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Selected AbstractsEffect of delayed supine positioning after induction of spinal anaesthesia for caesarean sectionACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2002F. Køhler Background: The study tested the hypothesis that the incidence of hypotension during spinal anaesthesia for caesarean section is less in parturients who remain in the sitting position for 3 min compared with parturients who are placed in the modified supine position immediately after induction of spinal anesthesia. Methods: Spinal anaesthesia was induced with the woman in the sitting position using 2.8 ml hyperbaric bupivacaine 0.5% at the L3,4 or L2,3 interspace. Ninety-eight patients scheduled for elective caesarean section under spinal anaesthesia were randomised to assume the supine position on an operating table tilted 10° to the left (modified supine position) immediately after spinal injection (group 0, n=52) or to remain in the sitting position for 3 min before they also assumed the modified supine position (group 3, n=46). Isotonic saline 2,300 ml was given intravenously over 15 min before spinal injection followed by 15 ml/kg over 15,20 min after induction of spinal anaesthesia. If the systolic blood pressure decreased to less than 70% of baseline or to less than 100 mmHg or if there was any complaint of nausea, ephedrine was given in 5 mg boluses intravenously every 2 min. Results: The blood pressure decreased significantly in both groups following spinal injection (P<0.001). Blood pressure variations over time differed significantly between the two groups (P<0.05). However, the incidence of maternal hypotension before delivery was similar in the two groups. The difference was caused by the time to the blood pressure nadir being significantly shorter in group 0 compared with group 3 (9.1±4.5 min vs. 11.7±3.7 min, P<0.01). Similar numbers of patients received rescue with ephedrine before delivery: 35 (67%) in group 0 vs. 26 (57%) in group 3 (NS). The mean total dose of ephedrine before delivery was 10.9 mg in group 0 vs. 9.2 mg in group 3 (NS). There were no differences in neonatal outcome between the two groups. Conclusion: At elective caesarean section, a 3-min delay before supine positioning does not influence the incidence of maternal hypotension after induction of spinal anaesthesia in the sitting position with 2.8 ml of bupivacaine 0.5% with 8% dextrose. [source] Physical Medicine and Rehabilitation (87)PAIN PRACTICE, Issue 1 2001A.J. Haig Paraspinal electromyography in high lumbar and thoracic lesions. (University of Michigan, Ann Arbor, MI) Am J Phys Med Rehabil 2000;79:336,342. This study aimed to use needle electromyography in the paraspinal muscles to localize the root level of a radiculopathy. Nine cases of clinically proven, isolated high lumbar or thoracic disk herniations of patients who underwent MiniPM were collected. Four were from a prospective study of 114 persons with low back pain (MiniPM had 100% sensitivity to magnetic resonance imaging-documented high disks). In the most medial "S" column, mean MiniPM scores were 0.7 for the level above the radiologically documented lesion (3.1 at the lesion and 1.6, 1.6, and 1.1 at the 3 spinous processes below the lesion). Similar numbers were obtained in the "M" column (slightly lateral), with no significant differences between S and M. Differences were significant between and at the level of the lesion for S (P < 0.06) and M (P < 0.01), and between the lesion level and 3 levels below for the M column (P < 0.01). Conclude that paraspinal electromyography has a higher than previously reported sensitivity for high lumbar lesions. Electromyography using MiniPM can localize some radiculopathies. The individual cases suggest that, consistent with the anatomy of the caudi equina, thoracic lesions and lateral lumbar lesions denervate only at 1 level, but more central lumbar lesions also denervate distally innervated paraspinal muscles. Comment by Miles Day, MD. This study is designed to assess the sensitivity of many MiniPM for higher-level rediculopathies, ie, lower thoracic and high lumbar, and to determine if findings are specific to the root level involved. The MiniPM is thought to assess the multifidus portion of the paraspinal muscles that are innervated from L2 to the sacrum. The clinical protocol tests the paraspinal extensively and provides a numerica score, thus eliminating some subjectivity of the EMG. The study demonstrates that MiniPM has good sensitivity for high lumbar and thoracic lesions and provides information on the level of the lesion independent of limb EMG. After reviewing the study, I agree with the authors that MiniPM is in itself not diagnostic for radiculopathy, but is only an additional test to help support other neuro physiological studies when evaluating for radiculopathy. It is not specific for diagnosing radiculopathy. [source] Changes in lung function and health status in patients with COPD treated with tiotropium or salmeterol plus fluticasoneRESPIROLOGY, Issue 2 2009Kazuyoshi KURASHIMA ABSTRACT Background and objective: The effects of tiotropium, a long-acting anticholinergic drug, were compared with those of the combination of salmeterol, a long-acting ,2 -agonist, and fluticasone, an inhaled corticosteroid, in patients with COPD. Methods: A 4-month, randomized, open cross-over study of tiotropium, 18 µg once daily, versus salmeterol, 50 µg, plus fluticasone, 200 µg, twice daily, was conducted in patients with COPD. Efficacy was assessed by spirometry and responses to the St George's Respiratory Questionnaire (SGRQ). After 4 months, patients were asked to select their subsequent therapy and indicate the reasons for their selection. Results: A total of 78 patients completed the study. There were no significant differences in the improvements in FEV1 or SGRQ scores between the therapies. Similar numbers of patients selected tiotropium (42.3%) and salmeterol plus fluticasone (57.7%). However, those who preferred one of the therapies demonstrated greater improvements in SGRQ scores with that therapy. One subgroup of patients (30.8%) showed greater improvements in dyspnoea and FEV1 in response to tiotropium, and the other subgroup of patients (35.9%) showed greater improvements in dyspnoea and FEV1 in response to salmeterol plus fluticasone. Some patients (14.1%) selected salmeterol plus fluticasone because of positive effects on sputum expectoration. Conclusions: The study was unblinded and the results need to be interpreted with caution. However, tiotropium and salmeterol plus fluticasone had similar overall effects on pulmonary function and SGRQ scores in patients with COPD. Responses to the two therapies were heterogeneous, and the patients who showed greater improvements in FEV1 or SGRQ scores with one of the therapies preferred it for their subsequent treatment. [source] Flight activity of the damson,hop aphid, Phorodon humuli.ANNALS OF APPLIED BIOLOGY, Issue 1 2005C.A.M. Campbell Abstract Flight activity of Phorodon humuli was monitored using suction traps, laboratory studies and mark and recapture experiments. Emigrants were trapped as they flew from a Myrobalan (Prunus cerasifera) hedge and among dwarf hops (Humulus lupulus). Daily flight curves were bimodal with 69% and 38% of emigrants caught in the morning peak near Myrobalan and among hops, respectively. The median period of flight activity was from 2 h after sunrise until 30 min before sunset. The lower temperature for flight was 13.5°C in the field and 14.9°C for take off in the laboratory. Variations in wind speed had little effect on flight activity explaining <2.5% of the total variance among insect counts. The percentage of emigrants on hop declined exponentially with time. The relationship, y= 10.9(±2.0) + 64.3(±2.3) × 0.92(±0.01)t where t = daylight hours (standard error in parentheses), explained 98.3% of the variance. Hence, 62% of new arrivals flew within 1 day of arrival and 79% within 2 days. Similar numbers arrived as departed at 08:30, 10:30 and 12:30 h, but at 14:30 h twice as many arrived than departed and at 16:30 h, the accumulation was threefold. Daily flight curves of return migrants and males leaving hop were bimodal with 70% and 80%, respectively, trapped in the earlier peak. In the field, the median lower temperature for flight was 13.2°C for return migrants and a nonsignificantly different 12.8°C for males. The mean temperature for take off by return migrants was 15.7°C in the laboratory. [source] Prognostic significance of asymptomatic coronary artery disease in patients with diabetes and need for early revascularization therapyDIABETIC MEDICINE, Issue 9 2007E.-K. Choi Abstract Aims, Information on the clinical outcome of patients with diabetes with silent myocardial ischaemia is limited. We compared the clinical and angiographic characteristics, and the clinical outcomes of diabetic patients with asymptomatic or symptomatic coronary artery disease (CAD). Methods, Three hundred and ten consecutive diabetic patients with CAD were divided into two groups according to the presence of angina and followed for a mean of 5 years. Fifty-six asymptomatic patients with a positive stress test and CAD on coronary angiography were compared with 254 symptomatic patients, 167 with unstable angina and 87 with chronic stable angina. Results, Although the severity of coronary atherosclerosis was similar in asymptomatic and symptomatic patients, revascularization therapy was performed less frequently in the asymptomatic than the symptomatic patients (26.8 vs. 62.0%; P < 0.001). Asymptomatic patients experienced a similar number of major adverse cardiac events (MACEs; death, non-fatal myocardial infarction, and revascularization; 32 vs. 28%; P = 0.57), but had higher cardiac mortality than symptomatic patients (26 vs. 9%; P < 0.001). However, patients who underwent revascularization therapy at the time of CAD diagnosis in these two groups showed similar MACE and cardiac mortality (20.0 vs. 22.5%, 6.7 vs. 5.3%, respectively; all P > 0.05). Conclusions, This study suggests that diabetic patients with asymptomatic CAD have a higher cardiac mortality risk than those with symptomatic CAD, and that lack of revascularization therapy may be responsible for the poorer survival. [source] Rapid plant diversity assessment using a pixel nested plot design: A case study in Beaver Meadows, Rocky Mountain National Park, Colorado, USADIVERSITY AND DISTRIBUTIONS, Issue 4 2007Mohammed A. Kalkhan ABSTRACT Geospatial statistical modelling and thematic maps have recently emerged as effective tools for the management of natural areas at the landscape scale. Traditional methods for the collection of field data pertaining to questions of landscape were developed without consideration for the parameters of these applications. We introduce an alternative field sampling design based on smaller unbiased random plot and subplot locations called the pixel nested plot (PNP). We demonstrate the applicability of the PNP design of 15 m × 15 m to assess patterns of plant diversity and species richness across the landscape at Rocky Mountain National Park (RMNP), Colorado, USA in a time (cost)-efficient manner for field data collection. Our results produced comparable results to a previous study in the Beaver Meadow study (BMS) area within RMNP, where there was a demonstrated focus of plant diversity. Our study used the smaller PNP sampling design for field data collection which could be linked to geospatial information data and could be used for landscape-scale analyses and assessment applications. In 2003, we established 61 PNP in the eastern region of RMNP. We present a comparison between this approach using a sub-sample of 19 PNP from this data set and 20 of Modified Whittaker nested plots (MWNP) of 20 m × 50 m that were collected in the BMS area. The PNP captured 266 unique plant species while the MWNP captured 275 unique species. Based on a comparison of PNP and MWNP in the Beaver Meadows area, RMNP, the PNP required less time and area sampled to achieve a similar number of species sampled. Using the PNP approach for data collection can facilitate the ecological monitoring of these vulnerable areas at the landscape scale in a time- and therefore cost-effective manner. [source] Flow-substrate interactions create and mediate leaf litter resource patches in streamsFRESHWATER BIOLOGY, Issue 3 2006TRENT M. HOOVER Summary 1. The roles that streambed geometry, channel morphology, and water velocity play in the retention and subsequent breakdown of leaf litter in small streams were examined by conducting a series of field and laboratory experiments. 2. In the first experiment, conditioned red alder (Alnus rubra Bongard) leaves were released individually in three riffles and three pools in a second-order stream. The transport distance of each leaf was measured. Several channel and streambed variables were measured at each leaf settlement location and compared with a similar number of measurements taken at regular intervals along streambed transects (,reference locations'). Channel features (such as water depth) and substrate variables (including stone height, stone height-to-width ratio, and relative protrusion) were the most important factors in leaf retention. 3. In the second experiment, the role of settlement location and reach type in determining the rate of leaf litter breakdown was examined by placing individual conditioned red alder leaves in exposed and sheltered locations (on the upper and lower edges of the upstream face of streambed stones, respectively) in riffle and pool habitats. After 10 days, percent mass remaining of each leaf was measured. Generally, leaves broke down faster in pools than in riffles. However, the role of exposure in breakdown rate differed between reach types (exposed pool > sheltered pool > sheltered riffle > exposed riffle). 4. In the third experiment, the importance of substrate geometry on leaf litter retention was examined by individually releasing artificial leaves upstream of a series of substrate models of varying shape. Substrates with high-angle upstream faces (were vertical or close to vertical), and that had high aspect ratios (were tall relative to their width), retained leaves more effectively. 5. These results show that streambed morphology is an important factor in leaf litter retention and breakdown. Interactions between substrate and flow characteristics lead to the creation of detrital resource patchiness, and may partition leaf litter inputs between riffles and pools in streams at baseflow conditions. [source] Effects of drought on contrasting insect and plant species in the UK in the mid-1990sGLOBAL ECOLOGY, Issue 1 2002M. D. Morecroft Abstract Aim We examined the effects of drought in the summer of 1995 and the subsequent year on contrasting species of plants, moths, butterflies and ground beetles. We tested whether population increases were associated with: (a) species of warm environments (b) species of dry environments (c) species with rapid reproduction (d) species with high rates of dispersal. Location The study was conducted at Environmental Change Network (ECN) sites throughout Great Britain and Northern Ireland. Methods Climate monitoring, recording of plant species in permanent plots, transect walking for butterflies, light trapping for moths and pitfall trapping for carabid beetles were used. Results There was an overall increase in the number of species recorded in permanent vegetation plots between 1994 and 1996, principally among the annual and biennial vascular plants, probably as a result of gap colonization in grasslands. Most butterfly and moth species increased between 1994 and 1995. Among the butterflies, a southern distribution and high mobility were associated with species tending to increase throughout the period 1994,96, whereas declining species tended to have a northern distribution. A similar number of carabid beetle species increased as decreased in the period 1994,96; decreasing species tended to be associated with lower temperatures and wetter soils. Conclusions Current climate change scenarios indicate that the incidence of droughts in the United Kingdom will increase. A series of dry, hot summers could lead to a rapid change in the population of some species although others, including many plants, may be more resilient. This may lead to complex changes in ecosystems and needs to be considered in planning conservation strategies. [source] TIPS versus drug therapy in preventing variceal rebleeding in advanced cirrhosis: A randomized controlled trialHEPATOLOGY, Issue 2 2002Àngels Escorsell Prevention of variceal rebleeding is mandatory in cirrhotic patients. We compared the efficacy, safety, and cost of transjugular intrahepatic portosystemic shunt (TIPS) versus pharmacologic therapy in preventing variceal rebleeding in patients with advanced cirrhosis. A total of 91 Child-Pugh class B/C cirrhotic patients surviving their first episode of variceal bleeding were randomized to receive TIPS (n = 47) or drug therapy (propranolol + isosorbide-5-mononitrate) (n = 44) to prevent variceal rebleeding. Mean follow-up was 15 months. Rebleeding occurred in 6 (13%) TIPS-treated patients versus 17 (39%) drug-treated patients (P = .007). The 2-year rebleeding probability was 13% versus 49% (P = .01). A similar number of reinterventions were required in the 2 groups; these were mainly angioplasty ± restenting in the TIPS group (90 of 98) and endoscopic therapy for rebleeding in the medical group (45 of 62) (not significant). Encephalopathy was more frequent in TIPS than in drug-treated patients (38% vs. 14%, P = .007). Child-Pugh class improved more frequently in drug-treated than in TIPS-treated patients (72% vs. 45%; P = .04). The 2-year survival probability was identical (72%). The identified cost of therapy was double for TIPS-treated patients. In summary, medical therapy was less effective than TIPS in preventing rebleeding. However, it caused less encephalopathy, identical survival, and more frequent improvement in Child-Pugh class with lower costs than TIPS in high-risk cirrhotic patients. This suggests that TIPS should not be used as a first-line treatment, but as a rescue for failures of medical/endoscopic treatments (first-option therapies). [source] Experience in calibrating the double-hardening constitutive model MonotINTERNATIONAL JOURNAL FOR NUMERICAL AND ANALYTICAL METHODS IN GEOMECHANICS, Issue 13 2003M. A. Hicks The Monot double-hardening soil model has previously been implemented within a general purpose finite element algorithm, and used in the analysis of numerous practical problems. This paper reviews experience gained in calibrating Monot to laboratory data and demonstrates how the calibration process may be simplified without detriment to the range of behaviours modelled. It describes Monot's principal features, important governing equations and various calibration methods, including strategies for overconsolidated, cemented and cohesive soils. Based on a critical review of over 30 previous Monot calibrations, for sands and other geomaterials, trends in parameter values have been identified, enabling parameters to be categorized according to their relative importance. It is shown that, for most practical purposes, a maximum of only 5 parameters is needed; for the remaining parameters, standard default values are suggested. Hence, the advanced stress,strain modelling offered by Monot is attainable with a similar number of parameters as would be needed for some simpler, less versatile, models. Copyright © 2003 John Wiley & Sons, Ltd. [source] Spatial grouping of United States climate stations using a hybrid clustering approachINTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 7 2001Arthur T. DeGaetano Abstract The development of a hybrid clustering technique based on the geographic proximity of observing stations and some application-driven measure of statistical similarity (in this case rank correlation) is described. The procedure is then applied to temperature and precipitation data from the United States (US) Historical Climatology Network. The resulting station groups provide some insight into the number of observation stations that are necessary to monitor adequately the climate of the US. Based on temperature data alone, a 287-station subset of the original 1145 sites would be adequate to account for 80% of the spatial variability in seasonal temperature across the US. Geographically the distribution of these stations would be relatively sparse in the centre of the country with higher station density along the East Coast and from the Rocky Mountains to the West Coast. Generally, the temperature clusters match the existing US climate divisions to some extent. To monitor adequately the spatial variability of precipitation, a network of similar size could be used. However, such a network would only account for 65% of the spatial variability in precipitation. In this case, fairly uniform station density is indicated across the country with the highest station density in Florida and the Dakotas. A similar number of stations, but with slightly different geographic groupings would be adequate to monitor precipitation and temperature simultaneously. Copyright © 2001 Royal Meteorological Society [source] A Country on the Move: International Migration in Post-Communist Albania1INTERNATIONAL MIGRATION REVIEW, Issue 4 2006Calogero Carletto Albania is a country on the move. This mobility plays a key role in household-level strategies to cope with the economic hardship of transition. With the relaxing of controls on emigration at the beginning of the 1990s, international migration has exploded, becoming the single most important political, social, and economic phenomenon in post-communist Albania. Based on the 1989 and 2001 population censuses we estimate that over 600,000 Albanians live abroad, mostly in nearby Greece and Italy, with the vast majority coming from a limited number of districts located at the coastal and transport gateways to these destination countries, as well as Tirana. The available data also suggest that a similar number have considered migrating, and of these, half have tried and failed. Almost one-half of the children who since 1990 no longer live with their parents are now living abroad, a number of almost exodus proportions. This article also identifies clear patterns of temporary migration, with Greece being by far the most important destination and rural areas from the Center and North-East of the country being the primary origins of these flows. Although migration, with the resulting remittances, has become an indispensable part of Albanian economic development, there is increasing consensus on the necessity to devise more appropriate, sustainable strategies to lift households out of poverty and promote the country's growth. [source] Sexual Healthcare Needs of Women Aged 65 and OlderJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2004Margaret R. H. Nusbaum DO Objectives: To compare prevalence and type of sexual concerns and interest in and experience with discussing these concerns with physicians for women younger than 65 and 65 and older. Design: Cross-sectional survey. Setting: Departments of Family Practice and Obstetrics and Gynecology at Madigan Army Medical Center, Tacoma, Washington. Participants: Of 1,480 women seeking routine gynecological care, 964 (65%) responded; 163 (17%) were aged 65 and older. Measurements: Self-reported sexual concerns and interest in and experience with discussing these concerns with their physicians. Results: Older women had a similar number of sexual concerns as younger women and were more likely to be concerned about their partner's sexual difficulties. Older women were less likely to have ever had the topic of sexual health raised during healthcare visits. Even though these women were more likely to report youthful-appearing physicians as hindering the topic of sexual health, the majority indicated that they would have discussed their concerns had the physician raised the topic and were interested in a follow-up appointment to do so. Conclusion: Although the types of sexual concerns vary in frequency, women aged 65 and older have a similar number of sexual concerns as younger women. Older women want physicians to inquire about their sexual health. This discussion should include inquiries about their partner's sexual functioning. To overcome age as a barrier to this discussion, younger physicians should be particularly attentive to initiating the topic of sexual health. [source] Comparison of estimated breeding values, daughter yield deviations and de-regressed proofs within a whole genome scan for QTLJOURNAL OF ANIMAL BREEDING AND GENETICS, Issue 6 2001H. Thomsen An important issue in quantitative trait loci (QTL) detection is the use of phenotypic measurement as a dependent variable. Daughter yield deviations (DYDs) as the unit of choice are not available for all traits of interest. The use of de-regressed proofs (DRPFs) of estimated breeding values (EBVs) is an alternative to using daughter yield deviations. The objective of this study was to examine possible differences between DYDs and DRPFs within the use of QTL detection. The pedigree used was part of the granddaughter design of the German QTL effort. Consisting marker maps for livestock species were derived from all available data of 16 German Holstein paternal half-sib families with a total of 872 sires. The number of progeny ranged from 19 to 127. A whole genome scan was performed using weighted and unweighted multimarker regression with DYDs, DRPFs and EBVs as dependent variables for the traits milk, fat and protein yields. Results were compared with respect to the number of QTL detected. A similar number of QTL was detected with DRPFs and DYDs. Also, when dependent variables were weighted according to the variance of the trait, a higher number of QTL was detected at the desired level of significance as compared to using unweighted variables. Vergleich von Zuchtwerten, Daughter Yield Deviation und deregressierten Zuchtwerten bei der Genomanalyse zum Nachweis für QTL Ein bedeutender Einflussfaktor in der QTL-Analyse (QTL: Genorte für quantitativemarkmale) ist die Wahl der abhängigen Leistungsvariablen. Da Daughter Yield Deviations (DYDs) aber nicht für jedes Leistungsmerkmal zur Verfügung stehen, sollte untersucht werden, ob die De-regression von Zuchtwerten als alternative Variable in der QTL Analyse verwendet werden kann. Für die Untersuchung wurde ein Teil des Tiermaterials verwendet, das im Rahmen des Genomanalyseprojektes der Arbeitsgemeinschaft Deutscher Rinderzüchter untersucht wurde. Es standen 872 Bullen aus 16 väterlichen Halbgeschwisterfamilien der Rasse Deutsche Holsteins zur Verfügung. Die Zahl der Nachkommen pro Familie variierte von 19 bis 127. Unter Verwendung eines gewichteten als auch ungewichteten Multi-Marker Regressionsansatzes wurde ein Genomscan für die Leistungsmerkmale Milch-kg, Fett-kg und Eiweiss-kg durchgeführt, wobei als abhängige Variablen Zuchtwerte (EBV), Daughter Yield Deviations (DYD) und de-regressierte Zuchtwerte (DRPF) verwendet wurden. Die De-regression wurde auf der Basis der effektiven Töchterzahl, der Heritabilität des Merkmals und der additiv genetischen Verwandtschaftsmatrix durchgeführt. Alle Ergebnisse wurden in Hinblick auf die Anzahl der entdeckten QTL verglichen. Es zeigten sich dabei keine wesentlichen Unterschiede bei der Verwendung von DYDs und DRPFs. Die Rate der QTL Entdeckungen war bei beiden verwendeten Zuchtwerten annähernd gleich. Über den Vergleich unterschiedlicher Leistungsvariablen hinaus wurden die Ergebnisse der ungewichteten und gewichteten Analyse einander gegenübergestellt. Es konnte gezeigt werden, dass bei einer Gewichtung des Merkmals die Rate der QTL-Entdeckungen bei einem bestimmten Signifikanzniveau deutlich höher ist. [source] Effects of PTH and Alendronate on Type I Collagen Isomerization in Postmenopausal Women With Osteoporosis: The PaTH Study,,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 9 2008Patrick Garnero Abstract Fracture efficacy of PTH and alendronate (ALN) is only partly explained by changes in BMD, and bone collagen properties have been suggested to play a role. We analyzed the effects of PTH(1,84) and ALN on urinary ,,/,, CTX ratio, a marker of type I collagen isomerization and maturation in postmenopausal women with osteoporosis. In the first year of the previously published PaTH study, postmenopausal women with osteoporosis were assigned to PTH(1,84) (100 ,g/d; n = 119), ALN (10 mg/d; n = 60), or PTH and ALN together (n = 59). We analyzed patients on ALN alone (n = 60) and a similar number of patients assigned to PTH alone (n = 63). During the second year, women on PTH in the first year were reallocated to placebo (n = 31) or ALN (n = 32) and women with ALN continued on ALN. During the first year, there was no significant change in ,,/,, CTX ratio with PTH or ALN. At 24 mo, there was a marked increase of the ,,/,, CTX ratio in women who had received PTH during the first year, followed by a second year of placebo (median: +45.5, p < 0.001) or ALN (+55.2%, p < 0.001). Conversely, the ,,/,, CTX ratio only slightly increased (+16%, p < 0.05) after 2 yr of continued ALN. In conclusion, treatment with PTH(1,84) for 1 yr followed by 1 yr of placebo or ALN may be associated with decreased type I collagen isomerization. The influence of these biochemical changes of type I collagen on bone fracture resistance remains to be studied. [source] Plasmapheresis as rescue therapy in accelerated acute humoral rejection,JOURNAL OF CLINICAL APHERESIS, Issue 3 2003Kottarathil A. Abraham Abstract Accelerated acute humoral rejection (AHR) continues to occur in renal transplantation despite improved crossmatching, with potentially devastating consequences. Between 1 June 1998 and 31 December 2000, 440 renal transplants were performed in our center. AHR was diagnosed by the demonstration of typical pathological features on renal histology and positive direct immunofluorescence or detection of anti-HLA antibodies in serum. AHR developed in 20 (4.5%) of our renal transplant recipients, nine male and eleven female at an average of 16.3 days post transplantation. All of these patients had a negative current cytotoxic crossmatch prior to transplantation. The median serum creatinine at diagnosis was 5.96 mg/dL, and 83% of these individuals developed oliguric renal failure requiring dialysis after having initially attained good graft function (median of best serum creatinine before AHR was 2.64 mg/dL). The 18 recipients who had not infarcted their grafts at the time of diagnosis of AHR received plasmapheresis in conjunction with intensification of their immunosuppressive regimen. This regimen was successful in reversing AHR in 78% of those treated with apheresis. In the 14 responders, graft survival at 6 months was 100% and at 12 months was 91%. Median serum creatinine at 6 and 12 months was 1.26 and 1.33 mg/dL, respectively. Patients received an average of 8.1 plasma exchanges. However, responders received a significantly higher frequency of plasmapheresis (P = .0053), despite undergoing a similar number of exchanges overall. Plasmapheresis appears to be an effective modality for reversing AHR and maintaining graft function. J. Clin. Apheresis 18:103,110, 2003. © 2003 Wiley-Liss, Inc. [source] Invasive mutualisms and the structure of plant,pollinator interactions in the temperate forests of north-west Patagonia, ArgentinaJOURNAL OF ECOLOGY, Issue 1 2006CAROLINA L. MORALES Summary 1Alien species may form plant,animal mutualistic complexes that contribute to their invasive potential. Using multivariate techniques, we examined the structure of a plant,pollinator web comprising both alien and native plants and flower visitors in the temperate forests of north-west Patagonia, Argentina. Our main objective was to assess whether plant species origin (alien or native) influences the composition of flower visitor assemblages. We also examined the influence of other potential confounding intrinsic factors such as flower symmetry and colour, and extrinsic factors such as flowering time, site and habitat disturbance. 2Flowers of alien and native plant species were visited by a similar number of species and proportion of insects from different orders, but the composition of the assemblages of flower-visiting species differed between alien and native plants. 3The influence of plant species origin on the composition of flower visitor assemblages persisted after accounting for other significant factors such as flowering time, bearing red corollas, and habitat disturbance. This influence was at least in part determined by the fact that alien flower visitors were more closely associated with alien plants than with native plants. The main native flower visitors were, on average, equally associated with native and alien plant species. 4In spite of representing a minor fraction of total species richness (3.6% of all species), alien flower visitors accounted for > 20% of all individuals recorded on flowers. Thus, their high abundance could have a significant impact in terms of pollination. 5The mutualistic web of alien plants and flower-visiting insects is well integrated into the overall community-wide pollination web. However, in addition to their use of the native biota, invasive plants and flower visitors may benefit from differential interactions with their alien partners. The existence of these invader complexes could contribute to the spread of aliens into novel environments. [source] Homocysteine, the MTHFR 677 C,T polymorphism and family history of premature cardiovascular diseaseJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 3 2009A. Carey Background:, Cardiovascular disease (CVD) is the main cause of premature death in the UK and accounts for 36% of all premature male deaths and 27% of female deaths every year (British Heart Foundation, 2006). Although many risk factors for CVD are known, family history has been identified as being of particular importance in premature CVD (Lloyd-Jones et al., 2004). Recently, it was suggested that an elevated homocysteine (tHcy) may be associated with premature CVD (Homocystiene Studies Collaboration, 2002). The main genetic determinant of tHcy is the common 677 C,T polymorphism, in the enzyme methylenetetrahydrofolate reductase (MTHFR), which is prevalent in approximately 10% of the UK population. Relatively few studies have examined the association between tHcy and premature CVD and hardly any have considered the role of this polymorphism. The aim of this study therefore was to examine the relationships between the MTHFR 677 C,T polymorphism, tHcy and a family history of CVD in patients with established premature CVD. Methods:, An analysis was conducted on medical, lifestyle and family history data collected from patients and age-sex matched controls, recruited through the GENOVIT study in 2003. This case,control study involved n = 404 premature CVD patients and a similar number of age-sex matched controls, all of whom were screened for the TT genotype. A subset of patients (n = 196) and controls (n = 167) provided a blood sample, from which the tHcy concentration was established. Independent sample t -tests were used to determine differences between patients and controls and differences among genotype groups were examined using a one-way analysis of variance, followed by a Tukey's post hoc test. Results:, Plasma tHcy was significantly elevated in patients with a family history of CVD (compared to those without) (P = 0.013). A nonsignificant trend towards higher tHcy (compared to those without) was observed in patients with the TT genotype (P = 0.419). Furthermore, specifically in those with the TT genotype, those with a family history of CVD (compared to those without) showed significantly higher tHcy concentrations (P < 0.005). Those with the TT genotype who smoked had significantly higher tHcy (P < 0.05) than the CC and CT genotypes. Discussion:, The findings presented provide evidence to support an association between the MTHFR 677C,T polymorphism, elevated homocysteine and family history of premature CVD. Given that dietary levels of riboflavin have been shown to lower homocysteine specifically in individuals with the TT genotype (McNulty et al., 2006), these results have implications for the dietary management of premature CVD in those individuals with a genetic predisposition for elevated tHcy. In conclusion, further research in larger cohort numbers, regarding the correlation between family history, tHcy and the MTHFR polymorphism, would be beneficial for establishing their cause and effect relationship. References British Heart Foundation (2006) All Deaths and Deaths Under 75 by Cause and Sex, 2005, England, Wales, Scotland, N Ireland and United Kingdom. Available at http://www.bhf.org.uk/research_health_professionals/resources/heart_statistics.aspx. Homocystine Studies Collaboration (2002) Homocysteine and the risk of ishaemic heart disease and stroke. JAMA288, 2015,2022. Llyod-Jones, D.M., Nam, B.H., D'Agostino, R.B., Levy, D., Murabito, J.M., Wang, T.J., Wilson, P.W. & O'Donnell, C.J. (2004) Parental cardiovascular disease as a risk factor for cardiovascular disease in middle-aged adults, a prospective study of parents and offspring. JAMA291, 2204,2211. McNulty, H., Dowey le, R.C., Strain, J.J., Dunne, A., Ward, M., Molloy, A.M., McAnena. L.B., Hughes, J.P., Hannon-Fletcher, M. & Scott, J.M. Riboflavin lowers homocysteine in individuals homozygous for the MTHFR 677C->T polymorphism. Circulation113, 74,80. [source] Vaginal misoprostol for cervical priming before dilatation and curettage in postmenopausal women: A randomized controlled trialJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 3 2004Soysuwan Bunnasathiansri Abstract Aim: To investigate the efficacy of vaginal misoprostol for cervical priming before dilatation and curettage in postmenopausal women. Methods: Forty-four postmenopausal women with indication for dilatation and curettage were randomly assigned to receive either 400 µg of misoprostol or placebo vaginally 6 h before dilatation and curettage. The main outcome measures were the number of women who required cervical dilatation, cervical width, time taken to dilate to Hegar 6 and other complications. Results: The mean cervical diameter (4.59 millimeters in the misoprostol group vs 4.41 millimeters in the placebo group) was comparable between the two groups. A similar number of women in the misoprostol group and in the placebo group required cervical dilatation (12 vs 16, P = 0.35). The operative times for both groups were similar. The incidence of side-effects was comparable in both groups. There were two uterine perforations in the misoprostol group (2 vs 0). Conclusion: There was no significant benefit from applying 400 µg vaginal misoprostol 6 h prior to dilatation and curettage in postmenopausal women. [source] Removable prosthodontic services, including implant-supported overdentures, provided by dentists and denturistsJOURNAL OF ORAL REHABILITATION, Issue 4 2008J. G. EGAN Summary, The aim of this study was to evaluate the provision of removable prosthodontic services, including implant-supported overdentures, by dentists and denturists. A structured questionnaire was mailed to 474 randomly chosen dentists and 156 denturists registered to practise in New Zealand. Information was sought on the range of removable prosthodontic services provided (including implant-supported overdentures) and the professional fees charged for them. From 410 respondents, there was an overall response rate of 67.43%; 290 came from the dentists (males 78.6%, n = 228; females 21.48%, n = 62) and 120 from denturists (males 91.7%, n = 110; females 8.3%, n = 10). Most respondents were over 40 years of age, with one in three denturists (but only one in seven dentists) over 60 years of age. The extent of removable prosthodontic services varied. One-third of dentists referred complete denture patients and denturists referred a similar number of immediate denture cases. Denturists' complete denture, immediate denture and single reline prices were generally lower than those from dentists. Removable partial denture prices were similar. Implant-supported overdentures were recommended for edentulous patients by one-third of the dentists and three out of four denturists. Forty per cent of denturists (but only 10% of dentists) charged The relationship between craniofacial anatomy and obstructive sleep apnoea: a case-controlled studyJOURNAL OF SLEEP RESEARCH, Issue 3 2007AMA JOHAL Summary The aim of the study was to identify craniofacial and pharyngeal anatomical factors directly related to obstructive sleep apnoea (OSA). The design and setting was a hospital-based, case-controlled study. Ninety-nine subjects (78 males and 21 females) with a confirmed diagnosis of OSA, who were referred to the Dental Hospital for construction of a mandibular advancement splint were recruited. A similar number of control subjects, matched for age and sex, were recruited after completing snoring and Epworth Sleepiness Scale questionnaires to exclude habitual snoring and daytime sleepiness. An upright cephalogram was obtained and skeletal and soft tissue landmarks were traced and digitized. In OSA subjects the anteroposterior skeletal measurements, including maxillary and mandibular length were reduced (P < 0.001). The intermaxillary space was found to be 3.1 mm shorter in OSA subjects (P = 0.001). The nasopharyngeal airway in OSA subjects was narrower (P < 0.001) but pharyngeal length showed no difference. The tongue size was increased (P = 0.021), soft plate length, thickness and area were all greater (P < 0.001) and the hyoid bone was more inferiorly positioned in OSA subjects (P < 0.001). This study identifies a significant number of craniofacial and pharyngeal anatomical factors directly related to OSA. [source] Should Health-Care Providers in the United States Have Access to Influenza Vaccines Formulated for the Southern Hemisphere?JOURNAL OF TRAVEL MEDICINE, Issue 6 2008Raymond A. Strikas MD Background Influenza is the most common vaccine-preventable disease in travelers. It circulates year-round in the tropics, November to March in the northern hemisphere (NH), and April to October in the southern hemisphere (SH). In 2005, approximately 8.5 million US adults aged 18 years and older traveled to the Caribbean. A similar number traveled to the tropics and the SH. SH formulation of influenza vaccine is not available in the United States. We surveyed International Society of Travel Medicine (ISTM) members to ask if they would use SH influenza vaccine if available. Methods We electronically mailed a survey in December 2006 to 1,251 ISTM members in the United States. We asked if respondents would use SH vaccine for patients traveling to the SH or tropics, how many such patients per week they see, and their practice location. Results We received 157 responses for a response rate of 12.5%. Of these, 129 (82%) stated that they would be interested in having SH influenza vaccine available. Of those indicating interest, 73 (60%) reported seeing >10 patients traveling to the SH or tropics each week. Respondents reported practice settings in 34 states and the District of Columbia. Respondents requested more information about the likely cost of SH influenza vaccine, ordering conditions, vaccine use guidelines, comparability with NH vaccine, and approval of SH vaccine by the Food and Drug Administration. Conclusions Many travelers to the SH are at risk for influenza infection. Although only a limited number of ISTM members responded, respondents indicated considerable interest in availability of SH influenza vaccine for their patients. More data from travel medicine and other practitioners are needed on this topic. Inquiries are being made of influenza vaccine manufacturers about licensing SH influenza vaccines in the United States. Adding SH influenza vaccine to the vaccines available to NH clinicians could help mitigate the morbidity of influenza in travelers. [source] The odour of pyrazine increases the egg mass of domestic chickens (Gallus gallus domesticus L.)JOURNAL OF ZOOLOGY, Issue 3 2002Anat Barnea Abstract Forty leghorn chickens at the commencement of egg laying, were divided into two groups, each with 10 females and 10 males. One group was exposed to the odour of synthetic pyrazine (2-methoxy-3-isobutylpyrazine) for 16 weeks while the other acted as a control. During the first 4 weeks the hens exposed to pyrazine odour laid significantly fewer eggs (unfertilized) than the controls, but thereafter both groups laid a similar number. Mean egg mass of the pyrazine exposed hens was significantly (P= 0.012) greater (5.5%) than that of the control group. No significant difference was found in body mass or eggshell thickness. Similarly, there were no consistent significant differences between groups in oestrogen and testosterone concentrations in the blood of females and males, respectively. No pyrazine could be detected in cloacal extracts. The experiment shows that an external odour can affect the internal reproductive system of the chicken. It is suggested that the pyrazine-engendered increase in egg mass involves neuroendocrine regulation within the hypothalamus rather than hormonal interactions ,downstream' of the brain. [source] The Contribution of Collaborative and Individual Tasks to the Acquisition of L2 VocabularyMODERN LANGUAGE JOURNAL, Issue 1 2008YOUJIN KIM Over the past 2 decades, research has demonstrated that learner collaboration facilitates second language (L2) acquisition (Lapkin, Swain, & Smith, 2002; McDonough, 2004; Storch, 1998, 2004; Swain & Lapkin, 1998). Adopting a sociocultural perspective (e.g., Swain & Lapkin, 1998), the current study compared the effectiveness of collaborative and individual tasks on the acquisition of L2 vocabulary by Korean as a second language (KSL) learners (N= 32). The learners completed a pretest, a dictogloss task, and two posttests over a 3-week period. Half the learners carried out the dictogloss in pairs, but the other half worked individually while thinking aloud. The collaborative dialogue and think-aloud protocols were transcribed, and language-related episodes (LREs) were identified. The results indicated that although the learners who participated in the collaborative task had a similar number of LREs as the learners who worked individually, they performed significantly better on the vocabulary tests. The pedagogical implications for the use of collaborative tasks to promote the acquisition of L2 vocabulary are discussed. [source] Evidence based guidelines and current practice for physiotherapy management of knee osteoarthritisMUSCULOSKELETAL CARE, Issue 1 2009Nicola E. Walsh MSc MCSP Abstract Objectives:,To document physiotherapy provision for patients with knee osteoarthritis (OA) in relation to the United Kingdom (UK) recently published National Institute of health and Clinical Excellence (NICE) guidelines for osteoarthritis. Design:,Questionnaire survey of chartered physiotherapists. Method:,300 postal questionnaires were distributed to Physiotherapy Departments requesting information regarding source of referrals, treatment aims, preferred methods of treatment and service delivery. Results:,Responses were received from 83 physiotherapists (28 %), predominantly working in the UK National Health Service. Approximately equal numbers of referrals came from primary and secondary care. Aims of physiotherapy management were to; encourage self-management; increase strength and range of movement; reduce pain; and improve function. To achieve these, exercise was utilised by 100% of practitioners, often supplemented with electrotherapeutic modalities (66%), manual therapy (64%) and acupuncture (60%). The majority of patients received individual treatment for a total contact time of 1,2 hours, whilst most group interventions lasted 5,6 hours. Approximately half (54%) of respondents reported using outcome measures to determine treatment efficacy. Conclusions:,Although knee OA is usually managed in primary care, the similar number of referrals from primary and secondary care may suggest a deviation from evidence-based management guidelines. The guidelines' recommendations of exercise, patient education and self-management are observed by physiotherapists, but other modalities are often used despite poor or no research evidence supporting their efficacy. Whether any of these interventions are clinically beneficial is speculative as treatment outcomes were frequently under-evaluated. Copyright © 2008 John Wiley & Sons, Ltd. [source] Relationship Fundraising: How to Keep Donors LoyalNONPROFIT MANAGEMENT & LEADERSHIP, Issue 2 2001Adrian Sargeant This article explores how relationship marketing and its variant relationship fundraising may be used to assist nonprofits in reducing the lapse rate of donors to their organization. Employing a postal survey of ten thousand donors to causes in a variety of categories, the author concludes that although approximately one in five donors might lapse because of a change in financial circumstances, a similar number simply elect to switch their support to other organizations. The role of the quality of service offered to the donor in enhancing retention is also highlighted, as are donor perceptions of the feedback they receive and the impact they believe their gift might have on the cause. [source] Social facilitation affects longevity and lifetime reproductive success in a self-fertilizing land snailOIKOS, Issue 3 2000Bruno Baur Factors that reduce the reproductive output of self-fertilizing hermaphrodites are receiving increasing attention. The combined effects of reduced fecundity of selfing parents and inbreeding depression of the progeny have been referred to as self-fertilization depression. In isolated freshwater snails the reproductive output of selfing individuals also decreases due to the lack of social facilitation (absence of a conspecific). We examined the effect of social facilitation on lifetime reproductive success (number of young produced and longevity) over two generations in the simultaneously hermaphroditic land snail Balea perversa. In a parallel study we showed that B. perversa kept singly and in pairs reproduced exclusively by self-fertilization. In the parent generation, snails kept singly produced less offspring than snails kept in pairs. The difference in lifetime number of young was mainly due to differences in adult life span. Snails of the two groups did not differ in reproductive rate (number of young produced per 100 d of reproductive life) and hatchling size. In the offspring generation, snails kept singly did not differ from individuals kept in pairs in the lifetime number of young and hatchling survival. As in the parent generation, snails kept singly reproduced during a shorter period than snails kept in pairs. However, the shorter reproductive life span of snails kept singly was compensated for by a slightly (but not significantly) higher reproductive rate which resulted in a similar number of offspring produced for both groups. In both generations, snails of the two groups did not differ in size at first reproduction, adult growth rate and size at death. These findings suggest that social facilitation may affect longevity in selfing B. perversa. [source] Clinical and Economic Characteristics of Patients with Painful Neuropathic Disorders in GermanyPAIN PRACTICE, Issue 1 2009Ariel Berger MPH Abstract Using a large database with information from general practitioners (GP) throughout Germany, we identified all adults (age ,18 years) with encounters for painful neuropathic disorders (PNDs) between August 1, 2005 and July 31, 2006 (PND patients). We also constituted an age- and sex-matched comparison group, consisting of randomly selected patients without any GP encounters for PNDs during the same period. Selected characteristics were then compared between PND patients and those in the comparison group over the 1-year study period. The study sample consisted of 275,685 PND patients and a similar number in the matched comparison group; mean age was 53.7 years, and 57% were women. PND patients were more likely than matched comparators to have encounters for various comorbidities, including circulatory system disorders (47% vs. 20%, respectively), depression (9% vs. 2%), and anxiety (4% vs. 1%) (all P < 0.01). They also were more likely to have received pain-related medications (57% vs. 13% for comparison group; P < 0.01),most commonly, nonsteroidal anti-inflammatory drugs, benzodiazepines, and opioids, and less often, tricyclic antidepressants and anti-epileptics. PND patients averaged 7.3 more GP visits during the year (mean [95% CI] = 9.9 [9.9, 9.9] vs. 2.6 [2.6, 2.7] for comparison group); they also had significantly more specialist referrals and physician-excused absences from work (all P < 0.01). Patients with PNDs under the care of GPs in Germany have comparatively more comorbidities and higher levels of use of healthcare services. The pain-related medications that these patients receive raise concerns that PNDs may not be optimally treated in these settings. [source] An Evaluation of Hsp90 as a Mediator of Cortical Patterning in TetrahymenaTHE JOURNAL OF EUKARYOTIC MICROBIOLOGY, Issue 2 2001JOSEPH FRANKEL ABSTRACT. This study asks two questions: 1) whether Hsp90 is involved in the regulation of cortical patterning in Tetrahymena, and 2) if it is, whether specific defects in this regulation can be attributed to functional insufficiency of the Hsp90 molecule. To address question I, we compared the effects of a specific inhibitor of Hsp90, geldanamycin, on population growth and on development of the oral apparatus in two Tetrahymena species, T. pyriformis and T. thermophila. We observed that geldanamycin inhibits population growth in both species at very low concentrations, and that it has far more severe effects on oral patterning in T. pyriformis than in T. thermophila. These effects are parallel to those of high temperature in the same two species, and provide a tentative affirmative answer to the first question. To address question 2, we ascertained the base sequence of the genes that encode the Hsp90 molecules which are induced at high temperatures in both Tetrahymena species, as well as corresponding sequences in Paramecium tetraurelia. Extensive comparative analyses of the deduced amino acid sequences of the Hsp90 molecules of the two Tetrahymena species indicate that on the basis of what we currently know about Hsp90 both proteins are equally likely to be functional. Phylogenetic analyses of Hsp90 amino acid sequences indicate that the two Tetrahymena Hsp90 molecules have undergone a similar number of amino acid substitutions from their most recent common ancestor, with none of these corresponding to any known functionally critical region of the molecule. Thus there is no evidence that the Hsp90 molecule of T. pyriformis is functionally impaired; the flaw in the control of cortical patterning is more likely to be caused by defects in mechanism(s) that mediate the response to Hsp90, as would be expected from the "Hsp90 capacitor" model of Rutherford and Lindquist. [source] Synaptic heterogeneity between mouse paracapsular intercalated neurons of the amygdalaTHE JOURNAL OF PHYSIOLOGY, Issue 1 2007Raffaella Geracitano GABAergic medial paracapsular intercalated (Imp) neurons of amygdala are thought of as playing a central role in fear learning and extinction. We report here that the synaptic network formed by these neurons exhibits distinct short-term plastic synaptic responses. The success rate of synaptic events evoked at a frequency range of 0.1,10 Hz varied dramatically between different connected cell pairs. Upon enhancing the frequency of stimulation, the success rate increased, decreased or remained constant, in a similar number of cell pairs. Such synaptic heterogeneity resulted in inhibition of the firing of the postsynaptic neurons with different efficacies. Moreover, we found that the different synaptic weights were mainly determined by diversity in presynaptic release probabilities rather than postsynaptic changes. Sequential paired recording experiments demonstrated that the same presynaptic neuron established the same type of synaptic connections with different postsynaptic neurons, suggesting the absence of target-cell specificity. Conversely, the same postsynaptic neuron was contacted by different types of synaptic connections formed by different presynaptic neurons. A detailed anatomical analysis of the recorded neurons revealed discrete and unexpected peculiarities in the dendritic and axonal patterns of different cell pairs. In contrast, several intrinsic electrophysiological responses were homogeneous among neurons, and synaptic failure counts were not affected by presynaptic cannabinoid 1 or GABAB receptors. We propose that the heterogeneous functional connectivity of Imp neurons, demonstrated by this study, is required to maintain the stability of firing patterns which is critical for the computational role of the amygdala in fear learning and extinction. [source]
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