bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of potential immune response and in vivo survival of riboflavin‐ultraviolet light–treated red blood cells in baboons
Authors: Goodrich Raymond P. , Murthy Krishna K. , Doane Suzann K. , Fitzpatrick Christy N. , Morrow La Shayla , Arndt Patricia A. , Reddy Heather L. , Buytaert‐Hoefen Kimberley A. , Garratty George
Published: October 2008

BACKGROUND: Pathogen reduction methods have the potential to modify blood components, resulting in immunologic reactions or compromised blood components. This study evaluated the hypothesis that there is no immune response to riboflavin‐and‐ultraviolet [UV]‐light–treated red blood cells (RBCs), as observed by serology and by survival of RBCs in circulation.

STUDY DESIGN AND METHODS: Three baboons were in each treatment group: 1) untreated (negative control), 2) quinacrine mustard (QM)‐treated (positive control), and 3) riboflavin‐and‐UV light–treated (test group) RBCs. In the immunization phase, autologous test or control RBCs were injected subcutaneously on Days 0, 21, 42, and 49. Plasma samples from these days were tested against test or control RBCs by flow cytometry and standard serology. On Day 56, autologous 51Cr‐labeled test or control RBCs were injected. Blood samples were taken over 21 days after injection to determine RBC survival (t1/2).

RESULTS: Untreated and riboflavin‐and‐UV‐light–treated RBCs showed no evidence of significant immunoglobulin G (IgG) binding after incubation with autologous plasma. RBC‐bound IgG was detected on QM‐treated RBCs after incubation with autologous plasma. This antibody was inhibited by QM, as demonstrated by a hapten inhibition study. t1/2 values for the untreated and riboflavin‐and‐UV‐light–treated RBCs were 7.3 ± 0.8 and 7.5 ± 1.7 days, respectively; the t1/2 value for QM‐treated RBCs was 2.3 ± 2.9 days.

CONCLUSION: Treatment with riboflavin and UV light did not render RBCs immunogenic. Positive controls indicated that immunization promoted an immune response. In the 51Cr‐labeled RBC survival phase of the study, riboflavin‐and‐UV‐light–treated RBCs exhibited behavior similar to negative control RBCs. Detrimental immunologic or functional side effects were not observed.
The accuracy of natriuretic peptides (brain natriuretic peptide and N‐terminal pro‐brain natriuretic) in the differentiation between transfusion‐related acute lung injury and transfusion‐related circulatory overload in the critically ill
Authors: Li Guangxi , Daniels Craig E. , Kojicic Marija , Krpata Tami , Wilson Greg A. , Winters Jeffrey L. , Moore S. Breanndan , Gajic Ognjen
Published: October 2008

BACKGROUND: The diagnostic workup of transfusion‐related acute lung injury (TRALI) requires an exclusion of transfusion‐associated circulatory overload (TACO). Brain natriuretic peptide (BNP) and N‐terminal pro‐brain natriuretic (NT‐pro‐BNP) accurately diagnosed TACO in preliminary studies that did not include patients with TRALI.

STUDY DESIGN AND METHODS: In this prospective cohort study, two critical care experts blinded to serum levels of BNP and NT‐pro‐BNP determined the diagnosis of TRALI, TACO, and possible TRALI based on the consensus conference definitions. The accuracy of BNP and NT‐pro‐BNP was assessed based on the area under the receiver operating curve (AUC).

RESULTS: Of 115 patients who developed acute pulmonary edema after transfusion, 34 were identified with TRALI, 31 with possible TRALI, and 50 with TACO. Median BNP was 375 pg per mL (interquartile range [IQR], 123 to 781 pg/mL) in TRALI, 446 pg per mL (IQR, 128 to 743 pg/mL) in possible TRALI, and 559 pg per mL (IQR, 288 to 1348 pg/mL) in TACO patients (p = 0.038). The NT‐pro‐BNP levels among patients with TRALI, possible TRALI, and TACO differed significantly with a median value of 1559 pg per mL (IQR, 629 to 5114 pg/mL), 2349 pg/mL (IQR, 919 to 4610 pg/mL), and 5197 pg/mL (IQR, 1695 to 15,714 pg/mL; p = 0.004), respectively. The accuracy of BNP and NT‐pro‐BNP to diagnose TACO was moderate with an AUC of 0.63 (95% confidence interval [CI], 0.51‐0.74) and 0.70 (95% CI, 0.59 to 0.80).

CONCLUSIONS: Natriuretic peptides are of limited diagnostic value in a differential diagnosis of pulmonary edema after transfusion in the critically ill patients.
Post‐Olympic Powershift: The Return of the Middle Kingdom in a Post‐American World
Authors: GARDELS NATHAN
Published: October 2008

In the minds of its leaders and intellectuals, China is more than just another successful emerging economy and a rising regional power. For them, what is going on today might be considered a renaissance that will bring a neo‐Confucian sensibility to a post‐American world. In this section NPQ editor Nathan Gardels reports on his recent visit to Shanghai. Wang Hui, China's leading new left intellectual and author of The Rise of Modem Chinese Thought, offers his, views on subjects ranging from modernity to Tibet.
Notes on Post‐Secular Society
Authors: HABERMAS JÜRGEN
Published: October 2008

The resurgence of political Islam and the endurance of broad religious belief in the most modern of societies—America—has created a crisis of faith among secularists. If modernity no longer implies a secular outlook, and secularism, by definition, cannot generate any values beyond an indifferent tolerance of all belief, what role will religion play in the 21st century?

In an interesting confluence of reflection, Jürgen Habermas, one of Europe's leading secular liberal thinkers, argues that secular citizens must be open to religious influence, especially since the very identity of Western culture is rooted in Judeo‐Christian values. In his political afterlife, Tony Blair has converted to Catholicism and established a Faith Foundation to press for religious literacy because “you can't understand the modern world unless you understand the importance of religious faith.”

Similarly, when Pope Benedict XVI visited secular France in September, President Nicholas Sarkozy scandalized the lay establishment by saying, like Habermas, that “rejecting a dialogue with religion would be a cultural and intellectual error.” He called for “a positive secularism that debates, respects and includes, not a secularism that rejects.”

Despite the flurry of controversy over a recent spate of books extolling the virtues of atheism in the wake of Islamist terrorism, the more interesting issue by far is the emergence of post‐secular modernity.
God and the Political Planet
Authors: DEBRAY RÉGIS
Published: October 2008

The resurgence of political Islam and the endurance of broad religious belief in the most modern of societies—America—has created a crisis of faith among secularists. If modernity no longer implies a secular outlook, and secularism, by definition, cannot generate any values beyond an indifferent tolerance of all belief, what role will religion play in the 21st century?

In an interesting confluence of reflection, Jürgen Habermas, one of Europe's leading secular liberal thinkers, argues that secular citizens must be open to religious influence, especially since the very identity of Western culture is rooted in Judeo‐Christian values. In his political afterlife, Tony Blair has converted to Catholicism and established a Faith Foundation to press for religious literacy because “you can't understand the modern world unless you understand the importance of religious faith.”

Similarly, when Pope Benedict XVI visited secular France in September, President Nicholas Sarkozy scandalized the lay establishment by saying, like Habermas, that “rejecting a dialogue with religion would be a cultural and intellectual error.” He called for “a positive secularism that debates, respects and includes, not a secularism that rejects.”

Despite the flurry of controversy over a recent spate of books extolling the virtues of atheism in the wake of Islamist terrorism, the more interesting issue by far is the emergence of post‐secular modernity.
Globalization Is Running Out of Fuel
Authors: Klein Naomi
Published: October 2008

Globalization may not be coming apart at the seams—yet—but the seams are ever more apparent. Rising fuel prices challenge a model of global transportation based on cheap energy, reinforcing the possibility of decoupling through great regionaliza‐tion of trade. Already, 50 percent of trade among ASEAN plus China and Japan is among each other.

The Wall Street meltdown has spread a lack of confidence in the American financial system and the model of deregulation which stimulated rapid globalization of capital flows.

Along with other developments, all this raises the question of whether the United States is prepared to operate successfully in a world it no longer dominates.

An anti‐globalization leader, a former US labor secretary, a top American intellectual and a Nobel laureate address these issues.
Electrocardiographic Activity before Onset of Postoperative Atrial Fibrillation in Cardiac Surgery Patients
Authors: OVREIU MIRELA , NAIR BALA G. , XU MENG , BAKRI MOHAMED H. , LI LIANG , WAZNI OUSSAMA , FAHMY TAMER , PETRE JOHN , STARR NORMAN J. , SESSLER DANIEL I. , BASHOUR C. ALLEN
Published: October 2008

Background:Electrocardiographic (ECG) characteristics were analyzed in postoperative cardiac surgery patients in an attempt to predict development of new‐onset postoperative atrial fibrillation (AF).

Methods:Nineteen ECG characteristics were analyzed using computer‐based algorithms. The parameters were retrospectively analyzed from ECG signals recorded in postoperative cardiac surgery patients while they were in the cardiovascular intensive care unit (CVICU) at our institution. ECG data from 99 patients (of whom 43 developed postoperative AF) were analyzed. A bootstrap variable selection procedure was applied to select the most important ECG parameters, and a multivariable logistic regression model was developed to classify patients who did and did not develop AF.

Results:Premature atrial activity (PAC) was greater in AF patients (P < 0.01). Certain heart rate variability (HRV) and turbulence parameters also differed in patients who did and did not develop AF. In contrast, P‐wave morphology was similar in patients with and without AF. Receiver operating curve (ROC) analysis applied to the model produced a C‐statistic of 0.904. The model thus correctly classified AF patients with more than a 90% sensitivity and a 70% specificity.

Conclusion:Among the 19 ECG parameters analyzed, PAC activity, frequency‐domain HRV, and heart rate turbulence parameters were the best discriminators for postoperative AF.
Nonischemic Dilated Cardiomyopathy: Results of Noninvasive and Invasive Evaluation in 310 Patients and Clinical Significance of Bundle Branch Block
Authors: BREMBILLA‐PERROT BEATRICE , ALLA FRANÇOIS , SUTY‐SELTON CHRISTINE , HUTTIN OLIVIER , BLANGY HUGUES , SADOUL NICOLAS , CHOMETON FRÉDÉRIC , GROBEN LAURENT , LUPORSI JEAN D. , ZANNAD NOURA , ALIOT ETIENNE , CEDANO JUANICO , AMMAR SONIA , ABDELAAL AHMED , JUILLIÈRE YVES
Published: October 2008

Background:

The survival of patients with idiopathic dilated cardiomyopathy (IDCM) at III and IV stages of New York Heart Association (NYHA) is decreased in those with a bundle branch block (BBB) compared to those without BBB. Less is known on the prognosis of patients at earlier stages of NYHA and who had a left BBB (LBBB) or right BBB (RBBB).

We sought to evaluate the prevalence and the clinical significance of LBBB or RBBB in patients with IDCM and classes I and II of NYHA.

Methods:

Clinical data, noninvasive, and invasive studies were consecutively collected in 310 patients, with IDCM, followed up to 4.8±3.7 years.

Results:

Seventy‐six patients (25%) had LBBB, 21 (7%) had RBBB, and 212 had no BBB. Patients with BBB were older than other patients (P < 0.009). Left ventricular ejection fraction (LVEF) was lower in LBBB than in RBBB and other patients (P < 0.05). Syncope was more frequent in BBB than in absence (P < 0.05). Incidence of spontaneous ventricular tachycardia (VT) and atrial fibrillation, VT induction, total cardiac events, and sudden death were similar in the presence or absence of BBB. Deaths by heart failure and heart transplantations tended to be more frequent in BBB than in absence.

Conclusions:

LBBB was present in 25% of patients with IDCM; RBBB was rare. Patients with BBB were older and had more frequent syncope than patients without BBB; LVEF was lower in LBBB than in RBBB or in absence of BBB. BBB did not increase the risk of spontaneous VT, VT induction, or sudden death, and tended to increase deaths by heart failure and the indications of heart transplantation.
ICD Implantation and Arrhythmia‐Free Survival in Patients with Depressed LV Function Following Surgery for Valvular Heart Disease
Authors: YANG FELIX , SHAH BINDI , IWAI SEI , MARKOWITZ STEVEN M. , LERMAN BRUCE B. , STEIN KENNETH M.
Published: October 2008

Background:

Although prophylactic implantable cardioverter‐defibrillator (ICD) implantation is beneficial in patients with severe ischemic cardiomyopathy, it is unclear whether patients with cardiomyopathy due to valvular heart disease have a similar benefit.

Methods:

We followed 17 patients (14 men/three women, age 62 ± 13 years, left ventricular ejection fraction [LVEF] 29 ± 10%) who had nonischemic valvular cardiomyopathy, underwent valvular heart surgery (aortic valve replacement, mitral valve replacement, and/or mitral valve repair), and subsequently had an electrophysiology study (EPS), for a median of 2.8 years. These patients were compared with 34 patients with prior myocardial infarction and no significant valvular heart disease, who were matched (1:2) for age, gender, LVEF, EPS result, T‐wave alternans result, and ICD placement. Occurrence of arrhythmias was ascertained from ICD device clinic follow‐up and vital status was determined using the National Death Index.

Results:

There were no differences between the groups in overall survival (P = 0.24) or arrhythmia‐free survival (P = 0.38), and the 2‐year arrhythmia‐free survival was 82% for the valvular patients versus 73% for the ischemic patients. Among patients with ICDs, there was no difference between the groups in overall survival (P = 0.34), time to first appropriate ICD therapy (P = 0.54), and arrhythmia‐free survival (P = 0.51).

Conclusion:

Patients with valvular cardiomyopathy and residual left ventricular dysfunction following valvular surgery who underwent a tailored approach to ICD implantation had similar overall and arrhythmia‐free survival as patients with ischemic cardiomyopathy.
Insulin‐Treated Type 2 Diabetes Is Associated with a Decreased Survival in Heart Failure Patients after Cardiac Resynchronization Therapy
Authors: MANGIAVACCHI MAURIZIO , GASPARINI MAURIZIO , GENOVESE STEFANO , PINI DANIELA , KLERSY CATHERINE , BRAGATO RENATO , ANDREUZZI BRUNO , MUNICINÒ ANNAMARIA , REGOLI FRANÇOIS , GALIMBERTI PAOLA , CERIOTTI CARLO , GRONDA EDOARDO
Published: October 2008

Background:

Cardiac resynchronization therapy (CRT) improves cardiac performance and survival in patients with congestive heart failure. Recent observations suggest that diabetes is associated with a worse outcome in these patients. The aim of the study was to investigate the effect of diabetes and insulin treatment on outcome after CRT.

Methods:

Diabetic status and insulin treatment were assessed in 447 patients who underwent CRT (males 80.8%, mean age 65.7 ± 9.7 years, ejection fraction 29.9 ± 6.11%). Patients were stratified in three groups according to the presence or absence of diabetes and insulin treatment.

Results:

Nondiabetic patients were 366 (79.6%), noninsulin‐treated diabetic patients 62 (13.9%), insulin‐treated diabetic patients 29 (6.5%). The estimated death rate was 5.15 per 100 patients‐year in the nondiabetic group, 8.63 in noninsulin‐treated diabetics (HR 1.59, P = 0.240), and 15.84 in insulin‐treated diabetics (HR 3.05, P = 0.004). Cardiac mortality accounted for 81% of deaths in nondiabetic patients and for 56% of deaths in diabetic patients. Diabetic patients tended to have a worse recovery of left ventricular ejection fraction over time (P = 0.057) and of the distance at 6‐minute walking test (6MWT) (P = 0.018).

Conclusions:

Insulin‐treated diabetes is associated with a worse functional recovery and a higher mortality in patients with advanced heart failure after CRT. While cardiac death accounts for the majority of deaths in nondiabetic patients, a relevant proportion of the mortality in diabetic patients seem to result from noncardiac causes.
A Blended Sensor Restores Chronotropic Response More Favorably than an Accelerometer Alone in Pacemaker Patients: The LIFE Study Results
Authors: COMAN JAMES , FREEDMAN ROGER , KOPLAN BRUCE A. , REEVES RUSSELL , SANTUCCI PETER , STOLEN KIRA Q. , KRAUS STACIA M. , MEYER TIMOTHY E.
Published: October 2008

Background:

Adaptive rate sensors used in permanent pacemakers incorporate an accelerometer (XL) to increase heart rate with activity. Limited data exists regarding the relative benefit of a blended sensor (BS) (XL and minute ventilation) versus XL alone in restoring chronotropic response (CR) in chronotropically incompetent (CI) patients.

Methods:

One thousand five hundred thirty‐eight patients from the limiting chronotropic incompetence for pacemaker recipients (LIFE) study were implanted with a pacemaker and 1,256 patients had data collected at 1 month. Patients performed a treadmill test 1‐month postimplant while programed in nonrate responsive mode (DDD‐60) to determine CI. Only patients who completed at least three exercise stages and achieved a peak perceived exertion ≥16 were included in the analyses. The metabolic chronotropic relationship (MCR) slope was used to evaluate CR in 547 patients. Patients were randomized to XL or BS with a conservative fixed rate response factor (XL = 8, MV = 4). CI patients performed a follow‐up 6‐month treadmill test.

Results:

CI prevalence in this patient population (n = 547) was 34%. No differences in baseline characteristics existed between groups. Although both groups showed significant within‐group improvements in MCR slope from 1 to 6 months (both P < 0.001), the BS group had a significantly higher MCR slope at 6 months compared to the XL group (P = 0.011). Improvement in quality of life (QOL) did not differ between groups.

Conclusions:

In this general pacemaker population with CI, a BS programed empirically restores CR more favorably than an XL sensor programed nominally. Further studies are needed to determine if individual sensor optimization would lead to improvement in functional capacity, higher MCR slopes, and QOL.
Optimal Site for Atrial Lead Implantation in Myotonic Dystrophy Patients: The Role of Bachmann's Bundle Stimulation
Authors: NIGRO GERARDO , RUSSO VINCENZO , VERGARA PASQUALE , D'ANDREA ANTONELLO , GREGORIO GRAZIA DI , POLITANO LUISA , NIGRO GIOVANNI , CALABRÒ RAFFAELE
Published: October 2008

Aim:

The aim of this study was to identify the optimal site for atrial lead implantation in myotonic dystrophy type 1 (MD1) patients.

Methods:

The atrial pacing lead was positioned in the high‐lateral right atrial wall (site A), then in the right atrial appendage (site B), and finally on the interatrial septum (site C) in 22 patients. Pacing and sensing thresholds were obtained for all sites. The lead was repositioned and fixed at the optimal site, defined as the location with the lowest pacing and the highest sensing thresholds.

Results:

Mean pacing thresholds were 1.46 ± 0.32 V at site A, 1.45 ± 0.33 V at site B, and 0.84 ± 0.24 V at site C. P‐wave amplitude was 1.52 ± 0.45 mV at site A, 1.52 ± 0.49 mV at site B, and 2.60 ± 0.48 mV at site C. Atrial lead was implanted at site C in all patients without complications.

Conclusions:

Interatrial septum in the region of Bachmann's Bundle seems to be the optimal site for atrial lead implantation in MD1 patients.
A Randomized Trial of the Effect of Automated Ventricular Capture on Device Longevity and Threshold Measurement in Pacemaker Patients
Authors: KOPLAN BRUCE A. , GILLIGAN DAVID M. , NGUYEN LUC S. , LAU THEODORE K. , THACKERAY LISA M. , BERG KELLIE CHASE ,   for the ULTRA Study Investigators
Published: October 2008

Background:

An automatic capture (AC) algorithm adjusts ventricular pacing output to capture the ventricle while optimizing output to 0.5 V above threshold. AC maintains this output and confirms capture on a beat‐to‐beat basis in bipolar and unipolar pacing and sensing.

Objective:

To assess the AC algorithm and its impact on device longevity.

Methods:

Patients implanted with a pacemaker were randomized 1:1 to have the AC feature on or off for 12 months. Two threshold tests were conducted at each visit— automatic threshold and manual threshold. Average ventricular voltage output and projected device longevity were compared between AC on and off using nonparametric tests.

Results:

Nine hundred ten patients were enrolled and underwent device implantation. Average ventricular voltage output was 1.6 V for the AC on arm (n = 444) and 3.1 V for the AC off arm (n = 446) (P < 0.001). Projected device longevity was 10.3 years for AC on and 8.9 years for AC off (P < 0.0001), or a 16% increase in longevity for AC on. The proportion of patients in whom there was a difference between automatic threshold and manual threshold of ≤0.5 V through follow‐up was 99.0% (95% CI: 98.6, 99.3). The average difference between automatic threshold and manual threshold was 0.07 V (P = 0.002).

Conclusions:

This study showed that automatic threshold testing at follow‐up provided comparable information to manually measured threshold testing. AC provided a significant increase in projected device longevity compared to standard programing.
Focused Force Coronary Venoplasty to Eliminate a Refractory Stenosis Preventing LV Lead Placement in Two Patients
Authors: WORLEY SETH J. , GOHN DOUGLAS C. , PULLIAM ROBERT W.
Published: October 2008

This report describes two patients who underwent a second attempt at cardiac resynchronization therapy (CRT) in the setting of a severe stenosis in the lateral coronary vein that prevented passage of a left ventricular lead. Both stenoses were unresponsive to standard noncompliant balloon dilatation but were successfully treated with the addition of a second stiff angioplasty wire beside the noncompliant balloon. Venoplasty with the addition of a side wire beside the balloon should be considered for resistant coronary vein stenosis encountered during CRT device implantation.
Role of Real Time Three‐Dimensional Echocardiography in Heart Failure
Authors: Anwar Ashraf M. , Nosir Youssef F. M.
Published: October 2008

The incidence and prevalence of heart failure (HF) are increasing with high morbidity and mortality rates. Echocardiography is a very useful diagnostic tool for the evaluation of HF patients. Real time three‐dimensional echocardiography (RT3DE) was introduced in the last decade and has proved to provide an accurate assessment of ventricular volume, mass, and function. In addition, it provides a comprehensive evaluation of the valves. However, its application remained limited to research work in selected cases because of a suboptimal image quality. The recent advances in the transducer and computer software technology enhanced the use of RT3DE in clinical practice. The application of RT3DE adds much information that helps in the assessment of HF patients. RT3DE became the standard in the assessment of left ventricular (LV) volumes, function, and mass. RT3DE is a promising tool for testing LV dyssynchrony due to its accuracy and reproducibility comparable to magnetic resonance imaging. The application of RT3DE for stress and myocardial perfusion studies is encouraging due to its short image acquisition time, but still requires wide‐scale studies. Through cropping of the RT3DE full‐volume, the direct visualization of the heart valves (especially mitral valve) in a surgical view could be easily obtained. In the near future, one would expect RT3DE to become an integral part of the assessment of HF patients.
Echocardiographic Algorithm for Cardiac Resynchronization
Authors: Lafitte Stéphane , Reant Patricia , Serri Karim , Roudaut Raymond
Published: October 2008

Cardiac resynchronization therapy (CRT) has become a proven therapeutic strategy for refractory heart failure. Large clinical trials have shown a reduction in both morbidity and mortality in patients treated with CRT. Initial patient selection has relied mainly on electrocardiographic criteria that allowed identifying only 70% of responders. Accordingly, echocardiographic criteria were developed to identify dyssynchrony in the hope of improving patient selection. Multiple echocardiographic criteria have since been proposed, with no consensus as to which parameter better predicts CRT response. Although comparison studies using the different criteria are underway, the current evaluation of dyssynchrony should probably be an integrated multiparameter approach. The objective of this article is to review the role of echocardiography in the evaluation of cardiac dyssynchrony and propose a practical algorithm in order to improve CRT patient selection.
Optimization of Cardiac Resynchronization Therapy
Authors: Bhan Amit , Kapetanakis Stamatis , Monaghan Mark J.
Published: October 2008

Cardiac resynchronization is now an accepted and widespread therapy for patients with left ventricular (LV) systolic dysfunction. However, there are still a significant number of patients that do not appear to gain benefit, and this is currently the focus of a great deal of research. Contemporary resynchronization devices allow manipulation of both atrioventricular (AV) and ventricular‐to‐ventricular (VV) delays and there is evidence that optimization of these delays has a positive effect on hemodynamics. However, there are many ways that optimization can be performed and there is little consensus on how, if at all, it should be incorporated into clinical practice.
Crystallization Process and Some Properties of Li2O–SiO2Glass–Ceramics Doped with Al2O3and K2O
Authors: Fernandes Hugo R. , Tulyaganov Dilshat U. , Goel Ishu K. , Ferreira José M. F.
Published: October 2008

We report on the role of Al2O3and K2O on crystallization in glasses featuring a SiO2/Li2O ratio (3.13 to 4.88) far beyond that of lithium disilicate (LD, Li2Si2O5) stoichiometry. Glasses in both bulk and frit form were produced by the conventional melt‐quenching technique. Scanning electron microscopy analysis revealed surface nucleation as the dominant crystallization mechanism in glass–ceramics (GCs) derived from bulk glasses richer in Al2O3and K2O in the temperature range 800°–900°C and dendritic skeletal surface growth of lithium metasilicate crystalline phase (LS,Li2SiO3). The glasses with lower amounts of Al2O3and K2O showed an intermediate type of crystallization mechanism (simultaneous surface and volume nucleation) resulting in the preferential formation of Li2Si2O5. The formation of LD GCs by sintering and the crystallization of glass‐powder frits seems to occur via the precursor phase of LS, resulting in high‐strength materials.
Memory and prefrontal functions in earthquake survivors: differences between current and past post‐traumatic stress disorder patients
Authors: Eren‐Koçak E. , Kılıç C. , Aydın I. , Hızlı F. G.
Published: October 2008

Objective:  Many studies reported deficits in cognitive functions in post‐traumatic stress disorder (PTSD). Most were, however, conducted on man‐made trauma survivors. The high comorbidity of alcohol use and depression with PTSD in these studies further complicated the interpretation of their results. We compared prefrontal lobe functions and memory in three earthquake survivor groups: current PTSD, past PTSD and no PTSD. We hypothesized that prefrontal performances of the current and past PTSD groups would be worse than that of control group.

Method:  Survivors of the 1999 earthquakes in Turkey were evaluated for current and lifetime PTSD. Memory and prefrontal functions were assessed by a neuropsychological test battery.

Results:  Current PTSD patients performed worse on attention, verbal memory, verbal fluency, and psychomotor speed. Past PTSD group was similar to the controls on most cognitive measures, except for their vulnerability to proactive interference and low performance in verbal fluency for animal names.

Conclusion:  Our findings indicate that the prefrontal organization and monitorization of verbally processed information are defective in earthquake‐related PTSD patients, more so in the current PTSD group.
ORIGINAL ARTICLE: Tumor Necrosis Factor (TNF)–TNF Receptor Gene Polymorphisms and Their Serum Levels in Korean Women with Endometriosis
Authors: Chae Soo Jin , Kim Hoon , Jee Byung Chul , Suh Chang Suk , Kim Seok Hyun , Kim Jung Gu
Published: October 2008

Problem  The aim of this study was to investigate the relationship between the polymorphisms of the tumor necrosis factor‐α (TNF‐α) and TNF receptor (TNFR) genes and serum levels of TNF‐α and its soluble receptor (sTNFR) in Korean women with endometriosis.

Method of study  The TNF‐α C(−857)T, C(−863)A and T(−1031)C, and TNFR1 A(36)G, TNFR2 T(676)G, A(1663)G, T(1668)G and C(1690)T polymorphisms, and serum levels of TNF‐α, sTNFR1, and sTNFR2 were analyzed in women with (n = 105) and without endometriosis (n = 101).

Results  Serum sTNFR1 and sTNFR2 levels were significantly higher in women with endometriosis than in those without endometriosis, whereas no difference in serum TNF‐α level was noted. Single polymorphisms of TNF‐α and TNFR genes were not significantly different between the two groups. The frequencies of the TNF‐α T/C/C haplotype allele and the TNFR2 G/G/T haplotype allele were significantly decreased in women with endometriosis compared to women without endometriosis. Women carrying at least one copy of the TNFR2 T/G/T and /or G/G/C haplotype allele had an approximately two times higher risk of endometriosis than women without these haplotype alleles.

Conclusion  The haplotype alleles of the TNF‐α and TNFR2 gene polymorphisms are genetic factors associated with endometriosis, and circulating sTNFR rather than TNF‐α, may be involved in the development of endometriosis in Korean women.
REVIEW ARTICLE: Immunopathogenesis of Pelvic Endometriosis: Role of Hepatocyte Growth Factor, Macrophages and Ovarian Steroids
Authors: Khan Khaleque Newaz , Kitajima Michio , Hiraki Koichi , Fujishita Akira , Sekine Ichiro , Ishimaru Tadayuki , Masuzaki Hideaki
Published: October 2008

Endometriosis, a chronic disease characterized by endometrial tissue located outside the uterine cavity is associated with chronic pelvic pain and infertility. However, an in‐depth understanding of the pathophysiology of endometriosis is still elusive. It is generally believed that besides ovarian steroid hormones, the growth of endometriosis can be regulated by innate immune system in pelvic microenvironment by their interaction with endometrial cells and immune cells. We conducted a series of studies in perspectives of pelvic inflammation that is triggered primarily by bacterial endotoxin (lipopolysacccharide) and is mediated by toll‐like receptor 4 and showed their involvement in the development of pelvic endometriosis. As a cellular component of innate immune system, macrophages were found to play a central role in inducing pelvic inflammatory reaction. We further report here that peritoneal macrophages retain receptors encoding for estrogen and progesterone and ovarian steroids also participate in producing an inflammatory response in pelvic cavity and are involved in the growth of endometriosis either alone or in combination with hepatocyte growth factor (HGF). As a pleiotropic growth factor, HGF retains multifunctional role in endometriosis. We describe here the individual and step‐wise role of HGF, macrophages and ovarian steroid hormones and their orchestrated involvement in the immunopathogenesis of pelvic endometriosis.
George Akerson's Legacy: Continuity and Change in White House Press Operations
Authors: WALCOTT CHARLES E. , HULT KAREN M.
Published: October 2008

The growth and structural evolution of the White House press office have been primarily responses to the burgeoning and diversification of the mass communications media. As the White House press corps has grown, the press office adapted through expansion and structural elaboration. At the same time, the emergence of an increasingly complex media culture, partly a result of technological changes, called into question the role of traditional press and press relations within the overall White House communications and public outreach apparatus. As a consequence, while the press office has remained a central component of the White House Office and has evolved to meet new demands, its organizational location and, to some extent, its influence have varied within and across administrations. Meanwhile, organizational precedents and the institutional memories of those in and out of the White House have helped dampen major changes in structuring for communications.
Computerized tomography of the brain for elderly patients presenting to the emergency department with acute confusion
Authors: Hardy James Edward , Brennan Nicholas
Published: October 2008

Objective:  Confusion is a common reason for presentation of elderly patients to the ED. There are many potential causes of confusion, which include acute neurological events. Computerized tomography (CT) scans are often routinely ordered to investigate confusion, despite the recommendation of guidelines against routine use. The aim of the present study was to determine the usefulness of CT brain scans in a prospective cohort of confused elderly patients presenting to an ED.

Methods:  The progress notes of 106 consecutive patients over 70 years of age who had a CT brain scan for a presentation of acute confusion were reviewed for indications for the scan and the presence of neurological examination findings. Official radiology reports of CT brain scans were assessed for the presence of abnormalities.

Results:  Of the 106 patients, 12 (11%, 95% CI 5.29–17.35) had no documented neurological examination. Fifteen patients (14%, 95% CI 7.51–20.79) had acute abnormalities on CT scan, one of whom had two abnormalities. There were ten acute ischaemic strokes, four cerebral haemorrhages and two meningiomas. Thirteen of the patients with positive CT findings (93%, 95% CI 80.7–105.96) had new findings on neurological examination. The only patient with no neurological findings with a positive CT scan had had a fall. A history of a fall or the presence of neurological findings on examination was predictive of a positive CT scan (odds ratio 17.07, 95% CI 2.15–135.35).

Conclusion:  The results add further support to guidelines that suggest that CT scans of the brain for confused elderly patients should only be performed for those with acute neurological findings, head trauma or a fall.
The Female Sexual Response Cycle: Do Malaysian Women Conform to the Circular Model?
Authors: Sidi Hatta , Naing Lin , Midin Marhani , Nik Jaafar Nik Ruzyanei
Published: October 2008

Introduction

The concept of a sexual response cycle (SRC) for women has gained interest lately with the reintroduction of terms with new definitions and a new model for the sexual response, especially the Basson's circular model.

Aim

To determine the correlations among the SRC's phases (i.e., sexual desire, sexual arousal, orgasm, sexual satisfaction, and sexual pain) in Malaysian women, in order to validate the circular model of women's SRC.

Methods

Principal component analysis (PCA), a factor analysis technique with varimax rotation method, was used to explore the correlation structure of items in female respondents who scored on the Malay version of Female Sexual Function Index (FSFI). The number of factors or components to obtain was decided using Kaiser's criteria.

Main Outcome Measure

To measure the correlation between female SRC's domain.

Results

A total of 230 married women aged 18–70 years old participated in this study. Factor loadings using PCA with varimax rotation divided the sexual domains into three components based on Kaiser's criteria with eigenvalues of 6.11, 5.59, and 3.50, respectively. Sexual desire, sexual arousal, and lubrication were highly correlated, and therefore, they fall in one component, reflecting one construct, whereas orgasm and sexual satisfaction fall in another component. The third component was formed by the pain items.

Conclusion

The strong correlation between sexual desire/arousal/lubrication means that they were the same and may support the contemporary theory of circular model of SRC in women.
Couple Satisfaction to Different Therapeutic Modalities for Organic Erectile Dysfunction
Authors: Hassan A. , El-Hadidy M. , El-Deeck B.S. , Mostafa T.
Published: October 2008

Introduction

Erectile dysfunction (ED) treatment studies do not measure treatment response and treatment satisfaction (both patient and partner satisfaction) where dissatisfaction reflects an aspirations/achievement gap.

Aim

To test the subjective implications of satisfaction to various therapeutic modalities for pure or mixed organic ED, and to address changes in the health-oriented quality of life (QoL) and the relation of psychiatric status of these patients to treatment satisfaction.

Methods

A prospective study included of 354 couples classified according to their line of therapy into five treated groups: testosterone, sildenafil citrate, intracavernosal injection, external negative vacuum device, and penile prosthesis.

Main Outcome Measures

Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and the International Index of Erectile Function (IIEF). Satisfied patients were compared to unsatisfied cases using the PCASEE scale for QoL and Middlesex Hospital Questionnaire (MHQ) for psychiatric status.

Results

Sildenafil citrate-treated group represented the highest mean value of satisfaction score on EDITS, erectile function, orgasmic function, and overall satisfaction domains of IIEF. Penile implants-treated group was the second for satisfaction score on EDITS. The testosterone-treated group represented the highest mean value for sexual desire domain score of IIEF. Low scores in various domains of QoL were significantly improved among satisfied cases more than unsatisfied subjects after therapy. High association was found between dissatisfaction and scores for anxiety, obsession, and phobia, followed by scores of depression and somatic concomitant of anxiety.

Conclusion

ED is best conceived as intermingle of somatic, lifestyle, psychological, and partner relationship determinants. This should be taken into account to increase sexual satisfaction with improved QoL, and not only to produce rigid erection.
Female Sexual Function and Dysfunction in the Reproductive Years: The Influence of Endogenous and Exogenous Sex Hormones
Authors: Stuckey Bronwyn G.A.
Published: October 2008

Introduction

Sexual function in women in the reproductive age years is under psychological, sociocultural, and relationship influences, as well as the influence of sex hormones.

Aim

To examine the data relating to sexual function in women in the reproductive age group, particularly the influence of sex hormones. To examine, in particular, the influence of the menstrual cycle, pregnancy, the oral contraceptive pill and endogenous and exogenous testosterone.

Methods

Review of the literature on female sexual function, confining the search to the reproductive age range.

Results

Population studies of sexual function identify sexual disinterest as being the most common sexual complaint in premenopausal women. Most studies of menstrual cyclicity identify a periovulatory increase in sexual desire or activity. All prospective studies of sexuality in pregnancy document a decline in sexual function with progression of pregnancy. Studies of the influence of the oral contraceptive pill on sexual function are contradictory with most prospective controlled studies showing no deleterious effect. Studies of the influence of endogenous androgens on sexuality are also contradictory with one large cross-sectional study showing no correlation, but some case-controlled studies show low androgens in women with sexual dysfunction. Studies of testosterone therapy in premenopausal women are ambiguous, with no clear dose-response effect.

Conclusion

Sexual disinterest is prevalent in premenopausal woman despite being hormone replete. The assessment of androgen contribution is hampered by the unreliability of the testosterone assay in the female range. Large cross-sectional and longitudinal studies have not identified a correlation between testosterone and sexual function in women. Sexual dysfunction in the premenopausal age range is common. Sex hormones have a modifying effect on sexual function but social influences and learned responses are as important. The role of testosterone requires further study.
Determinants of spontaneous healing in traumatic perforations of the tympanic membrane
Authors: Orji F.T. , Agu C.C.
Published: October 2008

Objectives:  To analyse the various factors influencing spontaneous healing of traumatic tympanic membrane perforation in West Africa.

Study design:  Prospective clinical study.

Setting:  Tertiary referral centre.

Participants:  Consecutive patients with traumatic tympanic membrane perforations without history of previous middle ear disease.

Main outcome measures:  Healing outcome at 4, 8, 12 weeks; effects of perforation size, location, and mode of injury, active intervention and ear discharge on healing outcome.

Results:  Fifty‐three patients, 32 (60%) men and 21 (40%) women, aged 2–86 years, with traumatic tympanic membrane perforation who met our inclusion criteria were analysed. Ninety‐four percent of the perforations healed spontaneously. Spontaneous healing was significantly correlated with age (P < 0.05). It was significantly delayed by large perforations estimated at 50% or more of entire tympanic membrane, ear discharge, wrong intervention on acute perforation by ear syringing, and by penetrating injuries sustained through the ear canal (P < 0.05, P < 0.01, P < 0.01 and P < 0.01 respectively). Perforations in the anterior versus posterior quadrants showed no significant difference in the healing rate (P > 0.05). Non‐healing of the traumatic perforation was significantly associated with the large perforations, ear discharge and wrong intervention by ear syringing in chi‐square test (P = 0.01, P = 0.02 and P < 0.001 respectively), but only with penetrating injuries sustained through the ear canal and the ear syringing intervention in logistic regression test (P = 0.02 and P = 0.04 respectively).

Conclusion:  The rate of spontaneous healing of traumatic tympanic membrane perforation varied inversely with age of patient and size of perforation. It was delayed by middle‐ear infection, as well as in ears that sustain direct injuries and in ears that had wrong interventions. However, it was not dependent on whether the perforation was in the anterior or posterior location. Logistic regression analysis revealed that penetrating injuries sustained through the ear canal and the ear syringing intervention were the only risk factors important in predicting the non‐healing of traumatic tympanic membrane perforation.
Is surgical debridement and topical 5 fluorouracil the optimum treatment for woodworkers’ adenocarcinoma of the ethmoid sinuses? A case‐controlled study of a 20‐year experience
Authors: Almeyda R. , Capper J.
Published: October 2008

Objectives:  Woodworkers’ adenocarcinoma of the ethmoid sinuses is an extremely rare occupational malignancy with a locally aggressive course. Treatment with surgical exenteration and topical 5 fluorouracil (5FU) packs has become standard treatment over the last 10 years in this ENT unit. This study presents level 2 evidence that 5FU provides improved survival over previous management with primary radiotherapy and salvage craniofacial resection.

Design:  Retrospective case series with historical control group.

Setting:  District General Hospital.

Participants:  The records of 31 consecutive patients with the disease were analysed. Five patients died prior to treatment. One patient was treated with surgery alone and therefore excluded. Twenty‐five patients were included in the analysis. Fourteen were treated with primary radiotherapy and 11 with surgery and topical 5FU.

Outcome measures:  Disease free survival was measured using Kaplan–Meier survival analysis.

Results:  Five‐year disease free survival improved from 50% with primary radiotherapy to 86% with surgery and 5FU. This improvement is statistically significant (P = 0.03).

Conclusion:  Topical 5FU treatment improves survival of Woodworker’s adenocarcinoma of the ethmoid sinuses. This finding may be useful in the treatment of other locally aggressive sinonasal malignancies.
Geographies of the Contemporary Informal Sector in the Global South: Gender, Employment Relationships and Social Protection
Authors: Lloyd‐Evans Sally
Published: October 2008

This article explores past and present understandings of the phenomena popularly known as the ‘informal sector’ in the global South in order to re‐appraise its continued credibility as a conceptual framework for understanding work in the 21st century. The reality of the contemporary global economy is that a majority of the workforce are employed in casual, contractual, home‐based or own‐account work in the informal economy, escaping government regulations and social legislation. New worker‐oriented and gendered definitions of the informal sector, which encompass new spaces of unregulated waged, home‐based and even‐forced labour, have re‐awakened an interest in informality from a gendered, social justice perspective. Drawing on examples from the global South, with a particular focus on the Caribbean, the article examines how thinking about the informal sector has evolved from traditionalenterpriseanalyses to more gender sensitiveworker‐focusedperspectives. Following a critique of policies aimed to protect informal workers in old and new spaces of the global economy, it concludes by urging geographers to re‐engage with a new geography of informality which moves forward the goal of protecting and mobilising the world's informal workers in all their guises.
Geographies for Moving Bodies: Thinking, Dancing, Spaces
Authors: McCormack Derek P.
Published: October 2008

The body is well established as a research focus within contemporary human geography. Yet, the matter of how and in what ways bodies are geographical remains an open question. In this article, I address this question by examining work by geographers and others about the spaces ofmoving bodies. My points of departure are the twin claims that bodies move in more ways than one (spatio‐temporally, kinaesthetically, affectively, collectively, politically and imaginatively)andthat this movement is potentially generative of different kinds of spaces. These claims are developed through a discussion of dance. By drawing on work from a range of disciplines, I argue that research encounters with dance offer opportunities for thinking about three sets of issues: the relation between bodies and cultural geographies; the importance of affectivity in spatial experience; and the relation between the lived and the abstract. I conclude by outlining a series of pathways along which geographical research into the spaces of moving bodies might be developed further.