Effectiveness and safety of repeat courses of hylan G-F 20 in patients with knee osteoarthritis

Objective: To compare the effectiveness and safety of repeat treatment with hylan G-F 20 based on data from a randomized, controlled trial [Raynauld JP, Torrance GW, Band PA, Goldsmith CH, Tugwell P, Walker V, et al. A prospective, randomized, pragmatic, health outcomes trial evaluating the incorporation of hylan G-F 20 into the treatment paradigm for patients with knee osteoarthritis (Part 1 of 2): clinical results. Osteoarthritis Cartilage 2002;10:506-17]. The hypotheses tested were whether the single-course and repeat-course subgroups would be superior to appropriate care and not different from each other. Method: A total of 255 patients with knee osteoarthritis were randomized to appropriate care with hylan G-F 20 or appropriate care without hylan G-F 20. The hylan G-F 20 group was partitioned into two subgroups: (1) patients who received a single course of hylan G-F 20; and (2) patients who received two or more courses of hylan G-F 20. Results: For the primary effectiveness measure, change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score as a percent of baseline, the single-course subgroup improved by 41%, the repeat-course subgroup by 35%, and the appropriate care group by 14%. Both subgroups improved significantly more than the appropriate care group (P < 0.05), and were not statistically significantly different from each other (70% power to detect a 20% difference). Secondary effectiveness measures showed similar results. In the repeat-course subgroup, no statistically significant differences were found in the number of local adverse events, the number of patients with local adverse events, or arthrocentesis rates between the first and repeat courses of treatment. Conclusions: Although the study was neither designed nor powered to examine repeat treatment, this a posteriori analysis provides support for a favorable effectiveness and safety profile of hylan G-F 20 in repeat course patients. (C) 2004 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Quantitative analysis of the time courses of enzyme-catalyzed reactions

The catalytic properties of enzymes are usually evaluated by measuring and analyzing reaction rates. However, analyzing the complete time course can be advantageous because it contains additional information about the properties of the enzyme. Moreover, for systems that are not at steady state, the analysis of time courses is the preferred method. One of the major barriers to the wide application of time courses is that it may be computationally more difficult to extract information from these experiments. Here the basic approach to analyzing time courses is described, together with some examples of the essential computer code to implement these analyses. A general method that can be applied to both steady state and non-steady-state systems is recommended. (C) 2001 academic Press.

The preparation and readiness for voluntary movement: a high-field event-related fMRI study of the Bereitschafts-BOLD response

Activity within motor areas of the cortex begins to increase 1 to 2 s prior to voluntary self-initiated movement (termed the Bereitschaftspotential or readiness potential). There has been much speculation and debate over the precise source of this early premovement activity as it is important for understanding the roles of higher order motor areas in the preparation and readiness for voluntary movement. In this study, we use high-field (3-T) event-related fMRI with high temporal sampling (partial brain volumes every 250 ms) to specifically examine hemodynamic response time courses during the preparation, readiness, and execution of purely self-initiated voluntary movement. Five right-handed healthy volunteers performed a rapid sequential finger-to-thumb movement performed at self-determined times (12-15 trials). Functional images for each trial were temporally aligned and the averaged time series for each subject was iteratively correlated with a canonical hemodynamic response function progressively shifted in time. This analysis method identified areas of activation without constraining hemodynamic response timing. All subjects showed activation within frontal mesial areas, including supplementary motor area (SMA) and cingulate motor areas, as well as activation in left primary sensorimotor areas. The time courses of hemodynamic responses showed a great deal of variability in shape and timing between subjects; however, four subjects clearly showed earlier relative hemodynamic responses within SMA/cingulate motor areas compared with left primary motor areas. These results provide further evidence that the SMA and cingulate motor areas are major contributors to early stage premovement activity and play an important role in the preparation and readiness for voluntary movement. (C) 2003 Elsevier Inc. All rights reserved.

Oral Colonization of Streptococcus mutans in Six-month-old Predentate Infants

We hypothesize that S. mutans colonization occurs more frequently in pre-term children due to their relative immaturity. In this study of 172 predentate, six-month-old infants, we found that 50% of pre-term and 60% of full-term children harbored S. mutans. The colonization was confirmed by repeat sampling. Although there were minor differences, factors associated with S. mutans infection in pre-term and full-term infants were generally similar. In both groups, increased frequency of sugar was ranked the most important factor (p < 0.001), followed by breast-feeding (p < 0.001), and habits which allowed saliva transfer from mother to infant (p < 0.01). By contrast, non-colonization of S. mutans was associated with multiple courses of antibiotics (p < 0.001). Compared with pre-term children, there were higher percentages of full-term who had night feedings and consumed sugar during sleep times. Mothers with infected infants had S. mutans levels > 5 x 10(5) CFU/mL saliva (p < 0.001), poorer oral hygiene,, more periodontal disease, and lower socio-economic status (P < 0.02) and snacked frequently (p < 0.001), compared with mothers with non-infected infants.

Utility of serological follow-up of chronic strongyloidiasis after anthelminthic chemotherapy

The difficulty of establishing a diagnosis and confirming cure of strongyloidiasis is widely appreciated. As parasitological diagnosis is often unsatisfactory, serodiagnosis is frequently relied upon. The aim of this study was to investigate changes in Strongyloides-specific antibody levels among a group of 79 seropositive Indigenous Australians living in a Strongyloides-endemic region. Testing before and after treatment revealed that seroreversion occurred most commonly after multiple courses of ivermectin therapy, with antibody titres of 35/42 (83%) subjects becoming negative. Seroreversion was also common following a single course of ivermectin or multiple courses of a 3-day regimen of albendazole, with seroreversion occurring in 13/19 (68%) and 7/10 (70%) subjects respectively. One 3-day course of albendazole was less effective with 4/10 (40%) subjects seroreverting, whereas none of the five subjects receiving a single dose of albendazole and 1/10 (10%) of subjects receiving no therapy seroreverted. These results support the use of serological follow-up for strongyloidiasis, and indicate that reversion to negative serostatus after ivermectin therapy is frequent.

A naturalistic comparison of two right unilateral electroconvulsive therapy dosing protocols: 2-3X seizure threshold versus fixed high-dose

The aim of this study was to compare the outcomes associated with two differing right unilateral (RUL) electroconvulsive therapy (ECT) dosing protocols: 2-3X seizure threshold (2-3X ST) and fixed high dose (FHD) at 353 mC. A retrospective chart review was performed to compare patient outcomes during the implementation of two different dosing protocols: 2-3X ST from October 2000 to May 2001 and FHD from June 2001 to February 2002. A total of 56 patients received ECT under the 2-3X ST protocol, and 46 received ECT under the FHD protocol. In total, 13.6% of patients receiving ECT according to the 2-3X ST protocol received more than 12 ECT, whereas none of the FHD group received more than 12 ECT. The mean number of ECT per treatment course reduced significantly from 7.6 to 5.7 following the switch from the 2-3X ST protocol to the FHD protocol. There were no significant differences between the two groups in the incidence of adverse cognitive effects. ECT practitioners adhered to the 2-3X ST protocol for only 51.8% of ECT courses, with protocol adherence improving to 87% following introduction of the FHD protocol. Although this naturalistic retrospective chart survey had significant methodological limitations, it found that practitioners are more likely to correctly adhere to a fixed dose protocol, therefore, increasing its 'real world' effectiveness in comparison to titrated suprathreshold dosing techniques. The FHD protocol was associated with shorter courses of ECT than the 2-3X ST protocol, with no significant difference between the two protocols in clinically discernable adverse cognitive effects.

Photoinhibition in differently coloured juvenile leaves of Syzygium species

Photoinhibition, as measured by the dark-adapted chlorophyll a fluorescence ratio F-v/F-m, was assessed in Syzygium moorei, a species with dark green juvenile leaves, Syzygium corynanthum, which has light green juvenile leaves, and two species with pink-red juvenile leaves (Syzygium wilsonii and Syzygium luehmannii). All plants were glasshouse-grown (maximum PPFD 1500 mu mol m(-2) s(-1)) under optimum nutrition and water. When measured at midday, dark-adapted F-v/F-m ratios of juvenile leaves gradually increased in art species as percentage of full leaf expansion (% FLE) increased. Fluorescence measurement 3 h after sunset or pre-dawn also showed a developmental effect on F-v/F-m, with juvenile leaves of S, luehmannii and S. wilsonii showing much lower F-v/F-m at all stages of development. Dark-adapted F-v/F-m values in both juvenile and mature leaves generally never exceeded 0.8 at any stage in any of the species. Courses of F-v/F-m on sunny days showed greater diurnal photoinhibition in green juvenile (c, 50% FLE) leaves of S, moorei (24%) and S, corynanthum (36%) than in mature leaves of the previous flush in these species (<10%), Diurnal photoinhibition was statistically similar (18-24%) in pink-red juvenile and green mature leaves of S, luehmannii and S, wilsonii. Re-positioning juvenile leaves of S, wilsonii horizontally increased diurnal photoinhibition, Exposure of leaves to a standard mild photoinhibitory right treatment (30 min at 1000 mu mol m(-2) s(-1)) showed that juvenile leaves of air species had a lower percentage of high energy state quenching (qE) and a higher percentage of photoinhibitory quenching (ql) than mature leaves.

The incidence of schizophrenia: A systematic review

There has been a debate on whether or not the incidence of schizophrenia varies across time and place. In order to optimise the evidence upon which this debate is based, we have undertaken a systematicsystematic review of the literature. In this paper we provide an overview of the methods of the review and a preliminary analysis of the studies identified to date. Electronic databases (Medline, Psychlnfo, Embase, LILAC) were systematically searched for articles published between January 1965 and December 2001. The search terms were: (schizo* OR psycho*)AND (incidence OR prevalence). References were also identified from review articles, reference list and by writing to authors. To date we have identified 137 papers drawn from 33 nations. 37 papers in language other than English await translation. The currently included papers have generated 1413 different items of rate information data. In order to analyze these data we have undertaken several sequential filters in order to identify (a) non-overlapping data, (b) birth cohort study versus noncohort studies, (c) overall and sex-specific rates, (d) diagnostic criteria, (e) age ranges, (f) epoch of study, and (g) data on migrant or other special interest groups. In addition, we will examine the impact of urbanicity of site, age and/or sex standardization, and quality score on the incidence rates. The various discrete incidence rates will be presented graphically and the impact of various filters on these rates will be inspected using meta-analytic techniques. The use of meta-analysis may help elucidate the epidemiological landscape with respect to the incidence of schizophrenia and aid in the generation of new hypothesis. Acknowledgements: The Stanley Medical Research Institute supported project

Emily Kame Kngwarreye and the undeconstructible space of justice

Selected as part of an anthology featuring best or most representative of 20th century art writing. Other authors in anthology included Benjamin, Greenberg, Krauss, T.j. Clark, Roger Fry, Stuart Hall, etc. Intended as US textbook. My essay featured as part of study day on globalism in art at Tate Modern. Essay itself subject of PhD thesis by Sally Butler of EMSAH and other subsequent commentaries.

Cervical range of motion discriminates between asymptomatic persons and those with whiplash

Study Design. A comparative study of cervical range of motion in asymptomatic persons and those with whiplash. Objectives. To compare the primary and conjunct ranges of motion of the cervical spine in asymptomatic persons and those with persistent whiplash-associated disorders, and to investigate the ability of these measures of range of motion to discriminate between the groups. Summary of Background. Evidence that range of motion is an effective indicator of physical impairment in the cervical spine is not conclusive. Few studies have evaluated the ability to discriminate between asymptomatic persons and those with whiplash on the basis of range of motion or compared three-dimensional in vivo measures of range of motion in asymptomatic persons and those with whiplash-associated disorders. Methods. The study participants were 89 asymptomatic volunteers (41 men, 48 women; mean age 39.2 years) and 114 patients with persistent whiplash-associated disorders (22 men, 93 women; mean age 37.2 years) referred to a whiplash research unit for assessment of their cervical region. Range of cervical motion was measured in three dimensions with a computerized, electromagnetic, motion-tracking device. The movements assessed were flexion, extension, left and right lateral flexion, and left and right rotation. Results. Range of motion was reduced in all primary movements in patients with persistent whiplash-associated disorder. Sagittal plane movements were proportionally the most affected. On the basis of primary and conjunct range of motion, age, and gender, 90.3% of study participants could be correctly categorized as asymptomatic or as having whiplash (sensitivity 86.2%, specificity 95.3%). Conclusions. Range of motion was capable of discriminating between asymptomatic persons and those with persistent whiplash-associated disorders.

The social construction of PETE in higher education: Toward a research agenda

The focus of this paper is the social construction of physical education teacher education (PETE) and its fate within the broader process of curriculum change in the physical activity field. Our task is to map the dimensions of a research program centered on the social construction of the physical activity field and PETE in higher education. Debates in the pages of Quest and elsewhere over the past two decades have highlighted not only the contentious nature of PETE practices and structures but also that PETE is changing. This paper offers one way of making sense of the ongoing process of contestation and struggle through the presentation of a theoretical framework. This framework, primarily drawing upon the work of Lave and Wenger (1991) and Bernstein (1990, 1996), is described before it is used to study the social construction of PETE in Australia. We assess the progress that has been made in developing this research program, and the questions already evident for further developments of a program of study of the physical activity field in higher education.

It's the first bites that count: Survival of first-instar monarchs on milkweeds

Mortality of first instars is generally very high, but variable, and is caused by many factors, including physical and chemical plant characters, weather and natural enemies. Here, a summary of detailed field-based studies of the early-stage survival of a specialist lepidopteran herbivore is presented. First-instar larvae of the monarch butterfly, Danaus plexippus, a milkweed specialist, generally grew faster and survived better on leaves when latex flow was reduced by partial severance of the leaf petiole. The outcome depended on milkweed species, and was related to the amount of latex produced, as well as other plant characters, such as leaf hairs, microclimate and concentration of secondary metabolites. Even for a so-called 'milkweed specialist', larval performance and survival appears to be related to the concentration of cardenolides produced by the plants (a potential chemical defence against herbivory). This case study of monarchs and milkweeds highlights the need for field-based experiments to assess the effect of plant characters on the usually poor survival of early instar phytophagous insects. Few similar studies concerning the performance and survival of first-instar, eucalypt-specific herbivores have been conducted, but this type of study is considered essential based on the findings obtained using D. plexippus.