performance were obtained in 9 patients (2-7 weeks poststroke and 6 months later) and compared with serial healthy volunteer data. Results. Patients with moderate impairment and good recovery ( n = 5) activated the primary sensorimotor cortex (SM1) contralateral to the paretic hand moved, bilateral supplementary motor area (SMA), contralateral cingulate gyrus, and ipsilateral lateral premotor cortex. Activation in the bilateral SMA was greater at the initial study but reduced over time compared to healthy controls and poor recoverers. Patients with severe impairment and poor recovery ( n =4) showed limited activation of contralateral SM1 and SMA at both studies and no significant change over time. A posterior shift in SM1 activation was evident in good and poor recoverers. Conclusions. Activation of typical motor regions and recruitment of additional sites occur subacutely poststroke, with evolution to normal patterns in moderately impaired patients who recover well. In comparison, severely impaired, poor-recovery patients show persistent, reduced activation. Dynamic changes in SMA, differentially observed in good recoverers over 6 months, highlight its importance in recovery.
Bcr-Abl reduces endoplasmic reticulum releasable calcium levels by a Bcl-2–independent mechanism and inhibits calcium-dependent apoptotic signaling
Authors: Piwocka Katarzyna , Vejda Susanne , Cotter Thomas G. , O'Sullivan Gerald C. , McKenna Sharon L.
Published: February 2006

The Bcr-Abl oncoprotein plays a major role in the development and progression of chronic myeloid leukemia (CML). Several studies have suggested that the expression levels of Bcr-Abl are elevated at disease progression to blast crisis and that this plays a significant role in the achievement of drug resistance. We have established cell lines expressing low and high levels of Bcr-Abl to study the molecular mechanisms involved in disease progression and drug resistance. It is now known that the endoplasmic reticulum (ER) can play a major role in the regulation of apoptosis. We therefore investigated whether Bcr-Abl expression modulates ER homeostasis and interferes with ER-mediated apoptotic pathways to promote survival. Bcr-Abl–expressing cells exhibit a decreased amount of free releasable calcium in the ER as well as a weaker capacitative calcium entry response, relative to parental cells. This effect is independent of Bcl-2, which is a known modulator of ER calcium homeostasis. The reduction in ER releasable calcium results in inhibition of the ER/mitochondria-coupling process and mitochondrial calcium uptake. This study demonstrates a novel downstream consequence of Bcr-Abl signaling. The ability to negate calcium-dependent apoptotic signaling is likely to be a major prosurvival mechanism in Bcr-Abl–expressing cells.
A prospective study of the natural history of transient leukemia (TL) in neonates with Down syndrome (DS): Children's Oncology Group (COG) study POG-9481
Authors: Massey Gita V. , Zipursky Alvin , Chang Myron N. , Doyle John J. , Nasim Suhail , Taub Jeffrey W. , Ravindranath Yaddanapudi , Dahl Gary , Weinstein Howard J.
Published: February 2006

A unique transient leukemia (TL) has been described in newborns with Down syndrome (DS; or trisomy 21 mosaics). This leukemia has a high incidence of spontaneous remission; however, early death and subsequent development of acute megakaryoblastic leukemia (AMKL) have been reported. We prospectively evaluated 48 infants with DS and TL to determine the natural history and biologic characteristics of this disease, identify the clinical characteristics associated with early death or subsequent leukemia, and assess the incidence of subsequent leukemia. Blast cells associated with TL in DS infants exhibited FAB M7 morphology and phenotype. Most infants (74%) had trisomy 21 (or mosaicism) as the only cytogenetic abnormality in the blast cells. Most children were able to spontaneously clear peripheral blasts (89%), normalize blood counts (74%), and maintain a complete remission (64%). Early death occurred in 17% of infants and was significantly correlated with higher white blood cell count at diagnosis (P < .001), increased bilirubin and liver enzymes (P < .005), and a failure to normalize the blood count (P = .001). Recurrence of leukemia occurred in 19% of infants at a mean of 20 months. Development of leukemia was significantly correlated with karyotypic abnormalities in addition to trisomy 21 (P = .037). Ongoing collaborative clinical studies are needed to determine the optimal role of chemotherapy for infants at risk for increased mortality or disease recurrence and to further the knowledge of the unique biologic features of this TL.
Cul4A targets p27 for degradation and regulates proliferation, cell cycle exit, and differentiation during erythropoiesis
Authors: Li Binghui , Jia Nan , Kapur Reuben , Chun Kristin T.
Published: February 2006

As erythroid progenitors differentiate into precursors and finally mature red blood cells, lineage-specific genes are induced, and proliferation declines until cell cycle exit. Cul4A encodes a core subunit of a ubiquitin ligase that targets proteins for ubiquitin-mediated degradation, and Cul4A-haploinsufficient mice display hematopoietic dysregulation with fewer multipotential and erythroid-committed progenitors. In this study, stress induced by 5-fluorouracil or phenylhydrazine revealed a delay in the recovery of erythroid progenitors, early precursors, and normal hematocrits in Cul4A+/– mice. Conversely, overexpression of Cul4A in a growth factor-dependent, proerythroblast cell line increased proliferation and the proportion of cells in S phase. When these proerythroblasts were induced to terminally differentiate, endogenous Cul4A protein expression declined 3.6-fold. Its enforced expression interfered with erythrocyte maturation and cell cycle exit and, instead, promoted proliferation. Furthermore, p27 normally accumulates during erythroid terminal differentiation, but Cul4A-enforced expression destabilized p27 and attenuated its accumulation. Cul4A and p27 proteins coimmunoprecipitate, indicating that a Cul4A ubiquitin ligase targets p27 for degradation. These findings indicate that a Cul4A ubiquitin ligase positively regulates proliferation by targeting p27 for degradation and that Cul4A down-regulation during terminal erythroid differentiation allows p27 to accumulate and signal cell cycle exit.
Cytokine-induced IL-10–secreting CD8 T cells represent a phenotypically distinct suppressor T-cell lineage
Authors: Noble Alistair , Giorgini Angela , Leggat Jamie A.
Published: February 2006

Populations of regulatory T cells (Tregs) control autoimmune and allergic immunopathology induced by self or foreign antigens. Several types of CD4+ MHC class II–restricted Treg populations have been characterized, but the biology of CD8+, MHC class I–restricted Tregs is less understood. We show here that CD8+ Tregs are rapidly generated in the presence of IL-4 and IL-12, produce IL-10, and exhibit a unique cell-surface phenotype with coexpression of activation and naive cell-associated markers. They block activation of naive or effector T cells and suppress IgG/IgE antibody responses and graft-versus-host disease in vivo. Suppression is dependent on cell contact and mediated by direct T-cell–T-cell interaction that antagonizes T-cell–receptor (TCR) signals. The data establish the existence of a CD8 T-cell suppressor effector subset distinct in both phenotype and function from T cytotoxic 1 (Tc1) and Tc2 cells. Production of such CD8 Tregs has potential for cell-based therapy of CD4 or CD8 T-cell–mediated disease.
Identifying biological concepts from a protein-related corpus with a probabilistic topic model
Authors: Zheng Bin , McLean David C , Lu Xinghua
Published: February 2006

Background

Biomedical literature, e.g., MEDLINE, contains a wealth of knowledge regarding functions of proteins. Major recurring biological concepts within such text corpora represent the domains of this body of knowledge. The goal of this research is to identify the major biological topics/concepts from a corpus of protein-related MEDLINE© titles and abstracts by applying a probabilistic topic model.

Results

The latent Dirichlet allocation (LDA) model was applied to the corpus. Based on the Bayesian model selection, 300 major topics were extracted from the corpus. The majority of identified topics/concepts was found to be semantically coherent and most represented biological objects or concepts. The identified topics/concepts were further mapped to the controlled vocabulary of the Gene Ontology (GO) terms based on mutual information.

Conclusion

The major and recurring biological concepts within a collection of MEDLINE documents can be extracted by the LDA model. The identified topics/concepts provide parsimonious and semantically-enriched representation of the texts in a semantic space with reduced dimensionality and can be used to index text.