bluuebunny/crossref_metadata_2025 huggingface dataset:
Acupuncture and the Relaxation Response for Treating Gastrointestinal Symptoms in Hiv Patients on Highly Active Antiretroviral Therapy
Authors: Chang Bei-Hung , Sommers Elizabeth
Published: June 2011

Objectives

To examine the effect of acupuncture and the relaxation response (RR) for treating gastrointestinal (GI) symptoms in HIV patients who are using highly active antiretroviral therapy (HAART).

Methods

The authors conducted a 4-arm 2×2 double-blind randomised controlled trial in an acupuncture clinic in the USA. Sham acupuncture and health education were used as the control conditions of real acupuncture and RR elicitation, respectively. Enrolled patients were randomised to real acupuncture+RR (AR), sham acupuncture+RR (SR), real acupuncture+health education (AE) or sham acupuncture+health education (SE) study arm. Participants listened to CDs with RR-eliciting instructions or health education while receiving acupuncture intervention. Interventions were provided twice weekly for 4 weeks and once weekly for another 4 weeks. Participants used daily diaries to record GI symptom severity ratings (0–10). The authors estimated the intervention effect as the changes in symptom rating per intervention session increase using a mixed-effects regression model.

Results

A total of 130 people with HIV/AIDS who were on HAART and had persistent GI symptoms were enrolled and 115 started the study intervention. The AR group had greater intervention effects for loose stools symptoms than the other three groups (β=−0.149, −0.151 and −0.144, p value=0.013, 0.013 and 0.018 comparing AR to AE, SR and SE, respectively). The AR group also had significant intervention effects on reducing nausea symptoms when the intervention was given twice per week (β=−0.218, p=0.001).

Conclusions

Our trial provided preliminary data demonstrating the potential synergistic effects of acupuncture and RR for treating GI symptoms in HIV patients on HAART.
MILC PMOS Poly-Silicon TFT Circuits and Application in SOP
Authors: Sun Pengfei , Zhao Shuyun , Ho Tsz-Kin , Meng Zhiguo , Wong Man , Kwok Hoi Sing
Published: June 2011

Research towards thin film circuits is one of the most attractive directions of the large-area electronics and flexible electronics. In this work, the research on TFT shift register circuit which is critical for system integration on panel (SOP) is presented. The whole circuit is composed of MILC PMOS poly-Si TFTs. The TFT device exhibited field-effect mobility of 65.21cm2/Vs, threshold voltage of -3.5V and sub-threshold swing of 0.56V/dec. Some special design considerations were adopted to improve the robustness of the circuits. The whole shift register is composed of as many as 180 stages and exhibited well performance with frame frequency from 22Hz to 220Hz at the power supply voltage of 11V. No signal attenuation and distortion appeared from the first to the final stage. The effect of bootstrapping and dynamic behavior is analyzed. The fabrication and reliability analysis are also discussed in this paper. Overall, the high performance driver circuits based on our MILC PMOS process are possible and have the potential in the application of SOP.
Formation and Characterization of NiYb Silicides
Authors: Yuan Yongwen , Ivanov Eugene
Published: June 2011

We have studied the silicidation of nickel (Ni)-ytterbium (Yb) films deposited from sputtering target of Ni alloyed with Yb. We have conducted structural, electrical, and optical characterizations of the deposited films. Our results indicated the formation and properties of NiYb silicides were related to the Yb addition to Ni and the annealing conditions.
Cardiac pressure overload hypertrophy is differentially regulated by β-adrenergic receptor subtypes
Authors: Zhao Mingming , Fajardo Giovanni , Urashima Takashi , Spin Joshua M. , Poorfarahani Sara , Rajagopalan Viswanathan , Huynh Diem , Connolly Andrew , Quertermous Thomas , Bernstein Daniel
Published: June 2011

In isolated myocytes, hypertrophy induced by norepinephrine is mediated via α1-adrenergic receptors (ARs) and not β-ARs. However, mice with deletions of both major cardiac α1-ARs still develop hypertrophy in response to pressure overload. Our purpose was to better define the role of β-AR subtypes in regulating cardiac hypertrophy in vivo, important given the widespread clinical use of β-AR antagonists and the likelihood that patients treated with these agents could develop conditions of further afterload stress. Mice with deletions of β1, β2, or both β1- and β2-ARs were subjected to transverse aortic constriction (TAC). After 3 wk, β1−/−showed a 21% increase in heart to body weight vs. sham controls, similar to wild type, whereas β2−/−developed exaggerated (49% increase) hypertrophy. Only when both β-ARs were ablated (β1β2−/−) was hypertrophy totally abolished. Cardiac function was preserved in all genotypes. Several known inhibitors of cardiac hypertrophy (FK506 binding protein 5, thioredoxin interacting protein, and S100A9) were upregulated in β1β2−/−compared with the other genotypes, whereas transforming growth factor-β2, a positive mediator of hypertrophy was upregulated in all genotypes except the β1β2−/−. In contrast to recent reports suggesting that angiogenesis plays a critical role in regulating cardiac hypertrophy-induced heart failure, we found no evidence that angiogenesis or its regulators (VEGF, Hif1α, and p53) play a role in compensated cardiac hypertrophy. Pressure overload hypertrophy in vivo is dependent on a coordination of signaling through both β1- and β2-ARs, mediated through several key cardiac remodeling pathways. Angiogenesis is not a prerequisite for compensated cardiac hypertrophy.
Activation of Pak1/Akt/eNOS signaling following sphingosine-1-phosphate release as part of a mechanism protecting cardiomyocytes against ischemic cell injury
Authors: Egom Emmanuel Eroume A. , Mohamed Tamer M. A. , Mamas Mamas A. , Shi Ying , Liu Wei , Chirico Debora , Stringer Sally E. , Ke Yunbo , Shaheen Mohamed , Wang Tao , Chacko Sanoj , Wang Xin , Solaro R. John , Fath-Ordoubadi Farzin , Cartwright Elizabeth J. , Lei Ming
Published: June 2011

We investigated whether plasma long-chain sphingoid base (LCSB) concentrations are altered by transient cardiac ischemia during percutaneous coronary intervention (PCI) in humans and examined the signaling through the sphingosine-1-phosphate (S1P) cascade as a mechanism underlying the S1P cardioprotective effect in cardiac myocytes. Venous samples were collected from either the coronary sinus ( n = 7) or femoral vein ( n = 24) of 31 patients at 1 and 5 min and 12 h, following induction of transient myocardial ischemia during elective PCI. Coronary sinus levels of LCSB were increased by 1,072% at 1 min and 941% at 5 min ( n = 7), while peripheral blood levels of LCSB were increased by 579% at 1 min, 617% at 5 min, and 436% at 12 h ( n = 24). In cultured cardiac myocytes, S1P, sphingosine (SPH), and FTY720, a sphingolipid drug candidate, showed protective effects against CoCl induced hypoxia/ischemic cell injury by reducing lactate dehydrogenase activity. Twenty-five nanomolars of FTY720 significantly increased phospho-Pak1 and phospho-Akt levels by 56 and 65.6% in cells treated with this drug for 15 min. Further experiments demonstrated that FTY720 triggered nitric oxide release from cardiac myocytes is through pertussis toxin-sensitive phosphatidylinositol 3-kinase/Akt/endothelial nitric oxide synthase signaling. In ex vivo hearts, ischemic preconditioning was cardioprotective in wild-type control mice (Pak1f/f), but this protection appeared to be ineffective in cardiomyocyte-specific Pak1 knockout (Pak1cko) hearts. The present study provides the first direct evidence of the behavior of plasma sphingolipids following transient cardiac ischemia with dramatic and early increases in LCSB in humans. We also demonstrated that S1P, SPH, and FTY720 have protective effects against hypoxic/ischemic cell injury, likely a Pak1/Akt1 signaling cascade and nitric oxide release. Further study on a mouse model of cardiac specific deletion of Pak1 demonstrates a crucial role of Pak1 in cardiac protection against ischemia/reperfusion injury.
Induction of HLA-DP4–Restricted Anti-Survivin Th1 and Th2 Responses Using an Artificial Antigen-Presenting Cell
Authors: Tanaka Makito , Butler Marcus O. , Ansén Sascha , Imataki Osamu , Berezovskaya Alla , Nadler Lee M. , Hirano Naoto
Published: June 2011

Purpose: In previous cancer vaccine clinical trials targeting survivin, induction of specific CD8+ T-cell responses did not consistently lead to clinical responses. Considering the critical role of CD4+ T-cell help in generating antitumor immunity, integration of anti-survivin CD4+ T-cell responses may enhance the efficacy of anti-survivin cancer immunotherapy. Human leukocyte antigen (HLA)-DP4 is emerging as an attractive MHC target allele of CD4+ T cell-mediated immunotherapy, because it is one of the most frequent HLA alleles in many ethnic groups. In this article, we aimed to elucidate DP4-restricted CD4+ T-cell responses against survivin in cancer patients.

Experimental Design: We generated a human cell-based artificial antigen-presenting cell (aAPC) expressing HLA-DP4, CD80, and CD83 and induced DP4-restricted antigen-specific CD4+ T cells. The number, phenotype, effector function, and in vitro longevity of generated CD4+ T cells were determined.

Results: We first determined previously unknown DP4-restricted CD4+ T-cell epitopes derived from cytomegalovirus pp65, to which sustained Th1-biased recall responses were induced in vitro by using DP4-aAPC. In contrast, DP4-aAPC induced in vitro both Th1 and Th2 long-lived anti-survivin CD4+ T cells from cancer patients. Both survivin-specific Th1 and Th2 cells were able to recognize survivin-expressing tumors in a DP4-restricted manner. Neither survivin-specific interleukin 10 secreting Tr1 cells nor Th17 cells were induced by DP4-aAPC.

Conclusions: DP4-restricted anti-survivin Th1 and Th2 immunity with sufficient functional avidity can be induced from cancer patients. The development of strategies to concurrently induce both CD4+ and CD8+ T-cell responses against survivin is warranted for optimal anti-survivin cancer immunotherapy. Clin Cancer Res; 17(16); 5392–401. ©2011 AACR.
Platinum Sensitivity–Related Germline Polymorphism Discovered via a Cell-Based Approach and Analysis of Its Association with Outcome in Ovarian Cancer Patients
Authors: Huang R. Stephanie , Johnatty Sharon E. , Gamazon Eric R. , Im Hae Kyung , Ziliak Dana , Duan Shiwei , Zhang Wei , Kistner Emily O. , Chen Peixian , Beesley Jonathan , Mi Shuangli , O'Donnell Peter H. , Fraiman Yarden S. , Das Soma , Cox Nancy J. , Lu Yi , MacGregor Stuart , Goode Ellen L. , Vierkant Robert A. , Fridley Brooke L. , Hogdall Estrid , Kjaer Susanne K. , Jensen Allan , Moysich Kirsten B. , Grasela Matthew , Odunsi Kunle , Brown Robert , Paul Jim , Lambrechts Diether , Despierre Evelyn , Vergote Ignace , Gross Jenny , Karlan Beth Y. , deFazio Anna , Chenevix-Trench Georgia , Dolan M. Eileen
Published: June 2011

Purpose: Cell-based approaches were used to identify genetic markers predictive of patients' risk for poor response prior to chemotherapy.

Experimental Design: We conducted genome-wide association studies (GWAS) to identify single-nucleotide polymorphisms (SNP) associated with cellular sensitivity to carboplatin through their effects on mRNA expression using International HapMap lymphoblastoid cell lines (LCL) and replicated them in additional LCLs. SNPs passing both stages of the cell-based study were tested for association with progression-free survival (PFS) in patients. Phase 1 validation was based on 377 ovarian cancer patients receiving at least four cycles of carboplatin and paclitaxel from the Australian Ovarian Cancer Study (AOCS). Positive associations were then assessed in phase 2 validation analysis of 1,326 patients from the Ovarian Cancer Association Consortium and The Cancer Genome Atlas.

Results: In the initial GWAS, 342 SNPs were associated with carboplatin-induced cytotoxicity, of which 18 unique SNPs were retained after assessing their association with gene expression. One SNP (rs1649942) was replicated in an independent LCL set (Bonferroni adjusted P < 0.05). It was found to be significantly associated with decreased PFS in phase 1 AOCS patients (Pper-allele = 2 × 10−2), with a stronger effect in the subset of women with optimally debulked tumors (Pper-allele = 4 × 10−3). rs1649942 was also associated with poorer overall survival in women with optimally debulked tumors (Pper-allele = 9 × 10−3). However, this SNP was not significant in phase 2 validation analysis with patients from numerous cohorts.

Conclusion: This study shows the potential of cell-based, genome-wide approaches to identify germline predictors of treatment outcome and highlights the need for extensive validation in patients to assess their clinical effect. Clin Cancer Res; 17(16); 5490–500. ©2011 AACR.
Neonatal Respiratory Distress Syndrome: An Inflammatory Disease?
Authors: Speer Christian P.
Published: June 2011

Surfactant substitution has been a major breakthrough in the treatment of neonatal respiratory distress syndrome (RDS), primarily caused by a lack of pulmonary surfactant; it has significantly reduced mortality and acute pulmonary morbidity in preterm infants. Some very immature infants, however, have a poor response to surfactant replacement or an early relapse. This brief article is based on the hypothesis that neonatal RDS has a complex and multifactorial pathogenesis characterized by an injurious inflammatory sequence in the immature lung. Fetal exposure to chorioamnionitis has been shown to initiate an inflammatory reaction beginning in utero. A ‘low-grade’ inflammatory stimulus in utero may ‘prime’ the fetal lung for accelerated maturation of the surfactant system, especially in conjunction with prenatal steroids, and may protect the preterm infant from developing moderate to severe RDS. Depending on the severity of inflammatory injury to the alveolar-capillary unit, however, serum proteins will leak into the airways and induce surfactant inactivation. Following this intrauterine ‘first hit’, the immature infant may develop severe RDS and have a poor response to surfactant substitution. Secondary insults such as traumatic stabilization techniques, oxygen toxicity, initiation of mechanical ventilation and others injure the immature lung immediately after birth and perpetuate and may aggravate the inflammatory process. Observational studies in preterm infants and animal experiments support this concept. Whenever surfactant inactivation is suspected, higher or repetitive doses of natural surfactant may help to overcome surfactant inactivation and to restore lung function.
Lung-Protective Ventilation in Neonatology
Authors: van Kaam Anton
Published: June 2011

Ventilator-induced lung injury (VILI) is considered an important risk factor in the development of bronchopulmonary dysplasia (BPD) and is primarily caused by overdistension (volutrauma) and repetitive opening and collapse (atelectrauma) of terminal lung units. Lung-protective ventilation should therefore aim to reduce tidal volumes, and recruit and stabilize atelectatic lung units (open lung ventilation strategy). This review will summarize the available evidence on lung-protective ventilation in neonatology, discussing both high-frequency ventilation (HFV) and positive pressure ventilation (PPV). It shows that HFV does not appear to have a clear benefit over PPV, although most studies failed to apply a true open lung ventilation strategy during HFV. The evidence on the optimal tidal volume, positive end-expiratory pressure and the role for lung recruitment during lung-protective PPV is extremely limited. Volume-targeted ventilation seems to be a promising mode in terms of lung protection, but more studies are needed. Due to the lack of convincing evidence, lung-protective ventilation and modes seem to be implemented in daily clinical practice at a slow pace.
Evidence-Based Delivery Room Care of the Very Low Birth Weight Infant
Authors: Soll Roger F. , Pfister Robert H.
Published: June 2011

The first hour of a newborn’s life is fraught with difficulty. Recommendations regarding the fundamental issues of resuscitation of these infants are developed and disseminated by the International Liaison Committee on Resuscitation and other organizations. However, these recommendations frequently do not address the needs of the very low birth weight infant and do not address some of the nuances that might lead to improved outcome. Improved organization and teamwork as well as improved monitoring and respiratory support can potentially improve the outcome of these infants.
A Prognostic Model to Predict Clinical Outcomes with First-Line Gemcitabine-Based Chemotherapy in Advanced Pancreatic Cancer
Authors: Yi Jun Ho , Lee Jeeyun , Park Se Hoon , Lee Kyu Taek , Lee Jong Kyun , Lee Kwang Hyuck , Choi Dong Wook , Choi Seong-Ho , Heo Jin-Seok , Lim Do Hoon , Park Young Suk , Lim Ho Yeong , Kang Won Ki , Park Keunchil , Park Joon Oh
Published: June 2011

Objective: Our aim was to devise a prognostic model for advanced pancreatic cancer based on clinical parameters. Methods: We retrospectively analyzed the medical records of 298 patients who received gemcitabine-based chemotherapy from January 1999 to November 2008. Results: The median survival of all patients was 7 months [95% confidence interval (CI) 6.2–7.8]. Multivariate analysis revealed poor prognostic factors for overall survival such as the presence of liver metastasis [p < 0.001, hazard ratio (HR) 2.628, 95% CI 1.620–4.264], the presence of ascites or peritoneal carcinomatosis (p = 0.005, HR 1.783, 95% CI 1.194–2.661), serum C-reactive protein levels >1.2 mg/dl (p = 0.021, HR 1.568, 95% CI 1.070–2.300), and serum albumin levels <3.5 g/dl (p = 0.021, HR 1.701, 95% CI 1.085–2.667). Of 298 patients, 168 patients (56.4%) were categorized as low-risk with 0 or 1 risk factor, 80 patients (26.8%) were categorized as intermediate-risk with 2 risk factors, and 50 patients (16.8%) were categorized as high-risk with 3 or 4 risk factors. The median survival duration for the low-, intermediate-, and high-risk groups was 10.0 months (95% CI 8.7–11.3), 6.7 months (95% CI 5.7–7.7), and 4.4 months (95% CI 3.2–5.6), respectively. Conclusions: This prognostic model could help to select treatment for patients in clinical practice, and these risk-adapted treatment strategies should be further investigated in prospective studies in such patient populations.
Measuring the Penetration of a Skin Sensitizer and Its Delivery Vehicles Simultaneously with Confocal Raman Spectroscopy
Authors: Bonnist E.Y.M. , Gorce J.-P. , Mackay C. , Pendlington R.U. , Pudney P.D.A.
Published: June 2011

Among the factors determining the propensity of a chemical to induce skin allergy are the penetration into skin and the kinetics of ingress. Confocal Raman spectroscopy can provide such information as it enables direct, spatially resolved measurement of the skin and of any chemical uptake. Several chemicals can be monitored at once, and the method is non-destructive (light in, light out) so that the skin can be kept intact for repeated and continuous measurement. Raman spectroscopy was used to follow the penetration of 2.5 weight percent trans-cinnamaldehyde and its delivery vehicle into skin in vitro, up to 24 h after topical application. A custom-made Bronaugh-type diffusion cell that was suitable for the Raman experiment was used. Four different vehicles were tested: absolute ethanol, 50% aqueous ethanol, propylene glycol and acetone:olive oil (4:1); these gave different time scales for cinnamaldehyde penetration. The acetone:olive oil vehicle phase-separated on the skin surface and the cinnamaldehyde penetrated at different rates in the different phases, which may be of significance since this is the preferred solvent for the local lymph node assay (an in vivo animal test used to generate hazard information on skin sensitization). In conclusion, the Raman method gives valuable detailed information on chemical ingress, clearly differentiates between different delivery rates and allows solvent monitoring alongside the chemical of interest.
A 24-Week, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy, Safety and Tolerability of the Rivastigmine Patch in Japanese Patients with Alzheimer’s Disease
Authors: Nakamura Yu , Imai Yukimichi , Shigeta Masahiro , Graf Ana , Shirahase Toru , Kim Hyosung , Fujii Akifumi , Mori Joji , Homma Akira
Published: June 2011

Background: As of 2010, the rivastigmine patch was licensed for the treatment of Alzheimer’s disease (AD) in 64 countries. Methods: This 24-week, multicenter, randomized, double-blind, placebo-controlled study evaluated the efficacy, safety and tolerability of the 5-cm2 (9-mg loading dose; 4.6 mg/24 h delivery rate) and 10-cm2 (18-mg loading dose; 9.5 mg/24 h delivery rate) rivastigmine patch in Japanese patients with AD. Results: In the primary analysis population (intent-to-treat last observation carried forward) at week 24, delayed deterioration was seen with the 10-cm2 patch versus placebo on the Japanese version of the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-J cog; p = 0.005) and the Japanese version of the Clinician’s Interview-Based Impression of Change plus Caregiver Input (CIBIC plus-J; p = 0.067). Participants receiving the rivastigmine patch showed numerically less decline versus placebo at week 24 on the CIBIC plus-J, although this did not reach statistical significance. Statistical significance for the CIBIC plus-J was met following adjustment for body weight and baseline Mini-Mental State Examination score as dynamic allocation factors (p = 0.042) and on the Disability Assessment for Dementia (DAD; p = 0.024) and Mental Function Impairment (MENFIS; p = 0.016) subscales. Serious adverse events were rare and were consistent with the known safety profile of the rivastigmine patch. Conclusion: The rivastigmine patch has a favorable efficacy and tolerability profile in Japanese patients with AD.
Microparticles in Angiogenesis
Authors: Martinez M. Carmen , Andriantsitohaina Ramaroson
Published: June 2011

Considered during the past decades as cell dust, microparticles are now deemed true biomarkers and vectors of biological information between cells. Depending on their origin, the composition of microparticles varies and the subsequent message transported by them, such as proteins, mRNA, or miRNA, can differ. Recent studies have described microparticles as “cargos” of deleterious information in blood vessel wall under pathological situations such as hypertension, myocardial infarction, and metabolic syndrome. In addition, it has been reported that depending on their origin, microparticles also possess a therapeutic potential regarding angiogenesis. Microparticles can act directly through the interaction ligand/receptor or indirectly on angiogenesis by modulating soluble factor production involved in endothelial cell differentiation, proliferation, migration, and adhesion; by reprogramming endothelial mature cells; and by inducing changes in levels, phenotype, and function of endothelial progenitor cells. This results in an increase in formation of in vitro capillary-like tubes and the generation of new vessels in vivo under ischemic conditions, for instance. Taking into consideration these properties of microparticles, recent evidence provides new basis to expand the possibility that microparticles might be used as therapeutic tools in pathologies associated with an alteration of angiogenesis.
The 12-Month Effects of Early Motivational Interviewing After Acute Stroke
Authors: Watkins Caroline L. , Wathan Jennifer V. , Leathley Michael J. , Auton Malcolm F. , Deans Carol F. , Dickinson Hazel A. , Jack Cathy I.A. , Sutton Christopher J. , van den Broek Martin D. , Lightbody C. Elizabeth
Published: June 2011

Background and Purpose—

The purpose of this study was to determine whether motivational interviewing (MI), a patient-centered counseling technique, can benefit patients' mood and mortality poststroke.

Methods—

This was a single-center, open, randomized, controlled trial. The setting was a hospital with a stroke unit. Four hundred eleven consecutive patients on the stroke register were >18 years old, not known to be moving out-of-area postdischarge, not receiving psychiatric or clinical psychology intervention, and were without severe cognitive or communication problems preventing participation in interviews. All patients received usual stroke care. Patients in the intervention group also received 4 individual, weekly sessions of MI. The primary outcome was the proportion of patients with normal mood measured by the 28-item General Health Questionnaire (normal <5; low ≥5) using a mailed questionnaire at 12 months poststroke.

Results—

At 12-month follow-up (including imputed data), 37.7% patients in the control group and 48.0% patients in the intervention group had normal mood. Twenty-five (12.8%) of 195 patients in the control group and 13 (6.5%) of 199 patients in the intervention group had died. A significant benefit of motivational interviewing over usual stroke care was found for mood (
P
=0.020; OR, 1.66; 95% CI, 1.08 to 2.55) and mortality (
P
=0.035; OR, 2.14; 95% CI, 1.06 to 4.38).

Conclusions—

Results suggest that motivational interviewing improves patients' mood and reduces mortality 12 months poststroke.

Clinical Trial Registration—

URL:
www.controlled-trials.com
. Unique identifier: ISRCTN54465472.
Effects of Blood Pressure Lowering on Major Vascular Events Among Patients With Isolated Diastolic Hypertension
Authors: Arima Hisatomi , Anderson Craig , Omae Teruo , Woodward Mark , Hata Jun , Murakami Yoshitaka , MacMahon Stephen , Neal Bruce , Chalmers John ,   for the PROGRESS Collaborative Group
Published: June 2011

Background and Purpose—

Despite clear evidence that blood pressure (BP) lowering is effective for prevention of cardiovascular events among patients with isolated systolic hypertension and systolic–diastolic hypertension, there is ongoing uncertainty about its effects in those with isolated diastolic hypertension. The objective of the present analysis is to determine whether BP lowering provides benefits to patients with isolated diastolic hypertension.

Methods—

Patients with cerebrovascular disease and hypertension at baseline (n=4283) were randomly assigned to either active treatment (perindopril in all participants plus indapamide for those with neither an indication for nor a contraindication to a diuretic) or matching placebo(s). The primary outcome was total major vascular events.

Results—

There were 1923 patients with isolated systolic hypertension (systolic BP ≥140 mm Hg and diastolic BP <90 mm Hg), 315 with isolated diastolic hypertension (systolic BP <140 mm Hg and diastolic BP ≥90 mm Hg), and 2045 with systolic–diastolic hypertension (systolic BP ≥140 mm Hg and diastolic BP ≥90 mm Hg) at baseline. Active treatment reduced the relative risk of major vascular events by 27% (95% CI, 10% to 41%) among patients with isolated systolic hypertension, by 28% (−29% to 60%) among those with isolated diastolic hypertension, and by 32% (17% to 45%) among those with systolic–diastolic hypertension. There was no evidence of differences in the magnitude of the effects of treatment among different types of hypertension (
P
homogeneity=0.89).

Conclusions—

BP lowering is likely to provide a similar level of protection against major vascular events for patients with isolated diastolic hypertension as for those with isolated systolic hypertension and systolic–diastolic hypertension.

Clinical Trial Registration Information—

This trial was not registered because patients were enrolled before July 1, 2005.
Successful Microbubble Sonothrombolysis Without Tissue-Type Plasminogen Activator in a Rabbit Model of Acute Ischemic Stroke
Authors: Culp William C. , Flores Rene , Brown Aliza T. , Lowery John D. , Roberson Paula K. , Hennings Leah J. , Woods Sean D. , Hatton Jeff H. , Culp Benjamin C. , Skinner Robert D. , Borrelli Michael J.
Published: June 2011

Background and Purpose—

Microbubbles (MB) combined with ultrasound (US) have been shown to lyse clots without tissue-type plasminogen activator (tPA) both in vitro and in vivo. We evaluated sonothrombolysis with 3 types of MB using a rabbit embolic stroke model.

Methods—

New Zealand White rabbits (n=74) received internal carotid angiographic embolization of single 3-day-old cylindrical clots (0.6×4.0 mm). Groups included: (1) control (n=11) embolized without treatment; (2) tPA (n=20); (3) tPA+US (n=10); (4) perflutren lipid MB+US (n=16); (5) albumin 3 μm MB+US (n=8); and (6) tagged albumin 3 μm MB+US (n=9). Treatment began 1 hour postembolization. Ultrasound was pulsed-wave (1 MHz; 0.8 W/cm
2
) for 1 hour; rabbits with tPA received intravenous tPA (0.9 mg/kg) over 1 hour. Lipid MB dose was intravenous (0.16 mg/kg) over 30 minutes. Dosage of 3 μm MB was 5×10
9
MB intravenously alone or tagged with eptifibatide and fibrin antibody over 30 minutes. Rabbits were euthanized at 24 hours. Infarct volume was determined using vital stains on brain sections. Hemorrhage was evaluated on hematoxylin and eosin sections.

Results—

Infarct volume percent was lower for rabbits treated with lipid MB+US (1.0%±0.6%;
P
=0.013), 3 μm MB+US (0.7%±0.9%;
P
=0.018), and tagged 3 μm MB+US (0.8%±0.8%;
P
=0.019) compared with controls (3.5%±0.8%). The 3 MB types collectively had lower infarct volumes (
P
=0.0043) than controls. Infarct volume averaged 2.2%±0.6% and 1.7%±0.8% for rabbits treated with tPA alone and tPA+US, respectively (
P
=nonsignificant).

Conclusions—

Sonothrombolysis without tPA using these MB is effective in decreasing infarct volumes. Study of human application and further MB technique development are justified.
Osteopontin Enhances Endogenous Repair After Neonatal Hypoxic–Ischemic Brain Injury
Authors: van Velthoven Cindy T.J. , Heijnen Cobi J. , van Bel Frank , Kavelaars Annemieke
Published: June 2011

Background and Purpose—

Hypoxic–ischemic (HI) brain injury is a frequent cause of perinatal morbidity and mortality with limited therapeutic options. To identify molecules important for cerebral damage and repair, we investigated the growth factor-related gene expression profile after neonatal cerebral HI. We identified osteopontin (OPN) as the most highly upregulated factor early after HI. We therefore explored the role of endogenous OPN in brain damage and repair.

Methods—

Nine-day-old wild-type mice were exposed to cerebral HI; growth factor-related gene expression profiles were analyzed 1 to 7 days later by reverse transcriptase–polymerase chain reaction arrays. To determine the contribution of OPN to brain damage, we used p9 OPN
−/−
and wild-type mice. HI brain damage, sensorimotor function, and cell proliferation and differentiation were compared.

Results—

Gene expression profiling of 150 genes related to growth factors and neurotrophins showed that expression of 52 genes changed during the first 7 days after HI.
OPN
was the gene with the strongest increase expression at all time points measured. We show here for the first time that in response to neonatal HI, OPN-deficient mice developed increased gray and white matter loss and more pronounced sensorimotor deficits as compared with wild-type littermates. Furthermore, OPN deficiency decreases HI-induced cell proliferation/survival and oligodendrogenesis without affecting neuronal differentiation.

Conclusions—

OPN plays an important role in repairing brain injury after neonatal HI by regulating cerebral cell proliferation/survival and oligodendrocyte differentiation after injury. The observed promyelinative effect of OPN may offer novel possibilities for a therapy targeting white matter injury.
Oxfordshire Community Stroke Project Classification Poorly Differentiates Small Cortical and Subcortical Infarcts
Authors: Asdaghi Negar , Jeerakathil Thomas , Hameed Bilal , Saini Monica , McCombe Jennifer A. , Shuaib Ashfaq , Emery Derek , Butcher Kenneth
Published: June 2011

Background and Purpose—

The Oxfordshire Community Stroke Project (OCSP) is a common clinical stroke classification tool. We evaluated the accuracy of OCSP classification with a prospective magnetic resonance imaging (MRI) study.

Methods—

Stroke/transient ischemic attack patients presenting within 48 hours of onset were included in the study (n=130). Following computed tomography scan, OCSP classification, total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI), lacunar circulation infarcts (LACI), and posterior circulation infarcts (POCI) were performed by 3 independent examiners. All patients underwent diffusion-weighted MRI with planimetric volume measurement and classification into OCSP categories, organized by lesion location.

Results—

Patients were clinically classified as TACI (12 patients), PACI (62 patients), LACI (38 patients), and POCI (18 patients). In 101 patients with diffusion-weighted MRI lesions, correct classification rates were: TACI (83.3%), PACI (83%), LACI (39%), and POCI (86%). OCSP had the following sensitivity (SE), specificity (SP), and positive predictive value (PPV): TACI (SE, 100%; SP, 98%; PPV, 83%), PACI (SE, 73%; SP, 78%; PPV, 83%), LACI (SE, 47%; SP, 83%; PPV, 39%), and POCI (SE, 92%; SP, 98%; PPV, 86%). Sixty-one percent of patients in the LACI group had radiographic appearances consistent with PACI, and 15% of those classified as PACI had lacunar infarcts. No differences in stroke severity existed between patients classified correctly (median National Institutes of Health Stroke Scale [NIHSS]=4; interquartile range [IQR]=7) or incorrectly (median NIHSS=3; IQR=3). Patients classified correctly had larger infarct volume (median=6.75 mL; IQR=33.2) than did those who were incorrectly classified (1.86 mL; IQR=5;
P
=0.008).

Conclusions—

OCSP classification does not permit accurate discrimination between lacunar and small-volume cortical infarcts. Differential patterns of investigation for stroke etiology should not be based solely on clinical criteria.
Comparison of Exposure Controls, Item Pool Characteristics, and Population Distributions for CAT Using the Partial Credit Model
Authors: Lee HwaYoung , Dodd Barbara G.
Published: June 2011

This study investigated item exposure control procedures under various combinations of item pool characteristics and ability distributions in computerized adaptive testing based on the partial credit model. Three variables were manipulated: item pool characteristics (120 items for each of easy, medium, and hard item pools), two ability distributions (normally distributed and negatively skewed data), and three exposure control procedures (randomesque procedure, progressive–restricted procedure, and maximum information procedure). A number of measurement precision indexes such as descriptive statistics, correlations between known and estimated ability levels, bias, root mean squared error, and average absolute difference, exposure rates, item usage, and item overlap were computed to assess the impact of matched or nonmatched item pool and ability distributions on the accuracy of ability estimation and the performance of exposure control procedures. As expected, the medium item pool produced better precision of measurement than both the easy and hard item pools. The progressive–restricted procedure performed better in terms of maximum exposure rates, item average overlap, and pool utilization than both the randomesque procedure and the maximum information procedure. The easy item pool with the negatively skewed data as a mismatched condition produced the worst performance.
Effects of Vowel Duration and Vowel Quality on Vowel-to-Vowel Coarticulation
Authors: Mok Peggy P. K.
Published: June 2011

This work investigates how vowel duration and vowel quality affect degrees of vowel-to-vowel coarticulation. The effects of these two factors on vowel-to-vowel coarticulation have previously received little study. Phonological durational differences due to vowel length distinction were examined in Thai. It was hypothesized that shorter vowel duration could result in more vowel-to-vowel coarticulation, and further that the vowel /a/ would allow more vowel-to-vowel coarticulation than /i/ or /u/ cross-linguistically. Thus, the susceptibility of different vowel qualities to vowel-to-vowel coarticulation was examined using Thai data. Results show that shorter vowel duration did not affect vowel-to-vowel coarticulation; and the lower the vowel, the more susceptible it is to coarticulation. Possible factors contributing to such patterns are discussed.
Dynamic modeling and control of a bending combined roller system using Timoshenko beam theory and constrained model predictive control
Authors: Kuo Chung-Feng Jeffrey , Huy Quang Vu
Published: June 2011

The roller system is an essential and very important part of a lot of fabric processing machines in the textile industry. This study proposes a new bending roller control system (BRCS) to control bending deformation and vibration of the roller system. First, a new mathematical model of a combined roller is obtained by using an eigenfunction expansion method and Timoshenko beam theory. The combined roller consists of inner steel and outer nylon layers to take full advantage and eliminate drawbacks of materials. Second, a hydraulic multi-cylinder system is put inside the roller at the suitable position. This solution not only increases significantly the power of the bending actuation system but also reduces the transient time of dynamic response and avoids damaging outside surfaces of the rollers. Finally, in order to improve dynamic response performance and open wide operating range of system, model predictive control (MPC) and constrained control are applied to the BRCS. Simulation results proved that the proposed control system is completely effective and reliable.
Image analysis of the elastane position effect on the appearance of wet pneumatic spliced elastic core-spun yarn
Authors: Jaouachi Boubaker , Moussa Ali , Ben Hassen Mohamed , Sakli Faouzi
Published: June 2011

This work discusses the contribution of the elastane filament (Spandex©) on the appearance of wet pneumatic elastic denim core-spun yarn. The cross-section views of the splice region were investigated using the image analysis method. In fact, this work also defines developed parameters such as the cover factor and the relative distance for quantifying the contribution of Spandex© filament position to the spliced yarn appearance. To improve the objective method (the image analysis), the subjective one (the expert’s rating and the composite desirability) was discussed. Compared to the computer image analysis results, the desirability function provides nearly identical results and proves that appearance can be evaluated objectively. However, compared to the expert’s rating which can complete the computer results, it remains insufficient to subjectively classify the splice appearance. Hence, our findings show that the Spandex© filament angular position is influenced by the important splicing conditions (splice length and duration of water joining). By providing the adequate splicing condition adjustments high splice physical performance is given and a particularly good appearance.
Metropolitan Fragmentation and Neo-localism in the Periphery
Authors: Klink Jeroen , Denaldi Rosana
Published: June 2011

In this paper, the Curitiba-centred narrative on the success of its urban planning experience will be qualified in light of the complexities of its metropolitan development trajectory. It will be claimed that the institutional vacuum that surrounds Brazilian metropolitan areas in general, and Greater Curitiba in particular, has been intensified by the emergence of a competitive and decentralised state spatial regime, which has consolidated a fragmented and neo-localist system of governance. Preliminary empirical evidence will be provided on the challenges that are being faced within the new regime in articulating socio-spatial, economic and environmental strategies in the direction of a more sustainable metropolitan future.
Growing Unequal? Changes in the Distribution of Earnings across Canadian Cities
Authors: Bolton Kenyon , Breau Sébastien
Published: June 2011

This paper investigates changes in the distribution of earnings across 87 metropolitan areas in Canada. It does so using micro data taken from the 20 per cent long-form sample of the census for the years 1996, 2001 and 2006. Results point to overall increases in urban inequality and to greater heterogeneity in inequality across the urban hierarchy, with larger cities growing particularly unequal over time. Cross-sectional and panel regression models suggest that city size, unemployment, deindustrialisation and the percentage of a city’s population composed of visible minorities contribute to increased inequality. In contrast, a city’s level of economic development has a mitigating effect on inequality, although this effect appears to fade away over time. The effects of changes in a city’s age, education and gender profiles on inequality are mixed.
Influence of backing materials towards the fatigue strength of butt-welded joints
Authors: Kim M H , Kim H J , Han J H , Lee J M , Kim Y D , Kang N H , Kang M J , Kim C H
Published: June 2011

The purpose of this study is to investigate the fatigue strength of butt-welded joints with special attention paid to employing different kinds of backing plates. The effect of the under-matched weld was also considered. Four different cases of backing scenarios for butt-welded specimens such as steel backing, ceramic backing, CMT (no backing by cold metal transfer) and UM (under-matched welded specimen) were investigated. A series of fatigue tests was performed to compare the fatigue strength of butt-welded joints with respect to different backing scenarios. Effective notch stress was used for the interpretation of fatigue strength of butt-welded specimens with backing plates based on finite element analyses for calculating fatigue notch factors. When results were presented from the effective notch stress, all backing scenarios considered in this study exhibited the fatigue strengths corresponding to the FAT 225 curve. From the experimental results of this study, it was determined that the fatigue strengths of butt-welded joints were found to be in the order of CMT, ceramic backing, UM, and steel backing. No significant decrease in fatigue strength, however, was observed when backing plates were steel backing and ceramic backing types.
Confidence interval estimation for the Bland–Altman limits of agreement with multiple observations per individual
Authors: Zou GY
Published: June 2011

The limits of agreement (LoA) method proposed by Bland and Altman has become a standard for assessing agreement between different methods measuring the same quantity. Virtually, all method comparison studies have reported only point estimates of LoA due largely to the lack of simple confidence interval procedures. In this article, we address confidence interval estimation for LoA when multiple measurements per individual are available. Separate procedures are proposed for situations when the underlying true value of the measured quantity is assumed changing and when it is perceived as stable. A fixed number of replicates per individual is not needed for the procedures to work. As shown by the worked examples, the construction of these confidence intervals requires only quantiles from the standard normal and chi-square distributions. Simulation results show the proposed procedures perform well. A SAS macro implementing the methods is available on the publisher's website.
When Status Hurts: Dimensions of Women’s Status and Domestic Abuse in Rural Northern India
Authors: Mogford Elizabeth
Published: June 2011

This study is a multiple logistic regression analysis of the relationship between dimensions of women’s status and domestic abuse in rural Uttar Pradesh, India, using the 1998-1999 National Family Health Survey (NFHS-2). Findings indicate that the effects of a woman’s status on her likelihood of experiencing abuse depend on the social realm within which status operates. Specifically, more “public” dimensions of status are associated with a greater probability of abuse, while “domestic” dimensions are protective. The findings are interpreted in terms of transitioning gender norms in Uttar Pradesh and provide clarity to the literature on the complex relationship between status and abuse.
The Importance of Resources and Information in the Lives of Battered Mothers
Authors: Fleury-Steiner Ruth E. , Thompson Brady Laura
Published: June 2011

An increasing body of research has documented the overlap between intimate partner violence and child abuse. To date, very little research has explored mothers’ perspectives on how child protection services (CPS) actually investigates and intervenes in families where intimate partner violence (IPV) as well as child abuse or neglect have occurred. The current research explores the complex role of information and resources in child protection investigations and interventions. In-person interviews were conducted with 19 mothers who had been battered and who had been involved with CPS because of the violence. Mothers reported difficulties in sharing information with and receiving information from CPS workers, but some also reported benefiting from information they received. Moreover, for a handful of women, the CPS intervention was a source of emotional strength. Implications for improving CPS interventions when IPV is occurring are discussed.
Effect of Environmental Contaminants on Beta Cell Function
Authors: Makaji Emilija , Raha Sandeep , Wade Michael G. , Holloway Alison C.
Published: June 2011

There is an increasing concern that chemicals in the environment are contributing to the global rise in the prevalence of type 2 diabetes (T2D). However, there is limited evidence for direct effects of these chemicals on beta cell function. Therefore, the goals of this study were (1) to test the hypothesis that environmental contaminants can directly affect beta cell function and (2) examine mechanistic pathways by which these contaminants could affect beta cell function. Using mouse beta TC-6 cells, we examined the acute effects of 6 substances (benzo[a]pyrene, bisphenol A [BPA], propylparaben, methylparaben, perfluorooctanoic acid, and perfluorooctyl sulfone) on insulin secretion. Only BPA treatment directly affected insulin secretion. Furthermore, chronic exposure to BPA altered the expression of key proteins in the cellular and endoplasmic reticulum stress response. These data suggest that long-term BPA exposure may be detrimental to beta cell function and ultimately be an important contributor to the etiology of T2D.
Proinflammatory role of angiotensin II in a rat nephrosis model induced by adriamycin
Authors: Muñoz Maydelin , Rincón Jaimar , Pedreañez Adriana , Viera Ninoska , Hernández-Fonseca Juan P , Mosquera Jesús
Published: June 2011

Introduction: Nephrotic syndrome induced by adriamycin (ADR) is an experimental model of glomerulosclerosis in humans. The AT1 receptor for angiotensin II (Ang II) is involved in the renal expression of the nuclear factor-kappa B (NF-ΚB) during this nephrosis. NF-ΚB is a transcription factor for proinflammatory effects of Ang II; however, there is no information about the role of this receptor in the renal proinflammatory events in ADR nephrosis.

Materials and methods: To determine the role of Ang II in ADR nephrosis, Sprague-Dawley rats were treated with ADR (6 mg/kg iv). One ADR group received oral losartan treatment (15 mg/kg gavage) 3 days before ADR injection and then daily for 4 weeks, and the other group water. Animals were sacrificed at week 4 and renal macrophage infiltration, ICAM-1, superoxide anion (O2-) and Ang II expressions were analysed by indirect immunofluorescence and histochemical techniques.

Results: ADR rats showed increased expression of ICAM-1, Ang II, O2- and macrophage infiltration, events that were diminished by losartan treatment. Ang II expression remained unaltered after antagonist treatment. Proteinuria was reduced after 3 weeks of treatment.

Conclusions: These data suggest that Ang II plays a role in the inflammatory events during ADR-induced nephrosis, probably mediated by AT1 receptors.