bluuebunny/crossref_metadata_2025 huggingface dataset:
Profiling the Sexually Abusive Behaviour of Men with Intellectual Disabilities
Authors: Thompson David
Published: March 2010

Of a total of 120 men with intellectual disabilities who were referred for sex education, 75 had allegedly perpetrated some form of sexual abuse. Presented here is a statistical analysis of the offences that these men committed and the responses they received. The most common victims are shown to be people with intellectual disabilities, women staff, children and women in the general public. Variation is found between the nature of the offences across victim groups, with people with intellectual disabilities being on the receiving end of the most serious forms of assault Seriousness of the assaults was also found to be dependent on the ability of the perpetrator. The responses to the men were not found to be correlated with the nature of the sexual abuse but to whom was abused: the abuse of children and women in the general public giving rise to the strongest responses. Protection of victims from subsequent abuse was also related to this specific variable: here people with intellectual disabilities and women staff gained the least protection. Attempts to isolate predictive factors of abusive behaviour proved unsuccessful. For example, abusers and non‐abusers within the sample had experienced sexual abuse themselves at similar rates. The study draws attention to the high proportion of men receiving intellectual disability services who appear not to have intellectual disabilities and the poor level of risk management of men with histories of sexually abusing.
Service Responses to Men with Intellectual Disabilities who have Unacceptable or Abusive Sexual Behaviours: The Case Against Inaction
Authors: Brown Hilary , Thompson David
Published: March 2010

This paper documents service responses to a small group of men with intellectual disabilities whose sexual behaviour was considered to be unacceptable or abusive. The data were gathered through a small‐scale action research project using case studies to explore current practice and staff attitudes. Service responses were hindered by unclear definitions of abusive sexual behaviour and inconsistent perceptions of risk and they were characterised by poor coordination, lack of specific care‐planning, failure to agree to appropriate additional supervisory measures and lack of clarity within and between agencies. The purchaser/provider split did not function to enhance accountability or facilitate monitoring of interventions but seemed in some cases to exacerbate misunderstanding and ‘buck‐passing’. Complex ethical and advocacy issues remained unaddressed in these men's lives as did the necessity of protecting vulnerable people who might be potential victims of their behaviour.
Drug Treatment of Depression Associated with Dementia or Presented as ‘Pseudodementia’ in Older Adults with Down Syndrome
Authors: Tsiouris John A. , Patti Paul J.
Published: March 2010

The response to antidepressant drugs, mainly the selective serotonin reuptake inhibitors (SSRIs), was evaluated in adults with intellectual disability (ID) and Down syndrome (DS) who presented with depression and decline in activities of daily living (ADL) skills. Among other patients with ID referred to a specialised clinic for diagnostic work‐up, 37 adults with DS over the age of 40 and a mean age of 51.4 years were evaluated and 34 were followed‐up.

Depression associated with dementia was diagnosed in 16 cases, and depression presented as functional decline ‘pseudodementia’ was found in four cases.

Recommendations for treatment with antidepressants were followed in 10 cases with a marked improvement in functioning compared to a rapid decline in the 10 cases where treatment was refused.

Treatment with the SSRIs antidepressant drugs resulted in improved quality of life, differentiated ‘pseudodementia’ from dementia, and possibly delayed the dementing process in adults with DS and presentation of depression associated with dementia.
Using the Functional Independence Measure to Assess Adults with Cerebral Palsy: An Exploratory Report
Authors: Balandin Susan , Alexander Betty , Hoffman Deborah
Published: March 2010

The Functional Independence Measure (FIM) was selected as an assessment to be conducted annually with adults attending The Spastic Centre of New South Wales (SCNSW), Australia, an organisation specifically for individuals with cerebral palsy. Service‐providers were trained in the administration of the FIM and in the use of a customised data base. Initially 173 adults with cerebral palsy were assessed, this number included 135 individuals in supported and open employment. The FIM is currently being used to assess all adults attending the SCNSW as part of an annual review. The data from this ongoing assessment procedure will assist in lobbying government to ensure that individuals have access to the attendant care services that they require to function optimally in the community and will provide a longitudinal data base for study of some of the effects of the ageing process on individuals with cerebral palsy. A case study is presented which illustrates the use of the FIM with a couple who live independently in the community.
When Parents Relinquish Care: Informal Support Networks of Older People with Intellectual Disability
Authors: Bigby Christine
Published: March 2010

Adults with intellectual disability lack the two key providers of informal support in later life, children and a spouse. This qualitative study examined the informal support networks of 62 older people with intellectual disability who had left parental care after mid‐life. Semi‐structured interviews with multiple informants were used to collect data about their supportive relationships. Informal networks were found to be small, dense and dominated by family members. A striking feature was the existence of a ‘key person’ who combined frequent contact, strong commitment and performance of a range of instrumental tasks. Key people were predominantly siblings but also included more distant relatives and friends. These findings indicate that, for this subgroup of older people, normative family roles such as ‘protector’ and ‘facilitator’ (Sussman, 1985) were fulfilled by informal network members despite the absence of spouses or children.
An Investigation of Behaviour Disturbance and Adaptive Behaviour of Children with Severe Intellectual Disabilities and Epilepsy: A Comparative Study
Authors: Jones Slan , Cull Christine A.
Published: March 2010

Fourteen children with severe intellectual disabilities and epilepsy were compared with a matched control group of children without epilepsy, with respect to their behaviour. The few significant findings suggest that features of hyperactivity may be more likely to occur in the children with epilepsy, and that they have poorer life skills, particularly in the area of independent functioning.
The Nature of Stressors Reported by People with an Intellectual Disability
Authors: Bramston P. , Fogarty G. , Cummins R.A.
Published: March 2010

There has been little research on stress as perceived by people with an intellectual disability. This is somewhat surprising considering the changes in philosophy and service delivery models across the western world that have resulted in people with an intellectual disability being at the forefront of massive attitudinal shifts within society. In this study, administration of the Lifestress Inventory to 459 people with a mild or moderate intellectual disability revealed that people with a disability reported experiencing an average of 8.57 stressors from a list of 31 stressors. When the stress intensity ratings for the individual stressors were examined it was clear that most stressors bothered the participants ‘a fair bit’. People with an intellectual disability reported a lot of stress from negative interpersonal relationships with peers and others.
The Attainments of Pupils with Severe Learning Difficulties on a Simple Counting and Error Detection Task
Authors: Porter J.
Published: March 2010

Counting is an important everyday skill, especially where there is an underlying understanding which enables the skill to be used strategically. Early researchers have often been pessimistic about the attainments of children with severe learning difficulties (or severe intellectual disabilities), emphasising limitations in their understanding. This study set out to examine the skills and understanding of 58 pupils with the presentation of a simple counting and error detection task. Almost half of the pupils could be described as acquiring the skills of counting and a further fifth were able to demonstrate understanding and use their knowledge to solve the error detection task. Mental age proved to be the best predictor of performance tested, although a few pupils functioned at a level below the expected. An important area for further study is to investigate the learning opportunities provided to pupils and, in particular, what experiences facilitate insights into the counting task.
Teaching Young Children with Developmental Disabilities to Request More Play Using the Behaviour Chain Interruption Strategy
Authors: Roberts‐Pennell Donna , Sigafoos Jeff
Published: March 2010

Three young children with developmental disabilities and severe communication impairments were taught to request more play using the behaviour chain interruption strategy (BCIS). With this strategy, the child's ongoing play behaviour is blocked or interrupted to create the need for the child to request more. Instruction occurred in the midst of two play routines with probes conducted to assess generalisation to one other play routine and to the beginning of the activities. A multiple‐baseline across subjects design demonstrated that the BCIS was effective in teaching two of the three children to request more. For these two children, generalisation to an untrained play activity was also noted. Only one of these children, however, also used the newly acquired request to initiate play. These results extend previous research on teaching communication skills to children with developmental disabilities and severe communication impairment by demonstrating the effectiveness of BCIS in the context of play activities within early intervention programmes. Student characteristics which may predict the effectiveness of the procedure are discussed.
Level of Knowledge and Risk of Contracting HIV/AIDS Amongst Young Adults with Mild/Moderate Intellectual Disability
Authors: McGillivray Jane A.
Published: March 2010

This study was designed to explore the level of knowledge and risk of contracting HIV/AIDS amongst a sample of 60 young adults with mild/moderate intellectual disability. In comparison to a sample of undergraduate students, they showed greater deficits in their general knowledge of the disease and in methods to minimise risk of infection. They also had less adaptive attitudes regarding AIDS in general and specifically with regard to condom use, and they had lower confidence in their capacity to accomplish safe‐sex practices. Furthermore, when presented with hypothetical risk situations they were more likely to present unsafe sexual solutions to the interpersonal dilemmas. These indications of potential risk were compounded by the finding that the majority were either sexually active or had strong intentions to become so, and that poor performance on the range of measures was associated with greater behavioural risk as assessed by actual or anticipated sexual activities. The implications of these results are discussed in relation to the need for urgent implementation and ongoing evaluation of multifaceted educational programmes.
The Prevalence and Balance of Care for Intellectual Disability: Secondary Analyses of the OPCS Disability Surveys
Authors: Kavanagh Shane M. , Opit Louis J.
Published: March 2010

Government policy continues to emphasise the commissioning and needs‐assessment role of health authorities, local authorities and — to a greater extent — general practitioners. To date, much available information for this purpose has been based on service utilisation data or from registers based on case finding from service contacts. As an alternative, we conducted secondary analyses of the national Surveys of Disability of Children and Adults by the Office of Population Censuses and Surveys. The prevalence of intellectual disability for people who had ‘mental handicap’ reported as an underlying health problem was 3.5 per 1000 in the overall population. Rates rose from 1.7 per 1000 among those aged 4 and under, reaching a peak of 6.3 per 1000 among 16–19 year olds and falling to 2.8 per 1000 among people aged 75 or more. Residence in a communal establishment increased markedly with age. People in households had high levels of disability and consequently problems with personal care. Furthermore, behaviour problems were commonplace. Consequently, carers spent long hours caring and often reported adverse effects on their health.
See What I Mean: Interpreting the Meaning of Communication by People with Severe and Profound Intellectual Disabilities
Authors: Grove Nicola , Bunning Karen , Porter Jill , Olsson Cecilia
Published: March 2010

In a social and political climate which encourages active participation in decision‐making by people who have severe and profound intellectual disabilities, the onus is often on practitioners, carers and advocates to represent the wishes and interests of individuals. The issue of the validity of their interpretations is then foregrounded. This paper discusses theoretical issues associated with the development of guidelines to support a process of validation. It is argued that meaning should be viewed as the negotiated outcome of interactions, always involving inference. Validity of interpretation is thus a continuous rather than a categorical variable, and needs to be supported by the systematic collection of evidence from a range of sources. This framework is compatible with a social constructivist view of communicative development, and allows for information derived from subjective, intuitive insights to be combined with information obtained through observation and testing.
Staff Perceptions of Communication with a Partner who is Intellectually Disabled
Authors: McConkey Roy , Purcell Margaret , Morris Irene
Published: March 2010

Nineteen staff employed in small‐scale residential and day services were video‐recorded interacting with a client whom they knew well in two different contexts (selected from three possible contexts: either social, consultative or task‐related). Prior to each session, staff rated themselves and the clients on how likely they were to use a range of communication acts. These ratings were repeated after the session and the video‐recordings were rated similarly by two speech and language therapists. Although staff were able to predict and adapt their communications across the three contexts, their perceptions of communication were dominated by the use or non‐use of a ‘teaching’ strategy; that is one based around corrections, giving instructions and reinforcements, and the use of pointing and touch. Staff were less able to predict and assess the use of other verbal acts, such as commenting, and non‐verbal signals such as facial expressions and gestures both by themselves and by the clients.
Development of an Independent Behaviour Assessment Scale for Bangladesh
Authors: Munir Shirin Z. , Zaman Sultana , McConachie Helen
Published: March 2010

The paper describes the stages in development of an assessment of the adaptive behaviour skills of children in Bangladesh. Item selection and reduction are described, based on an ecological analysis of behaviours expected of children aged between two and nine years of age, living in both urban and rural settings. The IBAS has four major subscales: motor skills, socialisation, communication and daily living skills. Norms have been constructed based on testing a nationally representative sample of 1404 children. Content, construct and discriminant validity are established, and the reliability of the total scale and subscales is high, both between testers and over time. The IBAS can provide a baseline indication of level of skills in a child with intellectual disability, and aid in planning an appropriate curriculum‐based programme in discussion with the child's family.
The Relationship between Staff Sickness Levels and Client Assault Levels in a Health Service Unit for People with an Intellectual Disability and Severely Challenging Behaviour
Authors: Murray George C. , Sinclair Bridget , Kidd Gillian R. , Quigley April , McKenzie Karen
Published: March 2010

The present study examined relationships between assault levels and sickness levels in staff working in a specialist challenging behaviour unit. The staff group experienced an average of 279.7 total assaults and an average of 422.5 hours sickness occurred each month. No significant relationships were found between total assaults and sickness levels, short‐ or long‐term. Implications of these findings are discussed in relation to the available literature. Methodological difficulties are also discussed.
Indexing Psychological Distress in People with an Intellectual Disability: Use of the Symptom Checklist‐90‐R
Authors: Kellett S.C. , Beail N. , Newman D.W. , Mosley E.
Published: March 2010

The development, usage and clinical utility of psychometric tests for the assessment of mental health problems experienced by people with an intellectual disability has only recently become a clinical issue and subject of methodological debate. In general there are a paucity of measures, little consideration for reliability/validity issues and lack of intellectual disability group norms. In this paper we describe the application of the Symptom Checklist (SCL‐90‐R) with people with intellectual disabilities. Results suggest that the measure has high reliability and validity with this population and that the SCL‐90‐R effectively indexes mental health concerns. Significant differences were observed across symptom dimensions and global indices between community and clinical groups. Preliminary norms on the SCL‐90‐R for intellectually disabled people are provided. The data are discussed in terms of the potential for the SCL‐90‐R to be used as an outcome measure for intellectually disabled people with mental health problems regardless of the mode of intervention. Guidance is provided for applying the measure with intellectually disabled individuals.
Intellectual Disability and HIV Infection: A Service‐related Study of Policies and Staff Attitudes
Authors: MacDonald Raymond A.R. , Murray James L. , Levenson Victor L.
Published: March 2010

This paper reports on a study of staff knowledge and attitudes in relation to policies on HIV infection in organisations providing services to people with intellectual disabilities. Staff in three different service providers (NHS, Social Service and private and voluntary organisations) were sent the Staff Attitudes Towards Persons with Learning Disabilities and HIV Infection Scale (LDHIVS; Murray & Minnes, 1994a). The response rate was 54%, (N = 178): 46% of respondents did not know or were unsure of policies concerning clients with HIV infection; 69% of respondents reported that these policies either did not influence their behaviour or that they were unsure if they did. Results also indicated that staff working in a direct‐care capacity for the NHS held less positive attitudes towards clients with HIV infection than NHS staff working in a management capacity. The results are discussed with reference to HIV prevention, health promotion and appropriate service support for people with intellectual disabilities.
Physiological mechanisms of drought‐induced tree mortality are far from being resolved
Authors: Sala Anna , Piper Frida , Hoch Günter
Published: March 2010

Commentary p 264
Workforce Factors for Psychologists in CAMHS in New Zealand
Authors: Lambie Ian , Stewart Malcolm W.
Published: March 2010

Background:  Recruitment and retention of psychologists for Child and Adolescent Mental Health Services (CAMHS) is difficult worldwide. This study: 1) identified factors that promote or hinder recruitment and retention of CAMHS psychologists; 2) explored training and its impact on CAMHS as a career choice; and 3) identified strategies to improve recruitment and retention of CAMHS psychologists in New Zealand.

Method:  Surveys were undertaken with four New Zealand groups: 1) all registered psychologists; 2) final‐year professional psychology interns; 3) directors for professional psychology training programmes; and 4) psychology professional leaders in the public health system.

Result:  Psychologists with more pre‐qualification training in CAMHS were more likely to work in CAMHS. Other psychologists reported they would have more likely worked in CAMHS if they had received more pre‐qualification training. Factors that promote or hinder training, recruitment and retention are discussed.

Conclusions:  A range of practical strategies for improving recruitment and retention of psychologists to CAMHS were identified, including particular strategies for psychologists from minority cultures (particularly, Maori and Pacific Island psychologists). While undertaken in New Zealand, many of these findings are relevant internationally.
AN ELEMENTAL AND LEAD‐ISOTOPIC STUDY ON BRONZE HELMETS FROM ROYAL TOMB NO. 1004 IN YIN RUINS
Authors: TIAN J. H. , JIN Z. Y. , LI R. L. , YAN L. F. , CUI J. Y.
Published: March 2010

Lead isotope and element composition analyses were performed by thermal ionization mass spectrometry (TIMS) and inductively coupled plasma optical emission spectroscopy (ICP–OES) on bronze helmets from royal tomb No. 1004 at Yin Ruins, the last capital of China's Shang Dynasty (17th to 11th centuries bc). The data show that the copper‐based alloy helmets can be divided into two categories: tin bronze and leaded tin bronze; and the lead isotope ratios for both categories are in the range of highly radiogenic lead (HRL). This result offers some important clues to answering questions concerning the provenance of raw metal materials, as well as the chronology of this famous royal tomb.
Rapid brain penetration of interleukin‐1 receptor antagonist in rat cerebral ischaemia: pharmacokinetics, distribution, protection
Authors: Greenhalgh AD , Galea J , Dénes A , Tyrrell PJ , Rothwell NJ
Published: March 2010

Background and purpose:  Limited data on the brain penetration of potential stroke treatments have been cited as a major weakness contributing to numerous failed clinical trials. Thus, we tested whether interleukin‐1 receptor antagonist (IL‐1RA), established as a potent inhibitor of brain injury in animals and currently in clinical development, reaches the brain via a clinically relevant administration route, in experimental stroke.

Experimental approach:  Male, Sprague‐Dawley rats [either naïve or exposed to middle cerebral artery occlusion (MCAo)] were given a single s.c. dose of IL‐1RA (100 mg·kg−1). The pharmacokinetic profile of IL‐1RA was assessed in plasma and CSF up to 24 h post‐administration. Brain tissue distribution of administered IL‐1RA was assessed using immunohistochemistry. In a separate experiment, the neuroprotective effect of the single s.c. dose of IL‐1RA in MCAo was assessed versus a placebo control group.

Key results:  A single s.c. dose of IL‐1RA reduced damage caused by MCAo by 33%. This dose resulted in sustained, high concentrations in plasma and CSF, penetrated brain tissue exclusively in areas of blood–brain barrier breakdown and co‐localized with morphologically viable neurones. CSF concentrations did not reflect massive parenchymal infiltration of IL‐1RA in MCAo animals compared to naïve.

Conclusions and implications:  These data are the first to show that a potential treatment for stroke, IL‐1RA, rapidly reaches salvageable brain tissue via an administration route that is clinically relevant. This allows confidence that IL‐1RA, as a candidate for further clinical development, is able to confer its protective actions both peripherally and centrally.
Induction of apoptosis by the ginsenoside Rh2 by internalization of lipid rafts and caveolae and inactivation of Akt
Authors: Park E‐K , Lee EJ , Lee S‐H , Koo KH , Sung JY , Hwang EH , Park JH , Kim C‐W , Jeong K‐C , Park B‐K , Kim Y‐N
Published: March 2010

Background and purpose:  Lipid rafts and caveolae are membrane microdomains with important roles in cell survival signalling involving the Akt pathway. Cholesterol is important for the structure and function of these microdomains. The ginsenoside Rh2 exhibits anti‐tumour activity. Because Rh2 is structurally similar to cholesterol, we investigated the possibility that Rh2 exerted its anti‐tumour effect by modulating rafts and caveolae.

Experimental approach:  A431 cells (human epidermoid carcinoma cell line) were treated with Rh2 and the effects on cell apoptosis, raft localization and Akt activation measured. We also examined the effects of over‐expression of Akt and active‐Akt on Rh2‐induced cell death.

Key results:  Rh2 induced apoptosis concentration‐ and time‐dependently. Rh2 reduced the levels of rafts and caveolae in the plasma membrane and increased their internalization. Furthermore, Akt activity was decreased and consequently, Akt‐dependent phosphorylation of Bad, a pro‐survival protein, was decreased whereas the pro‐apoptotic proteins, Bim and Bax, were increased upon Rh2 treatment. Unlike microdomain internalization induce by cholesterol depletion, Rh2‐mediated internalization of rafts and caveolae was not reversed by cholesterol addition. Also, cholesterol addition did not restore Akt activation or rescue cells from Rh2‐induced cell death. Rh2‐induced cell death was attenuated in MDA‐MB‐231 cells over‐expressing either wild‐type or dominant‐active Akt.

Conclusions and implications:  Rh2 induced internalization of rafts and caveolae, leading to Akt inactivation, and ultimately apoptosis. Because elevated levels of membrane rafts and caveolae, and Akt activation have been correlated with cancer development, internalization of these microdomains by Rh2 could potentially be used as an anti‐cancer therapy.
Endocannabinoid modulation of hyperaemia evoked by physiologically relevant stimuli in the rat primary somatosensory cortex
Authors: Ho W‐SV , Patel S , Thompson JR , Roberts CJ , Stuhr KL , Hillard CJ
Published: March 2010

Background and purpose: In vitrostudies demonstrate that cannabinoid CB1receptors subserve activity‐dependent suppression of inhibition in the neocortex. To examine this mechanismin vivo, we assessed the effects of local changes in CB1receptor activity on somatosensory cortex neuronal activation by whisker movement in rats.

Experimental approach: Laser Doppler flowmetry and c‐Fos immunohistochemistry were used to measure changes in local blood flow and neuronal activation, respectively. All drugs were applied directly to the cranium above the whisker barrel fields of the primary somatosensory cortex.

Key results: The CB1receptor agonist WIN55212‐2 potentiated the hyperaemia induced by whisker movement and this potentiation was occluded by bicuculline. The CB1receptor antagonists, rimonabant and AM251, inhibited hyperaemic responses to whisker movement; indicating that activation of endogenous CB1receptors increased during whisker movement. Whisker movement‐induced expression of c‐Fos protein in neurons of the whisker barrel cortex was inhibited by rimonabant. Movement of the whiskers increased the 2‐arachidonoylglycerol content in the contralateral, compared to the ipsilateral, sensory cortex.

Conclusions and implications: These results support the hypothesis that endocannabinoid signalling is recruited during physiologically relevant activation of the sensory cortex. These data support the hypothesis that the primary effect of CB1receptor activation within the activated whisker barrel cortex is to inhibit GABA release, resulting in disinhibition of neuronal activation. These studies provide physiological data involving endocannabinoid signalling in activity‐dependent regulation of neuronal activation and provide a mechanistic basis for the effects of cannabis use on sensory processing in humans.

This article is part of a themed issue on Cannabinoids. To view the editorial for this themed issue visithttp://dx.doi.org/10.1111/j.1476‐5381.2010.00831.x
Changes in Salivary Prostaglandin Levels During Menstrual Migraine With Associated Dysmenorrhea
Authors: Durham Paul L. , Vause Carrie V. , Derosier Frederick , McDonald Susan , Cady Roger , Martin Vincent
Published: March 2010

(Headache 2010;50:844‐851)

Objective.— To measure prostaglandin levels in the saliva of individuals during menstrual migraine associated with dysmenorrhea (MMaD) and in response to treatment with a single tablet combination of sumatriptan succinate and naproxen sodium.

Background.— Prostaglandins are thought to play a role in MMaD as elevated serum prostaglandin levels have been reported during attacks of menstrual migraine and are increased in the menstrual fluid of women with dysmenorrhea. While triptans are the primary line of migraine treatment, nonsteriodal anti‐inflammatory drugs are the most commonly prescribed therapy for dysmenorrhea symptoms. Data from recent clinical studies have provided evidence that treatment with a single tablet combination of sumatriptan and naproxen sodium is an effective abortive therapy for attacks of MMaD.

Methods.— Women diagnosed with MMaD were treated with a sumatriptan succinate and naproxen sodium single tablet combination or placebo at time of migraine attack. Saliva samples were collected at time of attack as well as 2 and 4 hours after treatment. PGD2, PGE2, PGF2, PGI2, and TXA2 levels were determined by enzyme‐linked immunosorbent assay.

Results.— Elevated levels of PGD2, PGF2, and TXA2 at 2 and 4 hours and PGE2 at 4 hours were found in saliva obtained from placebo subjects when compared with onset of attack levels. However, in subjects treated with a single tablet combination of sumatriptan and naproxen sodium, the levels of PGD2, PGF2, and PGE2 were not elevated at either time point while TXA2 levels were still elevated at 4 hours.

Conclusions.— Data from this pilot study provide evidence that saliva levels of several prostaglandins increase during attacks of MMaD and that treatment with a single tablet combination of sumatriptan and naproxen sodium prevents elevation of prostaglandin levels.
Comparison of Kinematic Variables in Defining Lameness Caused by Naturally Occurring Rupture of the Cranial Cruciate Ligament in Dogs
Authors: Sanchez‐Bustinduy Maitane , de Medeiros Magda Alves , Radke Heidi , Langley‐Hobbs Sorrel , McKinley Trevelyan , Jeffery Nick
Published: March 2010

Objective:To (1) discover kinematic variables that differ between dogs with cranial cruciate ligament rupture (CCLR) and control dogs and (2) to identify suitable outcome variables for longitudinal studies on the effects of surgical interventions for CCLR in dogs.

Study Design:In vivo case–control comparison.

Animals:Dogs with unilateral CCLR (n=16), and no other detectable neurologic or orthopedic disease and 10 dogs without CCLR, neurologic, or orthopedic disease.

Methods:Kinematic data was collected from dogs as they walked at constant speed on a treadmill, using an infrared camera system and adhesive reflective markers applied to the pelvic limbs. Data on 5 selected variables was extracted and comparisons made between paired pelvic limbs in both CCLR and control dogs and between control and CCLR dogs.

Results:Comparisons in CCLR dogs revealed significant differences between affected and unaffected limbs for many examined variables; the largest differences were in paw velocity and stifle angular velocity. There were highly significant differences between CCLR and control dogs when examining paired limb ratios for 4 of the variables, the largest differences were in stride length and paw velocity.

Conclusions:Kinematic analysis provides straightforward and objective methods for defining the lameness associated with CCLR in dogs. Paw velocity and stride length were most notably reliable and not susceptible to systematic alterations in stifle joint dynamics that might be associated with specific surgical procedures.

Clinical Relevance:This study identifies several variables that can provide the objective measurements essential to evaluate the efficacy of surgical interventions for CCLR in dogs.
The Effect of Uniaxial Cyclic Tensile Load on Gene Expression in Canine Cranial Cruciate Ligamentocytes
Authors: Breshears Lee A. , Cook James L. , Stoker Aaron M. , Fox Derek B. , Luther Jill K.
Published: March 2010

Objective:To determine the effects of uniaxial cyclic tensile load amplitude and duration on gene expression in cranial cruciate ligamentocytes cultured in monolayer.

Study Design:In vitro experimental study.

Animals:Adult dogs (n=9) weighing 20–35 kg.

Methods:Cranial cruciate ligaments (CCL, n=18) were aseptically collected, diced, digested using clostridial collagenase, and primary monolayer cultures were established. CCL cells were seeded at a concentration of 3 × 105 cells/mL onto a specialized collagen membrane. After 24 hours to allow attachment, ligamentocytes were subjected to 0%, 4%, or 8% uniaxial strain for 24 or 48 hours using a sinusoidal strain profile at 0.5 Hz. At the end of each time point, the ligamentocytes were harvested and analyzed for collagen 1 (COL1), collagen 3 (COL3), and matrix metalloproteinase‐3 (MMP‐3) gene expression using reverse transcriptase real‐time polymerase chain reaction.

Results:Approximately 33% of CCL processed for this study yielded viable cell cultures compared with 100% of the medial collateral ligaments processed. For CCL cells under uniaxial strain, gene expression for COL1 was variable, but higher strains and longer time in culture resulted in increased COL1 expression. There were no significant differences found for COL3 at any time point or between strain regimens. In general, MMP‐3 gene expression was increased early in tissue culture and at higher strains.

Conclusions:COL1 and MMP‐3 gene expression can be influenced by amplitude and duration of strain on CCL cells in monolayer culture.

Clinical Relevance:These data have implications for modeling and understanding canine cruciate ligament pathophysiology. In particular, MMP‐3 could serve as a potential preventative or therapeutic target in cruciate disease.
Electrical Storm in Brugada Syndrome during Pregnancy
Authors: SHARIF‐KAZEMI MOHAMMAD B. , EMKANJOO ZAHRA , TAVOOSI AMIR , KAFI MOHAMMAD , KHEIRKHAH JALAL , ALIZADEH ABOLFATH , SADR‐AMELI MOHAMMAD A.
Published: March 2010

Clinical and molecular characterization of the Brugada syndrome has progressed rapidly since its initial description. The role of hormonal changes during pregnancy and postpartum period on the pathogenesis of Brugada syndrome has not been studied. Herein, we describe a case of revelation of Brugada syndrome during pregnancy in a young woman who presented with electrical storm as the first manifestation. Low‐dose isoproterenol infusion followed by oral quinidine inhibited the recurrence of ventricular tachyarrhythmia and normalized the electrocardiographic pattern. We emphasize the importance of hormonal changes during pregnancy as a precipitating factor for arrhythmic events in Brudaga syndrome. (PACE 2011; 34:e18–e21)
Ablation of Ligament of Marshall Attenuates Atrial Vulnerability to Fibrillation Induced by Inferior Left Atrial Fat Pad Stimulation in Dogs
Authors: LIU XINGPENG , YAN QIAN , LI HUI , TIAN YING , SU JING , TANG RIBO , LU CHUNSHAN , DONG JIANZENG , MA CHANGSHENG
Published: March 2010

Ligament of Marshall and Atrial Fibrillation Induction. Background: The role of ligament of Marshall (LOM) in the mechanism of “vagal” atrial fibrillation (AF) is still unknown.

Objective:
To investigate the impact of LOM ablation on atrial vulnerability to AF induced by inferior left atrial fat pad (ILAFP) stimulation in dogs.

Methods:
AF inducibility and atrial effective refractory period (ERP) were elevated before and after LOM ablation in 8 of 14 dogs (the ablation group). Same protocol but without LOM ablation was conducted in the remaining 6 dogs (the control group). The activation patterns of LOM and left pulmonary veins (LPVs) during sustained AF were analyzed. The distribution of epicardial cholinergic nerve fibers between LOM and ILAFP was investigated in the control group.

Results:
Ablation of LOM significantly attenuated AF inducibility (87.5% vs 33.3%, P < 0.001) and prolonged ERPs of the structures in contiguity with LOM (P < 0.05) in the ablation group. In contrast, there was no significant change in ERPs and AF inducibility in the control group. During sustained AF, fractionated atrial electrograms were more common in the LOM area than the LPVs (84% vs 18% of the analyzed episodes, P < 0.001). In 46.7% of the episodes with identifiable LOM spikes, atrial potentials, and LOM spikes were related in 2:1 or 3:2 pattern during the intermittent organized activity. Acetylcholinesterase staining revealed a close cholinergic nerved relationship between LOM and ILAFP.

Conclusions:
LOM plays a critical role in maintaining AF induced by stimulation of ILAFP. Ablation of LOM can markedly attenuate AF inducibility in this model. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1024‐1030, September 2010)
Area Under the Real‐Time Contact Force Curve (Force–Time Integral) Predicts Radiofrequency Lesion Size in an In Vitro Contractile Model
Authors: SHAH DIPEN C. , LAMBERT HENDRIK , NAKAGAWA HIROSHI , LANGENKAMP ARNE , AEBY NICOLAS , LEO GIOVANNI
Published: March 2010

FTI Predicts RF Lesion Size in Contractile Model. Introduction: Electrode tissue contact, radiofrequency (RF) power and duration are major determinants of RF lesion size. Since contact forces (CF) vary in the beating heart, we evaluated contact force–time integral (FTI) as a predictor of lesion size at constant RF power in a contractile bench model simulating the beating heart.

Methods and Results:
An open‐tip irrigated catheter was attached to a movable mount incorporating a dynamic force sensor allowing closed loop control to achieve desired force variations between the catheter tip and bovine skeletal muscle placed on a ground plate. RF energy (20 and 40 W for 60 seconds, 17 cc/min irrigation) was delivered during (1) constant contact (C) at 20 g, (2) variable contact (V) with a 20 g peak and 10 g nadir, and (3) intermittent contact (I) with a 20 g peak and 0 g nadir with loss of contact. V and I protocols were performed at 50 and 100 catheter movements/min and 2 systole:diastole time ratios (50:50 and 30:70). The area under the CF curve was calculated as the FTI. Measured FTI was highest in C, intermediate during V and lowest during I and correlated linearly with lesion volume (P < 0.0001 for 20 and 40 W). Lesion volume was highest in group C, intermediate in V and lowest in group I (P < 0.05 for C vs V, V vs I, and C vs I).

Conclusions:
Lesion size correlates linearly with measured contact FTI. Constant contact produces the largest and intermittent contact the smallest lesions despite constant RF power and identical peak contact forces. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1038‐1043, September 2010)
Regional Diastolic and Systolic Function by Strain Rate Imaging for the Detection of Intramural Viability during Dobutamine Stress Echocardiography in a Porcine Model of Myocardial Infarction
Authors: Schneider Carsten , Jaquet Kai , Geidel Stephan , Malisius Rainer , Boczor Sigrid , Rau Thomas , Zienkiewicz Tomacz , Hennig Detlef , Kuck Karl‐Heinz , Krause Korff
Published: March 2010

The aim of this study was to evaluate diastolic and systolic strain rate measurements for differentiation of transmural/nontransmural infarction during dobutamine stress echocardiography (DSE). An ameroid constrictor was placed around the circumflex artery in 23 pigs inducing chronic vessel occlusion. Five pigs without constrictor served as controls. During high‐dose DSE systolic strain rates (SRsys), systolic and postsystolic strain values (ɛsys, ɛps) and early and late diastolic strain rates (SRE and SRA) were determined. At week 6, animals were evaluated regarding myocardial fibrosis. Histology revealed nontransmural in 14 and transmural infarction in 9 animals. In controls, dobutamine induced a linear increase of SRsys to 12.3 ± 0.4 s−1 at 40 μg/kg per minute (P = 0.001) and a linear decrease of SRE to −6.6 ± 0.3 s−1 (P = 0.001). In the nontransmural group, SRsys, ɛsys, ɛps at rest, and during DSE were higher and SRE was lower than in the transmural infarction group (P = 0.01). Best predictors for viability were SRsys (ROC 0.96, P = 0.0003), SRE at 10 μg/kg per minute dobutamine stimulation (ROC 0.94, P = 0.001) and positive SR values during isovolumetric relaxation at 40 μg/kg per minute dobutamine (ROC 0.86, P = 0.004). The extension of fibrosis correlated with SRsys at rest, ɛsys at rest, and SRE at rest (P < 0.001). For the detection of viability similar diagnostic accuracies of SRE and SRsys were seen (sensitivity 93%/93%, specificity 96%/94%, respectively). Diastolic SR analysis seems to be equipotent for the identification of viable myocardium in comparison to systolic SR parameters and allows the differentiation of nontransmural from transmural myocardial infarction with high diagnostic accuracy. (Echocardiography 2010;27:552‐562)
Comparison of Tissue Doppler Dynamics with Doppler Flow in Evaluating Left Atrial Appendage Function by Transesophageal Echocardiography in Prehypertensive and Hypertensive Patients
Authors: Tenekecioğlu Erhan , Karabulut Aziz , Yılmaz Mustafa
Published: March 2010

Increased blood pressure (BP) is associated with an increase in cardiovascular mortality and morbidity. We aimed to analyze the effect of increased BP onto the function of left atrial appendage (LAA) in early stages of hypertension. Transesophageal echocardiography (TEE) was prospectively performed to assess LAA functions in 120 patients with increased BP, and in 58 normotensive subjects without cardiovascular disease. Patients with increased BP were divided according to Joint National Committee VII (JNC VII) report: prehypertensive,stage‐1 hypertensive and stage‐2 hypertensive patients. During TEE, LAA late‐emptying velocities (LAAEV) were significantly reduced only in stage‐2 hypertensives as compared with control group (P < 0.001). In contrast, LAA late‐contracting velocity (LAA TDI‐D2) was significantly reduced in prehypertensive,stage‐1 hypertensive and stage‐2 hypertensive patients, when compared with control group (P < 0.05, P < 0.001, and P < 0.001, respectively). The LAA maximal areas were increased significantly only in stage‐2 hypertensive patients when compared with control group (P < 0.05). During TEE, left atrial spontaneous echocardiographic contrast was found in 2 of 36 patients in prehypertension group, in 7 of 40 patients in stage‐1 hypertension group, and in 10 of 44 patients in stage‐2 hypertension group. Left atrial thrombi were observed in 3 (6.8%) patients of stage‐2 hypertension group. In conclusion, in patients with untreated prehypertension and hypertension, elevation of afterload imposed on left atrium involved both left atrium and LAA, resulting in impairment of the LAA function. Tissue Doppler imaging (TDI) enables the detection of this functional impairment in early stages of hypertension, even in prehypertensive phase, when compared with conventional Doppler flow measurement of the LAA. Even in prehypertensive phase, BP should be decreased to normal levels to prevent the LAA dysfunction. (Echocardiography 2010;27:677‐686)
Mitral Annular Velocities Generated by Speckle Tracking Imaging: Reproducibility and Correlation with Tissue Doppler Velocities
Authors: Kort Smadar , Madahar Purnema , Ajmera Akash , Brown David L.
Published: March 2010

Background: Early diastolic mitral annular velocities (E′) are routinely generated by tissue Doppler imaging (TDI), an angle‐dependent technique. Velocity vector imaging (VVI) lacks this limitation. Normal VVI E′ values and their correlation with TDI E′ are unknown. Methods: E′ by VVI and TDI were compared in 100 patients. Results: VVI velocities are lower and correlate moderately with TDI velocities for medial E′ (r = 0.405) and mildly for lateral E′ (r = 0.278) and are image quality dependent. In patients with diastolic or systolic dysfunction, no correlation was found. E′ < 0.06 m/s by VVI for the medial and lateral annulus can detect abnormal diastolic function with sensitivity of 90% and 77%, respectively, and with specificity of 56% and 52%, respectively. Conclusions: E′ by VVI is lower than by TDI with a poor agreement between the measurements, which are therefore not interchangeable. Although VVI can be performed offline, this method is dependent on image quality. (Echocardiography 2010;27:637‐643)
Isoproterenol‐Induced Myocardial Injury: A Systematic Comparison of Subcutaneous versus Intraperitoneal Delivery in a Rat Model
Authors: George Jon C. , Liner Ann , Hoit Brian D.
Published: March 2010

Introduction: Isoproterenol (ISO)‐induced myocardial injury is widely used as an experimental animal model; however, the optimal route of delivery, i.e., subcutaneous (SC) versus intraperitoneal (IP) has not been clarified. We systematically compared changes in cardiac function (echocardiography, Doppler and strain imaging) and exercise capacity induced by ISO via SC versus IP delivery. Methods: Twelve rats were used in this study and classified into three groups: Control (n = 2), SC‐ISO (n = 5), and IP‐ISO (n = 5), each receiving serial injections of ISO (100 mcg/kg) for 5 days (days 1–5). All rats underwent echocardiographic analysis of left ventricular function and functional capacity (FC) assessment on a treadmill protocol at baseline and post treatment. Hearts were excised and weighed at the end of the study. Results: Left ventricular (LV) systolic and diastolic dysfunctions were adequately induced by both SC and IP delivery: ≥13% reduction in fractional shortening, ≥12% increase in wall motion score index, and ≥35% increase in myocardial performance index; ≥49% increase in E/A ratio; ≥9% decline in anterior wall tissue velocity; ≥12% decline in circumferential and radial tissue strain and strain rates; ≥20% decline in FC; and ≥40% increase in echocardiographic LV mass and gross heart weight in both groups. Conclusion: Short‐duration ISO administration with serial injections via SC and IP routes induces significant myocardial dysfunction and impairs FC with few differences between both modalities. (Echocardiography 2010;27:716‐721)