bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential effects of temporal pole resection with amygdalohippocampectomy versus selective amygdalohippocampectomy on material‐specific memory in patients with mesial temporal lobe epilepsy
Authors: Helmstaedter Christoph , Richter Sabine , Röske Sandra , Oltmanns Frank , Schramm Johannes , Lehmann Thomas‐Nicolas 
Published: October 2007

Summary
Purpose: In the surgical treatment of mesial temporal lobe epilepsy, there is converging evidence that individually tailored or selective approaches have a favorable cognitive outcome compared to standard resections. There is, however, also evidence that due to collateral damage, selective surgery can be less selective than suggested. As part of a prospective transregional research project the present study evaluated the outcome in memory and nonmemory functions, following two selective approaches: a combined temporal pole resection with amygdalohippocampectomy (TPR+) and transsylvian selective amygdalohippocampectomy (SAH).
Methods: One year after surgery, cognitive outcomes of postoperatively seizure‐free patients with mesial TLE and hippocampal sclerosis, who underwent either TPR+ (N = 35) or SAH (N = 62) in two German epilepsy centers (Bonn/Berlin), were compared.
Results: Repeated measurement MANOVA and separate post hoc testing indicated a double dissociation of verbal/figural memory outcome as dependent on side and type of surgery. Verbal memory outcome was worse after left‐sided operation, but especially for SAH, whereas figural memory outcome was worse after right‐sided operation, preferentially for TPR+. Attention improved independent of side or type of surgery, and language functions showed some improvement after right‐sided surgeries.
Discussion: The results indicate a differential effect of left/right SAH versus TPR+ on material‐specific memory insofar as transsylvian SAH appears to be favorable in right and TPR+ in left MTLE. The different outcomes are discussed in terms of a different surgical affection of the temporal pole and stem, and different roles of these structures for verbal and figural memory.
Topiramate Moderately Reduces the Motivation to Consume Alcohol and Has a Marked Antidepressant Effect in Rats
Authors: Hargreaves Garth A. , McGregor Iain S. 
Published: October 2007

Background: In recent human studies, the anticonvulsant drug topiramate (TPM) has shown efficacy in treating alcohol craving and mood disorders. However, preclinical evidence supporting such effects is surprisingly sparse. Three experiments were conducted here to assess possible anticraving and antidepressant effects of TPM using animal models.Methods: In Experiment 1, rats were given 23 weeks ad libitum access to food, water, and either beer (4.44% ethanol v/v) or “near‐beer” (a calorie‐matched nonalcoholic beer, 0.44% ethanol) in their home cages. They were then restricted to daily 1 hour operant sessions in which they licked for water and either beer or near‐beer under a progressive ratio schedule of reinforcement in a lickometer apparatus. The acute effects of TPM on the motivation to consume beer or near‐beer were then assessed. The effects of naloxone were also assessed (as a positive control) after TPM testing. In Experiment 2, rats were given 11 weeks of ad libitum home‐cage access to food, water, and beer. They then received repeated daily injections of TPM and effects on beer consumption under ad libitum home cage access conditions were monitored. In Experiment 3, the effects of TPM were assessed in the modified Porsolt forced swim test, emergence test, and elevated plus‐maze (EPM) using alcohol naïve rats.Results: Topiramate (10, 20, and 40 mg/kg) significantly reduced the motivation to lick for beer, although the maximal effect was moderate in comparison with naloxone (10 mg/kg). However, naloxone, unlike TPM, also reduced responding for near‐beer suggesting an alcohol‐specific effect of TPM. In Experiment 2, TPM (40 and 80 mg/kg) tended to transiently reduce alcohol consumption in the home cage under ad libitum access but this effect disappeared with repeated administration of the drug. TPM (10 to 80 mg/kg, given twice over 4 hours before test) produced a robust dose‐dependent decrease in immobility and increase in active coping strategies in the forced swim test similar to that seen with desipramine (2 × 20 mg/kg). There were modest anxiolytic effects of TPM on the EPM and emergence tests.Conclusions: With acute administration, TPM is moderately effective and relatively selective in reducing the drive to consume alcohol in Wistar rats. This anti‐alcohol effect is modest in comparison with naloxone and appears to dissipate under conditions of chronic treatment and ad libitum alcohol access. A marked antidepressant‐like effect in the forced swim test and partial anxiolytic effects in other animal models suggests that TPM may be a beneficial treatment for affective disorders. These preliminary results suggest further research is warranted to resolve the mechanisms involved in TPM modulation of both mood and alcohol consumption.
Population‐Level Relationships Between Alcohol Consumption Measures and Ischemic Heart Disease Mortality in U.S. Time‐Series
Authors: Kerr William C. , Ye Yu 
Published: October 2007

Background:  Individual‐level studies indicate the possibility of both protective and harmful effects of alcohol consumption on Ischemic Heart Disease (IHD) mortality depending on the pattern of consumption. Population‐level relationships could be in either direction and previous studies have found mixed results.Methods:  Population‐level relationships between IHD mortality rates and per capita consumption of alcoholic beverages, cirrhosis mortality rates, cigarettes, and sugar sweetened soda for the period from 1950 to 2002 are modeled using autoregressive integrated moving average (ARIMA) and vector error correction methods.Results:  In multivariate ARIMA models controlling for accumulated heavy drinking as represented by cirrhosis mortality, a protective effect of 4%/l was found for total alcohol consumption while cirrhosis mortality rates had significant positive effects on IHD rates. Beverage‐specific models found no effect for wine, positive risks for spirits, and significant protective effects for beer. The protective effects for both total alcohol and beer were also found in vector error correction models. Significant positive effects of cigarette sales on IHD rates were also found in both types of models.Conclusions:  The complexity of alcohol’s relationship with IHD is highlighted. Aspects of pattern represented by beverage‐specific consumption and cirrhosis mortality indicate potential protective effects from moderate drinking and harmful effects from heavy drinking in accord with individual‐level findings.
The Biphasic Effects of Alcohol: Comparisons of Subjective and Objective Measures of Stimulation, Sedation, and Physical Activity
Authors: Addicott Merideth A. , Marsh‐Richard Dawn M. , Mathias Charles W. , Dougherty Donald M. 
Published: October 2007

Background:  Alcohol produces biphasic effects of both stimulation and sedation. Sensitivity to these effects may increase the risk for the development of alcoholism. Alcohol‐induced changes in stimulation and sedation are commonly assessed with self‐report questionnaires in human research and with physical activity monitoring in animal research. However, little is known about the effects of alcohol on physical activity or the relationship between physical activity and subjective self‐report measures of stimulation and sedation following alcohol consumption in humans.Methods:  Thirty healthy men and women (n = 15 each) from 21 to 38 years old completed daily measurements of physical activity and self‐reports of stimulation and sedation following alcohol or placebo consumption. Across each of the four experimental days, all participants consumed a placebo, 0.4, 0.6, or 0.8 g/kg dose of 95% alcohol in a counterbalanced order. Breath alcohol concentrations, physical activity levels, and self‐reported stimulation and sedation were measured at baseline and on the ascending and descending limbs of the breath alcohol concentration (BrAC) curve.Results:  All alcohol doses increased physical activity, but these increases were time‐ and dose‐dependent. Increases in physical activity lasted across both ascending and descending limbs of the BrAC curve. Following the 0.6 g/kg dose, both physical activity and self‐reported stimulation increased during the ascending BrAC. Separate analyses of self‐reported sedation scores indicated that alcohol consumption also increased sedation for the 0.6 and 0.8 g/kg doses. Physical activity was not significantly correlated with either self‐reported stimulation or sedation at any time point.Conclusions:  These findings suggest that assessments of subjectively measured stimulation and sedation and objectively measured physical activity each assess unique aspects of the effects of alcohol. Used simultaneously, these measures may be useful for examining underlying mechanisms of the effects of alcohol on behavior.
The Effect of Ambient Bright Light Therapy on Depressive Symptoms in Persons with Dementia
Authors: Hickman Susan E. , Barrick Ann Louise , Williams Christianna S. , Zimmerman Sheryl , Connell Bettye Rose , Preisser John S. , Madeline Mitchell C. , Sloane Philip D. 
Published: October 2007

OBJECTIVES: To assess the effect of ambient bright light therapy on depressive symptoms in persons with dementia.DESIGN: A cluster‐unit crossover intervention trial involving four lighting conditions: morning bright light, evening bright light, all‐day bright light, and standard light.SETTING: The common areas of two geriatric units in a state‐operated psychiatric hospital in North Carolina and in a dementia‐specific residential care facility in Oregon.PARTICIPANTS: Sixty‐six older adults with dementia.INTERVENTION: Ambient bright light therapy was delivered through a high‐intensity, low‐glare lighting system installed in the public areas of study units at both sites. Each lighting condition was provided for multiple 3‐week periods in a predetermined sequence.MEASUREMENTS: Staff caregivers completed the Cornell Scale for Depression in Dementia (CSDD) in the last week of each 3‐week period to provide information about participants' moods.RESULTS: Analysis indicated a sex‐by‐treatment interaction (P=.008). Significant sex differences were found in CSDD scores in response to evening light (P=.003), all‐day light (P=.001), and standard light (P≤.001). Depressive symptoms were lowest for women and highest for men during morning light.CONCLUSION: Findings do not support the use of ambient bright light therapy as a treatment for depressive symptoms in persons with dementia, although a subpopulation of persons with dementia may benefit from this intervention. It is likely that individual rather than unit‐level interventions are a more effective strategy for delivering bright light therapy for this population.
Sleep Problems in Elderly Women Caregivers Depend on the Level of Depressive Symptoms: Results of the Caregiver–Study of Osteoporotic Fractures
Authors: Kochar Jinesh , Fredman Lisa , Stone Katie L. , Cauley Jane A. ,   for the Study of Osteoporotic Fractures
Published: October 2007

OBJECTIVES: To determine whether depressive symptoms modify the association between caregiving and sleep problems in elderly women.DESIGN: Cross‐sectional study conducted in four communities in 1999 to 2001.SETTING: Home‐based interviewer‐administered questionnaires.PARTICIPANTS: Three hundred seventy‐five caregiver and 694 noncaregiver participants from the Study of Osteoporotic Fractures.MEASUREMENTS: Self‐reported frequency of three sleep problems in the previous month: trouble falling asleep, trouble staying asleep, and waking early and having trouble falling back asleep. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES‐D), excluding the sleep disturbance item.RESULTS: In adjusted analyses, caregivers did not report more sleep problems than noncaregivers, although respondents with high depressive symptoms (CES‐D≥16) were twice as likely to report each sleep problem. When depressive symptoms and caregiving were considered together, caregivers with high depressive symptoms were most likely to report sleep problems (adjusted odds ratios ranging from 2.5, 95% confidence interval (CI)=1.2–5.2 for trouble falling asleep to 4.0, 95% CI=2.0–7.8 for waking early, compared with nondepressed noncaregivers). By contrast, there was no difference in sleep problems between caregivers and noncaregivers who were not depressed. The combination of high depressive symptoms and high‐stress caregiving situations (e.g., caring for a spouse or a person with dementia, or living with the care recipient) also increased the likelihood of sleep problems.CONCLUSION: Caregivers with high levels of depressive symptoms reported sleep problems more than nondepressed noncaregivers. These results underscore the importance of screening elderly female caregivers for depressive symptoms and sleep problems.
Dietary Supplementation and Quality of Life of Older Patients: A Randomized, Double‐Blind, Placebo‐Controlled Trial
Authors: Gariballa Salah , Forster Sarah 
Published: October 2007

OBJECTIVES: To test the effect of nutritional support on older patient's quality of life.DESIGN: Double‐blind, randomized, placebo‐controlled trial conducted from March 2001 to January 2004.SETTING: United Kingdom.PARTICIPANTS: Two hundred twenty‐five hospitalized acutely ill older patients.INTERVENTION: Normal hospital diet plus 400‐mL oral nutritional supplements daily for 6 weeks. The composition of the supplement was such as to provide 995 kcal for energy and 100% of the Reference Nutrient Intakes for a healthy older person for vitamins and minerals.MEASUREMENTS: Baseline, 6‐week, and 6‐month nutritional status and quality of life.RESULTS: Randomization to the supplement group led to significantly better quality‐of‐life scores than in the placebo group at 6 months but not at 6 weeks, after adjustment for baseline quality of life, age, and sex. The effect of supplementation was seen in higher physical function, role physical, and social function scores. Corresponding treatment effects were 7.0 (95% confidence interval (CI)=0.5–13.6, P=.04), 10.2 (95% CI=0.1–20.2, P=.047), and 7.8 (95% CI=0.0–15.5, P=.05), respectively. There was no evidence of difference in Barthel scores at 6 months.CONCLUSION: Oral nutritional supplementation of acutely ill hospitalized older patients led to a statistically significant benefit in quality of life.
Screening of Older Community‐Dwelling People at Risk for Death and Hospitalization: The Assistenza Socio‐Sanitaria in Italia Project
Authors: Mazzaglia Giampiero , Roti Lorenzo , Corsini Giacomo , Colombini Angela , Maciocco Gavino , Marchionni Niccolò , Buiatti Eva , Ferrucci Luigi , Bari Mauro Di 
Published: October 2007

OBJECTIVES: To develop and validate mortality and hospitalization prognostic tools based upon information readily available to primary care physicians (PCPs).DESIGN: Population‐based cohort study. Baseline predictors were patient demographics, a seven‐item questionnaire on functional status and general health, use of five or more drugs, and previous hospitalization.SETTING: Community‐based study.PARTICIPANTS: Prognostic indexes were developed in 2,470 subjects and validated in 2,926 subjects, all community‐dwelling, aged 65 and older, and randomly sampled from the rosters of 98 PCPs in Florence, Italy.MEASUREMENTS: Fifteen‐month mortality and hospitalization.RESULTS: Two scores were derived from logistic regression models and used to stratify participants into four groups. With Model 1, based upon the seven‐item questionnaire, mortality rate ranged from 0.8% in the lowest‐risk group (0–1 point) to 9.4% in the highest risk group (≥3 points), and hospitalization rate ranged from 12.4% to 29.3%; area under the receiver operating characteristic curves (AUC) was 0.75 and 0.60, respectively. With Model 2, considering also drug use and previous hospitalization, mortality and hospitalization rates ranged from 0.3% to 8.2% and from 8.1% to 29.7%, for the lowest‐risk to the highest‐risk group; the AUC increased significantly only for hospitalization (0.67).CONCLUSION: Prediction of death and hospitalization in older community‐dwelling people can be easily obtained with two indexes using information promptly available to PCPs. These tools might be useful for guiding clinical care and targeting interventions to reduce the need for hospital care in older persons.
Effectiveness of Multidimensional Exercises for the Treatment of Stress Urinary Incontinence in Elderly Community‐Dwelling Japanese Women: A Randomized, Controlled, Crossover Trial
Authors: Kim Hunkyung , Suzuki Takao , Yoshida Yuko , Yoshida Hideyo 
Published: October 2007

OBJECTIVES: To evaluate the effectiveness of pelvic floor muscle (PFM) and fitness exercises in reducing urine leakage in elderly women with stress urinary incontinence (UI).DESIGN: Randomized, crossover, follow‐up trial.SETTING: Urban community in Japan.PARTICIPANTS: Seventy women aged 70 and older who reported urine leakage one or more times per month; 35 were randomly assigned to intervention and the other 35 to control.INTERVENTION: The intervention group attended an exercise class aimed at enhancing PFMs and fitness. Duration of the exercise was 60 minutes per session twice a week for 3 months. After 3 months of exercise, the intervention group was followed for 1 year.MEASUREMENTS: Body mass index (BMI), urine leakage, walking speed, and muscle strength were measured at baseline, after the intervention, and at follow‐up.RESULTS: In the intervention group, maximum walking speed and adductor muscle strength increased significantly after the intervention; there were no significant changes in the control group. After 3 months of exercise, 54.5% of the intervention group and 9.4% of the control group reported being continent. Within the cured group of UI, a significantly higher proportion had decreased their BMI at 3 months (P=.03) and increased walking speed at 3 (P=.04) and 12 (P=.047) months.CONCLUSION: Decrease in BMI and increase in walking speed may contribute to the treatment of UI, although the data do not support a positive correlation between strengthening of adductor muscle and improvement of UI, which needs more research.
A Pilot Study of Banxia Houpu Tang, a Traditional Chinese Medicine, for Reducing Pneumonia Risk in Older Adults with Dementia
Authors: Iwasaki Koh , Kato Shiro , Monma Yasutake , Niu Kaijun , Ohrui Takashi , Okitsu Reina , Higuchi Satoshi , Ozaki Shiro , Kaneko Noboru , Seki Takashi , Nakayama Katsutoshi , Furukawa Katsutoshi , Fujii Masahiko , Arai Hiroyuki 
Published: October 2007

OBJECTIVES: To evaluate whether the traditional Chinese herbal medicine Banxia Houpu Tang (BHT, formula magnolia et pinelliae) prevents aspiration pneumonia and pneumonia‐related mortality in elderly people.DESIGN: A prospective, observer‐blinded, randomized, controlled trial.SETTING: Two long‐term care hospitals for handicapped elderly patients in Japan from March 2005 to February 2006.PARTICIPANTS: One hundred four elderly patients (31 men and 73 women; mean age±standard deviation 83.5±7.8) with dementia and cerebrovascular disease, Alzheimer's disease, or Parkinson's disease.INTERVENTION: Ninety‐five participants (mean age 84.0, M:F=28:67) were randomly assigned to the BHT treatment group (n=47) or the control group (n=48) and took BHT or placebo for 12 months.MEASUREMENTS: The occurrence of pneumonia, mortality due to pneumonia, and the daily amount of self‐feeding.RESULTS: Complete data were available for analysis on 92 of the 95 subjects randomized. Four patients in the BHT group developed pneumonia, and one of them died as a result. Fourteen patients in the control group developed pneumonia, and six of them died as a result. There was a significant difference between the two groups in pneumonia onset (P=.008), and a tendency toward significance in pneumonia‐related mortality (P=.05). The relative risk of pneumonia in the BHT group compared with the control group was 0.51 (95% confidence interval (CI)=0.27–0.84, P=.008) and that of death from pneumonia was 0.41 (95% CI=0.10–1.03, P=.06) according to the Cox proportional hazards model. No adverse events were observed from treatment with BHT. The BHT group was able to maintain self‐feeding better than the control group (P=.006).CONCLUSION: Treatment with BHT reduced the risk of pneumonia and pneumonia‐related mortality in elderly patients with dementia.
The Agency Relationship in Churches: An Empirical Analysis
Authors: Zech Charles 
Published: October 2007

Abstract. The agency relationship has been observed in a variety of settings. Churches, like other organizations, are plagued with the typical agency problems of moral hazard, observability, goal displacement, and risk aversion. How do churches cope with these issues in dealing with their most critical resource, clergy? This study analyzes the agency relationship between churches and their clergy.Using data from nine denominations, this study finds strong evidence that pastor compensation is not tied directly to performance, but rather indirectly through promotion tournaments. Successful pastors are rewarded by being called to larger, presumably wealthier and more prestigious, congregations. Since it is so difficult to observe and measure a pastor's performance in specific activities, churches differentiate good pastors from mediocre ones by considering their total performance, rather than any specific activities.
Experimental Efficacy of Pericardial Instillation of Anti‐inflammatory Agents during Percutaneous Epicardial Catheter Ablation to Prevent Postprocedure Pericarditis
Authors: D'AVILA ANDRE , NEUZIL PETR , THIAGALINGAM ARAVINDA , GUTIERREZ PAULO , ALEONG RYAN , RUSKIN JEREMY N. , REDDY VIVEK Y. 
Published: October 2007

Introduction: Pericarditis is a potential complication of catheter‐based percutaneous epicardial mapping and ablation. This study evaluates the efficacy and safety of intrapericardial instillation of anti‐inflammatory agents after pericardial mapping and ablation in a porcine model of postprocedural pericarditis. Methods and Results: Twenty‐five healthy swine underwent epicardial mapping and ablation after transthoracic subxyphoid puncture. After 60 minutes of continuous catheter manipulation in the pericardial space, radiofrequency energy was delivered in a linear fashion to the epicardial surfaces of both atria. The animals were randomly divided to receive the anti‐inflammatory agents, Hyaluronic Acid and Triamcinolone, or control. Fourteen days after ablation, the hearts were excised and the degree of pericardial reaction/adhesions scored. The severity was uniformly graded 4 (intense) in all control animals and was characterized by intense adhesion between the parietal and the visceral pericardium obscuring tissue planes and epicardial anatomy. Hyaluronic Acid provided a mild benefit (score 3.0 ± 0.9), but 2 mg/kg of Triamcinolone significantly attenuated the inflammatory effect (all animals uniformly scored 1.0). Conclusion: In a porcine model of ablation‐related pericarditis, intrapericardial instillation of 2 mg/kg of intermediate‐acting corticosteroids effectively prevents post‐procedure inflammatory adhesion formation.