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Selected AbstractsManagement of chronic hand eczemaCONTACT DERMATITIS, Issue 4 2007Thomas L. Diepgen Hand eczema (HE) is one of the most frequent skin diseases and has often a chronically relapsing course with a poor prognosis resulting in a high social and economic impact for the individual and the society. In this article, we highlight the results of an expert workshop on the ,management of severe chronic hand eczema' with the focus on the epidemiology, the burden of severe HE, its classification and diagnostic procedures, and the current status of treatment options according to an evidence-based approach (randomized controlled clinical trials, RCTs). We conclude that despite the abundance of topical and systemic treatment options, disease management in patients with severe chronic HE is frequently inadequate. There is a strong need for RCTs of existing and new treatment options based on clearly diagnosed subtypes of HE and its severity. [source] The relationship of environmental and economic performance at the firm level: a review of empirical studies in Europe and methodological commentsENVIRONMENTAL POLICY AND GOVERNANCE, Issue 3 2002Marcus Wagner This paper reviews empirical studies on the relationship between environmental and economic performance carried out with European data in order to derive conclusions with regard to their methodological comparability. Two types of research are analysed, namely (model) portfolio studies and multiple-regression-based studies. For each type two representative empirical studies are contrasted in order to establish methodological influences, as well as the importance of data availability. The review allows us to formulate a set of criteria to support improved research design in the future. These point to a strong need to develop further the methodology of studies on the relationship between environmental and economic performance. Copyright © 2002 John Wiley & Sons, Ltd. and ERP Environment [source] Review of the functional surgical treatment of dystoniaEUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2001Paul Krack A review of functional surgery for dystonia is presented. Recently renewed interest in stereotaxy for dystonia has followed the resurgence of pallidotomy and the introduction of deep brain stimulation (DBS) in Parkinson's disease (PD) in the early 1990s. However, even since the 1950s, small series of patients treated with ablative surgery have been carefully studied, providing useful information, notably regarding the tolerability of surgery. In the setting of dystonia, thalamotomy was first performed with substantial benefits, but some authors outlined the great variability in outcome, and the high incidence of operative side-effects. In the ,modern' era of functional surgery for movement disorders, the globus pallidus internus (GPi) has emerged to be currently the best target for dystonia, based on small series of patients published in the last few years. Both bilateral posteroventral pallidotomy (PVP) and bilateral pallidal stimulation, performed by several teams, have benefited a variety of patients with severe dystonia, the most dramatic improvements being seen in primary dystonia with a mutation in the DYT1 gene. Whereas patients with secondary dystonia have often shown a lesser degree of improvement, some publications have nevertheless reported major benefit. There is today a strong need for carefully controlled studies comparing secondary and primary dystonia, DYT1 and non-DYT1 dystonia, ablative surgery and DBS, with additional assessment of neuropsychological changes, especially in children treated with bilateral pallidal procedures. [source] The effect of topically applied salicylic compounds on serotonin-induced scratching behaviour in hairless ratsEXPERIMENTAL DERMATOLOGY, Issue 4 2002J. S. Thomsen Abstract: There is a strong need for antipruritic substances for treating itch in clinical dermatology. In one recent human study, topically applied acetylsalicylic acid has been described to rapidly decrease histamine-induced itch. We have established a model for periferally elicited pruritus by injecting serotonin into the rostral back area (neck) in rats. Using this model, we aimed to investigate the antipruritic potential of four different salicylic compounds, which all possess different skin penetration characteristics. Eighteen rats were studied for 6 weeks. Prior to serotonin injections (2 mg/ml, 50 µl), 10 µl of test substances was applied to a circular area 18 mm in diameter. The four substances were salicylic acid, butyl salicylate, diethylamine salicylate and salicylamide, all solubilized in dimethyl isosorbide to a concentration of 5% w/w. Diethylamine salicylate and salicylamide were previously shown to be slowly absorbed through rat skin in contrast to salicylic acid and butyl salicylate. After serotonin injections, scratching was monitored by video recording for 1.5 h. Compared with the vehicle, a lower number of scratch sequences were seen when diethylamine salicylate (P < 0.001) and salicylamide (P = 0.005) had been applied. The numbers of scratch sequences were lower with diethylamine salicylate and salicylamide than with the vehicle throughout the 1.5-h study period. We conclude that topical application of diethylamine salicylate and salicylamide could suppress serotonin-induced scratching in rats. The antipruritic effect seems to be related to the slow drug release of the two substances. The results may be clinically relevant as serotonin induces itch in humans. [source] Post-return experiences and transnational belonging of return migrants: a Dutch,Moroccan case studyGLOBAL NETWORKS, Issue 4 2010JUNE DE BREE Abstract In this article we explore the links between return migration, belonging and transnationalism among migrants who returned from the Netherlands to northeast Morocco. While transnationalism is commonly discussed from the perspective of a receiving country, this study shows that transnationalism also plays a vital role in reconstructing post-return belonging. Return migration is not simply a matter of ,going home', as feelings of belonging need to be renegotiated upon return. While returnees generally feel a strong need to maintain various transnational practices, the meanings they attach to these practices depend on motivations for return, gender and age. For former (male) labour migrants, transnational practices are essential for establishing post-return belonging, whereas such practices are less important for their spouses. Those who returned as children generally feel uprooted, notwithstanding the transnational practices they maintain. The amount of agency migrants are able to exert in the return decision-making process is a key factor in determining the extent to which returnees can create a post-return transnational sense of home. [source] Detection of apoptotic caspase activation in sera from patients with chronic HCV infection is associated with fibrotic liver injuryHEPATOLOGY, Issue 5 2004Heike Bantel Chronic hepatitis C virus (HCV) infection is characterized by inflammatory liver damage and is associated with a high risk of development of cirrhosis and hepatocellular carcinoma. Although histological examination of liver biopsies is currently the gold standard for the detection of early liver damage, there is a strong need for better noninvasive methods. We recently demonstrated that the proapoptotic activation of caspases is considerably enhanced in histological sections from HCV-infected liver tissue, suggesting an important role of apoptosis in liver damage. Here, we investigated whether caspase activation is detectable also in sera from patients with chronic HCV infection. Using a novel enzyme-linked immunosorbent assay that selectively recognizes a proteolytic neoepitope of the caspase substrate cytokeratin-18, we demonstrate that caspase activity is markedly increased in the sera of HCV patients. Interestingly, while 27% of patients with chronic HCV infection showed normal aminotransferase levels despite inflammatory and fibrotic liver damage, more than 50% of those patients exhibited already elevated serum caspase activity. Moreover, 30% of patients with normal aminotransferase but elevated caspase activity revealed higher stages of fibrosis. In conclusion, compared with conventional surrogate markers such as aminotransferases, detection of caspase activity in serum might be a more sensitive method of detecting early liver injury. Thus, measurement of caspase activity might provide a novel diagnostic tool, especially for patients with normal aminotransferases but otherwise undiagnosed histologically active hepatitis and progressive fibrosis. (HEPATOLOGY 2004;40:1078,1087.) [source] Signs and symptoms from ectodermal organs in young Swedish individuals with oligodontiaINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 5 2006B. BERGENDAL Summary., Objectives., The aim was to assess signs and symptoms from other ectodermal organs in addition to teeth in young individuals with oligodontia and to establish the prevalence of oligodontia. Sample and methods., Children born 1981,94 reported by dental teams in the Public Dental Service to have oligodontia were asked to participate in a clinical study. The examinations comprised a structured interview on symptoms from ectodermal organs, and testing of salivary secretion. Results., One hundred and sixty-two individuals met the inclusion criteria, and 123 individuals (75·9%) participated in the clinical study. Half of the individuals had one to four signs or symptoms from ectodermal organs beside oligodontia. The most common sign was low salivary secretion. Twelve individuals (9·6%) with isolated oligodontia reported impaired function of the sweat glands, hair, or nails. The prevalence of oligodontia was 0·090%. Conclusions., An early identification of individuals with oligodontia can be made in a majority of cases by checking that all permanent incisors have erupted at the age of 8 years. The validity in asking individuals about normal and abnormal function of ectodermal organs was found to be low. This indicates that there is a strong need to establish routine clinical criteria for dysplasia of ectodermal organs. [source] A systematic review of the effectiveness of negative pressure wound therapy in the management of diabetes foot ulcersINTERNATIONAL WOUND JOURNAL, Issue 2 2008Georgia Noble-Bell Abstract Foot ulcers are a common complication in patients with diabetes. Negative pressure wound therapy (NPWT) is a wound care therapy that is being increasingly used in the management of foot ulcers. This article presents a systematic review examining the effectiveness of this therapy. The review question is how effective is NPWT in achieving wound healing in diabetes foot ulcers? The primary outcome for this study was the number of patients achieving complete wound healing (secondary outcomes, other markers of wound healing, adverse events and patient satisfaction). A systematic literature review and tabulative synthesis of randomised controlled trials (RCTs). The review identified four RCTs of weak to moderate quality. Only one study examining NPWT in postamputation wound healing reported data on the primary outcome. These data show a 20% improvement in wound healing [odds ratios = 2·0%, confidence interval (CI) ,1·0 to 4·0] and number needed to treat = 6 (CI 4,64). No serious treatment-related complications were reported by any of the studies. One study suggested a reduction in the risk of secondary amputation (absolute risk reduction = 7·9%, CI 0·5,15·43). Studies also reported an increase in granulation and wound-healing rates in patients treated with NPWT therapy. No data on patient satisfaction or experience were reported. While all the studies included in the review indicated that the NPWT therapy is more effective than conventional dressings, the quality of the studies were weak and the nature of the inquiries in terms of outcome and patient selection divergent. There is a strong need for larger trials to assess NPWT therapy in diabetes care with different groups of patients and in relation to different clinical objectives and parameters. [source] An investigation of incident frequency, duration and lanes blockage for determining traffic delayJOURNAL OF ADVANCED TRANSPORTATION, Issue 3 2009Yi (Grace) Qi Traffic delay caused by incidents is closely related to three variables: incident frequency, incident duration, and the number of lanes blocked by an incident that is directly related to the bottleneck capacity. Relatively, incident duration has been more extensively studied than incident frequency and the number of lanes blocked in an incident. In this study, we provide an investigation of the influencing factors for all of these three variables based on an incident data set that was collected in New York City (NYC). The information about the incidents derived from the identification can be used by incident management agencies in NYC for strategic policy decision making and daily incident management and traffic operation. In identifying the influencing factors for incident frequency, a set of models, including Poisson and Negative Binomial regression models and their zero-inflated models, were considered. An appropriate model was determined based on a model decision-making tree. The influencing factors for incident duration were identified based on hazard-based models where Exponential, Weibull, Log-logistic, and Log-normal distributions were considered for incident duration. For the number of lanes blocked in an incident, the identification of the influencing factors was based on an Ordered Probit model which can better capture the order inherent in the number of lanes blocked in an incident. As identified in this study, rain is the only factor that significantly influenced incident frequency. For incident duration and the number of lanes blocked in an incident, various factors had significant impact. As concluded in this study, there is a strong need to identify the influencing factors in terms of different types of incidents and the roadways where the incidents occured. [source] Trust in digital informationJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 3 2008Kari Kelton Trust in information is developing into a vitally important topic as the Internet becomes increasingly ubiquitous within society. Although many discussions of trust in this environment focus on issues like security, technical reliability, or e-commerce, few address the problem of trust in the information obtained from the Internet. The authors assert that there is a strong need for theoretical and empirical research on trust within the field of information science. As an initial step, the present study develops a model of trust in digital information by integrating the research on trust from the behavioral and social sciences with the research on information quality and human, computer interaction. The model positions trust as a key mediating variable between information quality and information usage, with important consequences for both the producers and consumers of digital information. The authors close by outlining important directions for future research on trust in information science and technology. [source] Plasticity and ambiguity of the electrophysiological phenotypes of enteric neuronsNEUROGASTROENTEROLOGY & MOTILITY, Issue 9 2009K. Nurgali Abstract, Advances in knowledge of enteric neurons electrophysiological characteristics have led to the realisation that the properties of the neurons are dependent on the state of the intestine, the region, the method of recording and the species. Thus, under different experimental conditions, electrophysiological studies cannot provide a reliable signature that identifies the functional type of neuron. In the normal guinea-pig small intestine, taken as a model tissue, neurons can be separated into two electrophysiological groups, S and AH neurons. Combined morphological and physiological studies place several classes of motor and interneurons in the S group, and intrinsic primary afferent neurons in the AH group. There is some evidence for subgroups of S neurons, in which electrophysiological differences are correlated with functional subtypes, but these subgroups have been incompletely investigated. Morphologically characterized Dogiel type II (DII) neurons are recognisable in many species, from mouse to human, but their electrophysiological characteristics are only partly conserved across species or cannot be satisfactorily defined due to technical difficulties. There is a strong need for a comprehensive analysis of channels and currents of S/Dogiel type I neuron subtypes, similar to the comprehensive analysis of AH/DII neurons in the guinea-pig, and similar studies need to be conducted in human and other species. The purpose of this review is to highlight that criteria used for electrophysiological definition of enteric neurons might not be sufficient to distinguish between functional classes of neurons, due to intrinsic properties of neuronal subpopulations, plasticity in pathological conditions and differences in recording techniques. [source] ,Smart' delivery systems for biomolecular therapeuticsORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 3 2005PS Stayton Structured Abstract Authors ,, Stayton PS, El-Sayed MEH, Murthy N, Bulmus V, Lackey C, Cheung C, Hoffman AS Objective ,, There is a strong need for drug delivery systems that can deliver biological signals from biomaterials and tissue engineering scaffolds, and a particular need for new delivery systems that can efficiently deliver biomolecules to intracellular targets. Viruses and pathogens have evolved potent molecular machinery that sense the lowered pH gradient of the endosomal compartment and become activated to destabilize the endosomal membrane, thereby enhancing protein or DNA transport to the cytoplasmic compartment. A key feature of many of these biological delivery systems is that they are reversible, so that the delivery systems are not directly toxic. These delivery systems have the ability to change their structural and functional properties and thus display remarkable ,smart' material properties. The objective of this presentation is to review the initial development of smart polymeric carriers that mimic these biological delivery systems and combine similar pH-sensitive, membrane-destabilizing activity for the delivery of therapeutic biomolecules. Design ,, We have developed new ,smart' polymeric carriers to more effectively deliver and broaden the available types of biomolecular therapeutics. The polymers are hydrophilic and stealth-like at physiological pH, but become membrane-destabilizing after uptake into the endosomal compartment where they enhance the release of therapeutic cargo into the cytoplasm. They can be designed to provide a range of pH profiles and membrane-destabilizing activities, allowing their molecular properties to be matched to specific drugs and loading ranges. A versatile set of linker chemistries is available to provide degradable conjugation sites for proteins, nucleic acids, and/or targeting moieties. Results ,, The physical properties of several pH-responsive polymers were examined. The activity and pH profile can be manipulated by controlling the length of hydrophobic alkyl segments. The delivery of poly(propyl acrylic acid) (PPAA)-containing lipoplexes significantly enhanced wound healing through the interconnected effects of altered extracellular matrix organization and greater vascularization. PPAA has also been shown to enhance cytoplasmic delivery of a model protein therapeutic. Polymeric carriers displaying pH-sensitive, membrane-destabilizing activity were also examined. The pH profile is controlled by the choice of the alkylacrylic acid monomer and by the ratio of the carboxylate-containing alkylacrylic acid monomer to alkylacrylate monomer. The membrane destabilizing activity is controlled by the lengths of the alkyl segment on the alkylacrylic acid monomer and the alkylacrylate monomer, as well as by their ratio in the final polymer chains. Conclusion ,, The molecular mechanisms that proteins use to sense and destabilize provide interesting paradigms for the development of new polymeric delivery systems that mimic biological strategies for promoting the intracellular delivery of biomolecular drugs. The key feature of these polymers is their ability to directly enhance the intracellular delivery of proteins and DNA, by destabilizing biological membranes in response to vesicular compartment pH changes. The ability to deliver a wide variety of protein and nucleic acid drugs to intracellular compartments from tissue engineering and regenerative scaffolds could greatly enhance control of important processes such as inflammation, angiogenesis, and biomineralization. [source] Current practices in depression careTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue S1 2007Albert Yeung MD Abstract Despite improved awareness among the medical community concerning common mental health disorders, the high prevalence of depression in the United States remains unchanged1 and has been compounded by increasing evidence of gaps in mental health care for ethnic and racial minorities.1,2 Thus, there is a strong need for the timely creation of comprehensive educational initiatives aimed at improving the quality of care provided by mental health professionals and primary care physicians. Fundamental to this process is the examination of current treatment standards, as well as identification of practices that require improved physician education. Consistent use of appropriate screening tools, diagnostic accuracy and timeliness, continual assessment of illness severity, adherence to practice guidelines, and individualized patient care need heightened attention to improve outcomes. This article describes the most prevalent types of depression and summarizes current practices in depression care, with an emphasis on treatment standards and opportunities for improved performance. [source] A Novel Approach to Align Adult Neural Stem Cells on Micropatterned Conduits for Peripheral Nerve Regeneration: A Feasibility StudyARTIFICIAL ORGANS, Issue 1 2009Shan-hui Hsu Abstract There is a strong need for nerve-tissue engineering using the guide conduit and Schwann cells or neural stem cells (NSCs) with regeneration potential for injured peripheral nerves. In this study, micropatterned poly(d,l -lactide) (PLA) conduits were fabricated by microlithography and solvent-casting. The PLA conduits were seeded with the novel green fluorescent protein (GFP)-positive adult mouse NSCs obtained using the patented method of one of the authors. About 85% of the seeded NSCs were successfully aligned on the micropatterned conduits within 72 h and expressed the genes related to the production of neurotrophic factors. Gene expressions for the neurotrophic factors, such as nerve growth factor and brain-derived neurotrophic factor were upregulated by the micropatterned conduits at 72 h. The micropatterned PLA conduits seeded with the aligned NSCs were used to bridge the 10-mm sciatic nerve gaps in rats and were found to facilitate nerve repair and functional recovery during a period of 6 weeks compared with the nonseeded group. This model can be used to study the role of adult NSCs in peripheral-nerve regeneration in the future. [source] Therapeutic Equivalence , Clinical Issues and Statistical Methodology in Noninferiority TrialsBIOMETRICAL JOURNAL, Issue 1 2005Axel Munk This special issue on therapeutic equivalence contains a selection of 8 papers presented at the conference ,Therapeutic Equivalence , Clinical Issues and Statistical Methodology in Noninferiority Trials' held in Düsseldorf, December 12,13, 2003. The aim of this conference was to gather experts from academics, industry and regulatory agencies in the field of therapeutic equivalence, in particular of noninferiority trials. Originally initiated as a small workshop, it soon turned out that there is obviously strong need to discuss these challenging issues at a broader auditorium. Indeed, the feedback to this conference was overwhelming, finally more than 300 researchers participated. Hence the idea emerged to collect the results and discussions in a single journal issue. It took more than a year to finish it, and various activities in this rapidly developing area have been going on and were incorporated. We are very grateful to the Editors E. Brunner and M. Schumacher of the Biometrical Journal for their encouragement and support to publish this special issue on the occasion of this conference. Further, the technical assistance and expertise of G. Skipka and K. Thangavelu is gratefully acknowledged. We are also indebted to Peter Bauer and Stephen Senn for their discussions of the subsequent articles by Bristol, Freitag, Hauschke, Slacik-Erben, Hensen and Kaufmann, Hung, Wang and O'Neill, Lange and Freitag, Tsong and Zhang, Wellek, and last but not least we would like to thank Joachim Röhmel for his contribution to this special issue. Joachim Röhmel contributed significantly during the last three decades to various branches of biostatistical research, and in particular to the design and analysis of equivalence trials. The aim of this special issue is therefore twofold, it is also devoted to the occasion of Joachim Röhmel's retirement from BfArM in 2004. In the following we would briefly like to express our deep appreciation of his scientific work. (© 2005 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] On Strategy and Management Control: The Importance of Classifying the Strategy of the BusinessBRITISH JOURNAL OF MANAGEMENT, Issue 3 2000Magnus Kald The point of departure for this paper is a number of contingency-theory studies on the relationship between business strategy and the design and use of management control. In these studies strategy has been operationalized in different ways , a major reason why the findings are ambiguous and difficult to integrate. Thus there is a strong need for a common frame of reference for classifying business strategy. In view of the multifaceted nature of the concept of strategy, however, it is neither desirable nor possible to arrive at a single method of classification that would be appropriate in all situations. Rather, the task is to integrate different strategic variables such as strategic pattern, strategic position and strategic mission. In this paper we show how these three variables may be assumed to influence, and be influenced by, what characterizes changes in strategy and how business units manage their product offerings. Unlike most previous studies in the field, this paper discusses how the strategic variables taken together may be assumed to influence the classification of strategy and thus the design and use of the management-control system. Our deductive analysis, and the hypotheses used in connection with it, show that studies which consider only one strategic variable may lead to erroneous conclusions about the relationship between strategy and management control. 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