bluuebunny/crossref_metadata_2025 huggingface dataset:
Upregulation of Nox4 by Hypertrophic Stimuli Promotes Apoptosis and Mitochondrial Dysfunction in Cardiac Myocytes
Authors: Ago Tetsuro , Kuroda Junya , Pain Jayashree , Fu Cexiong , Li Hong , Sadoshima Junichi
Published: February 2010

Rationale
:

NADPH oxidases are a major source of superoxide (O
2
−
) in the cardiovascular system. The function of Nox4, a member of the Nox family of NADPH oxidases, in the heart is poorly understood.

Objective
:

The goal of this study was to elucidate the role of Nox4 in mediating oxidative stress and growth/death in the heart.

Methods and Results
:

Expression of Nox4 in the heart was increased in response to hypertrophic stimuli and aging. Neither transgenic mice with cardiac specific overexpression of Nox4 (Tg-Nox4) nor those with catalytically inactive Nox4 (Tg-Nox4-P437H) showed an obvious baseline cardiac phenotype at young ages. Tg-Nox4 gradually displayed decreased left ventricular (LV) function with enhanced O
2
−
production in the heart, which was accompanied by increased apoptosis and fibrosis at 13 to 14 months of age. On the other hand, the level of oxidative stress was attenuated in Tg-Nox4-P437H. Although the size of cardiac myocytes was significantly greater in Tg-Nox4 than in nontransgenic, the LV weight/tibial length was not significantly altered in Tg-Nox4 mice. Overexpression of Nox4 in cultured cardiac myocytes induced apoptotic cell death but not hypertrophy. Nox4 is primarily localized in mitochondria and upregulation of Nox4 enhanced both rotenone- and diphenyleneiodonium-sensitive O
2
−
production in mitochondria. Cysteine residues in mitochondrial proteins, including aconitase and NADH dehydrogenases, were oxidized and their activities decreased in Tg-Nox4.

Conclusions
:

Upregulation of Nox4 by hypertrophic stimuli and aging induces oxidative stress, apoptosis and LV dysfunction, in part because of mitochondrial insufficiency caused by increased O
2
−
production and consequent cysteine oxidation in mitochondrial proteins.
A Novel Mitochondrial KATPChannel Assay
Authors: Wojtovich Andrew P. , Williams David M. , Karcz Marcin K. , Lopes Coeli M.B. , Gray Daniel A. , Nehrke Keith W. , Brookes Paul S.
Published: February 2010

Rationale:The mitochondrial ATP sensitive potassium channel (mKATP) is implicated in cardioprotection by ischemic preconditioning (IPC), but the molecular identity of the channel remains controversial. The validity of current methods to assay mKATPactivity is disputed.

Objective:We sought to develop novel methods to assay mKATPactivity and its regulation.

Methods and Results:Using a thallium (Tl+)-sensitive fluorophore, we developed a novel Tl+flux based assay for mKATPactivity, and used this assay probe several aspects of mKATPfunction. The following key observations were made. (1) Time-dependent run down of mKATPactivity was reversed by phosphatidylinositol-4,5-bisphosphate (PIP2). (2) Dose responses of mKATPto nucleotides revealed a UDP EC50of ≈20 μmol/L and an ATP IC50of ≈5 μmol/L. (3) The antidepressant fluoxetine (Prozac) inhibited mKATP(IC50=2.4 μmol/L). Fluoxetine also blocked cardioprotection triggered by IPC, but did not block protection triggered by a mKATP-independent stimulus. The related antidepressant zimelidine was without effect on either mKATPor IPC.

Conclusions:The Tl+flux mKATPassay was validated by correlation with a classical mKATPchannel osmotic swelling assay (R2=0.855). The pharmacological profile of mKATP(response to ATP, UDP, PIP2, and fluoxetine) is consistent with that of an inward rectifying K+channel (KIR) and is somewhat closer to that of the KIR6.2 than the KIR6.1 isoform. The effect of fluoxetine on mKATP-dependent cardioprotection has implications for the growing use of antidepressants in patients who may benefit from preconditioning.
Iron-Related Brain Damage in Patients With Intracerebral Hemorrhage
Authors: Pérez de la Ossa Natalia , Sobrino Tomás , Silva Yolanda , Blanco Miguel , Millán Monica , Gomis Meritxell , Agulla Jesús , Araya Pablo , Reverté Silvia , Serena Joaquin , Dávalos Antoni
Published: February 2010

Background and Purpose—

Iron plays a detrimental role after experimental intracerebral hemorrhage (ICH). This study investigates whether high-serum ferritin levels are associated with poor outcome in patients with ICH.

Methods—

We studied 92 consecutive patients with primary hemispheric ICH within the first 12 hours from onset of symptoms (median, 3.3 hours). National Institute of Health Stroke Scale score, ICH, and peripheral edema volumes were measured at admission, 72 hours, and 7 days. Serum levels of ferritin and biomarkers of the inflammatory response were determined. The adjusted effect of ferritin on the full range of Rankin scale was analyzed by a general linear model.

Results—

Fifty-one patients (55.4%) had poor outcome (Rankin score >2). Older age, higher stroke severity, larger hematoma volume, intraventricular extension, mass effect, and higher IL-6 and ferritin levels at baseline (270.6 [SD 81.4] vs 74.6 [SD 43.4] ng/mL;
P
<0.001) were associated with poor outcome. The higher the ferritin quartile, the worse the Rankin score. For every ferritin quartile, the Rankin score increased by a mean of 1.4 points (95% CI, 1.04–1.69) after adjusting for prognostic variables. Ferritin levels remained stable for 72 hours and did not correlate with acute phase reactants.

Conclusions—

High-serum ferritin levels at admission are independently associated with poor outcome in patients with ICH. These findings may suggest a neurotoxic effect of increased body iron stores in patients with hemorrhagic stroke.
Differences in Demographic Characteristics and Risk Factors in Patients With Spontaneous Vertebral Artery Dissections With and Without Ischemic Events
Authors: Arnold Marcel , Kurmann Rebekka , Galimanis Aekaterini , Sarikaya Hakan , Stapf Christian , Gralla Jan , Georgiadis Dimitrios , Fischer Urs , Mattle Heinrich P. , Bousser Marie-Germaine , Baumgartner Ralf W.
Published: February 2010

Background and Purpose—

Spontaneous vertebral artery dissection (sVADs) mainly cause cerebral ischemia, with or without associated local symptoms and signs (headache, neck pain, or cervical radiculopathy), or with local symptoms and signs only.

Methods—

We compared the presenting characteristics of consecutive patients with single sVADs and ischemic events and those with local symptoms and signs only.

Results—

Of the 186 patients with first-ever unilateral sVAD, 165 (89%) presented with cerebral ischemia, and 21 (11%) presented with local symptoms and signs only. Patients with sVAD and ischemia were more often male (63% vs 29%;
P
=0.002), older (mean±SD age, 43.6±9.9 vs 38.6±9.0 years;
P
=0.027), and smokers (14% vs 3%;
P
=0.010), but less often, they had a history of migraine without aura (17% vs 38%;
P
=0.025) than did patients without ischemia. The multivariate analysis confirmed independent associations between male sex (
P
=0.024), increasing age (0.027), and smoking (
P
=0.012) and sVADs causing cerebral ischemia.

Conclusions—

These results suggest that men, older patients, and smokers with sVADs may be at increased risk for ischemic events.
What Is a Minor Stroke?
Authors: Fischer Urs , Baumgartner Adrian , Arnold Marcel , Nedeltchev Krassen , Gralla Jan , Marco De Marchis Gian , Kappeler Liliane , Mono Marie-Luise , Brekenfeld Caspar , Schroth Gerhard , Mattle Heinrich P.
Published: February 2010

Background and Purpose—

The term “minor stroke” is often used; however a consensus definition is lacking. We explored the relationship of 6 “minor stroke” definitions and outcome and tested their validity in subgroups of patients.

Methods—

A total of 760 consecutive patients with acute ischemic strokes were classified according to the following definitions: A, score ≤1 on every National Institutes of Health Stroke Scale (NIHSS) item and normal consciousness; B, lacunar-like syndrome; C, motor deficits with or without sensory deficits; D, NIHSS ≤9 excluding those with aphasia, neglect, or decreased consciousness; E, NIHSS ≤9; and F, NIHSS ≤3. Short-term outcome was considered favorable when patients were discharged home, and favorable medium-term outcome was defined as a modified Rankin Scale score of ≤2 at 3 months. The following subgroup analyses were performed by definition: sex, age, anterior versus posterior and right versus left hemispheric stroke, and early (0 to 6 hours) versus late admission (6 to 24 hours) to the hospital.

Results—

Short-term and medium-term outcomes were most favorable in patients with definition A (74% and 90%, respectively) and F (71% and 90%, respectively). Patients with definition C and anterior circulation strokes were more likely to be discharged home than patients with posterior circulation strokes (
P
=0.021). The medium-term outcome of older patients with definition E was less favorable compared with the outcome of younger ones (
P
=0.001), whereas patients with definition A, D, and F did not show different outcomes in any subgroup.

Conclusions—

Patients fulfilling definition A and F had best short-term and medium-term outcomes. They would be best suited to the definition of “minor stroke.”
Should Decompressive Surgery Be Performed in Malignant Cerebral Venous Thrombosis?
Authors: Théaudin Marie , Crassard Isabelle , Bresson Damien , Saliou Guillaume , Favrole Pascal , Vahedi Katayoun , Denier Christian , Bousser Marie-Germaine
Published: February 2010

Background and Purpose—

In malignant cerebral venous thrombosis (CVT) patients, emergency decompressive surgery has been suggested as a life-saving procedure. We report 12 patients with malignant CVT, among whom 8 underwent operation.

Methods—

Retrospective study of 12 patients from 3 stroke units who had a malignant CVT as defined: (1) supratentorial cortical lesions attributable to superficial venous system thrombosis with or without sinus involvement; (2) with clinical (decreased consciousness and dilated pupils) or radiological signs of transtentorial herniation; (3) either at onset or after worsening despite heparin therapy. Surgery or abstention was decided individually by neurosurgeons on call.

Results—

There were 9 women and 3 men with a mean age of 45±15 years. The delay between heparin therapy and signs of malignancy ranged from 2 to 30 hours. At malignant worsening all but 1 patient had hemorrhagic lesions; the median deviation of septum pellucidum was 12 mm (interquartile range, 6.7–13); 5 patients (including 3 who underwent operation) had a unilateral dilated pupil; and 4 (2 who underwent operation) had bilateral dilated pupils. Eight patients underwent surgical decompression, external decompression in 4, both external and internal decompression in 3, and internal decompression in 1. The 4 patients who did not undergo operation died within 1 to 5 days after diagnosis. One patient who underwent operation died of a pulmonary embolism. The 7 others survived, with, at last follow-up (median, 23.1 months; interquartile range, 19.7–45.6), an excellent recovery of mRS 0 or 1 in 6 and mRS 3 in 1.

Conclusion—

Decompressive surgery may save lives and may even allow a good functional outcome in malignant CVT, even in patients with bilateral dilated pupils.
Relative Energy Index of Microembolic Signal Can Predict Malignant Microemboli
Authors: Choi Youngbin , Saqqur Maher , Stewart Eileen , Stephenson Caroline , Roy Jayanta , Boulanger Jean-Martin , Coutts Shelagh , Demchuk Andrew M.
Published: February 2010

Background and Purpose—

Microembolic signals (MES) found on transcranial Doppler range from harmless air bubbles to large, solid, particulate emboli from the heart and large vessels. The presence of MES is not always associated with poor clinical outcome. The purpose of our study was to determine whether the relative energy index of MES measured by power M-mode Doppler can distinguish malignant from benign MES and to identify patients with worse prognosis.

Methods—

We prospectively collected transcranial Doppler emboli monitoring data from patients with symptomatic carotid stenosis presenting with TIA or ischemic stroke. For each patient, we calculated the relative energy index of MES and categorized those >1.0 as malignant MES. We compared the clinical characteristics, number, and volume of diffusion-weighted imaging lesions, and degree of stenosis and plaque characteristics on CT angiogram of patients with malignant and benign MES.

Results—

We enrolled 92 patients, 29 with TIA and 63 with stroke, within 48 hours of symptom onset. Twenty-six patients had a total of 319 MES; of these, 82.4% were benign and were 17.6% malignant. Malignant MES traveled further within intracranial vessels than benign MES. The 9 patients with >1 malignant MES had significantly larger baseline diffusion-weighted imaging lesion volume, had a higher prevalence of intraluminal thrombus on CT angiogram of the neck and plaque ulceration, and were more likely to have a poor clinical outcome (modified Rankin Score ≥2) than those with benign MES (OR, 6.5; 95% CI, 1.47–28.68). The presence of malignant MES led to the institution of more aggressive secondary prevention measures.

Conclusions—

Power M-mode transcranial Doppler identifies a subgroup of patients with malignant MES. These signals are more frequent in longer arterial trajectory. Patients with malignant MES have larger baseline infarcts, a higher prevalence of intraluminal thrombus or ulcerated plaque in the carotid artery, and worse clinical outcome.
Effects of Hypobaric Hypoxia on Cerebral Autoregulation
Authors: Subudhi Andrew W. , Panerai Ronney B. , Roach Robert C.
Published: February 2010

Background and Purpose—

Acute hypoxia is associated with impairment of cerebral autoregulation (CA), but it is unclear if altered CA during prolonged hypoxia is pivotal to the development of cerebral pathology, such as that seen in acute mountain sickness (AMS). This investigation evaluated relationship between CA and AMS over 9 hours of hypobaric hypoxia.

Methods—

Fifty-five subjects (41 males, 14 females) were studied in normoxia (P
B
=625 mm Hg) and after 4 and 9 hours of hypobaric hypoxia (P
B
=425 mm Hg; ≈4875 m). Resting, beat-by-beat changes in arterial blood pressure, and middle cerebral artery blood flow velocity were recorded at each time point while breathing room air. Transfer function analyses were used to estimate autoregulation indices (ARI). In 29 subjects, ARI during isocapnic hyperoxia and cerebral vasomotor reactivity during modified rebreathing were also determined to isolate effects of hypoxia and CO
2
reactivity on CA.

Results—

Self-reported Lake Louise AMS Questionnaire scores ≥3 with headache were used to differentiate between AMS-positive (n=27) and AMS-negative (n=28) subjects (
P
<0.01). ARI decreased and CO
2
reactivity increased in both groups at 4 hours (
P
<0.01) and did not progress at 9 hours, despite increased incidence and severity of AMS (
P
<0.01). Impairments in ARI were alleviated with isocapnic hyperoxia at 4 and 9 hours (
P
<0.01) and were not related to CO
2
reactivity.

Conclusions—

These results indicate that hypoxia directly impairs CA but that impaired CA does not play a pivotal role in the development of AMS.
On the Dependence of Winter Precipitation Types on Temperature, Precipitation Rate, and Associated Features
Authors: Thériault Julie M. , Stewart Ronald E. , Henson William
Published: February 2010

The phase of precipitation formed within the atmosphere is highly dependent on the vertical temperature profile through which it falls. In particular, several precipitation types can form in an environment with a melting layer aloft and a refreezing layer below. These precipitation types include freezing rain, ice pellets, wet snow, and slush. To examine the formation of such precipitation, a bulk microphysics scheme was used to compare the characteristics of the hydrometeors produced by the model and observed by a research aircraft flight during the 1998 ice storm near Montreal, Canada. The model reproduced several of the observed key precipitation characteristics. Sensitivity tests on the precipitation types formed during the ice storm were also performed. These tests utilized temperature profiles produced by the North American Regional Reanalysis. The results show that small variations (±0.5°C) in the temperature profiles as well as in the precipitation rate can have major impacts on the types of precipitation formed at the surface. These results impose strong requirements on the accuracy needed by prediction models.
Interpreting Stationary Wave Nonlinearity in Barotropic Dynamics
Authors: Wang Lei , Kushner Paul J.
Published: February 2010

Stationary wave nonlinearity describes the self-interaction of stationary waves and is important in maintaining the zonally asymmetric atmospheric general circulation. However, the dynamics of stationary wave nonlinearity, which is often calculated explicitly in stationary wave models, is not well understood. Stationary wave nonlinearity is examined here in the simplified setting of the response to localized topographic forcing in quasigeostrophic barotropic dynamics in the presence and absence of transient eddies. It is shown that stationary wave nonlinearity accounts for most of the difference between the linear and full nonlinear response, particularly if the adjustment of the zonal-mean flow to the stationary waves is taken into account. The separate impact of transient eddy forcing is also quantified. Wave activity analysis shows that stationary wave nonlinearity in this setting is associated with Rossby wave critical layer reflection. A nonlinear stationary wave model, similar to those used in baroclinic stationary wave model studies, is also tested and is shown to capture the basic features of the full nonlinear stationary wave solution.
Differentiating between Clouds and Heavy Aerosols in Sun-Glint Regions
Authors: Hutchison Keith D. , Hauss Bruce , Iisager Barbara D. , Agravante Hiroshi , Mahoney Robert , Sei Alain , Jackson John M.
Published: February 2010

An approach is presented to distinguish between clouds and heavy aerosols in sun-glint regions with automated cloud classification algorithms developed for the National Polar-orbiting Operational Environmental Satellite System (NPOESS) program. The approach extends the applicability of an algorithm that has already been applied successfully in areas outside the geometric and wind-induced sun-glint areas of the earth over both land and water surfaces. The successful application of this approach to include sun-glint regions requires an accurate cloud phase analysis, which can be degraded, especially in regions of sun glint, because of poorly calibrated radiances of the National Aeronautics and Space Administration (NASA) Moderate Resolution Imaging Spectroradiometer (MODIS) sensor. Consequently, procedures have been developed to replace bad MODIS level 1B (L1B) data, which may result from saturation, dead/noisy detectors, or data dropouts, with radiometrically reliable values to create the Visible Infrared Imager Radiometer Suite (VIIRS) proxy sensor data records (SDRs). Cloud phase analyses produced by the NPOESS VIIRS cloud mask (VCM) algorithm using these modified VIIRS proxy SDRs show excellent agreement with features observed in color composites of MODIS imagery. In addition, the improved logic in the VCM algorithm provides a new capability to differentiate between clouds and heavy aerosols within the sun-glint cone. This ability to differentiate between clouds and heavy aerosols in strong sun-glint regions is demonstrated using MODIS data collected during the recent fires that burned extensive areas in southern Australia. Comparisons between heavy aerosols identified by the VCM algorithm with imagery and heritage data products show the effectiveness of the new procedures using the modified VIIRS proxy SDRs. It is concluded that it is feasible to accurately detect clouds, identify cloud phase, and distinguish between clouds and heavy aerosol using a single cloud mask algorithm, even in extensive sun-glint regions.
Land–Atmosphere Interactions during a Northwestern Argentina Low Event
Authors: Saulo Celeste , Ferreira Lorena , Nogués-Paegle Julia , Seluchi Marcelo , Ruiz Juan
Published: February 2010

The impact of changes in soil moisture in subtropical Argentina in rainfall distribution and low-level circulation is studied with a state-of-the-art regional model in a downscaling mode, with different scenarios of soil moisture for a 10-day period. The selected case (starting 29 January 2003) was characterized by a northwestern Argentina low event associated with well-defined low-level northerly flow that extended east of the Andes over subtropical latitudes. Four tests were conducted at 40-km horizontal resolution with 31 sigma levels, decreasing and increasing the soil moisture initial condition by 50% over the entire domain, and imposing a 50% reduction over northwest Argentina and 50% increase over southeast South America. A control run with NCEP/Global Data Assimilation System (GDAS) initial conditions was used to assess the impact of the different soil moisture configurations.

It was found that land surface interactions are stronger when soil moisture is decreased, with a coherent reduction of precipitation over southern South America. Enhanced northerly winds result from an increase in the zonal gradient of pressure at low levels. In contrast, when soil moisture is increased, smaller circulation changes are found, although there appears to be a local feedback effect between the land and precipitation. The combined effects of changes in the circulation and in local stratification induced by soil wetness modifications, through variations in evaporation and Convective Available Potential Energy (CAPE), are in agreement with what has been found by other studies, resulting in coherent modifications of precipitation when variations of CAPE and moisture flux convergence mutually reinforce.
Effectiveness of a Psychoeducative Intervention in a Summer Camp for Children With Type 1 Diabetes Mellitus
Authors: García-Pérez Lidia , Perestelo-Pérez Lilisbeth , Serrano-Aguilar Pedro , Trujillo-Martín Maria del Mar
Published: February 2010

Purpose

The purpose of this study was to evaluate the effectiveness of a psychoeducative intervention implemented in a summer camp for children with type 1 diabetes.

Methods

A prospective cohort study was conducted comparing 2 groups of children with type 1 diabetes. The intervention group (n = 34) received interventions that addressed knowledge, behaviors, skills, and psychological factors during a summer camp. The control group (n = 23) received the usual education and care. Evaluated measurements were glycosylated hemoglobin (A1C), diabetes knowledge, anxiety, psychological adaptation, and use of health care services.

Results

No significant changes in A1C annual average, body mass index (BMI), diabetes knowledge, anxiety, medical visits, or hospital admissions were observed after the intervention in comparison with before intervention. Only the adaptation to the school environment improved significantly. The control group significantly increased BMI and A1C.

Conclusions

No relevant variations in diabetes knowledge, anxiety, psychological adaptation, or use of health care services were found after the psychoeducative intervention implemented in the summer camp. Future studies with random allocation of subjects are necessary to confirm the intervention’s effectiveness.
Outcomes Reported by Spanish-Speaking Families in Early Intervention
Authors: Olmsted Murrey G. , Bailey Donald B. , Raspa Melissa , Nelson Robin E. , Robinson Nyle D. , Simpson Mary Ellen , Guillen Chelsea
Published: February 2010

In this study, the authors use data from two states to compare how families participating in early intervention who completed a Spanish version of the Family Outcomes Survey (FOS) ( n = 291) compared with Hispanic ( n = 486) and non-Hispanic ( n = 2,363) families who completed the English version. In general, most families reported positive outcomes, but there was variability in their responses. Families completing the survey in Spanish consistently reported lower outcome attainment than both Hispanic and non-Hispanic families completing the FOS in English. They also reported lower perceptions of the helpfulness of early intervention, but the three groups did not differ with regard to perceptions of family-centered practices. Factor analysis revealed that constructs assessed by the survey are similar for both the English and Spanish version of the survey. Hierarchical linear models analysis within the Spanish-language group indicated that family-centered practices were significantly related to family outcomes.
Autologous Chondrocyte Implantation in Cartilage Lesions of the Knee
Authors: Vasiliadis Haris S. , Danielson Barbro , Ljungberg Maria , McKeon Brian , Lindahl Anders , Peterson Lars
Published: February 2010

Background

Various treatment options are available for articular cartilage lesions, but controversy exists regarding the quality of the repair tissue and the durability of the results posttreatment. Noninvasive techniques are needed for the assessment of the repair tissue.

Hypothesis

Magnetic resonance imaging (MRI) with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) can give valuable information regarding the quality and quantity of the repaired cartilage lesion.

Study Design

Cohort study; Level of evidence, 3.

Methods

Thirty-six knees in 31 patients were assessed 9 to 18 years after treatment with autologous chondrocyte implantation (ACI). All patients had isolated lesions. The knees were clinically evaluated with the Knee injury and Osteoarthritis Outcome Score and the dGEMRIC technique. The T1 value was measured for 2 regions of interest (ROIs), 1 in the repair tissue area (ROI 1) and 1 in the surrounding cartilage (ROI 2), giving information of the content of proteoglycans.

Results

The average T1 value in ROI 1 was 467.5 milliseconds and in ROI 2, 495.3 milliseconds, which yielded no significant difference, thus suggesting comparable levels of proteoglycans in the repair tissue and surrounding cartilage. Intralesional osteophytes were in 64% of the lesions, mainly in younger patients with osteochondritis dissecans lesions or a history of subchondral bone surgeries. Medium or large bone marrow edema was found in 14% of the knees and subchondral cysts, in 39%. There was no correlation between the KOOS and any MRI findings.

Conclusion

Magnetic resonance imaging with dGEMRIC gives valuable information for the macroscopic appearance and micro-molecular quality of the repair tissue after ACI. Nine to 18 years posttreatment, the quality of the repair tissue is similar to the surrounding normal cartilage, although intralesional osteophytes, subchondral cysts, and bone marrow edema were common. The defect area is restored in most patients. However, there was no correlation between the dGEMRIC values and the KOOS outcomes.
Impact of dieldrin on liver morphological and biochemical parameters of rats
Authors: Hallegue Dorsaf , Tebourbi Olfa , Kacem Kamel , Sakly Mohsen , Ben Rhouma Khémaïs
Published: February 2010

The current study deals with the effect of the organochlorine insecticide on the liver of Wistar rats. The dieldrin effect on rats was tested after a single intraperitoneal (i.p.) injection of two doses: 3 and 6 mg/kg and observations were made 4 days later. Animals showed a significant dose-dependent increase in relative liver weight. Elevations of transaminases (aspartate aminotransferase [AST], alanine aminotransferase [ALT]), bilirubin and total activity of lactate dehydrogenase (LDH) were recorded in the sera of treated rats. Serum LDH-5 isoenzyme activity increases in a dose-dependent manner. In contrast, LDH-1 activity does not show any significant variations with respect to controls. Histological examination of the liver of dieldrin-treated animals revealed cytoplasmic vacuolation, focal necrosis and nuclear enlargement of hepatocytes. This study suggests that biochemical assessment (transaminases, LDH and bilirubin activity) and LDH (LDH-1 & LDH-5) isoenzyme profiles can be very helpful in defining the border of the liver injury, dieldrin damaged liver would be a valuable addition to histological analysis in evaluating histopathological liver changes.
Endoscopic Management of Intraventricular Brain Tumors in Pediatric Patients: A Review of Indications, Techniques, and Outcomes
Authors: Ahmad Faiz , Sandberg David I.
Published: February 2010

Endoscopic neurosurgical techniques have enabled pediatric neurosurgeons to treat a number of conditions in a minimally invasive manner. In addition to its pivotal role in the treatment of hydrocephalus, endoscopy is increasingly being used in the management of intraventricular brain tumors. Endoscopy has become the first-line modality for obtaining tumor samples from many intraventricular tumors, some of which do not ultimately need aggressive surgical treatment. Endoscopic techniques enable simultaneous treatment of hydrocephalus with tumor biopsy, saving patients an additional procedure. Endoscopy may also be used for complete excision of intraventricular tumors in selected cases. Overall, surgeries performed endoscopically are less invasive than conventional open neurosurgery and often enable shorter lengths of hospital stay and decreased costs. This article reviews endoscopic management of intraventricular tumors in children with a focus on indications, techniques, and outcomes. Relevant case examples are provided to illustrate the utility of these procedures.
A 16-Year-Old Girl With Bilateral Visual Loss and Left Hemiparesis Following an Immunization Against Human Papilloma Virus
Authors: DiMario Francis J. , Hajjar Mirna , Ciesielski Thomas
Published: February 2010

We report the course of a 16-year-old girl who presented with near complete visual loss associated with chiasmal neuritis and a biopsy proven tumefactive demyelinating lesion on magnetic resonance imaging (MRI) in association with a recent immunization against human papilloma virus.
Statins in Sepsis
Authors: Dobesh Paul P. , Swahn, PharmD Candidate Stephanie M. , Peterson, PharmD Candidate Evan J. , Olsen Keith M.
Published: February 2010

Sepsis is a common intensive care unit event occurring in approximately 750 000 patients annually, with a case mortality rate approaching 50%. Sepsis is characterized by a chaotic and excessive release of inflammatory cytokines and procoagulants including tumor necrosis factor, interleukin (IL)-1, IL-6, IL-8, platelet-activating factor, and tissue factor. Efforts to inhibit individual cytokines in order to modify poor outcomes have been generally disappointing, suggesting the need to target multiple inflammatory mediators to obtain clinical benefit. Statins lower lipids by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, which in turn inhibits the rate-limiting step in cholesterol biosynthesis. In addition to lowering total cholesterol, statins have pleiotropic effects on inflammation and immunity. Instead of impacting a single entity in the sepsis syndrome, statins may have positive effects on multiple inflammatory, immunomodulating, and coagulation targets involved in the development of infection and sepsis. There have been a number of institutional- and population-based studies that have evaluated the impact of statins in patients with infection and sepsis. Most of these studies, but not all, have demonstrated a number of positive outcomes in patients with statins, including reduction in mortality. Based on these data, statins are a promising therapy in the management of patients with sepsis and warrant larger and more rigorous clinical trials.
Current Concepts in the Prevention and Treatment of Ventilator-Associated Pneumonia
Authors: Micek Scott T. , Skrupky Lee P.
Published: February 2010

Ventilator-associated pneumonia (VAP) is one of the most common causes of infection in intensive care unit (ICU) patients. Efforts to prevent VAP have focused on both pharmacologic and nonpharmacologic strategies. Two of the more controversial pharmacologic approaches included selective decontamination of the digestive tract (SDD) and decontamination of the oropharynx using topical antimicrobials or antiseptics including chlorhexidine (CHX). Additionally, avoidance of pharmacotherapy-related risk factors is hypothesized to reduce VAP rates. Successful treatment of VAP is becoming increasingly difficult in the era of antibiotic resistance. Utilization of local antibiograms, implementation of standardized treatment pathways, and optimization of pharmacodynamic-based dosing offer methods to improve empiric therapy selections. De-escalation of therapy should be a constant focus in an attempt to reduce overall antibiotic consumption and the selection pressure on ICU flora, thus minimizing the development and spread of antimicrobial resistance in the ICU.
Treatment Algorithms in Critical Care: Do They Improve Outcomes?
Authors: Nissen Stephen W. , Olsen Keith M.
Published: February 2010

Patients admitted to the intensive care unit (ICU) often have significant underlying morbidities that require complex treatment plans. Because of these complexities, numerous guidelines have been developed to facilitate the management of the critically ill patient. Some of these guidelines include sepsis, community-acquired and ventilator-associated pneumonia, sedation, and glycemic control. Once guidelines are written, a treatment protocol must be developed and implemented within the critical care unit. Our medical center has implemented multiple treatment protocols, often with preprinted order sets with various degrees of success. In 2003, we implemented and later evaluated a sedation order form and protocol. Patients whose sedation was initiated with a standardized order form had more frequent sedation score assessment, less time between sedation vacations, reduced ICU length of ICU stay, and a trend in reduction of ventilator days. However, only 37% of eligible patients were treated using the order form and the protocol, despite the potentially beneficial effects. Some recommendations within guidelines are based on sound clinical evidence supported by randomized controlled trials, although others are based on expert opinion only. The most often-cited reason for protocol noncompliance is disagreement with the published clinical trial data. This paper examines both infectious and noninfectious treatment guidelines and the supportive evidence that they improved patient outcomes. In addition, strategies for successful implementation of a treatment guideline are discussed for clinicians to follow in order to maximize clinical outcomes.
On the Causal Power Generation Limit for a Vibratory Energy Harvester in Broadband Stochastic Response
Authors: Scruggs J.T.
Published: February 2010

This article illustrates that certain relatively well-known results from feedback control theory can be used to determine the maximum-attainable power generation for a vibratory energy harvester excited by a stationary broadband stochastic disturbance. For such applications, control techniques based on impedance matching theory cannot be used to optimize power generation, because the dynamic controller they prescribe is always anticausal. However, an optimal causal controller does exist, and can be derived using H2/LQG theory. Levels of power generation with this controller are compared to those of the anticausal optimal performance, as well as to traditional 'tuning' techniques which match the anticausal impedance only at the resonant frequency. It is demonstrated that tuning techniques can be significantly sub-optimal in broadband applications, especially when electronic conversion is relatively efficient. In addition to being useful in the design of controllers for energy harvesting applications, these results may also be used to ascertain the insurpassable power generation limits associated with a given combination of transducer and electronic hardware.
Review Article: Bupropion for the Treatment of Neuropathic Pain
Authors: Shah Tanmay H. , Moradimehr Abdolali
Published: February 2010

Neuropathic pain is a common problem in clinical practice, affecting patients physically, emotionally, financially, and socially. Current treatment includes antidepressants, antiepileptics, and opioid analgesics. Bupropion is a specific inhibitor of neuronal noradrenaline reuptake and a weak inhibitor of dopamine reuptake, which shows some promise in the treatment of neuropathic pain.
Medication Adherence in Older Renal Transplant Recipients
Authors: Russell Cynthia L. , Cetingok Muammer , Hamburger Karen Q. , Owens Sarah , Thompson Denise , Hathaway Donna , Winsett Rebecca P. , Conn Vicki S. , Madsen Richard , Sitler Lisa , Wakefield Mark R.
Published: February 2010

This project examined patterns, predictors, and outcomes of medication adherence in a convenience sample of 37 renal transplant recipients aged 55 years or older in a Mid-Southern U.S. facility using an exploratory, descriptive, longitudinal design. Electronic monitoring was conducted for 12 months using the Medication Event Monitoring System. An alarming 86% of the participants were nonadherent with medications. Four clusters of medication taking and timing patterns were identified with evening doses presenting particular challenges. Depression, self-efficacy, social support, and medication side effects did not predict medication adherence. There was no significant difference in medication adherence scores between those with and without infections. Medication adherence pattern data from electronic monitoring provides an opportunity for health care professionals to move away from blaming the patient by attempting to identify predictors for medication nonadherence. Medication dose taking and timing patterns could be explored with patients so that medication adherence interventions could target specific patient patterns.
The Impact of Anemia on Nursing Home Residents
Authors: Resnick Barbara , Sabol Valerie , Galik Elizabeth , Gruber-Baldini Ann L.
Published: February 2010

The purpose of this secondary data analysis was to describe the prevalence and treatment of anemia and test the impact of anemia on physical and psychosocial outcomes at baseline and following restorative care interventions. A total of 451 residents from 12 nursing homes participated in this study. The average age of the participants was 83.74 ( SD = 8.24), the majority were female (79%), White (66%), and unmarried (90%). A total of 245 (54%) residents were anemic, and 66% were treated with at least one medication. Physical performance was worse in those with anemia, and those with anemia associated with chronic kidney disease had lower self-efficacy and outcome expectations for functional activities than those without anemia. There was no time by treatment interaction between those with and without anemia. The findings provide some additional support for the prevalence of anemia and suggest that those with anemia associated with chronic kidney disease are less motivated to engage in functional activities.
Anchoring the Portuguese Voter: Panel Dynamics in a Newer Electorate
Authors: Lewis-Beck Michael S. , Costa Lobo Marina
Published: February 2010

While Portuguese democracy is no longer so new, its national postelection surveys are, with the first in 2002. On the vital question of what provides the voter a social-psychological anchor, initial evidence gave the nod to party identification over ideological identification. However, party identification was poorly measured, data were cross-sectional, and the models single equation. Fortunately, panel studies are now available for the 2005 legislative and the 2006 presidential elections. Estimating dynamic, multi-equation models with two-stage, instrumental variable regression procedures establishes the preeminence of ideologically driven voting. Furthermore, ideological identification appears composed of a unique pre-democratic component, in addition to the more usual social, moral, and economic elements.
Review series: Occupational and environmental lung disease: Chronic obstructive pulmonary disease and the workplace
Authors: Fishwick David , Barber Chris M , Darby Anthony C
Published: February 2010

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disease associated with increasing morbidity and mortality worldwide. Whilst tobacco smoking is the important cause, other cuases are regognised. This article discusses the contribution that harmful inhaled occupational exposures make to the overall burden of COPD, and goes on to discuss other aspects of the COPD workplace interface. Prevention is key. All healthcare professionals have a resposibility to consider workplace issues when dealing with their COPD patients.
A Gendered Perspective on the Relationship Between Self-Control and Deviance
Authors: Nofziger Stacey
Published: February 2010

A consistent finding within criminology is the large sex gap in offending. Although research has examined this phenomenon extensively, the sex gap is still largely unexplained. This study proposes the sex gap in offending can be better understood through exploring the relationship between self-control and gender identity. Using data collected as part of the Tucson Youth Project, this study found gender identity was a crucial link between sex, self-control, and involvement in deviant behavior. Specifically, femininity was associated with greater self-control, and both these variables predicted deviance, even when controlling for sex. In contrast, masculinity had no effect on deviant behavior.
Long-Term Patterns of Offending in Women
Authors: Rebecca Block Carolyn , Blokland Arjan A. J. , van der Werff Cornelia , van Os Rianne , Nieuwbeerta Paul
Published: February 2010

The empirical and theoretical knowledge base on criminal careers is heavily influenced by data on boys and men.What pathways do women follow in and out of crime through their adulthood? With data from the Criminal Career and Life-Course Study, this article describes the criminal careers of 432 women and 4,180 men, a representative sample of all those who had a criminal case adjudicated in 1977 with retrospective criminal histories up to age 12 and prospective data to death or 2003. Comparing women and men, this article describes life-span patterns of prevalence, onset, duration, termination, frequency, crime mix, and overall trajectories and discusses implications for practice and for developmental and life-course theory.
Changes in Metabolic Control of Phenylketonuria in Children Attending a Summer Camp
Authors: Peipert Joyce , Rohr Fran , Phornphutkul Chanika , Waisbren Susan
Published: February 2010

The objective of this study was to determine the change in blood phenylalanine (Phe; mg/dL) as a marker for metabolic control in 18 children ages 7 to 15 years with classical phenylketonuria (PKU) attending a 5-day summer overnight camp in Sandwich, Massachusetts, in 2003. The authors validated their results with a group of 20 children who attended camp in 2002. The mission was to provide children with a camp experience in which their diet was facilitated by the staff. The children were encouraged to take responsibility for their dietary management with minimal direct intervention. Blood samples were collected on filter papers for analysis by tandem mass spectroscopy on the first and last evenings of camp. Mean blood Phe at the beginning of camp was 8.8 mg/dL (SD = 4.5), and the final Phe was 4.6 mg/dL (SD = 2.5; mean difference = 4.2; 95% confidence interval: 2.6, 5.8). This difference is both clinically and statistically significant (P < .0001). Prior year results validated the authors’ findings. Short-term effects of the camp environment resulted in improved metabolic control. Factors speculated as attributing to this improvement include decreased barriers to dietary compliance (variety of readily available low-protein foods, reinforcement of diet through recording intake in diet record books, increased acceptance of the diet because of a large number of other campers also with PKU) and readily available staff to assist with diet adherence.
Teachers of Adult Music Learners: An Assessment of Characteristics and Instructional Practices, Preparation, and Needs
Authors: Bowles Chelcy L.
Published: February 2010

This study investigated characteristics and experiences of teachers of adult music learners, instructional aspects they perceive to be unique to teaching adults, and their self-perceived needs in providing quality experiences for adult learners. A 25-item questionnaire investigating the topics of preparation, goals, methodology, materials, evaluation, behavior management, and attitudes was distributed to instructors with 2 or more years of experience teaching adult learners. Most of the 66 respondents were highly experienced (74% having taught adults 6 or more years), and they provided information about issues unique to teaching adults or that might be similar for teaching music at any age level. Respondents indicated that methodologies should be flexible and individualized, expressed a desire for age-appropriate materials, and said that training specific to adult teaching is advantageous. The longevity and breadth of teaching experience and consistency of responses across demographic variables are indicative of issues that have implications for the profession.
Inquiring Into Children’s Music Experiences: Groundings in Literature
Authors: Griffin Shelley M.
Published: February 2010

Highlighting various seminal studies in music education provides grounding for the necessity of connecting children’s school music experiences with their daily lived music experiences. Allowing children to make more seamless connections between these two contexts heightens the possibility of creating increasingly meaningful school music experiences. The review of literature in children’s nonguided music experiences and ethnographic-centered research contextualizes this prominent issue within the field of music education. Such research affirms the importance of attending to children’s experiences as a means of comprehending how children’s perspectives may be a central catalyst in shaping elementary school music curricula. The varied literature showed the clear need for continued inquiry within the field of music education that investigates children’s music experiences in their daily lives.
A Case Study: Middle School Boys’ Perceptions of Singing and Participation in Choir
Authors: Sweet Bridget
Published: February 2010

The purpose of this intrinsic case study was to learn about the perceptions of singing and participation in choir of the author’s eighth grade choir students. Specific areas of focus included insight on why the eighth grade boys sing and enjoy singing, perceptions of singing in a daily choir class, and perceptions of singing in an auditioned after-school choir. Primary data collection techniques included one formal group interview with the five boys, informal field notes, concert programs, difficulty level of choral music, and the author’s personal insights and observations as the boys’ choir teacher and participant observer. Four primary themes emerged: singing, other people, Choralier Men, and silliness. This study cannot be generalized to the general population of eighth grade boys or middle school choir. However, other middle school choral teachers may recognize similarities between the author’s teaching practices and their own, and benefit from consideration of these findings.