bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing risk exposures to zero and not having multiple partners: findings that inform evidence-based practices designed to prevent STD acquisition
Authors: DiClemente Ralph J , Crosby Richard A , Wingood Gina M , Lang Delia L , Salazar Laura F , Broadwell Sherry D
Published: December 2005

Our objective was to assess prospectively the relative contribution of reducing penile–vaginal risk exposure to zero and limiting the number of sex partners to one, on the acquisition of biologically confirmed sexually transmitted disease (STD) among African American women adolescents.

Data from a prospective cohort of 522 African American women adolescents enrolled in an HIV prevention trial were used. Baseline STD testing and single-dose directly observable treatment provided an infection-free cohort, who were followed and assessed at six-month intervals.

Self-administered vaginal swab specimens were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis at baseline, six, 12, and 18 months. Frequency of having multiple sex partners and unprotected vaginal sex over each six-month assessment interval was measured.

Adolescents who reported multiple sex partners, relative to only one partner, were more likely to test positive for an STD (adjusted odds ratio (AOR) = 2.9; P = 0.0001). Adolescents who reported unprotected vaginal sex relative to those reporting protected vaginal sex also had greater odds of testing positive for an STD (AOR = 1.5; P = 0.0001).

Prospective findings suggest that having multiple sex partners and engaging in unprotected vaginal sex both remain significant risk factors for STD acquisition among African American adolescent women. STD prevention programmmes need to target both risk factors to achieve optimal risk-reduction effectiveness.
Effectiveness of an educational leaflet on the prevention of external genital warts recurrences
Authors: Vilata Juan José , Badia Xavier ,   IPERTIM group
Published: December 2005

The study aims to assess the effectiveness of an educational leaflet in the prevention of external genital warts recurrences after achieving clearance with topical immune response modifiers treatment. A six-month follow-up, prospective, open, multi-centre randomized by centres study was conducted, which included a total of 216 patients. A total of 103 (47.7%) patients were given an educational leaflet. In all, 201 subjects (93.1%) came to the second follow-up visit, of which 62.7% achieved condyloma acuminatum (CA) clearance. During follow-up, 15% (confidence intervals [CI] 95%, 7.1–26.6%) of the patients who were given the educational leaflet, and 33.3% (CI 95%, 20.4–48.4%) of those who were not given the educational leaflet showed CA recurrences; the global rate of CA recurrence at the end of the six-month follow-up was 23.1% (CI 95%, 15.6–32.2%). The educational leaflet has therefore proved to be effective at reducing the recurrence rate after successful treatment with immune response modifiers.
An audit of completeness of clinical histories: before and after introduction of a pro forma
Authors: Schmidt Martina , Rizvi Nilofar , Lee David M , Wood Vanessa , Amisano Suzanne , Fairley Christopher K
Published: December 2005

The completeness of a random sample of medical records, before and after introduction of a pro forma, was measured in an audit. Twenty key variables that were considered as an essential part of every clinical history were assessed. There was a significant improvement in nine of the 18 items for men, and 11 of the 20 items for women. The mean completeness score increased from 14.5 to 15.9 (out of 18) in men, and from 15 to 17.5 (out of 20) in women ( P < 0.001). The improved completeness of medical records as a result of the proforma should result in the improved management of clients, in addition to providing improved documentation in the case of a medicolegal case.
The first point prevalence study of genital Chlamydia trachomatis infection in young male inmates in the UK
Authors: Menon-Johansson A S , Winston A , Matthews G , Portsmouth S , Daniels D
Published: December 2005

Our objective was to estimate Chlamydia trachomatis (CT) genital infection point prevalence in young male inmates using a non-invasive sampling technique. All new inmates were invited into the study that consisted of a questionnaire and the provision of a urine sample for analysis. The questionnaire asked about personal characteristics, sexual history and symptoms. CT was diagnosed using nucleic acid amplification tests. In all, 13% of new inmates were found to have CT infection. One-fifth of these CT-positive individuals had symptoms of urethral infection. CT prevalence among young male inmates is comparable with results obtained from young women in UK screening programmes. Numerous factors support the integration of CT screening in prisons into the national chlamydia screening programme.
Simultaneous occurrence of dysaesthetic peno/scroto-dynia and stomatodynia
Authors: Mancuso G , Berdondini R M
Published: December 2005

The 'dynias' are a group of chronic focal pain syndromes with a predilection for orocervical or urogenital regions. Only exceptionally do they involve both sites in the same patient. Here, we report a case of simultaneous occurrence of dysaesthetic peno/scroto dynia and stomatodynia.
Health and wellbeing of HIV-positive Australians: findings from the third national HIV Futures Survey
Authors: Grierson J W , Pitts M K , Misson S
Published: December 2005

The aim of this paper is to characterize the health and well being of people living with HIV/AIDS (PLWHA) in Australia. The HIV Futures 3 Survey was a self-complete anonymous questionnaire distributed through multiple sites. Data were collected on health, clinical and social variables.

There were 894 responses, 6% of the known HIV-positive population. Respondents were aged between 20 and 77; 79% were homosexual men. In all, 58% reported a viral load of <500 copies/mL, and 81% a CD4 count of over 250 cells/μL. In all, 38% reported another major health condition, and 26% a mental health condition. A total of 72% were using antiretroviral therapy. About 48% were in a regular relationship, and 42% of regular partners were HIV-positive. In all, 55% had stopped working because of HIV and 31% were living in poverty.

While the overall picture for PLWHA in Australia is optimistic, there remain clear patterns of health and social disadvantage that require ongoing policy vigilance and service provision.
Quantitative Raman Spectroscopy of Homogeneous Molecular Profiles in Optical Waveguides Using Internal Standards
Authors: Miller D. R. , Han O. H. , Bohn P. W.
Published: December 2005

Quantitative agreement between measured Raman signals and calculated integrated electric field intensity distributions is demonstrated in both three- and four-layer waveguides by the use of one member of the thin-film structure as an internal standard with which to eliminate the influence of all mode-varying parameters. Optical parameters were obtained in four-layer structures from a negative gradient search along the four-dimensional error surface and were then used to generate integrated electric field distributions. Experiments on poly(styrene)/poly(vinyipyrrolidone)/SiO2 structures showed excellent (r2 = 0.9999) linearity between measured and calculated values for cutoff modes, but a spectral interference prevented use of the modes which were active in both layers. Substitution of poly(styrene-d8) enabled a comparison of calculated and measured Raman signal ratios to be made for all modes, and again excellent linearity (r2 = 0.9985) was obtained.
The Resonance Raman Microprobe Detection of Single Bacterial Cells from a Chromobacterial Mixture
Authors: Dalterio R. A. , Baek M. , Nelson W. H. , Britt D. , Sperry J. F. , Purcell F. J.
Published: December 2005

High-quality resonance Raman spectra in the visible region can be obtained from very small aggregates of chromobacteria, and very useful spectra can be obtained from individual cells. Individual cells in bacterial mixtures have been clearly identified by argon-laser-excited resonance Raman spectra taken with a commercially available Spex Micramate. Organisms present in the vicinity of the laser beam and in the beam itself can be observed and counted with ease by means of a television image obtained via a vidicon tube attached to a microscope. The method appears capable of identification at the species level.
Signal Enhancement and Elimination of Water-Vapor Interference in Fourier-Transformed Infrared Photoacoustic Spectroscopy of Powdered Plant Materials
Authors: Gordon S. H.
Published: December 2005

A simple and efficient method to enhance the Fourier-transformed infrared photoacoustic signal from powdered samples of plant materials is described. The increase in signal strength appears to be inversely related to the rate of absorption of added water by the dry cellulose, starch, lignin, and hemicellulose of the plant. The method also provides an accurate and convenient technique for obtaining photoacoustic infrared spectra of powdered plant materials free of interference from incidental water vapor in the sample. A hypothesis to account for the nonlinear behavior of the interference is proposed.
Surface-Enhanced Raman Microspectroscopy at Electrode Surfaces
Authors: Hembree D. M. , Oswald J. C. , Smyrl N. R.
Published: December 2005

Surface-enhanced Raman microspectroscopy has been developed as a technique for characterizing processes occurring at the electrode/electrolyte interface. A spectroelectrochemical cell was designed to obtain Raman spectra of electrochemical species with the use of microscope optics, which allowed unambiguous placement of the laser focus at the electrode surface with spatial resolution on the order of 1 µm. It was also possible to visually inspect the surface morphology of the electrode with the use of the Raman microscope in the reflected-light mode. The capabilities of the spectroelectrochemical cell were demonstrated by observation of surface-enhanced Raman scattering (SERS) for a variety of model systems (pyridine, pyridinium ion, potassium cyanide) with the use of silver, copper, and nickel electrodes. The electrochemical behavior of a commercially important gold electroplating process is also reported.
Magnetic Confinement and Control of Trajectories of Discharge Species in Atmospheric-Pressure Analytical Spark Discharges
Authors: Majidi Vahid , Coleman David M.
Published: December 2005

A series of experiments, designed to help characterize the behavior of an analytical spark discharge in an external pulsed magnetic field, is described. Results include controlled formation and deformation of a spark's post-discharge torus utilizing different magnetic field configurations. One manifestation of this research was discovery of a new filamentary structure which extends from the spark conducting channel to the magnet pole face(s). These features were investigated via their refracted light (Schlieren) and spectroscopic (time/space/wavelength-resolved) properties. Practical ramifications of this control are discussed.
Stokes Mueller Treatment of Artifacts in Natural Raman Optical Activity
Authors: Hecht L. , Jordanov B. , Schrader B.
Published: December 2005

A description of Raman scattering based on the theory by Barron and on Stokes Mueller formalism was developed into a uniform mathematical calculus such that Raman scattering can now be easily represented by a simple phenomenological matrix. This matrix, the Mueller matrix of a modulator driven by a square-wave voltage, and the matrix for a laser regarded as a fictitious polarizer are presented for the first time. With the use of these three matrices and the ones for the analyzer, the polarizer, the linearly birefringent sample cell, the circularly birefringent sample, and the partially polarizing detector, the main reasons for the appearance of artifacts in Raman optical activity have been identified. On the basis of a calculation for right-angle scattering of an isotropic solution of chiral molecules, sources of artifacts appear to be the linear birefringence of the cell walls and of the modulator material. Phase-sensitive detection is found to observe Raman optical activity with a minimal number of artifacts.
Variable-Temperature Raman Studies of Langmuir-Blodgett Multilayers Using Integrated Optical Techniques
Authors: Barbaczy E. , Dodge F. , Rabolt J. F.
Published: December 2005

A unique integrated optical device has been constructed which allows the study of submicron films and Langmuir-Blodgett multilayers at both elevated (100°C) and cryogenic (−125°C) temperatures by Raman spectroscopy. The two-stage coupler maintains a constant pressure on the prism used for coupling the incoming laser light into the thin film whose spectrum is desired. A Raman study of L-B multilayers of cadmium arachidate (CdA) in the −125°C to 100°C illustrates the versatility of the integrated optical technique.
Electrothermal Radiometric Detection of the Semiconductor-to-Metal-Phase Transition in Single-Crystal (TaSe4)2I
Authors: Pekker Sándor , Eyring Edward M.
Published: December 2005

Electrothermal radiometry, a new radiometric technique for investigating phase transitions in semiconductors and metals, is described. Single crystals of (TaSe4)2I are heated by electric current pulses, and the thermal radiation of the samples is detected. The dependence of the electrothermal radiometry signal on the frequency and amplitude of the current pulses and on the temperature is discussed. The signal intensity is inversely proportional to the frequency. The static component of the temperature at the surface is obtained from the dependence on the current intensity. The temperature dependence is mostly determined by the change of the resistivity of the sample.
Infrared Spectroscopic Studies of the Surface Molecular Orientation Layer of Glass Fibers
Authors: Xue Gi , Liu Shiying , Jin Yi , Jiang Shankeng
Published: December 2005

The existence of a surface orientation layer in glass fiber was proved by a modified FT-IR diffuse reflectance spectroscopic technique. Glass fibers were arranged parallel to each other. Samples were put perpendicular and parallel to incident radiation. The relative intensity changes of reflection spectra show evidence for molecular orientation on the surface of glass fibers which have been cooled rapidly from high temperature, and for the removal of this layer by etching or annealing.
Isotopes and Atomic Absorption Spectrometry. Computer Simulations, Part I: Evaluation of the Simulation Model Using the Flame Atomic Absorption Determination of Lithium Isotope Abundances
Authors: Pathiratne K. A. S. , Lovett R. J.
Published: December 2005

An evaluation of a computer model developed to calculate absorbances involving multi-isotopic elements is presented. With the use of the model, an independently performed flame atomic absorption experiment to determine isotope abundances of lithium is simulated. The necessity of having accurate values of the critical model parameters (damping constant, isotope shift, fine structure separation, and collisional shift) is demonstrated. The ability of the model to reveal experimental relationships which would be difficult to observe unless the experiments were performed with extreme care is shown. Further, the potential of the model to simulate isotope effects in AAS and its use as an aid in the evaluation of experimental results are demonstrated.
Impact of insulin antibodies on insulin aspart pharmacokinetics and pharmacodynamics after 12-week treatment with multiple daily injections of biphasic insulin aspart 30 in patients with type 1 diabetes
Authors: Chen J-W , Frystyk J , Lauritzen T , Christiansen J S
Published: December 2005

Objective: This study aimed to evaluate the impact of insulin antibodies on insulin aspart pharmaco-kinetics and pharmacodynamics after 12-week multiple daily injections of biphasic insulin aspart 30 (30% fast-acting and 70% protamine-crystallised insulin aspart, BIAsp30) in patients with type 1 diabetes.

Methods: Twenty-three patients (8 women, 15 men) aged 44.8 (20.6–62.5) years (median and range) with diabetes duration of 19.5 (1.6–44.6) years and haemoglobin (Hb)A1C of 9.2% (8.1–12.3%) participated in the study, which consisted of 12-week treatment with multiple injections of BIAsp30. At the end of the treatment period, all patients attended two 24-h profile days 1 week apart for pharmacokinetic and pharmacodynamic assessments. HbA1C and insulin antibodies were also determined.

Results: Patients were stratified into two groups depending on whether the level of insulin binding to insulin antibodies was below or above 75% (moderate vs high (%, median and range): 62 (15–74) vs 80 (75–89)). High levels of insulin antibodies resulted in about threefold increase in AUC(0 – 24 h) (the area under the concentration-time curve during 24 h) for total insulin aspart (analysis of variance, P < 0.05). The differences in free insulin aspart pharmacokinetics, insulin pharmacodynamics and HbA1C were not statistically significant between patients with different levels of insulin antibodies. Total daily insulin dosage was significantly lower in patients with high than moderate levels of insulin antibodies.

Conclusions: In type 1 diabetic patients, high levels of circulating insulin antibodies result in elevated total, but not free, insulin aspart profiles. Consistent with the finding of similar insulin pharmacodynamics, the long-term glycaemic control is not significantly different between patients with different levels of insulin antibodies.
Cognitive functioning and well-being in euthyroid patients on thyroxine replacement therapy for primary hypothyroidism
Authors: Wekking Ellie M , Appelhof Bente C , Fliers Eric , Schene Aart H , Huyser Jochanan , Tijssen Jan G P , Wiersinga Wilmar M
Published: December 2005

Objective: Hypothyroidism is associated with neurocog.nitive impairment. Sparse data suggest that treatment of hypothyroidism, resulting in a return to euthyroidism, may be associated with only partial recovery of overall neurocognitive functioning. The aim of this study was to assess neurocognitive functioning and well-being in euthyroid patients with primary hypothyroidism on adequate thyroxine (T4) treatment. We also investigated whether serum TSH and thyroid antibodies are determinants of neurocognitive functioning and well-being.

Design: We assessed neurocognitive functioning and well-being in 141 patients with primary hypothyroidism.

Methods: Neurocognitive test results and scores on questionnaires measuring well-being of 141 patients were compared with the reference values for these tests as published and used in Dutch clinical neuropsychological practice. Assessment of neurocognitive functioning included tests for cognitive or psychomotor speed, attention, working memory as well as learning and memory. Well-being was measured with the Symptom Check List-90 total score and the Rand 36-item Health Survey subscales for ‘mental health’ and ‘vitality’.

Results: Patients showed poor performance on various domains of neurocognitive functioning compared with mean standard reference values, especially on a complex attention task and on verbal memory tests. Levels of well-being were significantly lower for patients compared with those of the general population. Neither serum TSH nor thyroid antibodies were determinants of neurocognitive functioning and well-being.

Conclusion: The results of this study suggest that neurocognitive functioning as well as psychological well-being may not be completely restored in patients with hypothyroidism, despite T4 treatment.
Surgery versus medical follow-up in patients with asymptomatic primary hyperparathyroidism: a decision analysis
Authors: Sejean Karine , Calmus Sophie , Durand-Zaleski Isabelle , Bonnichon Philippe , Thomopoulos Pierre , Cormier Catherine , Legmann Paul , Richard Bruno , Bertagna Xavier Y , Vidal-Trecan Gwenaelle M
Published: December 2005

Objectives: To examine the cost-effectiveness of strategies for management of primary asymptomatic hyperparathyroidism: surgical strategies and medical follow-up versus surgery.

Design: We used a Markov state-transition decision-analytic model for an hypothetical cohort of 55-year-old women to compare with a lifetime horizon costs and effectiveness of bilateral neck exploration (BNE), unilateral neck exploration (UNE), video-assisted parathyroidectomy (VAP) and lifelong medical follow-up shifting for either BNE or UNE in case of disease progression.

Methods: Data on localization tests, complications and treatment efficacies were derived from a systematic review of the literature. Outcomes were expressed as quality-adjusted life years (QALY). Costs (€2002) discounted at 3% yearly were estimated from the health care system perspective.

Results: In the base-case analysis, VAP strategy (VAPS) was the most effective and BNE strategy (BNES) was the least costly. UNE strategy (UNES) had an incremental cost-effectiveness ratio of €2688/QALY versus BNES and VAPS of €17 250/QALY in comparison with UNES. Surgical management was more effective than medical follow-up with acceptable incremental cost-effectiveness ratios. VAPS became less effective than UNES over 71 years. Differences between UNES and VAPS were sensitive to success and complication rates, quality-of-life weights and procedural costs. Medical follow-up strategies became the most effective if quality-of-life weight for this condition was higher than 0.99.

Conclusions: Surgery is more effective than medical follow-up at a reasonable cost and can be preferred except in patients choosing medical follow-up. Minimally invasive surgery is cost-effective compared to the traditional surgical approach.
Maternal anthropometric and metabolic factors in the first half of pregnancy and risk of neonatal macrosomia in term pregnancies. A prospective study
Authors: Clausen T , Burski T K , Øyen N , Godang K , Bollerslev J , Henriksen T
Published: December 2005

Objective: The prevalence of maternal overweight and fetal macrosomia is increasing. Fetal macrosomia is associated with increased risk of maternal and neonatal complications. The objective of the present study was to investigate if maternal metabolic parameters associated with maternal overweight were independent determinants of macrosomia (birth weight > 4500 g or above the 95 percentile of the z-score for standardized birth weight).

Design: Prospective population based cohort study of 2050 pregnancies and nested case control study. Methods: Outcome measures were adjusted risks for macrosomia in relation to early second trimester maternal serum lipids, glucose and insulin (cohort study) and leptin and insulin-like growth factor (73 cases and 146 matched controls).

Results: Gestational diabetes was not independently associated with fetal macrosomia. First trimester body mass index (BMI), gestational weight gain and placental weight were associated with macrosomia. High serum insulin and non-high density lipoprotein (HDL)-cholesterol and low serum HDL-cholesterol were associated with increased risk of macrosomia independent of BMI, weight gain, placental weight and gestational diabetes. Slim women with macrosomic infants had higher insulin compared with those with normal weight infants. This relation was not found among obese women. Leptin was not associated with macrosomia after adjusting for maternal BMI.

Conclusions: Blood parameters known to be associated with the metabolic syndrome were risk factors for macrosomia independent of maternal BMI.
Health-related quality of life, anxiety and depression in thyroid cancer patients under short-term hypothyroidism and TSH-suppressive levothyroxine treatment
Authors: Tagay Sefik , Herpertz Stephan , Langkafel Matthias , Erim Yesim , Freudenberg Lutz , Schöpper Nicole , Bockisch Andreas , Senf Wolfgang , Görges Rainer
Published: December 2005

Objective: Very few previous studies have compared the degree of health-related quality of life (HRQL), depression and anxiety of differentiated thyroid cancer patients (DTC) under short-term hypothyroid-ism and levothyroxine treatment.

Methods: Using patient-completed instruments, we examined the frequency of physical complaints, HRQL, anxiety and depression in 130 DTC patients hospitalized for radioiodine therapy or whole-body diagnostics (age 52 years, female 71%) under short-term hypothyroidism (4 weeks of levothyroxine withdrawal; DTC-H) and in 100 DTC out-patients under TSH-suppressive doses of levothyroxine subsequent to radioiodine therapy (DTC-L; age 49 years, female 81%).

Results: Compared with the German general population, DTC-H as well as DTC-L patients had significantly impaired HRQL. Notably, the decrease in HRQL was significantly higher in DTC-H than in DTC-L patients. Surprisingly, the prevalence of anxiety (44.6%) but not depression (17.7%) was much higher in the DTC-H patients than in the general population. In contrast to expectations, similar results for anxiety (44.0%) and depression (17.6%) were observed in the DTC-L patients.

Conclusions: This mounting evidence suggests that a consistent pattern of HRQL impairment is experienced by patients with DTC. The high frequency of anxiety and the significantly reduced HRQL should be considered in the aftercare of DTC patients.
Risk factors for congenital hypothyroidism: results of a population case-control study (1997–2003)
Authors: Medda Emanuela , Olivieri Antonella , Stazi Maria Antonietta , Grandolfo Michele E , Fazzini Cristina , Baserga Mariangiola , Burroni Massimo , Cacciari Emanuele , Calaciura Francesca , Cassio Alessandra , Chiovato Luca , Costa Pietro , Leonardi Daniela , Martucci Maria , Moschini Lidia , Pagliardini Severo , Parlato Giuseppe , Pignero Alberto , Pinchera Aldo , Sala Danielle , Sava Lidia , Stoppioni Vera , Tancredi Francesco , Valentini Fabiola , Vigneri Riccardo , Sorcini Mariella
Published: December 2005

Objective: To identify risk factors for permanent and transient congenital hypothyroidism (CH).

Design: A population-based case-control study was carried out by using the network created in Italy for the National Register of Infants with CH.

Methods: Four controls were enrolled for each new CH infant; 173 cases and 690 controls were enrolled in 4 years. In order to distinguish among risk factors for permanent and transient CH, diagnosis was re-evaluated 3 years after enrolment when there was a suspicion of transient CH being present. Familial, maternal, neonatal and environmental influences were investigated.

Results: An increased risk for permanent CH was detected in twins by a multivariate analysis (odds ratio (OR) = 12.2, 95% confidence interval (CI): 2.4–62.3). A statistically significant association with additional birth defects, female gender and gestational age >40 weeks was also confirmed. Although not significant, an increased risk of CH was observed among infants with a family history of thyroid diseases among parents (OR = 1.9, 95% CI: 0.7–5.2). Maternal diabetes was also found to be slightly associated with permanent CH (OR = 15.7, 95% CI: 0.9–523) in infants who were large for gestational age. With regard to transient CH, intrauterine growth retardation and preterm delivery were independent risk factors for this form of CH.

Conclusion: This study showed that many risk factors contribute to the aetiology of CH. In particular, our results suggested a multifactorial origin of CH in which genetic and environmental factors play a role in the development of the disease.
Osteoprotegerin serum levels in children with type 1 diabetes: a potential modulating role in bone status
Authors: Galluzzi Fiorella , Stagi Stefano , Salti Roberto , Toni Sonia , Piscitelli Elisabetta , Simonini Gabriele , Falcini Fernanda , Chiarelli Francesco
Published: December 2005

Objective: Children and adolescents with type 1 (insulin-dependent) diabetes mellitus (T1DM) show several impairment of bone metabolism and structure, resulting in a higher risk of decreased bone mass and its related complications later in life. Alterations of the nuclear factor-κB ligand (RANKL)/osteoprotegerin (OPG) system have been implicated in several metabolic bone diseases characterized by increased osteoclast differentiation and activation and enhanced bone resorption.

Design: We aimed to assess OPG levels and to investigate the possible relation between OPG levels, bone status and glycemic control in a group of prepubertal children with T1DM without microvascular complications.

Methods: Twenty-six prepubertal T1DM children (median age 9.9 years, range 4.1–13.1 years) were studied. In all patients, serum OPG, hemoglobin (Hb)A1c, parathyroid hormone (PTH) and 25-dihy-droxyvitamin D (25-D) levels were evaluated. Bone quality was determined by measuring the attenuation of ultrasound waves by bone (broadband ultrasound attenuation (BUA)) at the calcaneal site. The data were compared with those of a group of 45 age-, sex-and body-size-matched healthy children.

Results: Children with T1DM showed a reduced Z-score BUA in comparison with the control group (Student’s t-test, P < 0.0001). Plasma OPG levels were significantly higher in diabetic children than in controls (Student’s t-test, P < 0.0001). In T1DM children, Z-score BUA values displayed a significant correlation with OPG (Student’s t-test, r = −0.62; P = 0.001), and HbA1c (r = −0.59; P = 0.007). OPG levels were significantly correlated with HbA1c (r = 0.56; P = 0.008). In a multiple regression analysis including age, duration of diabetes, physical activity, calcium intake, mean HbA1c and Z-score BUA, only HbA1c significantly predicted serum OPG levels (beta 0.67; P = 0.003).

Conclusions: Prepubertal children with T1DM have a significant increase of OPG levels. OPG serum concentrations are correlated to calcaneal BUA and HbA1c values. OPG could be a new marker of reduced bone mass in children with T1DM.
Genetic strain variations in the metaphase-II phenotype of mouse oocytes matured in vivo or in vitro
Authors: Ibáñez Elena , Sanfins Alexandra , Combelles Catherine M H , Overström Eric W , Albertini David F
Published: December 2005

The interplay between genetic and epigenetic factors plays a central role in mammalian embryo production strategies that superimposeex vivoorin vivomanipulations upon strain background characteristics. In this study, we examined the relationship between genetic background and the phenotypic properties of mouse metaphase-II (M-II) oocytes that were matured underin vivo(IVO) orin vitroconditions, either in a basal (IVM) or a supplemented (IVM + ) medium. Differences existed amongst inbred (C57BL/6), outbred (CF-1, Black Swiss, NU/NU) and hybrid lines (B6D2F1) induced to superovulate with regard to cytoplasmic microtubule organizing center (MTOC) number but not spindle size or shape, except for larger and asymmetrical spindles in Black Swiss oocytes. When oocytes were matured in culture, meiotic spindle and cytoplasmic phenotypic properties of M-II oocytes were affected relative toin vivoconditions and between strains. Specifically, measures of meiotic spindle size, shape, polar pericentrin distribution and cytoplasmic MTOC number all revealed characteristic variations. Interestingly, the overall reduction in cytoplasmic MTOC number noted upon IVM was concomitant with an overall increase in spindle and polar body size. Maturation under IVM + conditions resulted in a further decrease in cytoplasmic MTOC number, but spindle and polar body characteristics were intermediate between IVO and IVM. How these oocyte phenotypic properties of maternal origin may be linked to predictive assessments of fecundity remains to be established.
Serum and follicular fluid leptin levels are correlated with human embryo quality
Authors: Anifandis Georgios , Koutselini Eleni , Stefanidis Ioannis , Liakopoulos Vassilios , Leivaditis Constantinos , Mantzavinos Themis , Vamvakopoulos Nikolaos
Published: December 2005

This prospective study was undertaken to reassess the prognostic value of leptin during critical stages of in vitro fertilization-embryo transfer (IVF-ET) and address its role in the functional staging of assisted reproductive technologies at the level of embryo quality. Serum and follicular fluid samples of 100 selected women undergoing the long IVF-ET protocol were collected for leptin and embryo quality determination. The highest serum leptin concentration (52.11 ± 4.27 ng/ml) was observed on ovum pick up day, while follicular fluid leptin was higher than all serum samples examined (62.59 ± 5.73 ng/ml). Serum leptin above 59.48 ± 7.6 ng/ml was associated with ‘poor’ embryo quality and above 56.87 ± 5.52 ng/ml with pregnancy failure. Elevated leptin concentrations were associated with reduced ovarian stimulation and response, follicle maturation, embryo quality and pregnancy success. Our findings suggest that leptin modulates embryo quality and may serve as a sensitive marker of IVF outcome.
Mammalian egg activation: from Ca2+ spiking to cell cycle progression
Authors: Jones Keith T
Published: December 2005

Mammalian eggs arrest at metaphase of the second meiotic division (MetII). Sperm break this arrest by inducing a series of Ca2+spikes that last for several hours. During this time cell cycle resumption is induced, sister chromatids undergo anaphase and the second polar body is extruded. This is followed by decondensation of the chromatin and the formation of pronuclei. Ca2+spiking is both the necessary and solely sufficient sperm signal to induce full egg activation. How MetII arrest is established, how the Ca2+spiking is induced and how the signal is transduced into cell cycle resumption are the topics of this review. Although the roles of most components of the signal transduction pathway remain to be fully investigated, here I present a model in which a sperm-specific phospholipase C (PLCζ) generates Ca2+spikes to activate calmodulin-dependent protein kinase II and so switch on the Anaphase-Promoting Complex/Cyclosome (APC/C). APC/C activation leads to securin and cyclin B1 degradation and in so doing allows sister chromatids to be segregated and to decondense.
Apoptosis in bovine cumulus–oocyte complexes after exposure to polychlorinated biphenyl mixtures during in vitro maturation
Authors: Pocar Paola , Nestler Daniela , Risch Michaela , Fischer Bernd
Published: December 2005

Aroclor-1254 (A-1254) is a commercial mixture of coplanar (dioxin-like) and non-coplanar (non dioxin-like) polychlorinated biphenyls (PCBs) affecting bovine oocytein vitromaturation (IVM) and developmental competence. In the present study, the role of cumulus cell apoptosis in mediating the toxic effects of PCBs duringin vitromaturation has been investigated. Results indicate that exposure of cumulus–oocyte complexes (COCs) to A-1254 significantly induced apoptosis of cumulus cells. Furthermore, A-1254 significantly increased the expression of the pro-apoptotic gene, Bax, concomitantly reducing the level of the anti-apoptotic gene, Bcl-2, in the cumulus cell compartment. The effects of pure mixtures of coplanar (PCB 77, 126 and 169) or non-coplanar (PCB 52, 101 and 153) PCBs were examined. Exposure of COCs to coplanar PCBs affected maturation at doses as low as 100.6 pg/ml. Furthermore, a significant increase in apoptosis and in Bax mRNA expression was observed. No variations in maturation or apoptosis were observed in the non-coplanar PCB group. To further analyze the role of cumulus cells, COCs and denuded oocytes (DOs) have been exposed to A-1254 or coplanar PCBs during IVM. Exposure of COCs significantly reduced the percentage of matured oocytes after 24 h of culture in both treatments. In contrast, exposure of DOs significantly decreased the maturation rate only at the highest dose investigated (100-fold greater than that affecting COCs). Taken together, the results indicate a direct role of cumulus cell apoptosis in mediating PCB toxicity on bovine oocytes, and a direct relationship between congener planarity and toxicity in bovine oocytes is suggested.
Not all germ cells are created equal: Aspects of sexual dimorphism in mammalian meiosis
Authors: Morelli Meisha A , Cohen Paula E
Published: December 2005

The study of mammalian meiosis is complicated by the timing of meiotic events in females and by the intermingling of meiotic sub-stages with somatic cells in the gonad of both sexes. In addition, studies of mouse mutants for different meiotic regulators have revealed significant differences in the stringency of meiotic events in males versus females. This sexual dimorphism implies that the processes of recombination and homologous chromosome pairing, while being controlled by similar genetic pathways, are subject to different levels of checkpoint control in males and females. This review is focused on the emerging picture of sexual dimorphism exhibited by mammalian germ cells using evidence from the broad range of meiotic mutants now available in the mouse. Many of these mouse mutants display distinct differences in meiotic progression and/or dysfunction in males versus females, and their continued study will allow us to understand the molecular basis for the sex-specific differences observed during prophase I progression.
Accuracy of Methods for Calculating Postnatal Growth Velocity for Extremely Low Birth Weight Infants
Authors: Patel Aloka L. , Engstrom Janet L. , Meier Paula P. , Kimura Robert E.
Published: December 2005

Objective. No uniform method for calculating growth velocity (GV) (grams per kilogram per day) among extremely low birth weight (ELBW) infants has been reported. Because the calculation of actual GV is so labor intensive, investigators have estimated GV with varying approaches, making comparisons across studies difficult. This study compares the accuracy of 3 mathematical methods used for estimating average GV, namely, 2-point models using the difference between weights at 2 time points divided by time and weight (either birth weight [BW] or average weight), linear regression models that are normalized for either BW or average weight, and an exponential model. The accuracy of all models was compared with actual GVs calculated from daily weight measures for a group of ELBW infants.

Methods. Actual GVs were calculated from daily weights for 83 ELBW infants admitted to the special care nursery and were compared with estimated GVs from each of the 5 models for the same infants.

Results. The exponential model, using weights from 2 time points, ie, GV = [1000 × ln(Wn/W1)]/(Dn − D1), was extremely accurate, with mean absolute errors of 0.02% to 0.10%. The 2-point and linear models were highly inaccurate when BW was used in the denominator, with mean absolute errors of 50.3% to 96.4%. The 2-point and linear models were fairly accurate when average weight was used in the denominator, with mean absolute errors of 0.1% to 8.97%. Additional analyses showed that the accuracy of the 2-point and linear model estimates was affected significantly by the combination of BW, length of stay, and chronic lung disease, whereas the exponential model was not affected by these combined factors.

Conclusions. GV estimates calculated with 3 commonly used models varied widely, compared with actual GVs; however, the exponential model estimates were extremely accurate. The exponential model provides the accuracy and ease of use that are lacking in current methods applied to infant growth research.
Patterns of Health Care Use That May Identify Young Children Who Are at Risk for Maltreatment
Authors: Friedlaender Eron Y. , Rubin David M. , Alpern Elizabeth R. , Mandell David S. , Christian Cindy W. , Alessandrini Evaline A.
Published: December 2005

Objectives. Early identification of children who are at risk for maltreatment continues to pose a challenge to the medical community. The objective of this study was to determine whether children who are at risk for maltreatment have characteristic patterns of health care use before their diagnosis of abuse or neglect that distinguish them from other children.

Methods. We performed a case-control study among Medicaid-enrolled children to compare patterns of health service among maltreated children in the year before a first report for abuse or neglect that led to an immediate placement into foster care, with patterns of health service use among matched control subjects. Exposure variables, obtained from Medicaid claims, included the total number of non–emergency department (ED) outpatient visits, the total number of ED visits, the frequency of injury-related diagnoses, the frequency of nonspecific diagnoses that have been previously linked to abuse, and the number of changes in a child’s primary care provider. Multivariate models were performed adjusting for cash assistance eligibility, race, and child comorbidities.

Results. We characterized the health service use patterns, during the year before their first maltreatment report, of 157 children with serious and substantiated abuse or neglect. Health service use during the same period was also characterized among 628 control subjects who were matched by age, gender, and number of months of Medicaid eligibility. Sixteen percent of cases changed their primary care providers, compared with 10% of the control subjects. Multivariable modeling demonstrated that maltreated children were 2.62 (95% confidence interval: 1.40–4.91) times more likely than control subjects to have had 1 previous change in primary care provider and 6.87 (95% confidence interval: 1.96–24.16) times more likely to have changed providers 2 or more times during the year before their first maltreatment report. There were no differences between case patients and control subjects in the frequency of ED visits and rates of diagnoses of injury or nonspecific somatic complaints.

Conclusions. Victims of serious and substantiated physical abuse and neglect change ambulatory care providers with greater frequency than nonabused children. Recognition of this patient characteristic may allow for earlier identification of children who are at risk for additional or future maltreatment.
Prediction of Death for Extremely Low Birth Weight Neonates
Authors: Ambalavanan Namasivayam , Carlo Waldemar A. , Bobashev Georgiy , Mathias Erin , Liu Bing , Poole Kenneth , Fanaroff Avroy A. , Stoll Barbara J. , Ehrenkranz Richard , Wright Linda L. ,   for the National Institute of Child Health and Human Development Neonatal Research Network
Published: December 2005

Objective. To compare multiple logistic regression and neural network models in predicting death for extremely low birth weight neonates at 5 time points with cumulative data sets, as follows: scenario A, limited prenatal data; scenario B, scenario A plus additional prenatal data; scenario C, scenario B plus data from the first 5 minutes after birth; scenario D, scenario C plus data from the first 24 hours after birth; scenario E, scenario D plus data from the first 1 week after birth.

Methods. Data for all infants with birth weights of 401 to 1000 g who were born between January 1998 and April 2003 in 19 National Institute of Child Health and Human Development Neonatal Research Network centers were used (n = 8608). Twenty-eight variables were selected for analysis (3 for scenario A, 15 for scenario B, 20 for scenario C, 25 for scenario D, and 28 for scenario E) from those collected routinely. Data sets censored for prior death or missing data were created for each scenario and divided randomly into training (70%) and test (30%) data sets. Logistic regression and neural network models for predicting subsequent death were created with training data sets and evaluated with test data sets. The predictive abilities of the models were evaluated with the area under the curve of the receiver operating characteristic curves.

Results. The data sets for scenarios A, B, and C were similar, and prediction was best with scenario C (area under the curve: 0.85 for regression; 0.84 for neural networks), compared with scenarios A and B. The logistic regression and neural network models performed similarly well for scenarios A, B, D, and E, but the regression model was superior for scenario C.

Conclusions. Prediction of death is limited even with sophisticated statistical methods such as logistic regression and nonlinear modeling techniques such as neural networks. The difficulty of predicting death should be acknowledged in discussions with families and caregivers about decisions regarding initiation or continuation of care.
Neurodevelopmental Outcome at 5 Years of Age of a National Cohort of Extremely Low Birth Weight Infants Who Were Born in 1996–1997
Authors: Mikkola Kaija , Ritari Niina , Tommiska Viena , Salokorpi Teija , Lehtonen Liisa , Tammela Outi , Pääkkönen Leena , Olsen Päivi , Korkman Marit , Fellman Vineta ,   for the Finnish ELBW Cohort Study Group
Published: December 2005

Objective. Increasing survival of extremely low birth weight (ELBW; birth weight <1000 g) infants raises a concern regarding the risks of adverse long-term outcome such as cognitive dysfunction. Few studies have reported long-term follow-up of representative regional cohorts. The objective of this study was to assess the 5-year outcome of a prospectively followed national ELBW infant cohort.

Methods. Of all live-born ELBW infants (n = 351) who were delivered in the 2-year period 1996–1997 in Finland, 206 (59%) survived until the age of 5 years. Of these, 103 were born at <27 gestational weeks (GW). A total of 172 children were assessed with neurocognitive tests (Wechsler Preschool and Primary Scale of Intelligence–Revised and a Developmental Neuropsychological Assessment [NEPSY]). Nine children with cognitive impairment and inability to cooperate in testing were not assessed. Motor development was assessed with a modified Touwen test.

Results. The rate of cognitive impairment in the ELBW survivors was 9%. The rate of cerebral palsy was 14% (19% of ELBW infants who were born at <27 GW). The mean full-scale IQ of the assessed children was 96 ± 19 and in children of GW <27 was 94 ± 19. Attention, language, sensorimotor, visuospatial, and verbal memory values of NEPSY assessment were significantly poorer compared with normal population means. Four percent needed a hearing aid, and 30% had ophthalmic findings. Of 21 children who had been treated with laser/cryo for retinopathy of prematurity, 17 (81%) had abnormal ophthalmic findings. Of the whole cohort, 41 (20%) exhibited major disabilities, 38 (19%) exhibited minor disabilities, and 124 (61%) showed development with no functional abnormalities but subtle departures from the norm. Only 53 (26%) of the total ELBW infant cohort were classified to have normal outcome excluding any abnormal ophthalmic, auditory, neurologic, or developmental findings. Being small for gestational age at birth was associated with suboptimal growth at least until age 5.

Conclusions. Only one fourth of the ELBW infants were classified as normally developed at age 5. The high rate of cognitive dysfunction suggests an increased risk for learning difficulties that needs to be evaluated at a later age. Extended follow-up should be the rule in outcome studies of ELBW infant cohorts to elucidate the impact of immaturity on school achievement and social behavior later in life.