bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brain Perfusion Following Single Seizures
Authors: Leonhardt Georg , De Greiff Armin , Weber Johannes , Ludwig Tanja , Wiedemayer Helmut , Forsting Michael , Hufnagel Andreas 
Published: November 2005

Summary:  Purpose: The aim of this study was to assess the regional relative interictal and postictal perfusion changes in temporal and parietal lobe epilepsy. Methods: We investigated interictal and postictal magnet resonance perfusion changes in five patients with temporal lobe epilepsy either with hippocampal sclerosis (n = 3) or without (n = 2), and in one patient with extratemporal (parietal lobe) epilepsy. T2*‐weighted single‐shot echo‐planar images were acquired after bolus application of 0.2 mmol/kg gadolinium‐diethylene triamine pentaacetic acid (GD‐DTPA) at baseline and after intervals of 2–12 min, 15–23 min, 28–50 min, 63–72 min, and 180–240 min. The bolus‐peak ratio was calculated in regions of interest in the hippocampus (HIP), parahippocampal gyrus (PHG), thalamus (THA), cortex (COR), and white matter (WM), yielding relative perfusion changes. Results: Interictally, we found relative hyperperfusion of the ictogenic side in five of six patients in the HIP. Postictally, the perfusion decreased in the HIP by 25–39% as compared to baseline, whereas the PHG showed a reverse pattern. In the late postictal phase, perfusion increased in the HIP again and decreased in the PHG. In the THA, the inter‐ and postictal changes were small (5–19%). COR and WM showed equivocal results. Conclusion: Postictal relative hypoperfusion in the HIP appears to be associated with the cessation of neuronal ictal discharge, whereas postictal hyperperfusion in the PHG lags behind and may reflect increased metabolism to restore the interictal state of neuronal excitability.
Levetiracetam Efficacy in Epileptic Syndromes with Continuous Spikes and Waves during Slow Sleep: Experience in 12 Cases
Authors: Aeby Alec , Poznanski Nathalie , Verheulpen Denis , Wetzburger Catherine , Van Bogaert Patrick 
Published: November 2005

Summary: Purpose:To assess the add‐on efficacy of levetiracetam on the EEG, behavior, and cognition of children with continuous spikes and waves during slow sleep (CSWS).Methods:Charts of children with behavioral and/or cognitive deterioration associated with CSWS who received levetiracetam at 50 mg/kg/day as add‐on treatment were retrospectively reviewed. Awake and sleep EEG recordings and detailed neuropsychological and behavioral assessments were available at baseline and 2 months after levetiracetam initiation. In children showing clinical and/or electrophysiological improvement after 2 months, levetiracetam was continued with a new evaluation at 1 year.Results:Twelve patients were included (9 cryptogenic and 3 symptomatic cases). Seven patients (58.3%) showed improvement of EEG record. Among these seven patients, neuropsychological evaluation was improved in three, and in the other four patients, not testable because of severe cognitive impairment, behavior was improved. Two patients improved in neuropsychological evaluation despite the lack of EEG improvement. Eight patients (66.6%) continued levetiracetam treatment after 2 months. After 1 year, four patients were still on levetiracetam, two because sustained effect on EEG and behavior and the two others because improvement in neuropsychological testing despite unchanged EEG. Levetiracetam was discontinued in the other four patients because of neuropsychological or behavioral deterioration associated with CSWS pattern, between 9 and 11 months after treatment initiation.Conclusions:This retrospective study suggests that levetiracetam has a positive effect on the EEG, the behavior, and the cognition of patients with epilepsy and CSWS. Additional studies are warranted in order to assess the place of this drug in these epileptic conditions.
The Prevalence of Autistic Spectrum Disorder in Children Surveyed in a Tertiary Care Epilepsy Clinic
Authors: Clarke Dave F. , Roberts Wendy , Daraksan Mina , Dupuis Annie , McCabe Jane , Wood Halyey , Snead O. Carter , Weiss Shelly K. 
Published: November 2005

Summary:  It is well documented that children with autistic spectrum disorder (ASD) have an increased prevalence of seizures; however, studies have not been done to evaluate the prevalence of ASD in children with epilepsy. This comorbidity is important to define as early diagnosis and intervention in some children with ASD has been shown to improve outcome. Method: Children with epilepsy seen in a tertiary care epilepsy clinic were evaluated using validated autism screening questionnaires (ASQ). In addition, questions about sleep‐related disorders, behavior, seizure characteristics, antiepileptic agents, and body mass index (BMI) were requested. An attempt was then made to determine if there was a correlation between the factors identified and ASD. Results: Of the 107 questionnaires returned, 97 ASQ's were properly completed and used in this study. Approximately 32% of children fit the ASQ criteria for having ASD. Most children had not been previously diagnosed. Worst behavior and daytime sleepiness was seen in those at greater risk (p < 0.01). Seizures also occurred earlier (approximately 2 years) in children at risk of having ASD. Conclusion: Though confirmatory diagnostic evaluations are needed, this questionnaire‐based study suggests that children with epilepsy are at greater risk of having ASD, and illustrates the need for more clinical vigilance. Behavioral difficulties and daytime sleepiness identified in these children could potentially affect their ability to learn. It is of interest that the age of seizure onset identified in those at greater risk corresponds with the approximate age of regression identified in some children with ASD.
Multiple Losses, EX ANTE Moral Hazard, and the Implications for Umbrella Policies
Authors: Breuer Michael 
Published: November 2005

AbstractUnder certain cost conditions the optimal insurance policy offers full coverage above a deductible, as Arrow and others have shown. However, many insurance policies currently provide coverage against several losses although the possibilities for the insured to affect the loss probabilities by several prevention activities (multiple moral hazard) are substantially different. This article shows that optimal contracts under multiple moral hazard generally call for complex reimbursement schedules. It also examines the conditions under which different types of risks can optimally be covered by a single insurance policy and argues that the case for umbrella policies under multiple moral hazard is limited in practice.
Deterring Fraud: The Role of General Damage Awards in Automobile Insurance Settlements
Authors: Loughran David S. 
Published: November 2005

AbstractAwards for pain and suffering and other noneconomic losses account for over half of all damages awarded under third‐party auto insurance bodily injury settlements. This article hypothesizes that third‐party insurers use general damage awards to reduce the incentive to submit exaggerated claims for specific damages for injuries and lost wages. Consistent with this hypothesis, the article finds evidence using data on over 17,000 closed bodily injury claims that special damage claims that exceed their expected value receive proportionally lower general damage awards than claims that do not. Among the implications of this research is the possibility that insurers will be less zealous in challenging fraudulent special damage claims under a third‐party insurance regime than they will be under a first‐party insurance regime in which access to general damages is limited.
On the Consequences of Behavioral Adaptations in the Cost–Benefit Analysis of Road Safety Measures
Authors: Gossner Olivier , Picard Pierre 
Published: November 2005

AbstractIt is sometimes argued that road safety measures or automobile safety standards fail to save lives because safer highways or safer cars induce more dangerous driving. A similar but less extreme view is that ignoring the behavioral adaptation of drivers would bias the cost–benefit analysis of a traffic safety measure. This article derives cost–benefit rules for automobile safety regulation when drivers may adapt their risk‐taking behavior in response to changes in the quality of the road network. The focus is on the financial externalities induced by accidents because of the insurance system as well as on the consequences of drivers' risk aversion. We establish that road safety measures are Pareto improving if their monetary cost is lower than the difference between their (adjusted for risk aversion) direct welfare gain with unchanged behavior and the induced variation in insured losses due to drivers' behavioral adaptation. The article also shows how this rule can be extended to take other accident external costs into account.
A Note on Bonus Scales
Authors: Andrade e Silva João Manuel , Centeno Maria de Lourdes 
Published: November 2005

AbstractWe revisit the optimal bonus scales introduced by Norberg (Norberg, R., 1976, Scandinavian Actuarial Journal (2): 92‐107), Borgan, Hoem, and Norberg (Borgan, O., J. Hoem, and R. Norberg, 1981, Scandinavian Actuarial Journal (2): 165‐178), and Gilde and Sundt (Gilde, V., and B. Sundt, 1989, Scandinavian Actuarial Journal (1): 13‐22) and underline some potential problems of the linear scales. As a possible solution we propose the use of geometric scales.
Symptom dimensions in obsessive–compulsive disorder: prediction of cognitive‐behavior therapy outcome
Authors: Rufer M. , Fricke S. , Moritz S. , Kloss M. , Hand I. 
Published: November 2005

Objective:  A significant number of patients with obsessive–compulsive disorder (OCD) fail to benefit sufficiently from treatments. This study aimed to evaluate whether certain OCD symptom dimensions were associated with cognitive‐behavioral therapy (CBT) outcome.Method:  Symptoms of 104 CBT‐treated in‐patients with OCD were assessed with the clinician‐rated Yale‐Brown Obsessive–Compulsive Scale symptom checklist. Logistic regression analyses examined outcome predictors.Results:  The most frequent OCD symptoms were aggressive and contamination obsessions, and compulsive checking and cleaning. Patients with hoarding symptoms at baseline (n = 19) were significantly less likely to become treatment responders as compared to patients without these symptoms. Patients with sexual and religious obsessions tended to respond less frequently, although this failed to reach statistical significance (P = 0.07). Regression analyses revealed that higher scores on the hoarding dimension were predictive of non‐response, even after controlling for possible confounding variables.Conclusion:  Our results strongly indicate that in‐patients with obsessive–compulsive hoarding respond poorly to CBT.
Epidermale Stammzellen
Authors: Rzepka Karin , Schaarschmidt Grit , Nagler Michael , Wohlrab Johannes 
Published: November 2005

ZusammenfassungDas moderne Verständnis der Biologie epidermaler Stammzellen eröffnet eine völlig neue Sichtweise der Funktion der Epidermis und angrenzender Epithelien. Aus dem Wissen um die Proliferation, Differenzierung und Regeneration von Keratinozyten ergeben sich eine Vielzahl pathogenetischer sowie klinisch‐therapeutischer Ansatzpunkte für verschiedenste Dermatosen.Das Reservoir epidermaler Stammzellen findet sich in der interfollikulären Epidermis, der Haarbalgregion und der germinalen Haarfollikelmatrix. Hier existieren eigene Stammzellklone, die als Nachkommen transient amplifizierende und postmitotische Zellen bilden. Diese sind das zellbiologische Äquivalent des Stratum germinativum der Epidermis. Die Stammzellklone sind in Clustern organisiert und weisen eine hohe Expression von Adhäsionsproteinen auf, die ihre Stabilität in einer spezifischen Umgebung aus Subpopulationen von Gewebszellen und extrazellulären Substraten in der so genannten Stammzellnische sichern. Die Differenzierung wird durch eine regulatorische Kaskade chemischer Signale aus dem Umfeld der Stammzellen sowie dem Erbgut der Zelle bestimmt.Die klinische Bedeutung von Stammzellen liegt vor allem in der Nutzung zur Therapie von Krankheiten, wobei durch Reimplantation autologer Stammzellen Epithelien rekonstruiert bzw. durch gezielte Transfektion gentherapeutische Ziele verfolgt werden können. Allerdings kann das Verhältnis von therapeutischem Nutzen zu den Risiken bisher nur begrenzt abgeschätzt werden.
Transglutaminases as diagnostically relevant autoantigens in patients with gluten sensitivity
Authors: Heil Peter Maximilian , Volc‐Platzer Beatrix , Karlhofer Franz , Gebhart Walter , Huber Wolf‐Dietrich , Benesch Thomas , Vogelsang Harald , Stingl Georg 
Published: November 2005

Summary Background: Patients with gluten sensitivity, i. e. celiac disease and dermatitis herpetiformis have anti‐endomysial antibodies recognizing transglutaminases, which are usually detected on appropriate tissue sections. It would be desirable to have available a reliable, tissue‐independent serological diagnostic tool. We compared disease‐specificity and sensitivity of tTG versus eTG‐based detection systems for the diagnosis of anti‐endomysial IgA‐antibodies. Patients and Methods: We examined 204 serum samples in duplicates with commercial human ELISA‐kits: 54 healthy blood donors, 20 celiac disease, 29 dermatitis herpetiformis and 101 with other autoimmune dermatoses. Results: The tTG‐based ELISA proved to be very disease‐specific (100 %) and sensitive for the diagnosis of gluten sensitivity (95 % celiac disease; 96.6 % dermatitis herpetiformis). The eTG‐based ELISA was also perfectly specific (100 %), but only 15 % of celiac disease‐sera and 44.8 % of dermatitis herpetiformis‐sera yielded positive results. Conclusions: The human tTG‐ELISA fulfills all criteria of a screening test and, because of being investigator‐independent, inexpensive and highly reproducible, compares favorably with the current diagnostic gold standard (indirect immunofluorescence and biopsy) of celiac disease and dermatitis herpetiformis. The low sensitivity of the eTG‐ELISA may have technical reasons, but could theoretically also be linked to disease activity or indicate the existence of an as yet undefined disease subset. Studies are currently under way to address these issues.
Anogenitaldermatosen – allergische und irritative Auslösefaktoren Analyse von Daten des IVDK1 und Literaturübersicht
Authors: Kügler Katrin , Brinkmeier Thomas , Frosch Peter J. , Uter Wolfgang 
Published: November 2005

Zusammenfassung Hintergrund: Anogenitaldermatosen (AGD) sind häufige und psychisch sehr belastende Erkrankungen. Klinisch ist oft unklar, ob eine Kontaktallergie oder irritative Faktoren beteiligt sind. Bezüglich Therapie und Prophylaxe ist von Bedeutung, welche Allergene oder Irritantien dann die Hauptrolle spielen. Patienten und Methoden: Daten des Informationsverbundes Dermatologischer Kliniken (IVDK, Zentrale in Göttingen) von 1999 bis 2003 wurden ausgewertet. 1 168 Patienten mit der Hauptdiagnose AGD wurden bezüglich klinischer Parameter und der Ergebnisse der Epikutantestung mit dem Gesamtkollektiv verglichen. Die Reaktionsquoten wurden alters‐ und geschlechtsstandardisiert. Ergebnisse: Der Verdacht auf ein allergisches Kontaktekzem bestand bei 39,5 % vor der Epikutantestung. Nach der Testung wurde bei 24,6 % die AGD als allergisches Kontaktekzem eingeordnet; eine chronisch irritative Dermatitis wurde bei 11,8 % diagnostiziert. Sonstige Diagnosen waren „Balanitis”, Lichen sclerosus et atrophicus sowie Herpes genitalis. Signifikant erhöhte Sensibilisierungsquoten gegenüber dem Kontrollkollektiv zeigten sich bei Patienten mit AGD für Cinchocain (6,6 %), Bufexamac (3,5 %) und Benzocain (2,4 %). Sofern irritative Faktoren eine Rolle als Ko‐Faktoren spielten (n = 422), wurden Feuchtigkeit (38,4 %), okklusives Milieu (30,3 %), mechanische Belastung (4,7 %) und Hitze (3,6 %) genannt. Schlussfolgerung: Sensibilisierungen auf Cinchocain, Benzocain und Bufexamac kommen bei Patienten mit AGD häufiger vor als bei Patienten mit anderen Dermatosen. Daher sollten Medikamente mit diesen Wirkstoffen in der Praxis sehr zurückhaltend eingesetzt werden. Die Inhaltsstoffe von Wasch‐/Pflegemitteln sowie Kontrazeptiva verschiedenen Typs scheinen nach der Literatur insgesamt selten zu einer Kontaktallergie zu führen, obwohl kasuistische Mitteilungen vorhanden sind. Die ausführliche Testung mit der DKG‐Standardreihe, den oben genannten Hauptsensibilisatoren Cinchocain, Benzocain und Bufexamac, und insbesondere mit den vom Patienten verwendeten Pflege‐ und Hilfsmitteln wird empfohlen.
Polling Opinions in the 2005 Election
Authors: Baines Paul 
Published: November 2005

Abstract
The winners of the General Election in May were not the political parties but the opinion pollsters, says Paul Baines. After 1992, when most pollsters predicted a hung parliament rather than a Conservative win, and 2001, when they overestimated the Labour lead, the 2005 election result was awaited by many pollsters with trepidation. Would their final eve-of-poll results be accurate or not?
Structure And Uncertainty: Graphical Models for Understanding Complex Data
Authors: Best Nicky , Green Peter 
Published: November 2005

AbstractStatistics is fundamental to making sense of the complexity of modern science. From the micro-level of the human genome to the macro-level of the universe, scientists need statistical models to help them extract meaning from empirical observations. Graphical models have been used across a wide variety of disciplines for building multivariate probabilistic models to represent, and draw inference about, complex phenomena. Nicky Best and Peter Green explain the ideas behind graphical models and show how they can be used to help tackle the challenges of complex statistical problems.
Informed consent and participant perceptions of influenza vaccine trials in South Africa
Authors: Moodley K , Pather M , Myer L 
Published: November 2005

Background and objectives:There are few insights from sub-Saharan Africa on research participants’ experiences of the informed consent process, particularly in the context of randomised controlled trials, where issues of randomisation and the use of placebos may be confusing concepts for participants. This study investigated the knowledge and perceptions of the informed consent process among individuals participating in influenza vaccine trials in two disadvantaged communities in South Africa.Method:Four to 12 months after completion of the trials, participants were contacted to return to participate in the informed consent study. The semistructured questionnaire administered to assess recall of trial procedures and the informed consent process covered key issues including: purpose of the study; awareness that the study was not part of routine treatment; voluntary nature of participation and freedom to withdraw; randomisation; placebos; and remuneration.Results:A total of 334 participants (93% of the original vaccine trial sample; mean age 68 years, median level of education grade 8, 69% women) completed the questionnaire. Only 21% were able to recall that they were allocated randomly to the different treatment arms. Only 19% of those involved in the placebo controlled study had interpreted the concept of placebo as an inactive medication.Conclusion:Although a good general recall of trial concepts was demonstrated, only a small proportion of the participants correctly interpreted and recalled the concepts of randomisation and placebos. Informed consent in this and similarly disadvantaged communities may often be inadequate and new ways to improve understanding of the research process should be explored.
Parental preferences for neonatal resuscitation research consent: a pilot study
Authors: Culbert A , Davis D J 
Published: November 2005

Objective:Obtaining informed consent for resuscitation research, especially in the newborn, is problematic. This study aimed to evaluate parental preferences for hypothetical consent procedures in neonatal resuscitation research.Design:Mail-out survey questionnaire.Setting/participants:Randomly selected parents who had received obstetrical or neonatal care at a tertiary perinatal centre.Main outcome measures:Parental levels of comfort (Likert-type scale 1–6) regarding different methods of obtaining consent in hypothetical resuscitation research scenarios.Results:The response rate was 34%. The respondents were a group of highly educated women with a higher family income than would be expected in the general population. In terms of results, parents valued the impact the research would have on their baby and the importance of a positive interaction with the physicians conducting the research study. Parents felt most comfortable with prospective consent in the setting of prenatal classes or prenatal visits with a physician, but they were somewhat uncomfortable with prospective consent upon admission to hospital after labour had begun. Parents were uncomfortable with waived consent, deferred consent, and opting out, no matter when during the pregnancy consent was requested.Conclusion:This pilot study reports parental preferences for prenatal information and consent for such research trials of neonatal resuscitation. A low response rate and potentially skewed demographics of the respondents prevent generalisability of this result. Interview studies should be performed to better determine parental preferences for informed consent in a more representative population.
Unemployment and smoking: does psychosocial stress matter?
Authors: De Vogli R , Santinello M 
Published: November 2005

Aim:Research indicates that cigarette smoking is strongly associated with unemployment. However, little is known regarding the underlying mechanisms explaining this relationship. The aim of this study is to examine the role of psychosocial factors as potential mediators between unemployment and smoking.Participants:4002 non-institutionalised, civilian adults living in the Veneto region of Italy.Design:The study was based on a computer assisted telephone interview (CATI). Linear by linear association tests were used to examine bivariate associations between unemployment, psychosocial factors, and smoking. Logistic regression models were developed to analyse the relationship between unemployment and smoking when adjusting for psychological factors.Results:The odds of smoking among the unemployed was 2.78 times (95% confidence interval (CI) 1.68 to 4.62) greater than that of higher managers and professionals controlling for demographic factors. The relationship between unemployment and smoking weakened (odds ratio 2.41, 95% CI 1.43 to 4.05) when psychosocial factors were entered into the analysis. The odds of the inability to control important things in life was 1.39 times (95% CI 1.11 to 1.75) greater, and the odds of emotional isolation was 1.45 times (95% CI 1.06 to 1.99) greater, among smokers compared to non-smokers controlling, for all other factors.Conclusions:Given that the data were cross sectional, firm conclusions cannot be drawn regarding the causal pathway connecting unemployment and smoking. However, this study suggests that psychosocial factors such as the inability to control and emotional isolation may be plausible mediators for the relationship.