bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of severe aplastic anaemia with combined immunosuppression: anti‐thymocyte globulin, ciclosporin and mycophenolate mofetil
Authors: Scheinberg Phillip , Nunez Olga , Wu Colin , Young Neal S. 
Published: April 2006

SummarySevere aplastic anaemia (SAA) can be successfully treated with immunosuppressive therapies or haematopoietic stem cell transplantation (HSCT). Response rates with horse anti‐thymocyte globulin (h‐ATG) plus ciclosporin (CsA) are about 60–70%, and robust responders have an excellent long‐term survival. We introduced a third immunosuppressive agent to standard h‐ATG/CsA, mycophenolate mofetil (MMF), in an attempt to improve the response rate and survival, and to decrease the relapse rate and clonal evolution to myelodysplasia. A total of 104 consecutive patients with SAA were treated with h‐ATG/CsA/MMF between May 1999 and June 2003 at the National Institutes of Health Clinical Center. The overall response rate at 6 months was 62%, with 24 (37% of responders) patients relapsing at a median of 389 d from ATG. Nine patients showed evidence of clonal evolution following ATG. After a median follow up of 42 months, the median survival among responders was not reached and among non‐responders was 58 months. Over half of the relapses occurred during MMF administration. Despite a strong theoretical rationale for its use, MMF did not result in the improvement of response or relapse rates when compared with historical standard h‐ATG/CsA.
Effects of human γ‐globin in murine β‐thalassaemia
Authors: Nishino Tamon , Cao Hua , Stamatoyannopoulos George , Emery David W. 
Published: April 2006

SummaryMurine models of β‐thalassaemia have been used to test therapeutic globin gene vectors. However, the level of γ‐globin expression necessary to achieve full phenotypic correction in these models is unclear. In order to address this issue, we carried out breeding and transplantation studies in murine models of β‐thalassaemia intermedia (Hbbth−3/+) and severe β‐thalassaemia major (Hbbth−3/Hbbth−3) using transgenic lines expressing various levels of human γ‐globin. Expression of γ‐globin RNA at a modest 7–14% of total α‐globin RNA resulted in the selective survival of HbF(+) erythrocytes, a fivefold increase in total HbF, and a phenotypic improvement in the β‐thalassaemia intermedia model. Full normalisation of erythrocyte indices in this model required γ‐globin RNA expression at 27% of α‐globin, resulting in an average 40% (6·8 g/dl) HbF. Studies using the homozygous Hbbth−3 model of lethal β‐thalassaemia major demonstrated that even this high level of γ‐globin expression, for reasons related to the function of the hybrid globin tetramers, could only prolong, but not fully support, survival. Taken together, these results indicate that only the heterozygous Hbbth−3 model of β‐thalassaemia intermedia can be reliably used for the pre‐clinical assessment of γ‐globin gene therapy vectors, as well as other means of γ‐globin gene induction.
Shaping ability of the M4 handpiece and Safety Hedstrom Files in simulated root canals
Authors: LLOYD A. , JAUNBERZINS A. , DHOPATKAR A. , BRYANT S. , DUMMER P. M. H. 
Published: April 2006

SummaryThe aim of this study was to assess the shaping ability of the M4 reciprocating handpiece and Safety Hedstrom files in simulated canals. A total of 40 simulated canals of various angles and positions of curvature were prepared with an M4 handpiece using Safety Hedstrom files oriented with the ground, flattened surface towards the inner aspect of the curve. A standard regimen was adopted throughout. Pre‐ and post‐operative longitudinal images of the canals were taken with a video camera and stored and manipulated in a computer with image analysis software. The presence of canal aberrations and the amount and location of resin material removed as a result of preparation were determined from composite images of superimposed pre‐ and post‐operative views.Preparation time varied significantly (P<0.001) between the canal types; overall, 20° canals were prepared more quickly than 40° canals. Zips and elbows were observed in 16 out of the 40 canals with most (11) being created in 40° specimens. Ledges were found in 19 canals and perforations in only 1. There were no significant differences between canal shapes for these aberrations.Excessive removal of material from the inner aspect of the canal at the curve to create a danger zone was found in 20 canals, but only in those with 40° curves. Significant differences in total canal width between the canal types were seen at the zips (P<0.05), elbows (P<0.05) and danger zones (P<0.001). Transportation at the danger zones varied significantly (P<0.001) between canal types.Under the conditions of this study, the M4 handpiece and Safety Hedstrom files created hour‐glass preparations in a substantial proportion of canals. In reality, the Safety Hedstrom file with its one flattened surface was ineffective at reducing removal of material along the inner aspect of canal curves in severely curved specimens and clearly has the potential to create strip perforations in teeth.
Cloning of rhesus monkey LILRs*
Authors: Slukvin I.I. , Grendell R.L. , Rao D.S. , Hughes A.L. , Golos T.G. 
Published: April 2006

AbstractLeukocyte Ig‐like receptors (LILRs) are a family of receptors that have inhibitory and activating functions and widely expressed by lymphoid and myeloid cells. Here we report the identification of the rhesus monkey LILRs by screening of rhesus spleen and decidua cDNA libraries and RT‐PCR cloning. We obtained eight different full‐length clones with structural and functional diversity similar to human LILRs, including LILRs with immunoreceptor tyrosine‐based inhibitory motifs, LILRs with truncated cytoplasmic tails containing positively charged arginine residues in the transmembrane domain, and putative soluble receptors lacking transmembrane or cytoplasmic domains. Characterization of rhesus LILRs will facilitate use of this non‐human primate model for the study of the functional role(s) of LILRs, including immune regulation through interaction with non‐classical MHC class I molecules.
ON HIGH‐SKILL AND LOW‐SKILL EQUILIBRIA: A MARKOV CHAIN APPROACH
Authors: Lavezzi Andrea Mario 
Published: April 2006

ABSTRACTIn this paper we propose to study the dynamics of human capital accumulation by means of a Markov chain. We identify the conditions for the emergence of ergodic and nonergodic dynamics, and relate them to various characteristics of an economic system. The model may generate high‐skill and low‐skill equilibria as well as intermediate situations. Policy implications are also discussed.
An Assessment of the Disorderly Adjustment Hypothesis for Industrial Economies*
Authors: Croke Hilary , Kamin Steven B. , Leduc Sylvain 
Published: April 2006

AbstractMuch has been written about prospects for US current account adjustment, including the possibility of what is sometimes referred to as a ‘disorderly correction’: a sharp fall in the exchange rate that boosts interest rates, depresses stock prices and weakens economic activity. This paper assesses some of the empirical evidence bearing on the plausibility of the disorderly adjustment scenario, drawing on the experience of previous current account adjustments in industrial economies. We examined the paths of key economic performance indicators before, during and after the onset of adjustment, building on the analysis of Freund (2000).We found little evidence among past adjustment episodes of the features highlighted by the disorderly adjustment hypothesis. Although some episodes in our sample experienced significant shortfalls in GDP growth after the onset of adjustment, these shortfalls were not associated with significant and sustained depreciations of real exchange rates, increases in real interest rates or declines in real stock prices. By contrast, it was among the episodes where GDP growth picked up during adjustment that the most substantial depreciations of real exchange rates occurred. These findings do not preclude the possibility that future current account adjustments could be disruptive, but they weaken the historical basis for predicting such an outcome.
Between‐Meal Risedronate Does Not Alter Bone Turnover in Nursing Home Residents
Authors: Agrawal Sabina , Krueger Diane C. , Engelke Jean A. , Nest Lori J. , Krause Peggy F. , Drinka Paul J. , Binkley Neil C. 
Published: April 2006

OBJECTIVES: To assess the effect of between‐meal weekly risedronate and daily calcium 630 mg and vitamin D 400 IU on bone turnover markers.DESIGN: Randomized,double‐blind,placebo‐controlled trial.SETTING: Skilled nursing home (NH).PARTICIPANTS: Sixty skilled‐NH residents (46 men, 14 women), mean age±standard deviation of 76±6, were randomized to receive risedronate 30 mg (n=31) or matching placebo (n=29) once weekly for 12 weeks. All received 315 mg calcium with 200 IU vitamin D twice daily.MEASUREMENTS: Bone‐specific alkaline phosphatase (BSAP), N‐telopeptide of type 1 collagen (NTx), 25‐hydroxyvitamin D (25OHD), and parathyroid hormone were measured at baseline and 6 and 12 weeks.RESULTS: Risedronate reduced BSAP significantly more than placebo (P<.05) at 6 weeks but not at 12 weeks; no treatment effect on serum NTx was observed. Defining hypovitaminosis D as a serum 25OHD concentration below 32 ng/mL, 50 of 53 (94%) study participants were low at baseline (mean 25OHD 19 ng/mL). Vitamin D levels remained insufficient in 74% of participants after 12 weeks.CONCLUSION: In this NH population, weekly risedronate administered using a between‐meal dosing schedule reduced serum BSAP at 6 weeks of treatment; this effect was not observed at 12 weeks. The overall lack of change in bone turnover markers suggests that this risedronate dose and schedule would not be expected to increase bone density or reduce fracture risk in this population. Hypovitaminosis D was common and not reliably corrected by 400 IU of vitamin D daily. Despite an extremely high osteoporotic fracture risk in NH residents, additional study is required to determine under which conditions pharmacological treatment is efficacious in this population and define approaches that assure vitamin D repletion.
Caregiver Characteristics Are Associated with Neuropsychiatric Symptoms of Dementia
Authors: Sink Kaycee M. , Covinsky Kenneth E. , Barnes Deborah E. , Newcomer Robert J. , Yaffe Kristine 
Published: April 2006

OBJECTIVES: To determine whether caregiver characteristics are independently associated with neuropsychiatric symptoms of dementia (NPS) after accounting for patient characteristics.DESIGN: Cross‐sectional analysis of data from the Medicare Alzheimer's Disease Demonstration and Evaluation study.SETTING: Community‐dwelling residents in eight U.S. cities.PARTICIPANTS: Five thousand seven hundred eighty‐eight patients with dementia and their caregivers.MEASUREMENTS: Caregivers were asked about the presence of 12 NPS in patients with dementia. Caregiver predictors included age, sex, education, income, marital status, relationship to the patient, whether they lived with patient, number of hours per week spent caregiving, self‐reported health, dependency in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), depression, and burden. Multivariate linear regression was used to determine which caregiver characteristics were independently associated with reports of more NPS in patients after controlling for the patient's age, sex, dementia severity, level of ADL dependency, and dementia type.RESULTS: Caregivers were on average 64 years old, 72% female, and 49% were the spouse of the patient (32% wives, 17% husbands). The mean burden score of caregivers was 15 (range 0–32, with higher scores indicating more burden), and 32% had significant depressive symptoms. Patients were on average 79 years old, 60% were female, and most had moderate to severe dementia. The mean number of NPS±standard deviation was 4.8±2.8. After adjusting for patient characteristics, caregivers who were younger, less educated, more depressed, more burdened, or spent more hours per week giving care reported more NPS in care recipients (all P≤.005).CONCLUSION: Certain caregiver characteristics are associated with NPS, independent of patient characteristics, including dementia severity. Clinicians should consider the dynamics between patients and caregivers when managing NPS. Understanding how different caregiver characteristics influence NPS may help tailor caregiver education and interventions.
Edge Wave Asymmetries
Authors: Panayotova Iordanka N. , Swanson Kyle L. 
Published: April 2006

Abstract
Meridional asymmetry arising from the inclusion of meridional variation in the Coriolis parameter is shown to be a fundamental property of the higher-order dynamics of Eady edge waves. This asymmetry may be relevant to structural characteristics of observed atmospheric transients, particularly short waves propagating along the extratropical dynamic tropopause.
Tropical Cyclone Motion in Response to Land Surface Friction
Authors: Wong Martin L. M. , Chan Johnny C. L. 
Published: April 2006

Abstract
Numerical experiments are performed with the fifth-generation Pennsylvania State University–National Center for Atmospheric Research Mesoscale Model (MM5) to study the effects of surface-moisture flux and friction over land on the movement of tropical cyclones (TCs). On an f plane, the TCs are initially placed 150 km due east of a north–south-oriented coastline in an atmosphere at rest. It is found that a TC could drift toward land when the roughness length is 0.5 m over land, with an average drift speed of ∼1 m s−1. Friction, but not surface-moisture flux over land, is apparently essential for the movement toward land. The friction-induced asymmetry in the large-scale flow is the primary mechanism responsible for causing the TC drift. The mechanism responsible for the development of the large-scale asymmetric flow over the lower to midtroposphere (∼900–600 hPa) appears to be the creation of asymmetric vorticity by the divergence term in the vorticity equation. Horizontal advection then rotates the asymmetric vorticity to give a northeasterly flow in the TC periphery (∼500–1000 km from the TC center). The flow near the TC center has a more northerly component because of the stronger rotation by the tangential wind of the TC at inner radii. However, the TC does not move with the large-scale asymmetric flow. Potential vorticity budget calculations indicate that while the horizontal advection term is basically due to the effect of advection by the large-scale asymmetric flow, the diabatic heating and vertical advection terms have to be considered in determining the vortex landward drift, because of the strong asymmetry in vertical motion. Two mechanisms could induce the asymmetry in vertical motion and cause a deviation of the TC track from the horizontal asymmetric flow. First, the large-scale asymmetric flow in the upper troposphere differs from that in the lower troposphere, both in magnitude and direction, which results in a vertical shear that could force the asymmetry. A vertical tilt of the vortex axis is also found that is consistent with the direction of shear and also the asymmetry in rainfall and vertical motion. Second, asymmetric boundary layer convergence that results from the internal boundary layer could also force an asymmetry in vertical motion.
Laboratory Experiments on Eddy Generation by a Buoyant Coastal Current Flowing over Variable Bathymetry*
Authors: Wolfe Christopher L. , Cenedese Claudia 
Published: April 2006

Abstract
Irminger rings are warm-core eddies formed off the west coast of Greenland. Recent studies suggest that these eddies, which are implicated in the rapid springtime restratification of the Labrador Sea, are formed by an internal instability of the West Greenland Current (WGC), triggered by bathymetric variations. This study seeks to explore the effect of the magnitude and downstream length scale of bathymetric variations on the stability of a simple model of the WGC in a series of laboratory experiments in which a buoyant coastal current was allowed to flow over bathymetry consisting of piecewise constant slopes of varying magnitude. The currents did not form eddies over gently sloping bathymetry and only formed eddies over steep bathymetry if the current width exceeded the width of the sloping bathymetry. Eddying currents were immediately stabilized if they flowed onto gently sloping topography. Bathymetric variations that persisted only a short distance downstream perturbed the flow locally but did not lead to eddy formation. Eddies formed only once the downstream length of the bathymetric variations exceeded a critical scale of about 8 Rossby radii. These results are consistent with the observed behavior of the WGC, which begins to form Irminger rings after entering a region where the continental slope abruptly steepens and becomes narrower than the WGC itself in a region spanning about 20–80 Rossby radii of downstream distance.
Spectral Distribution of Energy Dissipation of Wind-Generated Waves due to Dominant Wave Breaking
Authors: Young Ian R. , Babanin Alexander V. 
Published: April 2006

Abstract
This paper considers an experimental attempt to estimate the spectral distribution of the dissipation due to breaking of dominant waves. A field wave record with an approximately 50% dominant-breaking rate was analyzed. Segments of the record, comprising sequences of breaking waves, were used to obtain the “breaking spectrum,” and segments of nonbreaking waves were used to obtain the “nonbreaking spectrum.” The clear visible difference between the two spectra was attributed to the dissipation due to breaking. This assumption was supported by independent measurements of total dissipation of kinetic energy in the water column at the measurement location. It is shown that the dominant breaking causes energy dissipation throughout the entire spectrum at scales smaller than the spectral peak waves. The dissipation rate at each frequency is linear in terms of the wave spectral density at that frequency, with a correction for the directional spectral width. A formulation for the spectral dissipation function able to accommodate this effect is suggested. Directional spectra of the breaking and nonbreaking waves are also considered. It is shown that directional dissipation rates at oblique angles are higher than the dissipation in the main wave propagation direction.
Parametric Representation of the Primary Hurricane Vortex. Part II: A New Family of Sectionally Continuous Profiles
Authors: Willoughby H. E. , Darling R. W. R. , Rahn M. E. 
Published: April 2006

Abstract
For applications such as windstorm underwriting or storm-surge forecasting, hurricane wind profiles are often approximated by continuous functions that are zero at the vortex center, increase to a maximum in the eyewall, and then decrease asymptotically to zero far from the center. Comparisons between the most commonly used functions and aircraft observations reveal systematic errors. Although winds near the peak are too strong, they decrease too rapidly with distance away from the peak. Pressure–wind relations for these profiles typically overestimate maximum winds.
A promising alternative is a family of sectionally continuous profiles in which the wind increases as a power of radius inside the eye and decays exponentially outside the eye after a smooth polynomial transition across the eyewall. Based upon a sample of 493 observed profiles, the mean exponent for the power law is 0.79 and the mean decay length is 243 km. The database actually contains 606 aircraft sorties, but 113 of these failed quality-control screening. Hurricanes stronger than Saffir–Simpson category 2 often require two exponentials to match the observed rapid decrease of wind with radius just outside the eye and slower decrease farther away. Experimentation showed that a fixed value of 25 km was satisfactory for the faster decay length. The mean value of the slower decay length was 295 km. The mean contribution of the faster exponential to the outer profile was 0.10, but for the most intense hurricanes it sometimes exceeded 0.5. The power-law exponent and proportion of the faster decay length increased with maximum wind speed and decreased with latitude, whereas the slower decay length decreased with intensity and increased with latitude, consistent with the qualitative observation that more intense hurricanes in lower latitudes usually have more sharply peaked wind profiles.
Pinnock’s Pneumatology: A pentecostal Appreciation
Authors: Macchia Frank 
Published: April 2006

AbstractThis article responds to Clark Pinnock’s address on the ‘Promise of Pentecostal Ecclesiology’ in the context of appreciation for his long and mutually enriching interaction with Pentecostals. The response proceeds to take up Pinnock’s specific ecclesiological proposals by proposing an even fuller way to relate the Spirit with justification and by offering further thoughts on how to develop a theology of the charismatic structure of the church.
‘Not Like it Used to Be?’: Jesus, Miracles, and Today
Authors: Shelton James 
Published: April 2006

AbstractKeith Warrington claims that Jesus’ healings should not be taken as a model to be followed today and that the reason for the apostles’ powerful healing ministry was the presence and activity of Jesus, thus leaving the Church to a new healing paradigm found in James 5, which, he asserts, explains the decrease in healing today. Yet it would appear that the Apostles do indeed follow Jesus’ model of healing, and the evidence in Acts appears to militate against Warrington’s thesis. One has to ask if healing in James is so ‘markedly different’ from Jesus’ ministry. There is not a third class or third string team after Jesus, then the Apostles. Jesus and the Holy Spirit are still the agents of healing today as they were then.
Use of Etomidate as an Induction Agent for Rapid Sequence Intubation in a Pediatric Emergency Department
Authors: Zuckerbraun Noel S. , Pitetti Raymond D. , Herr Sandra M. , Roth Kimberly R. , Gaines Barbara A. , King Christopher 
Published: April 2006

Abstract
Objectives:
Although etomidate is widely used for rapid sequence intubation (RSI), there is no consensus on the optimal induction agent and no prospective pediatric emergency department (ED) study exists. The objective of this study was to assess the effectiveness and safety of etomidate as an induction agent for RSI in the pediatric ED.
Methods:
Data on RSI conditions and complications were collected prospectively on patients undergoing RSI in a tertiary pediatric ED from January 2003 to December 2003. ED hemodynamic data and inpatient data were collected retrospectively via chart review.
Results:
Seventy‐seven of 101 patients requiring intubation underwent RSI with etomidate. The mean (± SD) age was 8.2 (± 6.2) years. All 77 patients were successfully intubated. Intubation condition data were available for 69 of 77 patients (89.6%). Conditions were good in 68 of 69 (99%; 95% confidence interval = 92.2% to 99.9%). The mean (± SD) maximal percent decrease in systolic blood pressure was 10% (± 13.6%). A greater than 20% maximal percent decrease in systolic blood pressure occurred in 12 of 69 patients (17.4%; 95% confidence interval = 9.3% to 28.4%). There was no relationship between seizures after etomidate administration and prior seizure history (p = 0.25). Corticosteroids were given to 29 of 77 patients post‐RSI for varying diagnoses. All eight patients given corticosteroids for shock were in shock at the time of intubation.
Conclusions:
In the pediatric ED setting, etomidate as an induction agent provided successful RSI conditions and resulted in varied hemodynamic changes that were especially favorable in those patients presenting in decompensated shock. Hypotension and seizures were uncommon and occurred in patients with confounding diagnoses. Until the significance of a single dose of etomidate on adrenal dysfunction is further clarified, caution should be used in those patients at risk for adrenal insufficiency.