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Research Unit (research + unit)
Selected AbstractsSpecial Hospitals' Research Unit and beyondCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue S1 2002Professor Keith Soothill First page of article [source] Integrating Research into Clinical Practice: Development of an Echocardiography Research UnitECHOCARDIOGRAPHY, Issue 6 2009R.D.C.S., Tammy M. Green B.A. Introducing a research program into an echocardiography clinical practice can pose many challenges. Some initial factors to consider are the possible effects on the current clinical schedule and the equipment and personnel resources required to support the research projects. More importantly, how can an organization successfully complete reliable and accurate research projects? Here, we describe our experience with establishing an echocardiography research center within our clinical echocardiography practice. In addition, we identify key staff roles, highlight our current research practice methods, and suggest essential components that may prove advantageous when incorporating echocardiography research into a clinical practice. (ECHOCARDIOGRAPHY, Volume 26, July 2009) [source] Seeing America,diary of a drug-focused study tour made in 1967ADDICTION, Issue 6 2010Griffith Edwards ABSTRACT In 1965 the British government was forced to admit that the country had an escalating heroin problem, with the supply coming mainly from prescribing by private practitioners. Within the official responses to what was seen at that time as a very worrying public health situation was the decision to fund the setting-up of the Addiction Research Unit (ARU) at the Institute of Psychiatry, London. The US National Institute of Mental Health (NIMH) generously sponsored a study tour for the nominated director of the ARU shortly before the opening of the British research centre. Extensive contemporaneous diary notes of a visit included contact with administrators, researchers, clinicians, parish priests, narcotic agents and addicts themselves. From a mass of often conflicting advice, some insights could be derived. In particular, these included the need for an awareness of any country's way of dealing with drug problems as a dynamic, multi-factorial total system,a holistic ,national response'. A further conclusion was to see policy itself as a complex subject for analysis: drug policy should be as much an issue for research as drug taking. Besides these broad conclusions, the experience provided many specific leads to development of a British addiction research programme, and fostered professional friendships of immeasurable worth. [source] Efficacy screening trials of paroxetine, pentoxifylline, riluzole, pramipexole and venlafaxine in cocaine dependenceADDICTION, Issue 2005Domenic A. Ciraulo ABSTRACT Aims The two studies presented here were conducted to assess the efficacy of paroxetine, pentoxifylline, riluzole, venlafaxine and pramipexole as medications for the treatment of cocaine dependence. Design A multi-arm, modified blinded, placebo-controlled design was used. Setting The studies were conducted at the Boston VA Healthcare System and the Boston University School of Medicine Medication Development Research Unit (MDRU). Participants Participants met criteria for cocaine dependence during a 2-week screening period. Intervention Following random assignment to one of the treatment groups, subjects received active medication or placebo for 8 weeks in combination with cognitive behavioral counseling. In the first study the efficacy of the antidepressant paroxetine (20 mg daily), the phosphodiesterase inhibitor pentoxifylline (1200 mg daily) and the glutamate release inhibitor riluzole (100 mg daily) was assessed. The antidepressant venlafaxine (150 mg daily) and the dopamine agonist pramipexole (1.5 mg daily) were evaluated in the second study. Measurements Urine benzoylecgonine (BE) concentrations, self-report of cocaine use and global impression scores served as primary outcome measures. Secondary measures included assessments of cocaine craving and psychiatric functioning. Adverse events were monitored during the treatment period. Findings None of the active medications produced greater reductions in urine BE concentrations over the treatment period than did placebo. There were trends for BE levels to become reduced in the pentoxifylline group during the first 4 weeks of treatment and for Addiction Severity Index (ASI) drug composite scores to be lower in the pentoxyfylline group at end-point compared to the placebo group. Significant within-group reductions in reported cocaine use and craving were found for all treatment groups, but none of the active medications were superior to placebo on these measures. The accuracy of self-reported cocaine use declined over the study period. Overall, the active medications were well tolerated. Conclusions This study does not support the use of paroxetine, pentoxifylline, riluzole, venlafaxine or pramipexole for the treatment of cocaine dependence. However, these results need to be interpreted with caution because of the small size and lack of homogeneity of the experimental groups. [source] Crop planting dates: an analysis of global patternsGLOBAL ECOLOGY, Issue 5 2010William J. Sacks ABSTRACT Aim, To assemble a data set of global crop planting and harvesting dates for 19 major crops, explore spatial relationships between planting date and climate for two of them, and compare our analysis with a review of the literature on factors that drive decisions on planting dates. Location, Global. Methods, We digitized and georeferenced existing data on crop planting and harvesting dates from six sources. We then examined relationships between planting dates and temperature, precipitation and potential evapotranspiration using 30-year average climatologies from the Climatic Research Unit, University of East Anglia (CRU CL 2.0). Results, We present global planting date patterns for maize, spring wheat and winter wheat (our full, publicly available data set contains planting and harvesting dates for 19 major crops). Maize planting in the northern mid-latitudes generally occurs in April and May. Daily average air temperatures are usually c. 12,17 °C at the time of maize planting in these regions, although soil moisture often determines planting date more directly than does temperature. Maize planting dates vary more widely in tropical regions. Spring wheat is usually planted at cooler temperatures than maize, between c. 8 and 14 °C in temperate regions. Winter wheat is generally planted in September and October in the northern mid-latitudes. Main conclusions, In temperate regions, spatial patterns of maize and spring wheat planting dates can be predicted reasonably well by assuming a fixed temperature at planting. However, planting dates in lower latitudes and planting dates of winter wheat are more difficult to predict from climate alone. In part this is because planting dates may be chosen to ensure a favourable climate during a critical growth stage, such as flowering, rather than to ensure an optimal climate early in the crop's growth. The lack of predictability is also due to the pervasive influence of technological and socio-economic factors on planting dates. [source] Variability of the recent climate of eastern AfricaINTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 6 2004Carl J. Schreck III Abstract The primary objective of this study is to investigate the recent variability of the eastern African climate. The region of interest is also known as the Greater Horn of Africa (GHA), and comprises the countries of Burundi, Djibouti, Eritrea, Ethiopia, Kenya, Rwanda, Somalia, Sudan, Uganda, and Tanzania. The analysis was based primarily on the construction of empirical orthogonal functions (EOFs) of gauge rainfall data and on CPC Merged Analysis of Precipitation (CMAP) data, derived from a combination of rain-gauge observations and satellite estimates. The investigation is based on the period 1961,2001 for the ,short rains' season of eastern Africa of October through to December. The EOF analysis was supplemented by projection of National Centers for Environmental Prediction wind data onto the rainfall eigenmodes to understand the rainfall,circulation relationships. Furthermore, correlation and composite analyses have been performed with the Climatic Research Unit globally averaged surface-temperature time series to explore the potential relationship between the climate of eastern Africa and global warming. The most dominant mode of variability (EOF1) based on CMAP data over eastern Africa corresponds to El Niño,southern oscillation (ENSO) climate variability. It is associated with above-normal rainfall amounts during the short rains throughout the entire region, except for Sudan. The corresponding anomalous low-level circulation is dominated by easterly inflow from the Indian Ocean, and to a lesser extent the Congo tropical rain forest, into the positive rainfall anomaly region that extends across most of eastern Africa. The easterly inflow into eastern Africa is part of diffluent outflow from the maritime continent during the warm ENSO events. The second eastern African EOF (trend mode) is associated with decadal variability. In distinct contrast from the ENSO mode pattern, the trend mode is characterized by positive rainfall anomalies over the northern sector of eastern Africa and opposite conditions over the southern sector. This rainfall trend mode eluded detection in previous studies that did not include recent decades of data, because the signal was still relatively weak. The wind projection onto this mode indicates that the primary flow that feeds the positive anomaly region over the northern part of eastern Africa emanates primarily from the rainfall-deficient southern region of eastern Africa and Sudan. Although we do not assign attribution of the trend mode to global warming (in part because of the relatively short period of analysis), the evidence, based on our results and previous studies, strongly suggests a potential connection. Copyright © 2004 Royal Meteorological Society. [source] Circulation dynamics of Mediterranean precipitation variability 1948,98INTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 15 2003A. Dünkeloh Abstract Canonical correlation analysis is used to identify main coupled circulation,rainfall patterns and to relate recent variability and trends of Mediterranean precipitation to large-scale circulation dynamics. Analyses are based on geopotential heights (500 and 1000 hPa levels) for the North Atlantic,European area (National Centers for Environmental Prediction,National Center for Atmospheric Research reanalysis) and on highly resolved (0.5° × 0.5° ) monthly rainfall grids (Climatic Research Unit, Norwich) selected for the Mediterranean area during the 1948,98 period. Combining monthly analyses with similar characteristics to seasonal samples yields winter (October,March), spring (April,May) and summer (June,September) types of coupled variability; a particular autumn type for the whole Mediterranean does not occur on the monthly time scale. Coupled patterns specifically linked to one or two seasons include an east Atlantic jet (EA-Jet) related pattern for summer and a Mediterranean meridional circulation (MMC) pattern for winter and spring. The most important pattern recurring with dynamical adjustments throughout the whole year reflects the seasonal cycle of the Mediterranean oscillation (MO), which is linked (with seasonal dependence) to the Northern Hemisphere teleconnection modes of the Arctic oscillation (AO) and North Atlantic oscillation (NAO). Winter rainfall trends of the recent decades marked by widespread decreases in the Mediterranean area and by opposite conditions in the southeastern part are linked to particular changes over time in several of the associated circulation patterns. Thus, different regional rainfall changes are integrated into an overall interrelation between Mediterranean rainfall patterns and large-scale atmospheric circulation dynamics. Copyright © 2003 Royal Meteorological Society [source] Clinical networks for nursing researchINTERNATIONAL NURSING REVIEW, Issue 3 2002W. P. Gillibrand MS c Abstract As a central feature of national research and development strategies, clinical effectiveness emphasizes the importance of rigorous experimental research in nursing. It is naïve to assume that over-worked practitioners, with little research training and supervision, can undertake this type of research. Traditional approaches to research support rely on the practitioner registering for a higher degree and academic supervision. This assumes that the responsibility for research lies with practice, with higher education adopting a reactive stance in supporting research and development in nursing. The literature demonstrates a growing number of innovative models for facilitating nursing research. These, however, tend to focus on single appointments with limited and predefined access to clinical areas and patient populations. This article details a new initiative from the Clinical Nursing Practice Research Unit (CNPRU) that aims to support programmatic research in nursing practice through Clinical Networks for Nursing Research. Our research strategy is to contribute to the development of nursing science by facilitating effective collaboration between clinicians and higher education in core clinical specialties, including stroke rehabilitation, diabetes, mental health and community nursing. Each researcher has developed networks with a number of clinical areas, locally, regionally or nationally, through seminars, conferences or newsletters, to link practitioners and generate answerable research questions. Network communications also rely heavily on the establishment of interactive websites. This strategy has resulted in a number of collaborative, evaluative studies including clinical trials in rehabilitation, diabetic nursing and primary care. [source] Low plasma adiponectin concentration is associated with myocardial infarction in young individualsJOURNAL OF INTERNAL MEDICINE, Issue 2 2010J. Persson Abstract., Persson J, Lindberg K, Gustafsson TP, Eriksson P, Paulsson-Berne G, Lundman P. (Danderyd University Hospital; Karolinska Institutet, Novum; Karolinska University Hospital, Karolinska Institutet; Atherosclerosis Research Unit; Karolinska Institutet, Stockholm, Sweden). Low plasma adiponectin concentration is associated with myocardial infarction in young individuals. J Intern Med 2010; 268: 194,205. Objective., The importance of adiponectin in coronary heart disease remains to be elucidated. Therefore, the associations between plasma adiponectin levels and i) myocardial infarction and ii) genetic variation within the adiponectin gene were investigated. Methods., The study included young survivors (age <60 years) of a first myocardial infarction and gender- and age-matched controls (244 pairs). Adiponectin concentrations were analysed by radioimmunoassay. Two polymorphisms, rs266729 and rs1501299, of the adiponectin gene ADIPOQ were genotyped. Results., Adiponectin levels were inversely associated with myocardial infarction [odds ratio (OR) 9.3, 95% confidence interval (CI) 4.7,18.2, for the lowest quartile compared to the highest quartile]. This persisted after adjustment for history of hypertension, HDL cholesterol, smoking and body mass index (BMI) (OR 3.1, 95% CI 1.3,7.6). The rs266729 polymorphism was associated with adiponectin levels. Plasma adiponectin concentrations were lower in individuals with the rare G/G genotype [median 4.3 mg mL,1, interquartile range (IQR) 2.8,6.2] compared to the C/G (median 5.8 mg mL,1, IQR 3.9,8.0; P = 0.035) and C/C genotypes (median 5.5 mg mL,1, IQR 4.0,7.5; P = 0.083). Conclusion., Low plasma adiponectin concentrations are associated with myocardial infarction in individuals below the age of 60, and this remains significant after adjustment for history of hypertension, HDL cholesterol, smoking and BMI. In addition, adiponectin levels differ according to rs266729 genotype. [source] Cardiovascular disease and risk factors in persons with type 2 diabetes diagnosed in a large population screening: The Nord-Trøndelag Diabetes Study, NorwayJOURNAL OF INTERNAL MEDICINE, Issue 6 2000T. Claudi Abstract. Claudi T, Midthjell K, Holmen J, Fougner K, Krüger Ø, Wiseth R (University of Tromsø/Rønvik Health Center, Bodø; National Institute of Public Health, Community Medicine Research Unit, Verdal; University Hospital of Trondheim; and Norwegian University of Science and Technology, Trondheim, Norway). Cardiovascular disease and risk factors in persons with type 2 diabetes diagnosed in a large population screening: The Nord-Trøndelag Diabetes Study, Norway. J Intern Med 2000; 248: 493,501. Objective. To study cardiovascular status and risk factors in persons with newly diagnosed type 2 diabetes and controls in a large population. Design. Case,control study. Setting. Population screening Subjects. The screening of 74 499 individuals (88.1%), aged 20 years and older, in Nord-Trøndelag County, Norway, during 1984,86 detected 428 persons with undiagnosed diabetes according to the 1980 WHO criteria, of whom 205 attended a clinical follow-up examination assessing cardiovascular status and risk factors. Methods. For each of 205 cases, one control person matched by age and sex underwent the same clinical examination. Lipids, body mass index, waist/hip ratio, blood pressure, pulse rate, blood pressure medication, kidney function, cardiovascular disease, family history and lifestyle were recorded. Results. At the screening prior to the diagnosis of diabetes, those with diabetes reported poorer general health, less physical activity, more siblings with diabetes and more frequent use of antihypertensive medication. They had higher body mass index, systolic and diastolic blood pressure and pulse rate compared with controls. At the clinical evaluation, diabetics had higher urine albumin levels, increased waist/hip ratio, and higher total cholesterol/HDL cholesterol ratios than the controls. They also reported a greater incidence of angina pectoris and had more ECG changes. Conclusions. Diabetics presented with more cardiovascular risk factors, angina pectoris and ECG changes than the controls, and they had an established metabolic syndrome more often than controls. These results suggest that prevention of cardiovascular disease in diabetics requires earlier diagnosis of the diabetes. [source] Desmoglein 1 and 3 enzyme-linked immunosorbent assay in Iranian patients with pemphigus vulgaris: correlation with phenotype, severity, and disease activityJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 10 2007M Daneshpazhooh Abstract Background, Pemphigus vulgaris (PV) is a chronic autoimmune blistering disorder of the skin and mucosa characterized by the presence of autoantibodies against desmoglein3 (Dsg3). Some patients also have antibodies against desmoglein1 (Dsg1). The aims of this study were to evaluate the diagnostic value of Dsg enzyme-linked immunosorbent assay (ELISA) in Iranian PV patients, to assess its correlation with the clinical phenotype and severity of disease and to investigate the changes of these antibodies after treatment. Methods, Seventy-three patients with PV (29 men, 44 women) presenting to the Pemphigus Research Unit at Razi Hospital, Tehran, Iran were enrolled. ELISAs were used to detect IgG autoantibodies reactive with the ectodomains of Dsg1 and Dsg3, and the correlation of antibodies with the clinical phenotype as well as oral and skin disease severity was assessed. In addition, the tests were repeated in 18 patients after treatment and the resulting remission. Results, Anti-Dsg1 and anti-Dsg3 were detected in 56 (76.7%) and 69 (94.5%) patients, respectively. Anti-Dsg1 and anti-Dsg3 antibodies were present in 48 (94.1%) and 50 (98%) patients with mucocutaneous type, in 2 (12.5%) and 15 (93.7%) patients with mucosal type, and in 6 (100%) and 4 (66.7%) patients with cutaneous PV, respectively. The mean anti-Dsg1 index values were significantly higher in cutaneous and mucocutaneous phenotypes than mucosal PV (P < 0.001). The mean anti-Dsg3 index values were significantly lower in cutaneous and mucosal phenotypes than mucocutaneous PV (P < 0.01). The severity of skin lesions (but not oral lesions) was correlated with anti-Dsg1 antibody level (P < 0.001); on the other hand, the severity of oral lesions (P < 0.01) as well as skin lesions (P < 0.001) was significantly correlated with anti-Dsg3 antibody levels. Both anti-Dsg1 and anti-Dsg3 levels were significantly reduced after treatment and clinical remission (P < 0.001). Conclusion,, Dsg ELISA is not only a sensitive tool for the diagnosis of PV, it can also serve as a predictive means for assessing the severity as well as for monitoring the disease activity. Although, in general, the clinical phenotype is related to the antibody profile, there are occasional cases with discordant phenotype and antibody profile. These discrepancies might be explained by genetic variations or the presence of possible minor antigens involved in the pathogenesis of pemphigus. [source] Copper Concentrations in Channel Catfish Ictalurus punctatus Ponds Treated with Copper SulfateJOURNAL OF THE WORLD AQUACULTURE SOCIETY, Issue 1 2004Aaron A. McNevin Copper sulfate (CuSO45H2O) is used to reduce the abundance of blue-green algae and combat off-flavor in channel catfish culture. Copper sulfate usually is applied at a concentration of one-one hundredth of the total alkalinity. A study was performed at the Auburn University Fisheries Research Unit to determine the duration of elevated copper (Cu) concentration following copper sulfate applications. Two alkalinity treatments, 20-40 mg/L and 110-130 mg/L (as CaCO3), were examined. Copper sulfate was applied biweekly for 14 wk at 03 mg/L for the low alkalinity treatment and 1.2 mg/L for the high alkalinity treatment. Total copper concentrations in pond waters declined to the background level by 48-h post treatment. In addition, total copper concentrations were determined in waters of 38 catfish production ponds located in west central Alabama. The mean and standard deviation were 0.0092 ± 0.0087 mg Cu/L. Copper quickly precipitates from the water or is absorbed by sediments following copper sulfate treatment. Although concentrations of copper in pond waters increase immediately following copper sulfate treatment, they rapidly decrease and seldom exceed the United States Environmental Protection Agency's National Recommended Water Quality Criteria for Priority Toxic Pollutants of 0.013-mg Cu/L. Findings of this study suggest that copper sulfate treatment will not contaminate effluent from catfish ponds because of the short time that applied copper remains in the water column. Furthermore, the most frequent applications of copper sulfate occur in late summer months when rainfall is minimal and pond overflow is rare. [source] Bifocals and Down's syndrome: correction or treatment?OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 4 2009Mohammad Al-Bagdady Abstract Purpose:, Accommodation is reduced in approximately 75% of children with Down's syndrome (DS). Bifocals have been shown to be beneficial and they are currently prescribed regularly. Clinical observations suggest the likelihood of improving accommodative ability after bifocal wear. The aim of the study is to evaluate the potential use of bifocals as a treatment for the reduced accommodation. Methods:, Clinical records of 40 children from the Cardiff Down's Syndrome Vision Research Unit, who were prescribed bifocals, were reviewed. Accommodation was noted before wearing the bifocals and during either their latest visit or when the children stopped using bifocals. Accommodation was reassessed during a follow up visit for the children who stopped wearing bifocals. Development of accommodation before bifocal commencement, age at bifocal prescription, gender, type of refractive error, visual acuity and the presence of strabismus were examined to evaluate their contribution to accommodation improvement. Results:, The accommodative ability of 65% (n = 26) of the children improved (through the distance part of the lens) after using the bifocals. More than half of those developed accurate accommodation without the use of bifocals (n = 14). Accommodative responses did not show any improvement with age before the children began wearing bifocals. Accurate accommodation was sustained after returning to single vision lenses in all examined children. The age distribution of the children on bifocal commencement was diverse. Presence of strabismus, refractive error type, visual acuity and gender did not have any effect on gaining improvement. Conclusions:, Bifocals are an effective correction for the reduced accommodation in children with DS and also act to improve accommodation with a success rate of 65%. Bifocal wear can therefore be temporary, i.e. a ,treatment' for the deficit, in at least one third of children. [source] Limbal and Bulbar Hyperaemia in Normal EyesOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 1 2008Heiko Pult Abstract Purpose:, To investigate the appearance of limbal and bulbar hyperaemia in normal eyes, their relationship and the inter-observer agreement of clinical grading. Methods:, The right eyes of 120 healthy, non-contact lens-wearing subjects (m = 57, f = 63, median age = 45 years, range 18,77 years) were examined by two trained observers. Limbal and bulbar hyperaemia were scored using the Cornea and Contact Lens Research Unit (CCLRU) redness grading scales interpolated into 0.1 increments. Redness of four quadrants, and overall, were assessed, and quadrant-average redness was calculated. Inter-observer agreement was assessed at the start and end of the study (20 subjects each). Results:, For limbal redness, the overall (1.62 ± 0.46) (mean units ± S.D.) was not significantly different from the quadrant-average (1.61 ± 0.40) score. For bulbar redness, the overall (2.02 ± 0.49) was higher than the quadrant-average (1.82 ± 0.39) score (p < 0.0001). Significant correlations were found between bulbar and limbal quadrants (Pearson: r , 0.43, p < 0.0001). Significant differences in redness were found between quadrants (p < 0.0001), with nasal and temporal redder than superior and inferior quadrants. Small effects of age and gender were found for limbal redness. The inter-observer 95% limits of agreement were similar at the start and end of the study. They were larger for overall (0.57) compared with quadrant-average (0.28) redness. Conclusions:, For similar populations, a limbal redness above 2.5 or a bulbar redness above 2.6 (quadrant-average) or 3.0 (overall) may be considered abnormal. Limbal and bulbar redness were correlated. Quadrant-average scores are recommended instead of overall scores, as inter-observer agreement was better. [source] Airway hyperresponsiveness: the usefulness of airway hyperresponsiveness testing in epidemiology, in diagnosing asthma and in the assessment of asthma severityTHE CLINICAL RESPIRATORY JOURNAL, Issue 1 2007Celeste Porsbjerg MD Abstract The present PhD thesis was conducted at the Respiratory Research Unit at the Pulmonary Department L in Bispebjerg Hospital, Copenhagen, Denmark and describes airway hyperresponsiveness in asthma patients in four studies. The first study concerned risk factors for the development of asthma in young adults in a 12-year prospective follow-up study of a random population sample of 291 children and adolescents from Copenhagen, who were followed up from the age of 7,17 years (1986) until the age of 19,29 years (1998). During follow-up, 16.1% developed asthma, and in these subjects, the most important predictor of asthma development was airway hyperresponsiveness to histamine at baseline. Airway hyperresponsiveness is associated with more severe asthma and a poorer prognosis in terms of more exacerbations and less chance of remission of the disease. The second study described the relation between airway hyper-responsiveness to methacholine and the quality of life in 691 asthma patients: In asthma patients with airway hyperresponsiveness to methacholine, the quality of life measured with a validated questionnaire (Junipers Asthma Quality of Life Questionnaire) was significantly reduced compared to asthma patients who did not respond to bronchial provocation with methacholine. Airway hyperresponsiveness is not uncommonly observed in non-asthmatics, and the response to bronchial provocation with methacholine is therefore relatively non-specific. The mannitol test is a relatively new bronchial provocation test that acts indirectly on the smooth airway muscle cells through the release of mediators from inflammatory cells in the airways; the mannitol could consequently be a more specific test compared with methacholine. The third study showed that out of 16 non-asthmatics with airway hyperresponsiveness to methacholine, 15 did not respond to bronchial provocation with mannitol Because of the mechanism of action of mannitol, it seems plausible that the response to mannitol is more closely correlated to airway inflammation in asthma compared with the response to methacholine. The fourth study showed that in 53 adult asthma patients, who did not receive treatment with inhaled steroids, there was a positive correlation between the degree of airway inflammation and the degree of airway responsiveness to mannitol as well as to methacholine. The mannitol does, however, have the advantage of being a faster and simpler test to perform, requiring no additional equipment apart from a spirometer. Conclusions:, Airway hyperresponsiveness in children and in adolescents without asthma predicts asthma development in adulthood. Asthma patients with airway hyperresponsiveness to methacholine have a poorer quality of life as well as more severe disease and a poorer prognosis compared with asthma patients without airway hyperresponsiveness. Bronchial provocation with mannitol as well as with methacholine were useful for evaluating the severity of asthma and the degree of airway inflammation, and accordingly for determining the need for steroid statement. The mannitol test does, however, have practical advantages over the methacholine test that make it preferable for clinical use. [source] Optimal preoperative assessment and surgery for rectal cancer may greatly limit the need for radiotherapyBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2003M. Simunovic Background: Radiation is being used increasingly in the management of patients with rectal cancer. Over the past decade the Basingstoke Colorectal Research Unit has combined precision total mesorectal excision with the highly selective use of preoperative radiotherapy. Methods: One hundred and fifty consecutive patients who underwent major surgical excision for cancers of all stages comprised the study group. Preoperative clinical assessment was based largely on tumour size, fixation and distance from the anal verge. Only preoperative radiotherapy was considered and this only for tumours judged to be at high risk of mesorectal fascia involvement. Results: During a 5-year period 35 of 150 patients were selected for preoperative irradiation. In the non-irradiated patients the local recurrence rate after a median follow-up period of 870 (range 51,1903) days was 2·6 per cent (three of 115 patients), compared with 17·1 per cent (six of 35 patients) in those chosen for irradiation. Sixty patients (52·2 per cent) who were not irradiated were node positive. The local recurrence rate for the whole group was 6·0 per cent. Conclusion: The great majority of patients undergoing major excision for rectal cancer can be managed without radiation therapy if the preoperative assessment of the mesorectal fascia and surgery are performed optimally. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Detecting trends in tropical rainfall characteristics, 1979,2003INTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 8 2007K.-M. Lau Abstract Analyses of two state-of-the-art, blended space-based and ground-based global rainfall data sets from the Global Precipitation Climatology Project (GPCP) and the Climate Prediction Center Merged Analysis Product (CMAP) reveal that there was a significant shift in the probability distribution functions of tropical rainfall during the period 1979,2003. This shift features a positive trend in the occurrence of heavy (top 10% by rain amount) and light (bottom 5%) rain events in the tropics during 1979,2003 and a negative trend in moderate (25,75%) rain events. These trends are consistent in both data sets and are in overall agreement with the Climate Research Unit's (CRU) gauge-only rainfall data over land. The relationships among the trends and the possible long-term changes in rainfall characteristics are discussed. Copyright © 2006 Royal Meteorological Society [source] Circulating matrix metalloproteinase 9 levels in relation to sampling methods, femoral and carotid atherosclerosisJOURNAL OF INTERNAL MEDICINE, Issue 6 2008F. J. Olson Abstract. Objectives., To examine whether circulating levels of matrix metalloproteinase 9 (MMP-9) were associated with ultrasound-assessed intima-media thickness (IMT) and echolucent plaques in the carotid and femoral arteries. To examine preanalytical sources of variability in MMP-9 concentrations related to sampling procedures. Subjects and design., Plasma and serum MMP-9 levels were compared with ultrasound assessed measures of femoral and carotid atherosclerosis, in a cross-sectional study of 61-year-old men (n = 473). Preanalytical sources of variability in MMP-9 levels were examined in 10 healthy subjects. Main outcome measures were circulating levels of MMP-9 in serum and plasma, IMT of the carotid and femoral arteries, and plaque status based on size and echolucency. Setting., Research unit at university hospital. Results., Plasma concentrations of total and active MMP-9 were associated with femoral artery IMT independently of traditional cardiovascular risk factors, and were higher in subjects with moderate to large femoral plaques. Plasma MMP-9 concentration was higher in men with echolucent femoral plaques (P = 0.006) compared with subjects without femoral plaques. No similar associations were found for carotid plaques. MMP-9 concentrations were higher in serum than in plasma, and higher when sampling was performed with Vacutainer than with syringe. MMP-9 levels in serum were more strongly associated with peripheral neutrophil count compared with MMP-9 levels in plasma. Conclusions., Plasma MMP-9 levels were associated with atherosclerosis in the femoral artery, and total MMP-9 concentration was higher in men with echolucent femoral plaques. The choice of sample material and sampling method affect the measurements of circulating MMP-9 levels. [source] The Higher Education Policy Institute (HEPI) Report SummariesCRITICAL QUARTERLY, Issue 3 2004Anthony Smith These reports are useful summaries of a quantity of research undertaken over a course of years by the independent HEPI research unit, based in Oxford. They are researched responses to the range of issues and questions which have been current in UK higher education over the last five or six years. Future social historians will surely discern, through their tiny print and clear thought, the growing instrumentality of this era, the nervous concern of the authorities, as costs rise, to ensure that university education brings economic benefit to the nation as a whole. [source] A randomized trial of the effects of two novel nicotine replacement therapies on tobacco withdrawal symptoms and user satisfactionADDICTION, Issue 7 2010Hayden McRobbie ABSTRACT Aims To determine effects on craving, user satisfaction, and consumption patterns of two new nicotine replacement therapies (NRT) used for eight hours after overnight tobacco abstinence. Design In a within-subject, cross-over trial participants were randomly assigned Zonnic® nicotine mouth spray (1 mg/spray), Zonnic® nicotine lozenge (2.5 mg), Nicorette® gum (4 mg) and placebo lozenge on each of four study days. Setting University research unit. Participants Forty-seven dependent adult smokers. Measurements Participants rated their urges to smoke, irritability, concentration and restlessness before and during the first hour of product use on a 100-point scale. A subsample of 11 participants provided blood samples for nicotine analysis. Findings All active products reduced craving significantly more than placebo (mean reductions of 28.6, 25.8, 24.7 and 8.9 points for mouth spray, gum, lozenge and placebo). Mouth spray relieved craving faster than placebo and gum with significant reductions within five minutes of use (mean differences of ,14.5 (95% CI: ,23.0 to ,6.0) and ,10.6 (95% CI: ,19.1 to ,2.1) with placebo and gum respectively. Mouth spray produced a faster time to maximum plasma nicotine concentration (14.5 minutes, 95% CI: 8.0 to 21.0) compared to the lozenge (30.3 minutes, 95% CI: 21.1 to 39.5) and gum (45.8 minutes, 95% CI: 36.2 to 55.4). Maximum concentrations of blood nicotine were higher with mouth spray (10.0 ng/ml) and lozenge (10.8 ng/ml) compared to gum (7.8 ng/ml). Both lozenge and mouth spray were well tolerated. Conclusions The mouth spray and lozenge are at least as effective as 4 mg nicotine gum in relieving craving suggesting that they are likely to be effective in aiding smoking cessation. The mouth spray may be particularly useful for acute craving relief. [source] Do ,9 -tetrahydrocannabinol concentrations indicate recent use in chronic cannabis users?ADDICTION, Issue 12 2009Erin L. Karschner ABSTRACT Aims To quantify blood ,9 -tetrahydrocannabinol (THC) concentrations in chronic cannabis users over 7 days of continuous monitored abstinence. Participants Twenty-five frequent, long-term cannabis users resided on a secure clinical research unit at the US National Institute on Drug Abuse under continuous medical surveillance to prevent cannabis self-administration. Measurements Whole blood cannabinoid concentrations were determined by two-dimensional gas chromatography-mass spectrometry. Findings Nine chronic users (36%) had no measurable THC during 7 days of cannabis abstinence; 16 had at least one positive THC ,0.25 ng/ml, but not necessarily on the first day. On day 7, 6 full days after entering the unit, six participants still displayed detectable THC concentrations [mean ± standard deviation (SD), 0.3 ± 0.7 ng/ml] and all 25 had measurable carboxy-metabolite (6.2 ± 8.8 ng/ml). The highest observed THC concentrations on admission (day 1) and day 7 were 7.0 and 3.0 ng/ml, respectively. Interestingly, five participants, all female, had THC-positive whole blood specimens over all 7 days. Body mass index did not correlate with time until the last THC-positive specimen (n = 16; r = ,0.2; P = 0.445). Conclusions Substantial whole blood THC concentrations persist multiple days after drug discontinuation in heavy chronic cannabis users. It is currently unknown whether neurocognitive impairment occurs with low blood THC concentrations, and whether return to normal performance, as documented previously following extended cannabis abstinence, is accompanied by the removal of residual THC in brain. These findings also may impact on the implementation of per se limits in driving under the influence of drugs legislation. [source] Methadone doses of 100 mg or greater are more effective than lower doses at suppressing heroin self-administration in opioid-dependent volunteersADDICTION, Issue 10 2005Eric C. Donny ABSTRACT Aims Methadone maintenance has been an effective pharmacotherapy for the treatment of heroin dependence for nearly four decades. Recent clinical research suggests that methadone doses larger than those used in most clinics are more effective at suppressing illicit heroin use. This greater efficacy may result from greater cross-tolerance to the reinforcing effects of heroin. Design The purpose of this double-blind, within-subject study was to examine the relationship between methadone maintenance dose and the reinforcing effects of heroin. Setting Participants were stabilized on 50, 100 and 150 mg methadone (ascending order) during separate outpatient periods before being admitted to an inpatient research unit for testing at each maintenance dose. Participants Five opiate-dependent volunteers completed the study. Measurements During each 4-week inpatient testing period, participants sampled three doses of heroin (0, 10, or 20 mg; random order; one dose per week) and were subsequently allowed seven opportunities to choose between another injection of that week's heroin dose and varying amounts of money ($2,38). Findings The number of heroin injections chosen decreased as methadone dose was increased. Larger alternative monetary reinforcers were required to suppress heroin self-administration during maintenance on 50 compared to 100 or 150 mg methadone. Larger methadone doses also completely blocked the subjective effects of heroin and produced greater withdrawal suppression during the outpatient periods. Conclusions These results support other clinical and laboratory-based research indicating that persistent heroin use may be reduced by providing larger methadone maintenance doses that produce more effective cross-tolerance to heroin. [source] The association between metabolic syndrome, microalbuminuria and impaired renal function in the general population: impact on cardiovascular disease and mortalityJOURNAL OF INTERNAL MEDICINE, Issue 4 2007K. P. Klausen Abstract. Objective:, Microalbuminuria and metabolic syndrome are both associated with cardiovascular disease (CVD). The aim of this study was to determine the potential association between numbers of components in the metabolic syndrome, different levels of microalbuminuria and renal function. We also aimed to determine the risk of death and CVD at different levels of microalbuminuria and renal function and numbers of components in the metabolic syndrome. Design:, Population-based observational follow-up study Setting:, Epidemiological research unit (Copenhagen City Heart Study). Subjects:, A total of 2696 men and women, 30,70 years of age. Baseline measures:, Urinary albumin excretion (UAE), creatinine clearance and metabolic risk factors were measured in 1992,1994. Main outcome measurements:, The participants were followed prospectively by registers until 1999,2000 with respect to CVD, and until 2004 with respect to death. Results:, We found a strong association between microalbuminuria and the metabolic syndrome: 2% with none and 18% with five metabolic risk factors had microalbuminuria (P < 0.001). No association between impaired renal function defined as creatinine clearance <60 mL min,1 and the metabolic syndrome was found. Microalbuminuria was associated with increased risk of death and CVD to a similar extend as the metabolic syndrome, irrespective of concomitant presence of metabolic syndrome (RR,2; P < 0.001). Impaired renal function was not associated with increased risk of death and CVD in subjects with the metabolic syndrome. Conclusions:, Microalbuminuria (UAE >5 ,g min,1) confers increased risk of death and CVD to a similar extent as the metabolic syndrome. [source] Setting up an ambulatory sleep research unitTHE CLINICAL RESPIRATORY JOURNAL, Issue 1 2008Eyþór Björnsson No abstract is available for this article. [source] Libcitations: A measure for comparative assessment of book publications in the humanities and social sciencesJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 6 2009Howard D. White Bibliometric measures for evaluating research units in the book-oriented humanities and social sciences are underdeveloped relative to those available for journal-oriented science and technology. We therefore present a new measure designed for book-oriented fields: the "libcitation count." This is a count of the libraries holding a given book, as reported in a national or international union catalog. As librarians decide what to acquire for the audiences they serve, they jointly constitute an instrument for gauging the cultural impact of books. Their decisions are informed by knowledge not only of audiences but also of the book world (e.g., the reputations of authors and the prestige of publishers). From libcitation counts, measures can be derived for comparing research units. Here, we imagine a match-up between the departments of history, philosophy, and political science at the University of New South Wales and the University of Sydney in Australia. We chose the 12 books from each department that had the highest libcitation counts in the Libraries Australia union catalog during 2000 to 2006. We present each book's raw libcitation count, its rank within its Library of Congress (LC) class, and its LC-class normalized libcitation score. The latter is patterned on the item-oriented field normalized citation score used in evaluative bibliometrics. Summary statistics based on these measures allow the departments to be compared for cultural impact. Our work has implications for programs such as Excellence in Research for Australia and the Research Assessment Exercise in the United Kingdom. It also has implications for data mining in OCLC's WorldCat. [source] | ||||||||||||||||