bluuebunny/crossref_metadata_2025_split huggingface dataset:
The epilepsy treatment gap in developing countries: A systematic review of the magnitude, causes, and intervention strategies
Authors: Mbuba Caroline K. , Ngugi Anthony K. , Newton Charles R. , Carter Julie A. 
Published: June 2008

Summary In many developing countries, people with epilepsy do not receive appropriate treatment for their condition, a phenomenon called the treatment gap (TG). We carried out a systematic review to investigate the magnitude, causes, and intervention strategies to improve outcomes in developing countries. We systematically searched MEDLINE, EMBASE, and PsycINFO databases, supplemented by a hand search of references in the key papers. The degree of heterogeneity and a pooled TG estimate were determined using metaanalysis techniques. The estimates were further stratified by continent and location of study (urban, rural). Twenty‐seven studies met the inclusion criteria: twelve from Africa, nine from Asia and six from Latin America. We observed a high degree of heterogeneity and inconsistency between studies. The overall estimate of the TG was 56/100 [95% confidence interval (CI) 31.1–100.0]. The variation in estimates could possibly be explained by nonuniform TG estimation methods and the diverse study populations, among other factors. The TG was mainly attributed to inadequate skilled manpower, cost of treatment, cultural beliefs, and unavailability of antiepileptic drugs (AEDs). These factors have been addressed using different intervention strategies, such as education and supply of AEDs. Future research should estimate the TG coherently and develop sustainable interventions that will address the causes.
Prognosis after temporal lobe epilepsy surgery: The value of combining predictors
Authors: Uijl Sabine G. , Leijten Frans S.S. , Arends Johan B.A.M. , Parra Jaime , Van Huffelen Alexander C. , Moons Karel G.M. 
Published: June 2008

Summary
Purpose: Although several independent predictors of seizure freedom after temporal lobe epilepsy surgery have been identified, their combined predictive value is largely unknown. Using a large database of operated patients, we assessed the combined predictive value of previously reported predictors included in a single multivariable model.
Methods: The database comprised a cohort of 484 patients
who underwent temporal lobe surgery for drug‐resistant epilepsy. Good outcome was defined as Engel class 1, one year after surgery. Previously reported independent predictors were tested in this cohort. To be included in our final prediction model, predictors had to show a multivariable p‐value of <0.20.
Results: The final multivariable model included predictors obtained from the patient's history (absence of tonic–clonic seizures, absence of status epilepticus), magnetic resonance imaging [MRI; ipsilateral mesial temporal sclerosis (MTS), space occupying lesion], video electroencephalography (EEG; absence of ictal dystonic posturing, concordance between MRI and ictal EEG), and fluorodeoxyglucose positron emission tomography (FDG‐PET; unilateral temporal abnormalities), that were related to seizure freedom in our data. The model showed an expected receiver‐operating characteristic curve (ROC) area of 0.63 [95% confidence interval (CI) 0.57–0.68] for new patient populations. Intracranial monitoring and surgery‐related parameters (including histology) were not important predictors of seizure freedom. Among patients with a high probability of seizure freedom, 85% were seizure‐free one year after surgery; however, among patients with a high risk of not becoming seizure‐free, still 40% were seizure‐free one year after surgery.
Conclusion: We could only moderately predict seizure freedom after temporal lobe epilepsy surgery. It is particularly difficult to predict who will not become seizure‐free after surgery.
Valproate teratogenicity and epilepsy syndrome
Authors: Bromfield Edward B. , Dworetzky Barbara A. , Wyszynski Diego F. , Smith Caitlin R. , Baldwin Elizabeth J. , Holmes Lewis B. 
Published: June 2008

SummaryMaternal valproate (VPA) use is associated with a significant risk for congenital malformations in the exposed fetus. Since VPA is commonly used in epilepsy syndromes with a presumed genetic cause (idiopathic epilepsies), it is possible that maternal genetic background contributes to this outcome. We reviewed responses to telephone questionnaires and medical records, when available, of enrollees in the North American Antiepileptic Drug Pregnancy Registry, classifying reason for treatment as idiopathic generalized epilepsy (IGE), partial epilepsy (PE), nonclassifiable epilepsy (NCE), or not epilepsy (NE). Of 284 VPA‐exposed pregnancies, 30 (11.0%) were associated with malformations: IGE = 15/126 (12%), PE = 4/28 (14%), NCE = 9/105 (9%), NE = 2/25 (8%) (p > 0.7 for all comparisons). There was a trend toward increased malformation risk with higher VPA doses (p = 0.07). VPA, and not the underlying genetic syndrome, seems to be associated with the elevated risk for malformations in the drug‐exposed fetus.
Identification of Risks in the Life Cycle of Nanotechnology‐Based Products
Authors: Wardak Ahson , Gorman Michael E. , Swami Nathan , Deshpande Shilpa 
Published: June 2008

SummaryIn order to realize the projected market potential of nanotechnology, the environmental, health, and safety (EHS) uncertainties posed by a nano‐product (i.e., a nanotechnology‐enabled product) need to be characterized through the identification of risks and opportunities in early stages of product development. We present a methodology to identify risks from nano‐products using a scenario analysis approach that allows for expert elicitation on a set of preidentified use and disposal scenarios and what we have labeled “risk triggers” to obtain scores on their likelihood of occurrence and severity. Use and disposal scenarios describe product life‐cycle stages that could result in risk attributed to the nano‐product, whereas risk triggers are particular to nanoparticle properties. These are potential risks, as the risk assessment community is currently debating the specific risks attributed to nanotechnology. Through such a framework, our goal is to identify which products pose greater risks, where these risks occur in the product life cycle, and the impacts of these environmental risks on society. The comparison of risk triggers across nano‐products allows relative risk ranking on axes of exposure‐ and hazard‐related risk triggers. For the specific case of air fresheners, areas of acute risks resulted from bioavailability of nanoparticles in air release and water entrainment exposure scenarios; catalytic activity of nanoparticles in inhalation and air release exposure scenarios; the harmful effects due to the antibacterial property on useful bacteria particularly in susceptible populations; and, finally, risks from the lack of nanoparticle coating stability in air release scenarios.
Americans' Nanotechnology Risk Perception:
Authors: Smith Sara E. Smiley , Hosgood H. Dean , Michelson Evan S. , Stowe Meredith H. 
Published: June 2008

SummaryAlthough proposed nanotechnology applications hold great promise, little is known about the potential associated risks. This lack of clarity on the level of risk associated with nanotechnology has forced people to make decisions about consumption with incomplete information. A national random digit dialing telephone survey (N= 1014) was conducted in the United States to assess knowledge of nanotechnology and perception of risk in August 2006. This investigation looks critically at individuals' responses to questions about the balance of risks and benefits of nanotechnology, both at the outset of the survey and after respondents were given a brief introduction to the potential benefits and risks of the technology. Models were created to characterzise respondents who said they did not know how nanotechnology's risks and benefits balanced in the “preinformation” condition but who, in the postinformation condition, had a different opinion. Respondents who were highly educated, members of the Republican Party, or male were more likely to switch from “don't know” in the preinformation condition to “benefits outweigh risks” in the postinformation condition, whereas respondents who were less educated, members of the Democratic Party, or female were more likely to switch from “don't know” in the preinformation condition to “risks outweigh benefits” in the postinformation condition. This is the first study to our knowledge to develop a significant model of nanotechnology risk perception change, specifically with regard to gender differences. The power of information provision to sway opinions is also supported, highlighting the importance of developing educational efforts targeting vulnerable populations.
Midterm Follow‐Up of Percutaneous Closure of Secundum Atrial Septal Defect with Helex Septal Occluder
Authors: SMITH BENJAMIN G. , WILSON NEIL , RICHENS TREVOR , KNIGHT W. BRODIE 
Published: June 2008

Introduction:

The Helex Septal Occluder (HSO) is a relatively new device used in the percutaneous closure of atrial septal defects (ASDs). The immediate and short‐term results of its deployment have been reported, but the medium‐term results have not been described. The objective was to describe the midterm efficacy and safety of percutaneous closure of ASD with the HSO.
Methods:

The HSO was used in 33 children to close secundum ASDs between July 1999 and November 2000. Detailed data were collected at implantation and 31 children have been followed clinically and investigated with electrocardiogram (ECG) (n = 30), echocardiogram, and fluoroscopy (n = 30) at a mean of 63 (range 55–74) months after implantation.
Results:

The ages and body weights at implantation ranged from 13 to 220 months and 7.6 to 57.6 kg. The ASD diameter ranged from 7 to 17 mm. All sizes of HSO were deployed. The range of device to defect ratio was 1.4 to 3.3. Of the 21 residual shunts noted early after implantation, only four persisted, all small, at latest follow‐up. There were no new shunts. There were no new ECG abnormalities. There was a pronounced change in the configuration of one HSO without sequelae. In two patients in whom the locking loop missed the right atrial eyelet at deployment, there were no sequelae or residual shunts. There were no cases of frame fracture or explantation. There has been no death or long‐term morbidity.
Conclusions:

At midterm follow‐up the HSO is durable and effective, with a low incidence of adverse sequelae even in the small subgroup with imperfect configuration.
Impact of fruit feeding on overwintering survival of the multicolored Asian lady beetle, and the ability of this insect and paper wasps to injure wine grape berries
Authors: Galvan Tederson L. , Koch Robert L. , Hutchison William D. 
Published: June 2008

AbstractThe establishment of the multicolored Asian lady beetle, Harmonia axyridis (Pallas) (Coleoptera: Coccinellidae), in North America has resulted in negative impacts on fruit production. We investigated the overwintering survival of H. axyridis after feeding on four diets: injured wine grape berries, 25% sucrose solution, water, and a control containing no food or water. After being exposed to these diets for 6 days, live individuals were transferred to clean plastic Petri dishes, and held at 5 ± 1 °C in growth chambers throughout the winter. Survival was recorded every month. Adult lady beetles collected during the overwintering flight in mid‐October had higher survival rates than beetles collected from soybean fields in mid‐August. These results suggest that an adaptation period prior to diapause increases the chances of lady beetle survival over the winter. In addition, injured wine grape berries, sugar, and water decreased beetle mortality during the overwintering months. Our results also showed that under similar conditions, females have higher survival during the winter than males. The importance of sugar and water on winter survival may drive H. axyridis adults to vineyards for feeding on wine grapes. Finally, we tested if adults of H. axyridis and the European paper wasp, Polistes dominulus Christ (Hymenoptera: Vespidae), were able to break the grape skin. Harmonia axyridis adults and paper wasps were not able to cause the primary injury to berries of Frontenac grapes under laboratory conditions. These results suggest that control of paper wasps in vineyards may not affect H. axyridis aggregations, and that H. axyridis feeding on wine grapes depends on previous injury to grape berries.
ORIGINAL ARTICLE: Interleukin‐10 May Participate in Regulating Trophoblast Invasion in Human Placentae Throughout Gestation
Authors: Pang Zhan‐Jun , Zhou Jun‐Gui , Huang Li‐Ping 
Published: June 2008

Problem  A successful human pregnancy requires cytotrophoblasts from the fetal portion of the placenta to adopt tumor‐like properties. But unlike tumor metastasis, cytotrophoblast invasion is highly regulated both spatially and temporally. The mechanisms that regulate human trophoblast invasion are understood poorly.Method of study  With a view to obtain some findings on the mechanisms that regulate human trophoblast invasion, we applied the semi‐quantitative reverse transcription polymerase chain reaction (RT‐PCR) method to compare the expression of invasion‐associated genes in cytotrophoblasts isolated from first‐ and third‐trimester placental tissues.Results  In trophoblast cells of first‐trimester pregnancy, the mRNA contents of matrix metalloproteinase (MMP)‐9 and urokinase‐type plasminogen activator (uPA) were higher than that in the third‐trimester cytotrophoblasts, while no difference of MMP‐2 mRNA expression level was found between trophoblastic cells of different gestational ages. The expression level of plasminogen activator inhibitors‐1 mRNA in first‐trimester cytotrophoblasts was shown to be much lower than that in trophoblast cells prepared from third‐trimester placental tissues. Furthermore, expression of both tissue inhibitor of metalloproteinase (TIMP)‐1 and TIMP‐2 in cytotrophoblasts were significantly up‐regulated in third‐trimester when compared with the first‐trimester of pregnancy. To further investigate the factors that caused the change of invasion‐associated genes expression in trophoblast cells, we found that interleukin‐10 (IL‐10) could decrease the content of MMP‐9 mRNA in cytotrophoblasts of first‐trimester gestation, and the magnitude of suppression increased with increasing IL‐10 concentration.Conclusion  The gradually reduced trophoblast invasion with gestational weeks might be on account of the change of proteolytic enzymes/activator/inhibitor genes expression. IL‐10 could be one of the factors participating in the regulation of trophoblast invasion during gestational process.
ORIGINAL ARTICLE: Regulatory T Cells in a Spectrum of HPV‐Induced Cervical Lesions: Cervicitis, Cervical Intraepithelial Neoplasia and Squamous Cell Carcinoma
Authors: Adurthi Sreenivas , Krishna Sudhir , Mukherjee Geetashree , Bafna Uttamchand Deepak , Devi Uma , Jayshree Rudrapatna Subramanyam 
Published: June 2008

Problem  Thriving of tumors amidst rich immune infiltrates is an unexplained paradox.Method of study  Immune markers on lymphocytic infiltrates in HPV‐positive cervicitis, cervical intraepithelial neoplasia III (CIN III), squamous cell carcinoma (SCC) and normal cervices were characterized immunohistochemically. Regulatory T cells were enumerated and phenotypically characterized using antibodies to FOXP3.Results  SCCs had higher numbers of CD4 and CD8 cells; infiltrates expressed more CD25, TGFβ, and IL10 but had significantly lower IL2 compared with cervicitis and CIN III. Expression of CD25 and IL2 correlated well in cervicitis and CIN III but not in SCC. FOXP3 expression was also higher and ratios of CD4/FOXP3 and CD8/FOXP3 were lower in SCC. A fraction of cervicitis, CIN I, CIN II and CIN III had natural (n) regulatory T cells (Tregs); their lesional distribution was predominantly intraepithelial in cervicitis, while in CIN they were also present in the stroma. The proportion of FOXP3+ CD25+; FOXP3+ CD25− and TGFβ+ CD25+ in invasive tumors was 17; 19 and 22 respectively.Conclusion  Cervical tumors are marked by the presence of an immunoregulatory environment, and harbor equal proportions of ‘inactive’ n Tregs; activated n Tregs; and Tregs operating via TGFβ. nTregs in cervicitis and CIN may be a potential marker of persistence.
ORIGINAL ARTICLE: Studies on the Compatibility of HLA‐Class II Alleles in Patient Couples with Severe Pre‐Eclampsia Using PCR–RFLP Methods
Authors: Ooki Izumi , Takakuwa Koichi , Akashi Mami , Nonaka Taro , Yokoo Tomokazu , Tanaka Kenichi 
Published: June 2008

Problem  In this study, we investigated whether or not significant compatibility of human leukocyte antigen (HLA)‐class II alleles exists between spouses with severe pre‐eclampsia (PE) (including gestational hypertension, GH).Method of study  The HLA‐class II genotypes were determined using a polymerase chain reaction‐restriction fragment length polymorphism method. The number of incompatible alleles in 57 patient couples with severe PE (including GH) were determined, and compared with that in 74 control couples.Results  The number of patient couples and control couples with each number of mismatched alleles of the HLA‐DR, ‐DQ, and ‐DP genotypes was as follows. The number of patient couples with zero, one, two, three, and four‐allele mismatches was 41 (72.9%), and with five and six‐allele mismatches was 16 (27.1%). On the other hand, the number of control couples with zero, one, two, three, and four‐allele mismatches was 38 (51.4%), and with five and six‐allele mismatches was 36 (48.6%). Thus, the number of patient couples with five and six‐allele mismatches was significantly lower compared with that in control couples. The same result was obtained as regards the mismatched alleles of the HLA‐DR, ‐DQ, and ‐DP phenotypes.Conclusion  These findings suggest that significant compatibility of HLA‐class II alleles between spouses is implicated in the genesis of PE (including GH).
ABSTRACTS: 1 Implication of soluble receptors of VEGF, sVEGFR‐1 and sVEGFR‐2, in angiogenesis
Authors: Lorquet S , Berndt S , Blacher S , Noël A , Munaut C , Foidart JM , Pequeux C 
Published: June 2008

Introduction:  sVEGFR‐1 and sVEGFR‐2 are soluble forms of the membrane‐bound receptors of VEGF. sVEGFR‐1 is detected in plasma of pre‐eclamptic women, during ischemia and in some cancer cases. sVEGFR‐2, was recently detected in plasma of healthy people, in leukaemia and in systemic erythematosus lupus cases. sVEGFR‐1 has anti‐angiogenic properties in vitro and in vivo but sVEGFR‐2 remains uncharacterized and its physiological or pathological role is still unknown.Material and Methods:  The aim of this study was to understand and to characterize the role of sVEGFR2 in angiogenesis and in endothelial function.Results:  In aortic ring assay, an ex vivo model of angiogenesis, sVEGFR1 and sVEGFR2 were able to abolish VEGF‐induced angiogenesis. However, when used alone, they induced the formation of a “network”, supposed to be vascular in visible microscopy. As they were able to abolish the effect of VEGF on endothelial function but showed no direct effect alone, we performed an immuno‐staining of the “vascular network” induced by the soluble receptors. It showed that there were a few endothelial cells but mostly pericytes/smooth muscle cells (PC/SMC). Our first in vitro experiments on PC/SMC showed that sVEGFR‐1 and sVEGFR‐2 were able to promote the migration of PC/SMC, only in presence of endothelial cells.Conclusions:  Our results evidence that sVEGFR1 and sVEGFR2 inhibit VEGF‐induced angiogenesis in a similar way. However, they have also a direct effect on PC/SMC, promoting their migration. Our results suggest that these soluble receptors could act, not only on endothelial cells themselves, but by a direct effect on PC/SMC too. These results contribute to identify factors by which it could be possible to regulate the balance between pro‐angiogenic and anti‐angiogenic factors, especially in the case of the anti‐VEGF drugs used now as anti‐cancer therapies in clinics, where a transient “normalization” of the vessels is observed.
ABSTRACTS: 6 Human trophoblast: Development of double tissue confrontation assays
Authors: Gerit Moser , Regine Theuerkauf , Nina Flieser , Berthold Huppertz 
Published: June 2008

Problem:  Invasion of trophoblast differs between implantation and subsequent placentation. Here we present double tissue co‐culture in vitro models for trophoblast invasion.Material and Methods:  Pieces of decidua parietalis (6‐12 weeks gestation) were confronted directly with villous explants (direct confrontation) or after separate preculture for 72h (indirect confrontation). For “indirect confrontation” decidua pieces re‐epithelialized during preculture (constant agitation). All confrontations were harvested after 72h and were processed for immunohistochemistry.Results:  During indirect confrontation immunohistochemical staining for HLA‐G and cytokeratin 7 revealed trophoblast migration on top of the decidual epithelium and little invasion into the decidual stroma. During direct confrontation, the same staining revealed strong invasion of extravillous trophoblasts into decidual stroma.Conclusion:  Trophoblasts confronted to decidual epithelium seem to be less invasive than trophoblasts confronted to the decidual stroma directly. These model systems will be further used to investigate mechanisms underlying the interactions between trophoblasts and decidual epithelium/stroma.
Plasma homocysteine but not MTHFR gene polymorphism is associated with geriatric depression in the Chinese population
Authors: Yuan Yong-Gui , Zhang Zhi-Jun , Li Jing-Jing 
Published: June 2008

Background:Epidemiological studies suggested that elevated plasma homocysteine (Hcy) is associated with an increased risk of depression and cerebrovascular disease (CVD). There were few published reports of Hcy levels and methylenetetrahydrofolate reductase (MTHFR) C677T genotype in geriatric depression.Objective:To investigate the relationship among plasma Hcy level, MTHFR C677T polymorphism and geriatric depression in the Chinese population.Methods:The plasma Hcy level measured by capillary electrophoresis with ultraviolet detection and the C667T polymorphism of MTHFR detected using polymerase chain reaction-restriction fragment length polymorphism assay were determined in 116 patients with geriatric depression and in 80 healthy controls.Results:The plasma Hcy level in the patients with geriatric depression was significantly higher than that in controls (p < 0.001). The age of first episode and comorbid CVD were significantly correlated with plasma Hcy levels in geriatric patients (p = 0.014 and 0.008, respectively). The Hamilton Rating Scale for Depression total score and plasma Hcy level at baseline showed no significant correlation in the patients (r = −0.111, p = 0.397). There were no significant differences in the MTHFR C677T polymorphism genotypes and alleles between the patients and the healthy controls (p = 0.654 and 0.573, respectively).Conclusion:The elevated plasma Hcy level is a risk factor for geriatric depression. MTHFR C667T genotype is not associated with geriatric depression in the Chinese population.
Skin diseases in intensive care medicine
Authors: Fischer Matthias , William Thomas , Wohlrab Johannes 
Published: June 2008

SummaryThough most dermatoses are not life‐threatening, skin diseases play an important role in intensive care medicine. Skin findings in intensive care patients may reflect the underlying disease or be complications of intensive medical care. Most important are drug reactions, infections, bacterial toxin reactions, erythro‐derma, ANCA‐positive vasculitides (such as Wegener granulomatosis) and bleeding disorders.