bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gene therapy in epilepsy
Authors: Riban Véronique , Fitzsimons Helen L. , During Matthew J. 
Published: August 2008

SummaryResults from animal models suggest gene therapy is a promising new approach for the treatment of epilepsy. Several candidate genes such as neuropeptide Y and galanin have been demonstrated in preclinical studies to have a positive effect on seizure activity. For a successful gene therapy‐based treatment, efficient delivery of a transgene to target neurons is also essential. To this end, advances have been made in the areas of cell transplantation and in the development of recombinant viral vectors for gene delivery. Recombinant adeno‐associated viral (rAAV) vectors in particular show promise for gene therapy of neurological disorders due to their neuronal tropism, lack of toxicity, and stable persistence in neurons, which results in robust, long‐term expression of the transgene. rAAV vectors have been recently used in phase I clinical trials of Parkinson's disease with an excellent safety profile.Prior to commencement of phase I trials for gene therapy of epilepsy, further preclinical studies are ongoing including evaluation of the therapeutic benefit in chronic models of epileptogenesis, as well as assessment of safety in toxicological studies.
Spatial localization and time‐dependant changes of electrographic high frequency oscillations in human temporal lobe epilepsy
Authors: Khosravani Houman , Mehrotra Nikhil , Rigby Michael , Hader Walter J. , Pinnegar C. Robert , Pillay Neelan , Wiebe Samuel , Federico Paolo 
Published: August 2008

SummaryPurpose:  High frequency oscillations (HFOs) >200 Hz are believed to be associated with epileptic processes. The spatial distribution of HFOs and their evolution over time leading up to seizure onset is unknown. Also, recording HFOs through conventional intracranial electrodes is not well established. We therefore wished to determine whether HFOs could be recorded using commercially available depth macroelectrodes. We also examined the spatial distribution and temporal progression of HFOs during the transition to seizure activity.Methods:  Intracranial electroencephalography (EEG) recordings of 19 seizures were obtained from seven patients with temporal lobe epilepsy using commercial depth or subdural electrodes. EEG recordings were analyzed for frequency content in five spectral bands spanning DC‐500 Hz. We examined the spatial distribution of the different spectral bands 5 s before and 5 s after seizure onset. Temporal changes in the spectral bands were studied in the 30‐s period leading up to seizure onset.Results:  Three main observations were made. First, HFOs (100–500 Hz) can be recorded using commercial depth and subdural grid electrodes. Second, HFOs, but not <100 Hz oscillations, were localized to channels of ictal onset (100–200, 400–500 Hz, p < 0.05; 300–400 Hz, p < 0.001). Third, temporal analysis showed increased HFO power for approximately 8 s prior to electrographic onset (p < 0.05).Conclusions:  These results suggest that HFOs can be recorded by depth macroelectrodes. Also, HFOs are localized to the region of primary ictal onset and can exhibit increased power during the transition to seizure. Thus, HFOs likely represent important precursors to seizure initiation.
Neuropsychological Characteristics of Italian Children With Fetal Alcohol Spectrum Disorders
Authors: Aragón Alfredo S. , Coriale Giovanna , Fiorentino Daniela , Kalberg Wendy O. , Buckley David , Phillip Gossage J. , Ceccanti Mauro , Mitchell Elisha R. , May Philip A. 
Published: August 2008

Background:  Children with fetal alcohol spectrum disorders (FASD) display many problems ranging from deficits in intelligence to behavioral difficulties. Thus, many studies have aimed at defining the neuropsychological characteristics of children with FASD. The current article describes the neuropsychological characteristics of Italian children with severe diagnosis within FASD and compares them with controls. It was expected that intellectual functioning, language comprehension, academic skills, and inattention/hyperactivity would discriminate children with FASD from randomly selected peers without FASD.Methods:  This article presents data from a second cohort of children examined in 2005 as part of an in‐school epidemiological study of FASD in Italy. Of 80 children, 23 diagnosed with a FASD, and 57 randomly selected control children from the same first‐grade classes, participated. After screening for FASD via growth and dysmorphology, the children were administered a test of general intelligence (WISC‐R) as well as tests of nonverbal reasoning (Raven Colored Progressive Matrices), language comprehension (Rustioni), academic achievement (IPDA), and problem behavior (Disruptive Behavior Disorder Rating Scale).Results:  Children diagnosed with a FASD achieved lower scores than control children on Verbal, Performance, and Full Scale IQ. Profile analysis of the WISC‐R indicates overall differences between the groups. However, some intact functioning within the FASD group was found, as the Similarities and Vocabulary subtests were similar to the controls. After an alpha adjustment to 0.004, the Block Design, Object Assembly, and Mazes subtests were significantly different from controls. On tests of nonverbal reasoning, language comprehension, and academic achievement, the children with a FASD scored significantly lower. Moreover, teachers rated children with a severe diagnosis within FASD as showing more inattentive symptoms than controls, while hyperactive/impulsive characteristics among children with a FASD were comparable with the control children. Significant correlations between head circumference, child dysmorphology, WISC‐R, and Raven CPM scores are also reported.Conclusions:  This study indicates that a sample of Italian children with a FASD, when compared with control children, display poorer functioning on measures of general intelligence, nonverbal reasoning, academic achievement, and teacher‐rated problem behaviors. The findings also contribute to the formulation of a neuropsychological profile of children diagnosed with a FASD.
Incidence of Cardiovascular and Cerebrovascular Disease in Danish Men and Women With a Prolonged Heavy Alcohol Intake
Authors: Hvidtfeldt Ulla Arthur , Frederiksen Marie Engholm , Thygesen Lau Caspar , Kamper‐Jørgensen Mads , Becker Ulrik , Grønbæk Morten 
Published: August 2008

Background:  Several epidemiological studies have found U‐ or J‐shaped relationships between alcohol intake and cardiovascular conditions. The influence of heavy drinking is, however, sparsely studied. The objective of the present study was to examine whether alcohol addicts have higher incidence rates of cardio‐ and cerebrovascular diseases than the population in general.Methods:  The cohort comprised 19,185 subjects (15,368 men and 3,817 women) who attended outpatient clinics for alcohol abusers within the Copenhagen Hospital Corporation (1954 to 1992). Incidence rates were standardized (SIR) according to sex, age and calendar time to compare subjects’ cardio‐ and cerebrovascular incidence with that of the general population of Copenhagen.Results:  During the period 1977 to 2001 a total of 9,397 events of cardio‐ and cerebrovascular disease were observed. In both men and women, statistically significant higher incidence rates than would be expected in a standard population were observed for cardiovascular diseases (e.g., ischemic heart diseases, men: SIR = 1.76; 95% CI 1.69–1.83; women: SIR = 2.44; 95% CI 2.19–2.73) and cerebrovascular diseases (e.g., hemorrhagic stroke, men: SIR = 2.71; 95% CI 2.45–2.99; women: SIR = 2.77; 95% CI 2.18–3.48).Conclusions:  The study indicates increased risks of cardio‐ and cerebrovascular diseases in subjects with an excessive alcohol intake.
Toward Sustainable Nanoproducts
Authors: Şengül Hatice , Theis Thomas L. , Ghosh Siddhartha 
Published: August 2008

SummarySustainable development of nanotechnology will inevitably require incorporation of life cycle thinking to analyze environmental impacts of nanomanufacturing. While many concerns have been raised regarding the human and ecological health effects of and benefits from using nanoproducts, relatively little attention has been given to the manufacturing phase. Unlike many conventional manufacturing techniques, nanomanufacturing techniques require unique facility and process design as well as operation and control. Accordingly, the environmental burden of most nanomanufacturing techniques may be more profound than that of many other conventional techniques. This article reports on a comprehensive review of the current state of technologies used in the manufacture of nanostructured materials in order to identify those attributes that contribute to environmental impacts. It provides a preliminary analysis of significant attributes of commonly used nanomanufacturing techniques, including strict material purity requirements, less tolerance for defects, low process yields and material utilization efficiencies, repetitive processing steps, the need for specialized environments (such as high temperatures or cryogenic processing), the use of toxic chemicals and solvents, the need for moderate to high vacuum, the use or generation of greenhouse gases, high energy and water consumption, and the potential for chemical exposure.
Radiofrequency and Pulsed Radiofrequency Treatment of Chronic Pain Syndromes: The Available Evidence
Authors: Van Boxem Koen , Van Eerd Maarten , Brinkhuize Tjinta , Patijn Jacob , Van Kleef Maarten , Van Zundert Jan 
Published: August 2008

AbstractThere are currently 6 reviews on (pulsed) radiofrequency (RF) for the management of spinal pain. Two reviews on interventional pain management techniques in general also discuss RF. The outcomes of those reviews depend on the type of studies included and the opinion of the reviewers, which may result in different evidence levels.Radiofrequency denervation at the cervical and lumbar level has produced the most solid evidence. The differences in treatment outcome registered in the 5 randomized controlled trials (RCTs) regarding lumbar facet denervation can be attributed to differences in patient selection and/or inappropriate technique. There is not sufficient evidence supporting the use of RF facet denervation for the management of cervicogenic headache. The studies examining the management of cervical radicular pain suggest a comparable efficacy for RF and pulsed RF (PRF). The PRF treatment is supposed to be safer and therefore should be preferred. The superiority of RF treatment adjacent to the lumbar dorsal root ganglion for the management of lumbar radicular pain has not been demonstrated in an RCT.Information regarding RF treatment of sacroiliac joint pain is accumulating. No randomized sham‐controlled trials on the value of RF treatment of the Gasserian ganglion for the management of idiopathic trigeminal neuralgia have been published. One RCT indicates superiority of RF over PRF for the management of idiopathic trigeminal neuralgia. Future research to confirm or deny the efficacy of (P)RF should be conducted in carefully selected patient populations. The tests used for patient inclusion in such a trial could potentially help the clinician in selecting patients for this type of treatment. The value of PRF treatment of the peripheral nerves also needs to be confirmed in well‐designed trials.
Testing only donors with a prior history of pregnancy or transfusion is a logical and cost‐effective transfusion‐related acute lung injury prevention strategy
Authors: Powers Amy , Stowell Christopher P. , Dzik Walter H. , Saidman Susan L. , Lee Hang , Makar Robert S. 
Published: August 2008

BACKGROUND: Transfusion‐related acute lung injury (TRALI) is the leading cause of transfusion‐related fatality reported to the Food and Drug Administration. Donor screening may reduce TRALI risk. This study sought to compare the efficacy and safety of different TRALI risk‐reduction strategies at a hospital‐based donor center.STUDY DESIGN AND METHODS: Samples from 1053 donors who answered questions regarding pregnancy and transfusion history were tested for HLA Class I and II antibodies using a flow cytometry–based screening assay. Donor history was compared with the presence of HLA alloantibodies. These data were used to model several TRALI risk‐reduction strategies. The medical records of patients transfused fresh‐frozen plasma (FFP) from highly alloimmunized donors were retrospectively reviewed for TRALI.RESULTS: HLA alloimmunization was observed among 25.4 percent (256/1009) of all female donors and among 12.0 percent (3/25) of those male donors who gave a history of prior transfusion. Prior pregnancy, reported by 52.6 percent (531/1009) of females, correlated significantly with HLA alloimmunization (p < 0.0001). The rate of HLA alloimmunization increased with parity. A positive pregnancy history was a sensitive (87.9%) screen for HLA alloimmunization with a negative predictive value of 93.5 percent (95% confidence interval, 91.3%‐95.7%). Although 5.9 percent (27/459) of nulliparous, untransfused females demonstrated a positive screening test, only 1 percent (7/459) had a confirmed HLA alloantibody. Transfusion of FFP from donors found retrospectively to be highly alloimmunized led to reactions suggestive of TRALI in 2 of 26 recipients.CONCLUSIONS: Donor history is a reliable predictor of HLA alloimmunization. Testing only donors with a prior history of pregnancy or transfusion is a logical and cost‐effective TRALI prevention strategy.
Foreign Share, Insurance Density, and Penetration: An Analysis of the International Life Insurance Market
Authors: Ma Yu‐Luen , Pope Nat 
Published: August 2008

Abstract Recent trends toward liberalization and deregulation have sparked significant interest in the topic of international insurers' participation in foreign markets. This research develops a profile of foreign national market characteristics that attract international life insurer participation and additionally, empirically assesses the value that international participation has to the host market. Characteristics that are found to be statistically significant with respect to international participation include high levels of trade liberalization and/or low insurer market share concentration, high levels of national wealth, and high levels of government expenditure on social security retirement benefits. With respect to the benefits such participation provides, we see that the presence of international life insurers share positive relationships with both life insurance consumption and the magnitude of the role life insurance plays within the broader national economy of those host markets.
The Hungarian Insurance Market: Economic Transition in the Insurance Sector
Authors: Venard Bertrand , Halek Martin , Dorfman Mark S. 
Published: August 2008

AbstractThis article analyzes Hungary's insurance sector as an important part of the country's economic transition from a centrally planned economy to a market economy. It details the historic economic development of the Hungarian insurance market from a state monopoly to a competitive insurance market where foreign‐owned insurance companies have a dominant market share.
Recommendations from the Society for Academic Emergency Medicine (SAEM) Taskforce on Women in Academic Emergency Medicine
Authors: Kuhn Gloria J. , Abbuhl Stephanie B. , Clem Kathleen J. ,   for the Society for Academic Emergency Medicine (SAEM) Taskforce for Women in Academic Emergency Medicine
Published: August 2008

AbstractThe Society for Academic Emergency Medicine (SAEM) convened a taskforce to study issues pertaining to women in academic emergency medicine (EM). The charge to the Taskforce was to “Create a document for the SAEM Board of Directors that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine.” To this end, the Taskforce and authors reviewed the literature to highlight key data points in understanding this issue and made recommendations for individuals at four levels of leadership and accountability: leadership of national EM organizations, medical school deans, department chairs, and individual women faculty members. The broad range of individuals targeted for recommendations reflects the interdependent and shared responsibility required to address changes in the culture of academic EM. The following method was used to determine the recommendations: 1) Taskforce members discussed career barriers and potential solutions that could improve the recruitment, retention, and advancement of women in academic EM; 2) the authors reviewed recommendations in the literature by national consensus groups and experts in the field to validate the recommendations of Taskforce members and the authors; and 3) final recommendations were sent to all Taskforce members to obtain and incorporate additional comments and ensure a consensus. This article contains those recommendations and cites the relevant literature addressing this topic.
Availability and Quality of Computed Tomography and Magnetic Resonance Imaging Equipment in U.S. Emergency Departments
Authors: Ginde Adit A. , Foianini Anthony , Renner Daniel M. , Valley Morgan , Camargo, Jr Carlos A. 
Published: August 2008

AbstractObjectives:  The objective was to determine the availability and quality of computed tomography (CT) and magnetic resonance imaging (MRI) equipment in U.S. emergency departments (EDs). The authors hypothesized that smaller, rural EDs have less availability and lower‐quality equipment.Methods:  This was a random selection of 262 (5%) U.S. EDs from the 2005 National Emergency Department Inventories (NEDI)‐USA (http://www.emnet‐usa.org/). The authors telephoned radiology technicians about the presence of CT and MRI equipment, availability for ED imaging, and number of slices for the available CT scanners. The analysis was stratified by site characteristics.Results:  The authors collected data from 260 institutions (99% response). In this random sample of EDs, the median annual patient visit volume was 19,872 (interquartile range = 6,788 to 35,757), 28% (95% confidence interval [CI] = 22% to 33%) were rural, and 27% (95% CI = 21% to 32%) participated in the Critical Access Hospital program. CT scanners were present in 249 (96%) institutions, and of these, 235 (94%) had 24/7 access for ED patients. CT scanner resolution varied: 28% had 1–4 slice, 33% had 5–16 slice, and 39% had a more than 16 slice. On‐site MRI was available for 171 (66%) institutions, and mobile MRI for 53 (20%). Smaller, rural, and critical access hospitals had lower CT and MRI availability and less access to higher‐resolution CT scanners.Conclusions:  Although access to CT imaging was high (>90%), CT resolution and access to MRI were variable. Based on observed differences, the availability and quality of imaging equipment may vary by ED size and location.
From the Emergency Department to Vital Statistics: Cause of Death Uncertain
Authors: Keirns Carla C. , Carr Brendan G. 
Published: August 2008

AbstractVital statistics are widely used to evaluate trends in health and illness, inform policy, and allocate resources among health priorities. Literature comparing autopsies to clinical death certification has shown that the clinical “cause of death” certification is inaccurate or incomplete in many cases. Short of increasing autopsies, however, these studies have proposed few improvements. Using the case of death certification in the emergency department (ED), the authors analyzed the current approach to death certification. The authors propose the following to improve the quality of data: 1) acceptance of the declaration “manner of death, natural; cause of death, uncertain”; 2) training for physicians in the selection of appropriate underlying causes of death and “chains of causation”; and 3) participation of physicians with ongoing relationships to the patient in the certification process.
Simulation in a Disaster Drill: Comparison of High‐fidelity Simulators versus Trained Actors
Authors: Gillett Brian , Peckler Brad , Sinert Richard , Onkst Cherie , Nabors Spencer , Issley Steven , Maguire Christopher , Galwankarm Sagar , Arquilla Bonnie 
Published: August 2008

AbstractObjectives:  High‐fidelity patient simulation provides lifelike medical scenarios with real‐time stressors. Mass casualty drills must construct a realistic incident in which providers care for multiple injured patients while simultaneously coping with numerous stressors designed to tax an institution’s resources. This study compared the value of high‐fidelity simulated patients with live actor‐patients.Methods:  A prospective cohort study was conducted during two mass casualty drills in December 2006 and March 2007. The providers’ completion of critical actions was tested in live actor‐patients and simulators. A posttest survey compared the participants’ perception of “reality” between the simulators and live actor victims.Results:  The victims (n = 130) of the mass casualty drill all had burn‐, blast‐, or inhalation‐related injuries. The participants consisted of physicians, residents, medical students, clerks, and paramedics. The authors compared the team’s execution of the 136 critical actions (17 critical actions × 8 scenarios) between the simulators and the live actor‐patients. Only one critical action was missed in the simulator group and one in the live actor group, resulting in a miss rate of 0.74% (95% confidence interval [CI] = 0.01% to 4.5%). All questionnaires were returned and analyzed. The vast majority of participants disagreed or strongly disagreed that the simulators were a distraction from the disaster drill. More than 96% agreed or strongly agreed that they would recommend the simulator as a training tool. The mean survey scores for all participants demonstrated agreement that the simulators closely mimicked real‐life scenarios, accurately represented disease states, and heightened the realism of patient assessment and treatment options during the drill with the exception of nurse participants, who agreed slightly less strongly.Conclusions:  This study demonstrated that simulators compared to live actor‐patients have equivalent results in prompting critical actions in mass casualty drills and increase the perceived reality of such exercises.
A general equilibrium analysis of conjunctive ground and surface water use with an application to Morocco
Authors: Diao Xinshen , Dinar Ariel , Roe Terry , Tsur Yacov 
Published: August 2008

AbstractGroundwater resources (GW) account for nearly 30% of the world's sustainable water supplies. Yet, this resource, which is fraught with externalities, has largely been left unregulated. The economic literature on GW is predominantly of a partial equilibrium type. We analyze GW regulation in a general equilibrium setting, focusing on the stabilization value of GW under natural (drought) and economic (rural–urban water transfer) shocks. A general equilibrium approach allows evaluating direct and indirect effects of GW regulation on agriculture and nonagriculture sectors and extends the scope for water policy. The analysis is applied to Morocco by extending an existing computable general equilibrium (CGE) model to include ground and surface water (SW) resources. We study effects of (i) an increase in GW extraction cost (e.g., as a result of prolonged extraction beyond natural recharge that lowers the aquifer's water table), (ii) a transfer of SW from rural (irrigation) to urban (domestic) use, and (iii) a reduction of water availability due to severe drought. We estimate the value of GW and assess the direct (partial equilibrium) and indirect (general equilibrium) impacts. We find that GW plays a critical role in mitigating the negative effects of these types of shocks.