bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of stochastic and episodic movement of the optimum on the evolution of the G‐matrix and the response of the trait mean to selection
Authors: Jones A. G. , Bürger R. , Arnold S. J. , Hohenlohe P. A. , Uyeda J. C.
Published: September 2012

Theoretical and empirical results demonstrate that the G‐matrix, which summarizes additive genetic variances and covariances of quantitative traits, changes over time. Such evolution and fluctuation of the G‐matrix could potentially have wide‐ranging effects on phenotypic evolution. Nevertheless, no studies have yet addressed G‐matrix stability and evolution when movement of an intermediate optimum includes large, episodic jumps or stochasticity. Here, we investigate such scenarios by using simulation‐based models of G‐matrix evolution. These analyses yield four important insights regarding the evolution and stability of the G‐matrix. (i) Regardless of the model of peak movement, a moving optimum causes the G‐matrix to orient towards the direction of net peak movement, so that genetic variance is enhanced in that direction (the variance enhancement effect). (ii) Peak movement skews the distribution of breeding values in the direction of movement, which impedes the response to selection. (iii) The stability of the G‐matrix is affected by the overall magnitude and direction of peak movement, but modes and rates of peak movement have surprisingly small effects (the invariance principle). (iv) Both episodic and stochastic peak movement increase the probability that a population will fall below its carrying capacity and go extinct. We also present novel equations for the response of the trait mean to multivariate selection, which take into account the higher moments of the distribution of breeding values.
Work‐related factors associated with self‐care and psychological health among people with type 2 diabetes in Japan
Authors: Sato Miho , Yamazaki Yoshihiko
Published: September 2012

This study on individuals with type 2 diabetes living in Japan aimed to examine work‐related factors that influence self‐care and psychological health among people. A cross‐sectional survey was conducted among 121 working adults with type 2 diabetes. A self‐report questionnaire assessed demographics, work characteristics, self‐disclosure of diabetes, support in the workplace, work‐related difficulties due to diabetes, and workplace conformity. Dietary self‐care, exercise, depression, and emotional distress were also evaluated. The results indicated statistically significant influence of working night shifts, self‐disclosure of diabetes, and workplace conformity on dietary self‐care. Work‐related difficulties due to diabetes had negative effects on depression and emotional distress, and job control and support in the workplace were found to be correlated with emotional distress. These findings suggest that work‐related factors have an impact on some forms of self‐care activities and psychological health and that it is important to increase understanding of these issues and provide appropriate support for workers through education and counseling and adjustments in the workplace.
Evaluation of corneal changes with accommodation in young and presbyopic populations using Pentacam High Resolution Scheimpflug system
Authors: Ni Yao , Liu Xialin , Lin Ying , Guo Xiaobo , Wang Xueqin , Liu Yizhi
Published: September 2012

Background

To evaluate the changes occurring in the cornea with accommodation in young and presbyopic people.

Design

Prospective study.

Participants

Twenty‐three young and 15 presbyopic emmetropic volunteers.

Methods

The Pentacam High Resolution system was used to obtain data on the anterior eye segments of emmetropic volunteers in unaccommodated (with an accommodation stimulus of 0.0 D) and accommodated (with an accommodation stimulus of 5.0 D for the young volunteers and 1.0 D for the presbyopic) states.

Main Outcome Measures

Anterior and posterior corneal axial curvature, corneal volume, corneal aberration, anterior chamber depth and anterior chamber volume were evaluated.

Results

A significant decline in anterior chamber depth and anterior chamber volume was induced by accommodation in both young and presbyopic volunteers. There was a small but statistically significant change in corneal volume within 3.0, 5.0 and 7.0 mm diameters during accommodation in both groups. The changes in the corneal curvature map were significant with accommodation in both groups, although individual variations were found in anterior and posterior corneal axial curvature. Moreover, the decreased higher order aberrations were found in both anterior and entire cornea. In particular, spherical aberration was changed in the young group with 5.0 D accommodation stimulus.

Conclusion

This study showed that accommodation can influence the corneal shape and curvature, and, especially, decreased corneal high‐order aberrations. Although the modification in corneal shape was small, it produced variations in higher order aberrations with accommodation that may be beneficial for visual performance in near vision.
Association between myopia and diabetic retinopathy: a review of observational findings and potential mechanisms
Authors: Man Ryan EK , Sasongko Muhammad B , Wang Jie Jin , Lamoureux Ecosse L
Published: September 2012

A protective, but inconsistent association between myopia and a decreased risk of diabetic retinopathy (DR) has been suggested in several studies. However, it is unclear whether the structural, or the refractive components of myopia; or both, is the main contributor to this protective relationship. This paper provides a comprehensive review of existing evidence on the association between myopia, and its structural (axial length [AL], anterior chamber depth [ACD]) and refractive (lens biometry and corneal curvature [CC]) components, with DR. 11 studies consisting of 7230 subjects from 1960 to April 2012, were reviewed. A longer AL was the only variable associated with a lower risk and severity of DR. Therefore, the available evidence suggests that AL is the main contributor to the protective influence of myopia on DR observed in earlier studies. Further investigations are now needed to determine the mechanisms by which AL protects against DR.
Optometry‐based general population survey of pupil ruff atrophy and ocular hypertension
Authors: Ang Ghee S , Stevenson Peter J , Sargent Geoff , Grimmer Peter , Corbett Patricia , Jourdain Erin , Wells Anthony P
Published: September 2012

Background

To evaluate and describe the pupil ruff changes and relationship to intraocular pressure, pseudoexfoliation syndrome and glaucoma status in an optometric population in New Zealand.

Design

Prospective cross‐sectional survey of an optometric population.

Participants

Six hundred and twenty subjects over 50 years old routinely attending the participating optometry practices. Exclusion criteria included previous intraocular surgery, ophthalmic laser, uveitis, angle closure and secondary glaucoma.

Methods

Multicentre study involving 11 optometry practices in the Wellington region, New Zealand. The pupillary ruff and associated gonioscopy findings of study participants were graded based on the previously published Pupil Ruff Atrophy grading system. Parameters evaluated include pupillary ruff absence and abnormality, pseudoexfoliation material and trabecular meshwork pigmentation.

Main Outcome Measures

Correlations between intereye Pupil Ruff Atrophy grading differences and inter‐eye intraocular pressure and cup:disc ratio differences.

Results

Six hundred and twenty subjects were included, with a mean age of 62.2 ± 9.1 years and mean intraocular pressure of 14.8 ± 3.4 mmHg. Four hundred and fourteen (66.8%) had bilateral pupil ruff changes and 12 (1.5%) had pseudoexfoliation. Inter‐eye intraocular pressure asymmetry was significantly correlated with amount of missing pupillary ruff (r = 0.111; P = 0.022) and trabecular meshwork pigmentation (r = 0.147; P = 0.002). Inter‐eye cup:disc ratio asymmetry was not correlated with any of the Pupil Ruff Atrophy grading parameters.

Conclusions

Asymmetry of pupillary ruff absence and trabecular meshwork pigmentation was correlated with intraocular pressure asymmetry (but not with cup:disc ratio asymmetry) in a general optometric population setting in New Zealand.
Modeling psychological well‐being and family relationships among retired older people in Taiwan
Authors: Chiang Hui‐Hsun , Chien Li‐Hui , Lin Jie‐Siang , Yeh Yi‐Hui , Lee Tony Szu‐Hsien
Published: September 2012

Well‐being is an important indicator of an individual's quality of life, especially for retired people. In the present study, we investigated the psychological well‐being (PWB) of retired Taipei (Taiwan) older people and its associations with sex, family relationships, and health status. A structured questionnaire was used to measure demographics, family relationships, and perceived health status, as well as Ryff's PWB Scales. Data were analyzed from 268 retired olderpeople recruited from social service centres and public parks from September to November 2010. The Multiple Indicators Multiple Causes model demonstrated a very good fit of Ryff's PWB Scales and their relations to sex, family relationships, and perceived health status. The link with PWB was stronger for family relationships than for perceived health. The Mandarin translation of Ryff's PWB Scales was found to be suitable and easy to administer to Taiwanese olderpeople. The findings suggest that nurses should note that improving family relations will facilitate the PWB of retired olderpeople, which results in better outcomes of care.
The Legionella pneumophila orphan sensor kinase LqsT regulates competence and pathogen–host interactions as a component of the LAI‐1 circuit
Authors: Kessler Aline , Schell Ursula , Sahr Tobias , Tiaden André , Harrison Christopher , Buchrieser Carmen , Hilbi Hubert
Published: September 2012

Legionella pneumophila is an amoeba‐resistant opportunistic pathogen that performs cell–cell communication through the signalling molecule 3‐hydroxypentadecane‐4‐one (LAI‐1, Legionella autoinducer‐1). The lqs (Legionella quorum sensing) gene cluster encodes the LAI‐1 autoinducer synthase LqsA, the cognate sensor kinase LqsS and the response regulator LqsR. Here we show that the Lqs system includes an ‘orphan’ homologue of LqsS termed LqsT. Compared with wild‐type L. pneumophila, strains lacking lqsT or both lqsS and lqsT show increased salt resistance, greatly enhanced natural competence for DNA acquisition and impaired uptake by phagocytes. Sensitive novel single round growth assays and competition experiments using Acanthamoeba castellanii revealed that ΔlqsT and ΔlqsS‐ΔlqsT, as well as ΔlqsA and other lqs mutant strains are impaired for intracellular growth and cannot compete against wild‐type bacteria upon co‐infection. In contrast to the ΔlqsS strain, ΔlqsT does not produce extracellular filaments. The phenotypes of the ΔlqsS‐ΔlqsT strain are partially complemented by either lqsT or lqsS, but are not reversed by overexpression of lqsA, suggesting that LqsT and LqsS are the sole LAI‐1‐responsive sensor kinases in L. pneumophila. In agreement with the different phenotypes of the ΔlqsT and ΔlqsS strains, lqsT and lqsS are differentially expressed in the post‐exponential growth phase, and transcriptome studies indicated that 90% of the genes, which are downregulated in absence of lqsT, are upregulated in absence of lqsS. Reciprocally regulated genes encode components of a 133 kb genomic ‘fitness island’ or translocated effector proteins implicated in virulence. Together, these results reveal a unique organization of the L. pneumophila Lqs system comprising two partially antagonistic LAI‐1‐responsive sensor kinases, LqsT and LqsS, which regulate distinct pools of genes implicated in pathogen–host cell interactions, competence, expression of a genomic island or production of extracellular filaments.
Metaherpetic corneal disease in a dog associated with partial limbal stem cell deficiency and neurotrophic keratitis
Authors: Ledbetter Eric C. , Marfurt Carl F. , Dubielzig Richard R.
Published: September 2012

Objective  To describe clinical, in vivo confocal microscopic, histopathologic, and immunohistochemical features of a dog with metaherpetic corneal disease that developed subsequent to a protracted episode of canine herpesvirus‐1 (CHV‐1) dendritic ulcerative keratitis.

Case description  A 7‐year‐old, spayed‐female, Miniature Schnauzer was treated for bilateral CHV‐1 dendritic ulcerative keratitis. Following resolution of ulcerative keratitis, sectoral peripheral superficial corneal gray opacification, vascularization, and pigmentation slowly migrated centripetally to the axial cornea of both eyes. Corneal sensitivity measured with a Cochet–Bonnet esthesiometer was dramatically and persistently reduced. In vivo corneal confocal microscopic examination revealed regions of epithelium with a conjunctival phenotype. In these areas, the surface epithelium was thin, disorganized, and composed of hyper‐reflective epithelial cells. Goblet cells and Langerhans cells were frequent, and the subbasal nerve plexus was completely absent or markedly diminished. Histopathologic abnormalities in the globes were restricted to the superficial cornea and included sectoral corneal conjunctivalization, increased anterior stromal spindle cells, and vascularization. Immunohistochemical evaluation of the corneas with anti‐neurotublin antibody demonstrated attenuation of the epithelial and subbasal nerve plexuses with marked stromal hyperinnervation and increased numbers of morphologically abnormal neurites.

Conclusions  Similar to herpes simplex virus keratitis in humans, CHV‐1 ulcerative keratitis may be associated with the development of chronic degenerative corneal disease in dogs. In the described dog, this chronic corneal disease included progressive corneal opacification because of partial limbal stem cell deficiency and neurotrophic keratitis. Long‐term monitoring of dogs following resolution of active CHV‐1 keratitis may be indicated, particularly when ulcerations persist for an extended period.
Biracial and monoracial infant own‐race face perception: an eye tracking study
Authors: Gaither Sarah E. , Pauker Kristin , Johnson Scott P.
Published: September 2012

We know that early experience plays a crucial role in the development of face processing, but we know little about how infants learn to distinguish faces from different races, especially for non‐Caucasian populations. Moreover, it is unknown whether differential processing of different race faces observed in typically studied monoracial infants extends to biracial infants as well. Thus, we investigated 3‐month‐old Caucasian, Asian and biracial (Caucasian‐Asian) infants’ ability to distinguish Caucasian and Asian faces. Infants completed two within‐subject, infant‐controlled habituation sequences and test trials as an eye tracker recorded looking times and scanning patterns. Examination of individual differences revealed significant positive correlations between own‐race novelty preference and scanning frequency between eye and mouth regions of own‐race habituation stimuli for Caucasian and Asian infants, suggesting that facility in own‐race face discrimination stems from active inspection of internal facial features in these groups. Biracial infants, however, showed the opposite effect: An ‘own‐race’ novelty preference was associated with reduced scanning between eye and mouth regions of ‘own‐race’ habituation stimuli, suggesting that biracial infants use a distinct approach to processing frequently encountered faces. Future directions for investigating face processing development in biracial populations are discussed.

A video abstract of this article can be viewed at http://youtu.be/a_dDXfFuEfY
Neural correlates of perceptual narrowing in cross‐species face‐voice matching
Authors: Grossmann Tobias , Missana Manuela , Friederici Angela D. , Ghazanfar Asif A.
Published: September 2012

Integrating the multisensory features of talking faces is critical to learning and extracting coherent meaning from social signals. While we know much about the development of these capacities at the behavioral level, we know very little about the underlying neural processes. One prominent behavioral milestone of these capacities is the perceptual narrowing of face–voice matching, whereby young infants match faces and voices across species, but older infants do not. In the present study, we provide neurophysiological evidence for developmental decline in cross‐species face–voice matching. We measured event‐related brain potentials (ERPs) while 4‐ and 8‐month‐old infants watched and listened to congruent and incongruent audio‐visual presentations of monkey vocalizations and humans mimicking monkey vocalizations. The ERP results indicated that younger infants distinguished between the congruent and the incongruent faces and voices regardless of species, whereas in older infants, the sensitivity to multisensory congruency was limited to the human face and voice. Furthermore, with development, visual and frontal brain processes and their functional connectivity became more sensitive to the congruence of human faces and voices relative to monkey faces and voices. Our data show the neural correlates of perceptual narrowing in face–voice matching and support the notion that postnatal experience with species identity is associated with neural changes in multisensory processing (Lewkowicz & Ghazanfar, 2009).
Young Word Learners’ Interpretations of Words and Symbolic Gestures Within the Context of Ambiguous Reference
Authors: Suanda Sumarga H. , Namy Laura L.
Published: September 2012

Early in development, many word‐learning phenomena generalize to symbolic gestures. The current study explored whether children avoid lexical overlap in the gestural modality, as they do in the verbal modality, within the context of ambiguous reference. Eighteen‐month‐olds’ interpretations of words and symbolic gestures in a symbol‐disambiguation task (Experiment 1) and a symbol‐learning task (Experiment 2) were investigated. In Experiment 1 (N = 32), children avoided verbal lexical overlap, mapping novel words to unnamed objects; children failed to display this pattern with symbolic gestures. In Experiment 2 (N = 32), 18‐month‐olds mapped both novel words and novel symbolic gestures onto their referents. Implications of these findings for the specialized nature of word learning and the development of lexical overlap avoidance are discussed.
WHAT DO BUSINESS CLIMATE INDEXES TEACH US ABOUT STATE POLICY AND ECONOMIC GROWTH?*
Authors: Kolko Jed , Neumark David , Mejia Marisol Cuellar
Published: September 2012

ABSTRACT State business climate indexes capture state policies that might affect economic growth. State rankings in these indexes vary wildly, raising questions about what the indexes measure and which policies are important for growth. Indexes focused on productivity do not predict economic growth, while indexes emphasizing taxes and costs predict growth of employment, wages, and output. Analysis of sub‐indexes of the tax‐and‐cost‐related indexes points to two policy factors associated with faster growth: less spending on welfare and transfer payments; and more uniform and simpler corporate tax structures. But factors beyond the control of policy have a stronger relationship with economic growth.
No Mangoes in the Tundra: Spatial Heterogeneity in Agricultural Productivity Analysis*
Authors: Eberhardt Markus , Teal Francis
Published: September 2012

In line with the wider macro productivity literature existing studies of agricultural production largely neglect technology heterogeneity, variable time‐series properties and the potential for heterogeneous but correlated total factor productivity (TFP) across countries. Our empirical approach accommodates these difficulties and seeks to model the nature of the cross‐section dependence in a sample of 128 countries (1961–2002). Our results suggest that agro‐climatic environment drives similarity in TFP evolution across countries with heterogeneous production technology. This provides a possible explanation for the failure of technology transfer from advanced countries of the temperate ‘North’ to arid and/or equatorial developing countries of the ‘South’.
The data warehouse virtualization framework for operational business intelligence
Authors: Farooq Farrah
Published: September 2012

In order to explore the most current information and react faster to changing business conditions, organizations consider real‐time data warehousing a powerful technique to achieve operational business intelligence (BI). We propose in this paper a novel real‐time data warehouse (RTDW) framework based on the virtualization concept. Our approach introduces a conceptual modelling technique, known as ring modelling, for real‐time data management and multidimensional analysis. This technique produces a flexible semi‐structured data model that accommodates unknown business process data and relationships as they evolve, handles schema changes and aggregate‐management efficiently, and scales well with the large size of increasing data volumes. With the help of a telecommunication business example, We evaluated our proposed approach in an extensive experimental study where we compared our approach Ring Model with existing structured multidimensional conceptual models (MCMs), i.e. relational OLAP and multidimensional OLAP, and with semi‐structured MCM, i.e. XML Cubes, in terms of scalability, data storage estimations, data updates loading time, and query response times. Our performance results show that encouraging speedups are achieved.
Legislative Control of Powers Delegated to the Executive: The Case of the EU
Authors: Blom‐Hansen Jens
Published: September 2012

How can legislators derive the benefits of delegation without unduly empowering the executive? This article investigates how this dilemma is met in the European Union (EU) political system where executive power is delegated to the Commission. The argument is that the European member states have found a unique solution. They install committees of member state representatives to monitor the EU Commission, the so‐called comitology committees. However, the extent to which comitology committees are installed and their exact competence vary considerably across policy areas. This article uses a delegation perspective to understand this variation. An analysis of comitology provisions in 686 directives and regulations shows that institutional conflict and issue complexity, well‐known factors from the delegation literature, are important predictors of comitology control of the Commission. The findings support one of the two prevailing images of comitology—comitology as a control mechanism, not deliberative democracy.
Protecting Sovereignty, Protecting the Planet: State Delegation to International Organizations and Private Actors in Environmental Politics
Authors: Green Jessica F. , Colgan Jeff
Published: September 2012

As global interdependence grows, states often use international organizations to achieve both domestic and foreign policy goals. One way states respond to demands for cooperation is to delegate to international organizations and private actors. In this article, we use new data spanning a century of international environmental law to understand when and why states delegate to international organizations to manage environmental problems. We find that delegation is a persistent phenomenon that facilitates the implementation of states' preferences. However, they make this decision with care: States tend to delegate functions with lower sovereignty costs, such as implementation and monitoring, but rarely delegate rule making and enforcement. We also find that heterogeneous preferences among states increases the likelihood of delegation. Overall, our results suggest that states seek to delegate out of a motivation both to reduce transaction costs and to establish credible commitments.
Identification and Estimation of Club Convergence Models with Spatial Dependence
Authors: Bernadini Papalia Rosa , Bertarelli Silvia
Published: September 2012

This article deals with heterogeneity and spatial dependence in economic growth analysis by developing a two‐stage strategy that identifies clubs by a mapping analysis and estimates a club convergence model with spatial dependence. Since estimation of this class of convergence models in the presence of regional heterogeneity poses both identification and collinearity problems, we develop an entropy‐based estimation procedure that simultaneously takes account of ill‐posed and ill‐conditioned inference problems. The two‐step strategy is applied to assess the existence of club convergence and to estimate a two‐club spatial convergence model across Italian regions over the period 1970 to 2000.
Don't Plan! The Use of the Notion of ‘Culture’ in Transforming Obsolete Industrial Space
Authors: Krivý Maroš
Published: September 2012

How is the notion of ‘culture’ understood and used in planning the transformation of obsolete industrial space? This article analyses the evidence from a current planning project in Suvilahti, Helsinki. It shows that ‘culture’ is imagined and employed as an instrument capable of producing difference in urban space. The transformation of the Cable Factory in Helsinki and the subsequent consensus on the importance of ‘culture’ are shown to have influenced the planning of Suvilahti. On the one hand, planning is being carried out with a deliberate minimization of planning interventions and the promotion of the spontaneous, non‐planned practices of cultural producers: the future Suvilahti is imagined as a ‘cultural enclave’ and its community is characterized as a ‘living organism’. On the other, ‘culture’ is planned in terms of its supposedly positive effects on urban space. Planners do not want to interfere with the non‐planned character of ‘cultural production’, yet at the same time they express certainty about cultural production's positive spatial and socioeconomic effects. The transformation of Suvilahti is playing an important part in the large‐scale planning project to redevelop the old industrial harbour in Kalasatama, Helsinki. The changes in the nature of planning are analysed under the concept of cultural governmentality.
Some Considerations Regarding the Persistence of the Economic Elite in Mexico in the First Half of the Twentieth Century
Authors: GALINDO JOSÉ
Published: September 2012

This article presents an analysis of some of the most important works on the persistence of the economic elite in Mexico during the first half of the twentieth century. The study seeks to answer the following question: How did the formation and character of the Mexican economic elites change during this period? It examines the effect of events such as the Mexican Revolution (1910–1920) and the agrarian reform programmes, as well as political instability and institutional uncertainty, on the persistence or weakening of the landowning and industrial elite who had consolidated their power during the Porfiriato period (1876–1911).
Vasodilator and antihypertensive effects of a novel N‐acylhydrazone derivative mediated by the inhibition of L‐type Ca2+ channels
Authors: Pereira Sharlene Lopes , Kummerle Arthur Eugen , Fraga Carlos Alberto Manssour , Barreiro Eliezer Jesus , Sudo Roberto Takashi , Zapata‐Sudo Gisele
Published: September 2012

New bioactive N‐acylhydrazone derivatives synthesized from safrole previously have been found to promote intense vasodilation and antihypertensive activity. In this study, we describe the synthesis and the cardiovascular effects of the new N‐acylhydrazone derivative (E)‐N‐methyl‐N′‐(thiophen‐3‐ylmethylene)benzo[d][1,3]dioxole‐5‐carbohydrazide (LASSBio‐1289). Thoracic aorta and left papillary muscles from Wistar–Kyoto (WKY) rats and spontaneously hypertensive rats (SHR) were prepared for isometric tension recording. LASSBio‐1289 promoted relaxation of endothelium‐intact and denuded aortic rings with respective pIC50 (−log IC50) values of 5.07 ± 0.09 and 4.26 ± 0.09 (P < 0.001) for WKY rats and 5.43 ± 0.05 and 5.58 ± 0.07 (P > 0.05) for SHR. The vasodilator activity of LASSBio‐1289 was increased in the KCl‐contracted aorta. LASSBio‐1289 attenuated the contracture elicited by Ca2+ in depolarized aorta from both WKY rats and SHR. In endothelium‐intact aorta from WKY rats, LASSBio‐1289‐induced relaxation was unchanged after incubation with propranolol, ZM 241385, atropine, diphenhydramine, and HOE140, but was significantly reduced by L‐NAME and ODQ. LASSBio‐1289 decreased papillary muscles contractility only at concentrations above 200 μm. Acute intravenous injection of LASSBio‐1289 (3 mg/kg) produced a significant hypotensive response in SHR but not in WKY rats, suggesting its antihypertensive profile. The antihypertensive effect was also observed in SHR during 14 days of intraperitoneal and oral administration. In conclusion, our data demonstrated that LASSBio‐1289 induces both endothelium‐independent vasorelaxation involving the inhibition of Ca2+ influx through L‐type Ca2+ channels in aorta from WKY rats and SHR, and endothelium‐dependent relaxation mediated by the NO/cyclic GMP pathway in WKY rats.
Preoperative anaemia is common in patients undergoing major gynaecological surgery and is associated with a fivefold increased risk of transfusion
Authors: Browning Roger M. , Trentino Kevin , Nathan Elizabeth A. , Hashemi Navid ,   The Western Australian Patient Blood Management Program
Published: September 2012

Aims

To ascertain the incidence of preoperative anaemia in a cohort of patients undergoing major gynaecological surgery in a tertiary Australian hospital over a two‐year period and to investigate whether it is associated with an increased rate of transfusion or complications.

Methods

Using the Western Australian Patient Blood Management (PBM) Data System, we obtained data for 843 women undergoing major gynaecological surgery over a two‐year period at King Edward Memorial Hospital, Subiaco, Western Australia. We used regression analysis to investigate the relationship between preoperative anaemia, red cell transfusion, length of hospital stay and complications.

Results

Preoperative anaemia was present in 18.1% of women and was associated with a significantly increased risk of receiving a red cell transfusion (OR = 5.74, P < 0.001). After adjusting for confounders, preoperative anaemia was not independently associated with increased complications or hospital length of stay, but receiving a red cell transfusion was (P < 0.001).

Conclusion

This study demonstrates preoperative anaemia is common in women undergoing elective major gynaecological surgery and is associated with increased red cell transfusions. A system to detect and treat anaemia prior to surgery in these patients should be implemented, and interventions should be evaluated to ensure they are effective.
Multifocal Childhood Cutaneous Tuberculosis: Report of Two Interesting Cases from Sikkim, India
Authors: Verma Shikha , Thakur Binod Kumar , Gupta Amlan
Published: September 2012

Abstract:  Cutaneous tuberculosis is an important health problem in developing countries such as India. Poverty, overcrowding, malnutrition, and ignorance are predisposing factors. The commonly seen variants of cutaneous tuberculosis are scrofuloderma, lupus vulgaris, and tuberculosis verrucosa cutis. Malnourished children may present with unusual forms of cutaneous tuberculosis. Herein we report two interesting cases of multifocal cutaneous tuberculosis in malnourished children.
Erythema Multiforme Possibly Triggered by Rabies Vaccine in a 10‐Year‐Old Boy
Authors: Verma Prashant
Published: September 2012

Abstract:  This report documents a possible rabies vaccine–induced erythema multiforme manifestation in a 10‐year‐old boy.
Facial Lichen Striatus in Children: Retracing the Lines of Blaschko
Authors: Mu Euphemia W. , Abuav Rachel , Cohen Bernard A.
Published: September 2012

Abstract:  We report seven patients with facial lichen striatus along the lines of Blaschko who presented to our pediatric dermatology unit between 2003 and 2009. The mean age of diagnosis was 4.6 years (range 2.5–9 years). Three of the cases were associated with atopic dermatitis, and one case presented with vitiligo. In the six patients for whom we have follow‐up, all lesions resolved without pigmentary changes in an average of 11 months. This case series describes the distribution, presentation, and natural history of lichen striatus along facial lines of Blaschko. From our experience, clinical diagnosis and monitoring without biopsy is a reasonable approach to the management of uncomplicated lichen striatus, particularly when the face is involved.
Impressive Pseudotumoral Proliferative Nodules in a Giant Congenital Nevus of a Newborn
Authors: Palmieri Giancarlo , Bianciardi Valassina Maria Francesca , Proia Giorgio , El Hachem May , Callea Francesco , Zama Mario
Published: September 2012

Abstract:  The potential for malignant transformation of a giant congenital melanocytic nevus (GCMN), although rare, should be considered, especially in proliferative lesions that have nodules on their surface, as they can clinically and histologically mimic melanoma and generally have a poor prognosis. We present the case of a newborn boy with a giant nevus of uneven blackish color on the back with variable degrees of intensity of pigmentation, almost entirely covered by nodules of large and variable sizes, soft texture, and a tendency to ulcerate and bleed. The unusual clinical and histologic appearance made the case particularly interesting and featured a not well‐defined biologic behavior, thus deserving a radical surgical approach to fulfill diagnostic and therapeutic aims.
Suture Boots: An Aid for the Injection of Onabotulinum Toxin A for Primary Focal Hyperhidrosis
Authors: Salvaggio Heather L. , Wagner Annette M.
Published: September 2012

Abstract:  Primary focal hyperhidrosis is a difficult problem for adults, children, and adolescents, causing significant impairment in quality of life. Onabotulinum toxin A injection is an effective third‐line treatment for primary focal hyperhidrosis. Here we describe a technique to ensure adequate depth of botulinum toxin placement in the dermis using suture boots as an aid for injection.
Update on the Role of Systemic Vitamin D in Atopic Dermatitis
Authors: Mutgi Krishna , Koo John
Published: September 2012

Abstract:  Atopic dermatitis (AD) is a common chronic inflammatory type of eczema. The underlying cause of AD has not been established. Several studies have shown initial epidermal barrier dysfunction with subsequent immune activation as the underlying mechanism. Recently, in addition to its classical role in calcium homeostasis, vitamin D has been recognized for its effect on immunomodulation. Animal studies, case reports, and randomized clinical trials have suggested that vitamin D, through various mechanisms, may alleviate the symptoms of AD. The majority of these studies indicate an inverse relationship between the severity of atopic dermatitis and vitamin D levels. Furthermore, studies have shown that, in individuals with AD who are deficient in vitamin D, repletion of vitamin D results in decreased severity of disease. We present a review of the present literature that suggests a potentially significant role for vitamin D in the treatment of AD.
An international pilot study of an internet‐based platform to facilitate clinical research in epilepsy: The EpiNet project
Authors: Bergin Peter , Sadleir Lynette , Legros Benjamin , Mogal Zarine , Tripathi Manjari , Dang Nitika , Beretta Simone , Zanchi Clara , Burneo Jorge , Borkowski Thomas , Cho Yang Je , Ossemann Michel , Striano Pasquale , Srivastava Kavita , Tan Hui Jan , Wanigasinghe Jithangi , D’Souza Wendyl ,   for the EpiNet study group
Published: September 2012

Purpose:  We created an epilepsy patient database that can be accessed via the Internet by neurologists from anywhere in the world. The database was designed to enroll and follow large cohorts of patients with specific epilepsy syndromes, and to facilitate recruitment of patients for investigator‐initiated clinical trials.

Methods:  The EpiNet database records physician‐derived information regarding seizure type and frequency, epilepsy syndrome, etiology, drug history, and investigations. It can be accessed from any country by approved investigators via a secure, password‐protected Website. All data are encrypted. The database is for both research and clinical purposes. Investigators were invited to register any patient with epilepsy, but were particularly encouraged to register patients when uncertain of the optimal management. Participation required approval from investigators’ ethics committees and institutional review boards, and all patients or their caregiver provided written informed consent. Patients were not enrolled in clinical trials in this pilot study.

Key Findings:  The international pilot study recruited patients from September 2010 to November 2011. Sixty‐four investigators or research assistants from 25 centers in 13 countries registered 1,050 patients. Patients with a wide range of epilepsy syndromes and etiologies were registered. Patients’ ages ranged from 2 weeks to 90 years.

Significance:  The Website was successfully used by doctors working in different health systems. The pilot study confirmed that this low‐cost, collaborative approach to research has great potential. Large, multicenter cohort studies will commence in 2012, and randomized clinical trials are being planned. All epileptologists are invited to join this project.
Geographic variation of epilepsy for older Americans: How close to the geographic variation of stroke?
Authors: Pisu Maria , Kratt Polly , Faught Edward , Martin Roy C. , Kim Yongin , Clements Kay , Knowlton Robert , Funkhouser Ellen , Richman Joshua S.
Published: September 2012

Purpose:  Given the strong association of stroke and epilepsy in older persons, and the existence of a Stroke Belt in the United States, we hypothesized that geographic variation in epilepsy prevalence would follow geographic patterns similar to stroke.

Methods:  We used a 2005 5% random sample of Medicare beneficiaries 65 and older in 48 U.S. contiguous states. Epilepsy was identified from claims for physician visits, hospitalizations, and outpatient procedures. Prevalence was obtained by state and county. Logistic regressions determined the independent association of the likelihood of epilepsy (prevalent or new case) and residence in Stroke Belt states, controlling for residence in highest epilepsy prevalence states, demographics (race, age, gender), comorbid conditions, cerebrovascular disease, dementia, and county characteristics.

Key Findings:  Of 1,212,015 beneficiaries, 11.9 per 1,000 had prevalent and 2.9 new cases of epilepsy. Nine of 11 Stroke Belt states were among the 20 states with the highest epilepsy prevalence. Counties in the 10 highest epilepsy prevalence states were more likely to be large urban counties with a higher number of neurologists or neurosurgeons per capita. The higher likelihood of prevalent epilepsy cases associated with Stroke Belt residence was explained by beneficiaries’ race; that associated with residence in high epilepsy prevalence states was not. The likelihood of new epilepsy cases was negatively associated with Stroke Belt residence when controlling for covariates.

Significance:  The geographic variation in epilepsy prevalence is not explained by variations in known risk factors. Further research should investigate why eastern U.S. states have higher frequency of epilepsy.
Vagus nerve stimulation elevates seizure threshold in the kindling model
Authors: Alexander Georgia M. , McNamara James O.
Published: September 2012

Purpose:  Vagus nerve stimulation (VNS) provides partial relief of medically refractory partial seizures in a subset of patients. The optimal pattern of stimulation and the mechanism of the antiseizure effects are uncertain. Establishing the efficacy of VNS in an animal model of epilepsy would provide an experimental preparation with which to address these questions. We sought to determine whether VNS exerted antiseizure effects in the kindling model of epilepsy.

Methods:  We implanted adult rats with bipolar stimulating electrodes in the right amygdala and VNS devices around the left vagus nerve. Following induction of kindling, electrographic seizure threshold (EST) was determined by quantifying the amygdala electrode current required to evoke a seizure. Once stable ESTs were established, VNS devices were programmed to deliver U.S. Food and Drug Administration (FDA)–approved, clinically used (standard) or an experimental (microburst) pattern of stimulation of variable intensity. VNS devices were programmed identically in control animals except that no current was delivered. EST was examined at 60 min and 1 week in the control and vagus nerve stimulated groups.

Key Findings:  Significant reductions of EST values were detected in control animals when tested both 60 min and 1 week following device programming. Both clinically used and experimental patterns of VNS prevented the reduction of EST evident in control animals when tested either 60 min or 1 week after device programming.

Significance:  These findings establish an experimental preparation with which to elucidate the antiseizure mechanisms of VNS and to determine patterns of VNS most effective at elevating seizure threshold.
Body Fat Distribution and Risk Factors for Fibrosis in Patients with Alcoholic Liver Disease
Authors: Naveau Sylvie , Dobrin Anca‐Stela , Balian Axel , Njiké‐Nakseu Micheline , Nohra Pascal , Asnacios Amani , Prévot Sophie , Perlemuter Gabriel
Published: September 2012

Background

Only a small proportion of alcoholic patients develop advanced liver disease, suggesting that factors other than alcohol intake may influence alcoholic liver disease (ALD) progression. We have shown that body mass index (BMI) is an independent risk factor for fibrosis in alcohol‐induced liver disease and that adipose tissue inflammation is correlated with liver lesions in alcoholic patients. The aim of this study was to determine whether visceral adipose tissue, as assessed by abdominal height measurement, affected individual susceptibility to fibrosis in alcoholic patients.

Methods

We included 127 consecutive alcoholic patients with abnormal liver test findings for whom liver histology data were available. Abdominal height was measured with a Holtain‐Kahn abdominal caliper. We carried out univariate comparisons followed by multivariate regression analysis, to investigate the relationship between abdominal height and fibrosis score.

Results

Abdominal height (p < 0.005), waist circumference (p < 0.05), fasting blood glucose concentration (p < 0.05), serum triglyceride concentration (p < 0.05), serum bilirubin (p < 0.005), and BMI (p = 0.05) were higher, whereas high‐density lipoprotein (HDL) cholesterol level (p < 0.01) was lower in the 72 patients with significant (F2–F4) fibrosis than in the 55 patients with F0–F1 fibrosis. In multivariate regression analysis, only abdominal height (β = 7.2, p < 0.002) was independently and positively correlated with fibrosis score, which was also negatively correlated with HDL cholesterol level (β = −1.04, p < 0.05).

Conclusions

We provide the first demonstration that abdominal height may be a predictor of significant fibrosis in patients with ALD. Our findings support a role for visceral fat accumulation, independent of BMI and of metabolic syndrome criteria, in the onset of alcoholic liver damage.
Acute Effect of Ethanol on Hepatic Reticular G6Pase and Ca2+ Pool
Authors: Jacobs‐Harper Amy , Crumbly Ashlee , Romani Andrea
Published: September 2012

Background

Hydrolysis of glucose 6‐phosphate (G6P) via glucose 6‐phosphatase (G6Pase) enlarges the reticular Ca2+ pool of the hepatocyte. Exposure of liver cells to ethanol (EtOH) impairs reticular Ca2+ homeostasis. The present study investigated the effect of acute EtOH administration on G6P‐supported Ca2+ accumulation in liver cells.

Methods

Total microsomes were isolated from rat livers acutely perfused with varying doses of EtOH (0.01, 0.1, or 1% v/v) for 8 minutes. Calcium uptake was assessed by 45Ca redistribution. Inorganic phosphate (Pi) formation was measured as an indicator of G6Pase hydrolytic activity.

Results

G6P‐supported Ca2+ uptake decreased in a manner directly proportional to the dose of EtOH infused in the liver, whereas Ca2+ uptake via SERCA pumps was decreased by ~25% only at the highest dose of alcohol administered. The reduced accumulation of Ca2+ within the microsomes resulted in a smaller inositol 1,4,5‐trisphosphate (IP3)‐induced Ca2+ release. Kinetic assessment of IP3 and passive Ca2+ release indicated a faster mobilization in microsomes from EtOH‐treated livers, suggesting alcohol‐induced alteration of Ca2+ releasing mechanisms. Pretreatment of livers with chloromethiazole (CMZ) or dithiothreitol (DTT), but not 4‐methyl‐pyrazole prevented the inhibitory effect of EtOH on G6Pase activity and Ca2+ homeostasis.

Conclusions

Liver G6Pase activity and IP3‐mediated Ca2+ release are rapidly inhibited following acute (8 minutes) exposure to EtOH, thus compromising the ability of the endoplasmic reticulum to dynamically modulate Ca2+ homeostasis in the hepatocyte. The protective effect of CMZ and DTT suggests that the inhibitory effect of EtOH is mediated through its metabolism via reticular cyP4502E1 and consequent free radicals formation.
A Biomechanical Comparison of Three Hybrid Linear‐Circular External Fixator Constructs
Authors: Hudson Caleb C , Lewis Daniel D , Cross Alan R , Dunbar Nicholas J , Horodyski MaryBeth , Banks Scott A , Pozzi Antonio
Published: September 2012

Objective

To evaluate the stiffness, displacement, ring deformation and bone model motion of 3 configuations of linear‐circular hybrid fixator constructs loaded in axial compression, craniocaudal and mediolateral bending, and torsion.

Study Design

Biomechanical evaluation.

Sample Population

Three hybrid construct configurations with 8 replicates/configuration.

Methods

ConstructIa used a single, 84 mm, incomplete ring and 2 tensioned olive wires to stabilize 1 bone segment and a primary hybrid rod with 3 fixation pins to stabilize the other bone segment. ConstructsIadandIb were similar toIa with the addition of a secondary diagonal hybrid rod. ConstructIb had a fixation pin inserted orthogonally from the diagonal rod. Constructs were loaded for 10 cycles in each mode of loading using a materials testing machine. Ring deformation was assessed by obtaining serial ring measurements. Bone model motion at the fracture gap as a result of loading was also calculated.

Results

Axial compression: constructsIadandIb were significantly stiffer than constructIa. Craniocaudal bending: ConstructIb was significantly stiffer than construct Ia. Mediolateral bending: there were no significant differences between constructs. Torsion: Construct Ib was significantly stiffer than constructsIa andIad. Permanent ring deformation did not occur. Bone model translational motion decreased in constructsIadandIb compared to constructIa.

Conclusions

Addition of a secondary hybrid rod as well as biplanar fixation pin placement improved construct stiffness in several loading modes.
Cardiac Resynchronization Therapy as Rescue Therapy in End‐Stage Heart Failure: Illustration by Three‐Dimensional Speckle Tracking Strain Echocardiography
Authors: Guiot Aurélie , Castel Anne Laure , Guyomar Yves , Cuvelier Estelle , Delelis François , Graux Pierre , Maréchaux Sylvestre
Published: September 2012

We report the case of a 73‐year‐old man admitted for refractory heart failure following implantation of a dual‐chamber pacemaker. Three‐dimensional (3D) echocardiography with speckle tracking area strain identified severe left ventricular (LV) dysfunction and LV dyssynchrony following right ventricular pacing. As the patient's clinical condition rapidly worsened despite optimal medical treatment, a cardiac resynchronization therapy (CRT) pacemaker was successfully implanted as rescue therapy. Symptoms rapidly regressed and echocardiographic assessment following CRT demonstrated an immediate improvement in LV systolic function, confirmed at 9‐month follow‐up with evidence of reverse remodeling. New imaging technologies such as 3D echocardiography with speckle tracking area strain may help to identify and follow up patients who will benefit from CRT as rescue therapy.