bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome after extended callosal section in patients with primary idiopathic generalized epilepsy
Authors: Cukiert Arthur , Burattini Jose Augusto , Mariani Pedro Paulo , Cukiert Cristine Mella , Argentoni‐Baldochi Meire , Baise‐Zung Carla , Forster Cássio Roberto , Mello Valeria Antakli 
Published: November 2008

SummaryPurpose:  We report the outcome of patients with refractory idiopathic generalized epilepsy (IGE) who were submitted to extended one‐stage callosal section.Methods:  Eleven patients with IGE who were submitted to extended one‐stage callosal section were studied. Preoperative workup included history and neurologic examination, interictal, and ictal electroencephalography (EEG) recording, high resolution 1.5T magnetic resonance imaging (MRI) and intelligence quotient (IQ) testing. All patients were submitted to extended one‐stage microsurgical callosal section, leaving only the splenium intact.Results:  Preoperative ictal patterns included repetitive spike and wave or polyspike and wave discharges or fast epileptic recruiting rhythm. MRI showed no focal lesions. Preoperatively, mean general IQ was 85. Postoperatively, at least a 75% reduction in the frequency of generalized tonic–clonic seizures was noted in all patients. In three patients absences disappeared completely, and the others had at least 90% reduction in seizure frequency. Only one patient had myoclonic seizures preoperatively, and these seizures disappeared after callosal section. After surgery, mean general IQ was 89. A very clear increase in attention level was noted in all patients. Postoperative interictal EEG recordings showed rupture of bilateral synchrony in all patients.Discussion:  This article reports on a large and homogeneous series of patients with refractory IGE submitted for callosal section. There was a marked decrease in generalized seizure frequency and increase in the attention level in this patient population. Our results suggest that corticocortical interaction might have a role in IGE pathogenesis. Callosotomy is a safe, effective, and underused palliative procedure in these well‐selected patients with refractory IGE.
Monoamine variability in the chronic model of atypical absence seizures
Authors: Bercovici Eduard , Cortez Miguel A. , Wang Xiaomei , Snead III O. Carter 
Published: November 2008

SummaryPurpose:  We studied the variability of the slow‐spike‐and‐wave discharges (SSWDs) derived from AY‐9944 (AY) treatment during brain development of Long‐Evans hooded (LEh) rats.Methods:  Although all LEh rats received the standard dose of AY (7.5 mg/kg), we have observed an intersubject variability of the total SSWD duration at postnatal day (P) 55. Therefore, we set out to investigate the underlying brain levels of norepinephrine (NE), dopamine (DA), and serotonin (5‐HT) and its metabolite (5‐HIAA), as determined by high‐performance liquid chromatography (HPLC) analyses from four different brain regions: thalamus (Th), frontoparietal cortex (Cx), hippocampus (Hp), and brainstem (Bs).Results:  All brains were obtained after two baseline electrocorticographic (ECoG) recordings with characteristic chronic, recurrent, bilaterally synchronous 4–6 Hz SSWD, at P 55 (336.25 ± 97.23 s/h) and P60 (494.50 ± 150.36 s) (r = 0.951, r2 = 0.904, p < 0.005, Pearson product). The thalamic NE levels and the brainstem NE, DA, and 5HT levels were all significantly correlated with baseline SSWD duration at P55 and P60 (p < 0.01, Pearson product).Conclusion:  Our data indicate that brain monoamine levels may determine the intersubject variability of SSWD duration in AY rats with chronic atypical absence seizures.
New‐onset geriatric epilepsy care: Race, setting of diagnosis, and choice of antiepileptic drug
Authors: Hope Omotola A. , Zeber John E. , Kressin Nancy R. , Bokhour Barbara G. , VanCott Anne C. , Cramer Joyce A. , Amuan Megan E. , Knoefel Janice E. , Pugh Mary Jo 
Published: November 2008

SummaryPurpose:  There is a growing movement to assess the quality of care provided to patients in the US, but few studies have examined initial care for epilepsy patients. We examined the relationships among patient race, setting of initial diagnosis, and initial treatment for older veterans newly diagnosed with epilepsy.Methods:  We used Department of Veterans Affairs (VA) inpatient, outpatient, pharmacy and Medicare data (1999–2004) to identify patients 66 years and older with new‐onset epilepsy. High quality care was defined as avoiding a suboptimal agent (phenytoin, phenobarbital, primidone) as defined by experts. Predictors included demographic and clinical characteristics, and the context of the initial seizure diagnosis including the setting (e.g. emergency, neurology, hospital, primary care). We used mixed‐effects multivariable logistic regression modeling to identify predictors of initial seizure diagnosis in a neurology setting, and receipt of a suboptimal AED.Results:  Of 9,682 patients, 27% were initially diagnosed in neurology and 70% received a suboptimal AED. Blacks and Hispanics were less likely to be diagnosed in neurology clinics (black OR = 0.7 95% CI 0.6–0.8; Hispanic OR = 0.6 95% CI 0.5–0.9). Diagnosis in a non‐neurology setting increased the likelihood of receiving a suboptimal agent (e.g. Emergency Department OR = 2.3 95% CI 2.0–2.7). After controlling for neurology diagnosis, black race was independently associated with an increased risk of receiving a suboptimal agent.Discussion:  We demonstrated that differences in quality of care exist for both clinical setting of initial diagnosis and race. We discussed possible causes and implications of these findings.
Neutrophils of Centenarians Show Function Levels Similar to Those of Young Adults
Authors: Alonso‐Fernández Patricia , Puerto Marta , Maté Ianire , Ribera José Manuel , De La Fuente Mónica 
Published: November 2008

OBJECTIVES: To analyze several functions and antioxidant parameters of peripheral blood neutrophils from healthy centenarians (men and women) and compare them with those of healthy young (aged 25–35) and middle‐aged (aged 65–75) men and women.DESIGN: Cross‐sectional study.SETTING: Community‐based.PARTICIPANTS: Twenty‐one healthy centenarians (8 men), 30 young adults (15 men), and 30 middle‐aged adults (15 men).MEASUREMENTS: Several neutrophil functions (adherence, chemotaxis, phagocytosis, and stimulated and nonstimulated intracellular superoxide anion levels) and antioxidant parameters (glutathione levels and catalase activity) were measured in peripheral blood neutrophil suspension in the three study groups.RESULTS: Neutrophil functions of the middle‐aged group were worse than those of young adults and centenarians (lower chemotaxis and phagocytosis and higher adherence and superoxide anion levels). The neutrophil functions of the centenarians were closer to those of the young adults. Age‐related differences in neutrophil functions were fundamentally similar in men and women, except for intracellular superoxide anion levels, which were lower in young adult women than in young adult men. With normal aging, total glutathione levels decrease, but the centenarians in this study showed levels similar to those of young adults. Centenarians showed the highest catalase activity of the three groups.CONCLUSION: Progressive impairment of the immune system accompanies aging. The better preservation of function and antioxidant systems in the neutrophils of centenarians could play a key role in the longevity of these subjects.
The Effect of Surgical Site Infection on Older Operative Patients
Authors: Kaye Keith S. , Anderson Deverick J. , Sloane Richard , Chen Luke F. , Choi Yong , Link Katherine , Sexton Daniel J. , Schmader Kenneth E. 
Published: November 2008

OBJECTIVES: To determine the effect of surgical site infection (SSI) on mortality, duration of hospitalization, and hospital cost in older operative patients.DESIGN: Retrospective matched‐outcomes study.SETTING: Eight hospitals, including Duke University Medical Center, and seven community hospitals.PARTICIPANTS: Patients aged 65 and older undergoing surgery from 1991 to 2003. Cases were defined as patients who developed deep incisional or organ or space SSI; controls were operative patients who did not develop SSI. Controls were frequency matched to cases according to type and year of operative procedure and to hospital in a 1:1 ratio.MEASUREMENTS: Mortality, duration of hospitalization (including re‐admissions), and hospital charges for the 90 days after surgery.RESULTS: One thousand three hundred thirty‐seven patients were enrolled in the study: 561 cases with SSI and 576 controls without SSI. In cases, the most common SSI pathogen was Staphylococcus aureus (n=275, 51.6%). Of S. aureus isolates, 58.2% were methicillin resistant. One hundred sixteen subjects died within 90 days of surgery (8.6%). In multivariable analysis, SSI was associated with greater mortality risk (odds ratio (OR)=3.51, 95% confidence interval (CI)=2.20–5.59), 2.9 times longer postoperative hospitalization (95% CI=2.61–3.13), and 1.9 times greater hospital charges (95% CI=1.78–2.10).CONCLUSION: In elderly operative patients, SSI was associated with almost 4 times greater mortality, a mean attributable duration of hospitalization after surgery of 15.7 days (95% CI=13.9–17.6) and mean attributable hospital charges of $43,970 (95% CI=$31,881–56,060).
Pain Assessment in Persons with Dementia: Relationship Between Self‐Report and Behavioral Observation
Authors: Horgas Ann L. , Elliott Amanda F. , Marsiske Michael 
Published: November 2008

OBJECTIVES: To investigate the relationship between self‐report and behavioral indicators of pain in cognitively impaired and intact older adults.DESIGN: Quasi‐experimental, correlational study of older adults.SETTING: Data were collected from residents of nursing homes, assisted living, and retirement apartments in north‐central Florida.PARTICIPANTS: One hundred twenty‐six adults, mean age 83; 64 cognitively intact, 62 cognitively impaired.MEASUREMENTS: Pain interviews (pain presence, intensity, locations, duration), pain behavior measure, Mini‐Mental State Examination, analgesic medications, and demographic characteristics. Participants completed an activity‐based protocol to induce pain.RESULTS: Eighty‐six percent self‐reported regular pain. Controlling for analgesics, cognitively impaired participants reported less pain than cognitively intact participants after movement but not at rest. Behavioral pain indicators did not differ between cognitively intact and impaired participants. Total number of pain behaviors was significantly related to self‐reported pain intensity (β=0.40, P=.000) in cognitively intact elderly people.CONCLUSION: Cognitively impaired elderly people self‐report less pain than cognitively intact elderly people, independent of analgesics, but only when assessed after movement. Behavioral pain indicators do not differ between the groups. The relationship between self‐report and pain behaviors supports the validity of behavioral assessments in this population. These findings support the use of multidimensional pain assessment in persons with dementia.
Chronic Pain and Obesity in Elderly People: Results from the Einstein Aging Study
Authors: McCarthy Lucas H. , Bigal Marcelo E. , Katz Mindy , Derby Carol , Lipton Richard B. 
Published: November 2008

OBJECTIVES: To determine the prevalence of chronic pain in elderly people and its relationship with obesity and associated comorbidities and risk factors.DESIGN: Cross‐sectional.SETTING: Community.PARTICIPANTS: A representative community sample of 840 subjects aged 70 and older.MEASUREMENTS: The prevalence of chronic pain and its relationship with obesity (categories defined according to body mass index (BMI)), other medical risk factors, and psychiatric comorbidities were examined. Chronic pain was defined as pain of at least moderate severity (≥4 on a 10‐point scale) some, most, or all of the time for the previous 3 months.RESULTS: The sample was mostly female (62.8%), and the average age was 80 (range 70–101). The prevalence of chronic pain was 52% (39.7% in men; 58.9% in women). Subjects with chronic pain were more likely to report a diagnosis of depression (odds ratio (OR)=2.5, 95% confidence interval (CI)=1.40–4.55) and anxiety (OR=2.3, 95% CI=1.22–4.64). Obese subjects (BMI 30–34.9) were twice as likely (OR=2.1, 95%CI=1.33–3.28) and severely obese subjects (BMI≥35) were more than four times as likely (OR=4.5, 95% CI=1.85–12.63) as those of normal weight (BMI 18.5–24.9) to have chronic pain. Obese subjects were significantly more likely to have chronic pain in the head, neck or shoulder, back, legs or feet, and abdomen or pelvis than subjects who were not obese. In multivariate models, obesity (OR=2.0, 95% CI=1.27–3.26) and severe obesity (OR=4.1, 95% CI=1.57–10.82) were associated with chronic pain after adjusting for age, sex, diabetes mellitus, hypertension, depression, anxiety, and education.CONCLUSION: Chronic pain is common in this elderly population, affects women more than men, and is highly associated with obesity.
Predicting blood donation intentions and behavior among Australian blood donors: testing an extended theory of planned behavior model
Authors: Masser Barbara M. , White Katherine M. , Hyde Melissa K. , Terry Deborah J. , Robinson Natalie G. 
Published: November 2008

BACKGROUND: Donor retention poses a significant problem to blood collection agencies around the world. Previous research using an augmented theory of planned behavior (TPB) approach has demonstrated that attitude, subjective norm, self‐efficacy, moral norm, anticipated regret, donation anxiety from prior blood donations, and self‐identity as a blood donor predicts experienced donors' intentions and that intentions, self‐efficacy, moral norm, and anticipated regret may impact upon people's actual blood donation behavior.STUDY DESIGN AND METHODS: Established blood donors (n = 263) completed questionnaires assessing standard TPB constructs, anticipated regret, moral norm, donation anxiety, and self‐identity as a blood donor. Three months later, a second questionnaire assessing blood donation behavior in the intervening 3 months was mailed and returned by 182 donors.RESULTS: With structural equation modeling, the final augmented TPB model provided an excellent fit to the data and included a direct path from intention to behavior and indirect paths to behavior through intention for attitude, self‐efficacy, and anticipated regret. Moral norm, donation anxiety, and donor identity indirectly predicted intention through attitude. In total, 51 percent of the variance in donors' attitudes, 86 percent of variance in donors' intentions, and 70 percent of the variance in donors' behavior were accounted for in the final model.CONCLUSION: An augmented TPB framework proved efficacious in determining the predictors of the intentions and behavior of established blood donors. Further, this framework highlighted the importance of considering in the future how donors' motivations for donating blood may evolve as a function of the number of prior donations.
Lay Public or Experts? e‐Participation in Authorization for GMO Products in the European Union
Authors: Ferretti Maria Paola , Lener Matteo 
Published: November 2008

AbstractIn the European Union, for the first time, lay people can participate directly in the procedure of assessment of GMO (genetically modified organisms) products, an exercise normally reserved for scientists and legal experts. What makes this a unique strategy of participation is that for each single application for authorization, lay people have the opportunity to express their views. This article presents the result of the first in‐depth analysis of this type of Internet participatory exercise in the first years of its implementation. It shows that, despite generally participatory technology assessment aims at deliberative consensus on technical questions, this forum is instead a way to expose the work of regulative authorities to public scrutiny and to express dissent and opposition to the European Commission policy on GMOs.
Assessing Material and Symbolic Variations in Punctuated Equilibrium and Public Policy Output Patterns
Authors: Givel Michael 
Published: November 2008

AbstractNumerous researchers have confirmed sharp and punctuated policy change. Newer findings in U.S. forest policy in the Pacific Northwest and U.S. state tobacco policy have found largely nonpunctuated changes. What are the implications for punctuated equilibrium theory? U.S. state tobacco policy‐making from 1990 to 2006 indicates a wide variety of nonpunctuated policy output patterns including: linear and constant, gently oscillating and increasing, linear and increasing, and linear and constant and then nonexponentially increasing. All nonpunctuated policies resulted in symbolic policy output change except state tobacco licensing, higher tobacco taxes, and enactment of clean indoor air legislation, which resulted in partially material and partially symbolic policy output change. Emerging from this research is a new public policy model based on social policy realism. Public policy output change can be quite complex, sometimes punctuated and sometimes not, reflecting the balance of power between sometimes competing and cooperating interest groups.
Current Funding Practices in Academic Science Stifle Creativity
Authors: Carlson Toby N. 
Published: November 2008

AbstractMoney is trumping creativity in academic science. This statement was previously given substance in an article I published, along with a companion paper by Mark Roulston in the Bulletin of the American Meteorological Society (Carlson, 2006a;Roulston, 2006) and in a subsequent address I gave to the Heads and Chairs meeting in Boulder, Colorado (Carlson, 2006b). Here, I expand further on the issues treated in these papers, and make a plea for changing the way funding is administered in academic science. Using examples I show that the present worsening situation places a dead hand on the spirit and creative output of academic scientists, especially junior faculty. I suggest a possible solution, which would enable academic scientists to function in a stable environment, free from spurious financial pressures and dictates from university administration and funding agencies.
Intelligently Designing Deliberative Health Care Forums: Dewey's Metaphysics, Cognitive Science and a Brazilian Example
Authors: Ralston Shane J. 
Published: November 2008

Imagine you are the CEO of a hospital [. . .]. Decisions are constantly being made in your organization about how to spend the organization's money. The amount of money available to spend is never adequate to pay for everything you wish you could spend it on, therefore you must set spending priorities. There are two questions you need to be able to answer . . . How should we set priorities in this organization? How do we know when we are doing it well?When people seek to achieve good public policy, the result will tend to be good public policy. In a collective choice process, public‐spirited individual participants produce good public policy by deliberating—talking with each other, listening to each other's arguments, and being willing to learn and change their minds based on such dialogue. –Steven Kelman (1992: 181)
Public policy scholars agree that those persons (or agencies) vested with the authority to establish health care priorities should elicit public input before making rationing decisions. The two most common approaches are (i) consultation and (ii) deliberation. Though deliberation has obvious advantages over consultation, it falters in the face of the objection that ordinary citizens lack the cognitive resources for the extended, rigorous inquiry required of them in undertaking the priority‐setting task. To overcome this objection, I propose that deliberative forums for health care rationing should be designed so that they imitate the natural pattern of human experience. The experience of deliberation should encompass both prolonged periods of less‐demanding cognitive activity, in which citizens passively receive information, and briefer periods of more‐demanding cognitive activity, in which they engage in active problem‐solving. In arguing for this thesis, I rely on two theoretical sources and one practical case study, in the following order: (i) John Dewey's metaphysics of experience, (ii) cognitive science research on schemas and frames, and (iii) the Health Care Council in São Paulo, Brazil.
Figures of transversality: State power and prenatal screening in contemporary Vietnam
Authors: GAMMELTOFT TINE M. 
Published: November 2008

ABSTRACTIn this article, I explore how prenatal screening is imbricated within state agendas, aspirations, and imaginings in contemporary Vietnam. In an effort to develop new ethnographic tropes for understanding the formation called “the state,” I argue for a phenomenological take that emphasizes its affective and embodied aspects. Seeing the anomalous fetus as a “figure of transversality,” as a critical focus for powerful imaginings and desires, I show how state–society relations in Vietnam are suffused by visceral affectivity and moral engagement. In the realm of reproduction, intense sentiments of anxiety, dread, desire, ambition, and hope tie together the state and its citizens, animating individual aspirations as well as national population policies. [state, science, technology, population, disability, Vietnam]
Arts and owners: Intellectual property law and the politics of scale in Indonesian arts
Authors: ARAGON LORRAINE V. , LEACH JAMES 
Published: November 2008

ABSTRACTInternational and national agendas are redesigning the terms of intellectual‐property (IP) laws to create cultural property for developing nations. Debates over IP and cultural‐property “rights” or legal needs for “protection” are critical to anthropology's effort to reflect on how the production of knowledge, even culture itself, is variously construed to originate with, or “belong to,” particular individuals, ethnic communities, or nation‐states. We explore the implications of two Indonesian legal documents to show the disjunction between discourses of regional artists who describe the ritual exchanges, relationships, and transgenerational messages their arts shape and (inter)nationalist legal initiatives that bypass artists' concepts of process, access, and authority in an effort to disembed and control ritual‐based expressions as products with exclusive owners. [intellectual property, cultural property, law, art, tradition, globalization, Indonesia]
The banana plant and the moon: Conservation and the Malagasy ethos of life in Masoala, Madagascar
Authors: KELLER EVA 
Published: November 2008

ABSTRACTFor people in rural Madagascar, the growth of one's kin group and the joint processes of movement and anchorage in the land are fundamental aspects of a successful life. In this article, I examine the clash between the Malagasy ethos of growth and the canonical conservationist ethos of static equilibrium. I argue that biodiversity conservation on the Masoala peninsula leaves local people with a sense of having been defeated in the purpose of life as they understand it. I further suggest that, in the case of people of slave descent, such defeat reverses the historical process of shedding slave status. [Madagascar, Masoala, conservation, national parks, concepts of growth, slavery]