bluuebunny/crossref_metadata_2025 huggingface dataset:
Activation of pro‐survival Akt and ERK1/2 signalling pathways underlie the anti‐apoptotic effects of flavanones in cortical neurons
Authors: Vauzour David , Vafeiadou Katerina , Rice‐Evans Catherine , Williams Robert J. , Spencer Jeremy P. E.
Published: August 2007

There is growing interest in the potential beneficial effects of flavonoids in the aging and diseased brain. We have investigated the potential of the flavanone hesperetin and two of its metabolites, hesperetin‐7‐O‐β‐d‐glucuronide and 5‐nitro‐hesperetin, to inhibit oxidative stress‐induced neuronal apoptosis. Exposure of cortical neurons to hydrogen peroxide led to the activation of apoptosis signal‐regulating kinase 1 via its de‐phosphorylation at Ser963, the phosphorylation of c‐jun N‐terminal kinase and c‐Jun (Ser73) and the activation of caspase 3 and caspase 9. Whilst hesperetin glucuronide failed to exert protection, both hesperetin and 5‐nitro‐hesperetin were effective at preventing neuronal apoptosis via a mechanism involving the activation/phosphorylation of both Akt/protein kinase B and extracellular signal‐regulated kinase 1 and 2 (ERK1/2). Protection against oxidative injury and the activation of Akt and ERK1/2 followed a bell‐shaped response and was most apparent at 100 nmol/L concentrations. The activation of ERK1/2 and Akt by flavanones led to the inhibition of the pro‐apoptotic proteins, apoptosis signal‐regulating kinase 1, by phosphorylation at Ser83 and Bad, by phosphorylation at both Ser136 and Ser112 and to the inhibition of peroxide‐induced caspase 9 and caspase 3 activation. Thus, flavanones may protect neurons against oxidative insults via the modulation of neuronal apoptotic machinery.
ribosort: a program for automated data preparation and exploratory analysis of microbial community fingerprints
Authors: SCALLAN Ú. , LILIENSIEK A. , CLIPSON N. , CONNOLLY J.
Published: August 2007

ribosort is a computer package for convenient editing of automated ribosomal intergenic spacer analysis (ARISA) and terminal restriction fragment length polymorphism (TRFLP) data. It is designed to eliminate the labourious task of manually classifying community fingerprints in microbial ecology studies. This program automatically assigns detected fragments and their respective relative abundances to appropriate ribotypes. It permits simultaneous sorting of multiple profiles and facilitates direct workflow from TRFLP and ARISA output through to community analyses. ribosort also provides several options to merge repeat profiles of a sample into a single composite profile. By creating a ‘ribotypes by samples’ matrix ready for statistical analyses, use of the package saves time and simplifies the preparation of DNA fingerprint data sets for statistical analysis. In addition, ribosort performs exploratory analysis on the data by creating multidimensional scaling plots that compare the similarity of sample profiles using the statistical software r.
Novel nuclear intron‐spanning primers for Arecaceae evolutionary biology
Authors: BACON CHRISTINE D. , FELTUS F. ALEX , PATERSON ANDREW H. , BAILEY C. DONOVAN
Published: August 2007

In this study, 96 nuclear ‘conserved intron‐scanning primers’ were screened across subfamilies the Arecaceae (palms) for potential use in research focused on palm evolutionary biology. Primers were evaluated based on their ability to amplify single polymerase chain reaction products in Arecaceae, the clarity of sequencing reads, and the interspecific variability observed. Ultimately, the results suggest that: (i) seven of the loci are likely to be suitable when comparing non‐Arecaceae outgroups and Arecaceae ingroups; (ii) seven loci may be of use when comparing subfamilies of Arecaceae; and (iii) four of the loci may be of use when comparing closely related genera.
Thirteen polymorphic microsatellite DNA loci from whiptails of the genus Aspidoscelis (Teiidae: Squamata) and related cnemidophorine lizards
Authors: CRAWFORD NICHOLAS G. , ZALDÍVAR‐RAE JAIME , HAGEN CRIS , SCHABLE AMANDA , ROSENBLUM ERICA BREE , GRAVES JEFF A. , REEDER TOD W. , RITCHIE MICHAEL G. , GLENN TRAVIS C.
Published: August 2007

We describe polymerase chain reaction primers and amplification conditions for 13 microsatellite DNA loci isolated from two bisexual species of whiptail lizards Aspidoscelis costata huico and Aspidoscelis inornata. Primers were tested on either 16 or 48 individuals of A. c. huico and/or 26 individuals of A. inornata. Ten of the 13 primers were also tested against a panel of 31 additional whiptail taxa. We detected three to nine alleles per locus in A. c. huico and four to 19 alleles per locus in A. inornata, with observed heterozygosity ranging from 0.60 to 0.87 and from 0.15 to 1.00, respectively. These primers will be an important resource for surveys of genetic variation in these lizards.
Isolation and characterization of microsatellite loci in Aspergillus sydowii, a pathogen of Caribbean sea fan corals
Authors: RYPIEN KRYSTAL L. , ANDRAS JASON P.
Published: August 2007

Here we report on nine microsatellite loci designed for Aspergillus sydowii, a widely distributed soil saprobe that is also the pathogenic agent of aspergillosis in Caribbean sea fan corals. Primers were tested on 20 A. sydowii isolates from the Caribbean, 17 from diseased sea fans and three from environmental sources. All loci were polymorphic and exhibited varying degrees of allelic diversity (three to nine alleles). Gene diversity (expected heterozygosity) ranged from 0.353 to 0.821. These primers will enable future research into the epidemiology of A. sydowii as an emergent infectious disease.
PERMANENT GENETIC RESOURCES: Isolation and characterization of polymorphic trinucleotide and dinucleotide microsatellite loci for the ice goby, Leucopsarison petersii
Authors: KOKITA TOMOYUKI , TAKAHASHI SAYAKA
Published: August 2007

Eleven microsatellite markers were isolated and characterized for the ice goby, Leucopsarion petersii, from genomic libraries enriched for (ATG)9 and (CA)16. Twenty individuals from a single population were used to screen polymorphism in these loci. The number of alleles per locus and observed heterozygosity ranged from four to 22 and from 0.35 to 1.00, respectively. All loci did not significantly deviated from Hardy–Weinberg equilibrium, and there was no evidence of linkage disequilibrium between all loci‐pairs. These loci showed Mendelian inheritance in a full‐sib family. The high level of polymorphism of these loci will be useful for studies of population genetics.
PERMANENT GENETIC RESOURCES: Development of polymorphic microsatellite loci for the endangered Topeka shiner, Notropis topeka
Authors: ANDERSON CYNTHIA M. , SARVER SHANE K.
Published: August 2007

We have developed a set of eight polymorphic microsatellite markers for the endangered Topeka shiner, Notropis topeka. Allelic diversity at each of these loci was assessed in a single isolated population from eastern South Dakota, USA. The allelic diversity ranged from four to 15 alleles. These are the first microsatellite markers to be reported for this species. These markers are being used in a more thorough study of the population structure throughout the remaining range of this species.
PERMANENT GENETIC RESOURCES: Development and characterization of 14 polymorphic microsatellite loci in the endangered tree Euptelea pleiospermum (Eupteleaceae)
Authors: ZHANG J. , YAO X. , WEI X. , CHEN L. , JIANG M.
Published: August 2007

Fourteen polymorphic microsatellite loci were developed and characterized for the endangered and tertiary relict tree, Euptelea pleiospermum. A genomic DNA enrichment protocol was used to isolate microsatellite loci and polymorphism was explored using 32 individuals from one natural population. The observed number of alleles ranged from two to nine. The ranges of observed and expected heterozygosities were 0.25–1.00 and 0.22–0.85, respectively. These microsatellite markers provide powerful tools for the ongoing conservation genetic studies of E. pleiospermum.
PERMANENT GENETIC RESOURCES: Isolation and characterization of 10 tetranucleotide microsatellite loci in an enigmatic East African bird, the spot‐throat (Modulatrix stictigula)
Authors: SELLAS ANNA B. , FELDHEIM KEVIN A. , BOWIE RAURI C. K.
Published: August 2007

We describe the isolation of 10 tetranucleotide microsatellites from the spot‐throat using an enrichment protocol. All loci were highly variable with the number of alleles ranging from six to 20 and observed heterozygosity ranging from 0.410 to 0.940. Although all loci were in Hardy–Weinberg equilibrium, locus Mst95 showed significant homozygote excess in both surveyed populations, possibly a consequence of the presence of null alleles at this locus. These loci will be used to determine the extent to which spot‐throat populations are isolated in order to help set conservation priorities for this ancient African lineage.
Caenorhabditis elegans integrates food and reproductive signals in lifespan determination
Authors: Crawford Douglas , Libina Nataliya , Kenyon Cynthia
Published: August 2007

Dietary restriction extends lifespan and inhibits reproduction in many species. In Caenorhabditis elegans, inhibiting reproduction by germline removal extends lifespan. Therefore, we asked whether the effect of dietary restriction on lifespan might proceed via changes in the activity of the germline. We found that dietary restriction could increase the lifespan of animals lacking the entire reproductive system. Thus, dietary restriction can extend lifespan independently of any reproductive input. However, dietary restriction produced little or no increase in the long lifespan of animals that lack germ cells. Thus, germline removal and dietary restriction may potentially activate lifespan‐extending pathways that ultimately converge on the same downstream longevity mechanisms. In well‐fed animals, the somatic reproductive tissues are generally completely required for germline removal to extend lifespan. We found that this was not the case in animals subjected to dietary restriction. In addition, in these animals, loss of the germline could either further lengthen lifespan or shorten lifespan, depending on the genetic background. Thus, nutrient levels play an important role in determining how the reproductive system influences longevity.
MBNQA criteria in education: assigning weights from a Malaysian perspective and proposition for an alternative evaluation scheme
Authors: Islam Rafikul
Published: August 2007

In order to improve quality and productivity among American companies, the Malcolm Baldrige National Quality Award (MBNQA) was launched by the National Institute of Standards and Technology (NIST) under the US Department of Commerce in 1987. Over the years, the award has proved to be effective in improving companies' market share, customer satisfaction, employee morale, and also profitability. MBNQA has been a ‘role model’ in developing a national quality award for many other countries in the world. Furthermore, for organizational self‐assessment, the criteria framework of MBNQA has been in use throughout the world. Presently, the award is offered in three categories: Business, Education, and Health care. The present paper is concerned with MBNQA in Education. NIST has developed a comprehensive set of criteria to be fulfilled in order to be eligible to win the award. However, in the existing literature, it is not clear how the weights are assigned to the criteria and subcriteria. The present paper uses the analytic hierarchy process (AHP) to reassign criteria weights from a Malaysian perspective. Furthermore, the paper points out the fallacy of the present evaluation scheme and proposes an alternative one based upon the absolute measurement procedure of AHP. The modified scheme is expected to enhance the fairness of the evaluation of the award aspirants. The paper also shares the experiences gathered in data collection using AHP.
LUSTRE COLOUR AND SHINE FROM THE OLLERIES XIQUES WORKSHOP IN PATERNA (SPAIN), 13TH CENTURY AD: NANOSTRUCTURE, CHEMICAL COMPOSITION AND ANNEALING CONDITIONS*
Authors: ROQUÉ J. , MOLERA J. , PÉREZ‐ARANTEGUI J. , CALABUIG C. , PORTILLO J. , VENDRELL‐SAZ M.
Published: August 2007

Lustre is a medieval ceramic decoration, corresponding to a nanostructured thin layer formed by metallic copper and silver nanocrystals embedded in a glass matrix, which required deep knowledge on the part of the artisans with regard to the raw materials used and the kiln conditions. Their empirical knowledge led to the achievement of colourful lustre decorations ranging from reddish to yellowish or even greenish, some of them with a metallic shine with an associated purplish iridescence. Lustre ceramics dating from the 13th century from the Olleries Xiques workshop in Paterna (Spain) have been studied, linking their chemical composition and nanostructure with their colours and shine. Two kinds of nanostructures are found, yellowish lustre decoration constituted by a silver metal–glass nanocomposite, and reddish lustre decoration constituted by metallic copper nanocrystals and copper oxide nanocrystals; in some cases, metallic copper nanocrystals covered with an oxidized shell of CuO and partly Cu2O have been found. However, even with significant amounts of copper oxide, the lustre still exhibits a copper metal‐like shine. The bluish iridescence observed at a specular angle in the lustre could not be explained completely by means of the chemical composition, and metallic silver nanoparticle light scattering is proposed as a possible explanation.
‘DE CAERIMONIAE’ TECHNOLOGICAL CHOICES IN COPPER‐SMELTING FURNACE DESIGN AT EARLY BRONZE AGE CHRYSOKAMINO, CRETE*
Authors: PRYCE T. O. , BASSIAKOS Y. , CATAPOTIS M. , DOONAN R. C.
Published: August 2007

The excavation of a number of Early Bronze Age sites in the Aegean has recovered perforated ceramic fragments. Archaeometallurgical analysis of slag adhering to these fragments indicates that they are the remains of copper‐smelting furnaces. Despite compelling analytical data supporting this identification, no attempt has been made, thus far, to establish how these unusual furnaces may have operated. The use of perforations is poorly understood and can be considered a counter‐intuitive solution for the reduction of oxidic copper ores. The experiments reported here explore the possible technological choices made by the ancient metalworkers of Chrysokamino to ensure the effective reduction of copper minerals. Temperature data and slag samples were obtained to ascertain the technical performance of the furnace structure with, and without, perforations. Possible reasons are given for the use of a perforated design, and the implications of such technological choices are considered.
FTIR AND SOLID‐STATE13C CP/MAS NMR SPECTROSCOPY OF CHARRED AND NON‐CHARRED SOLID ORGANIC RESIDUES PRESERVED IN ROMAN IRON AGE VESSELS FROM THE NETHERLANDS*
Authors: OUDEMANS T. F. M. , BOON J. J. , BOTTO R. E.
Published: August 2007

In this study, solid‐state13C magnetic resonance spectroscopy using cross‐polarization combined with high‐powered proton decoupling and magic‐angle sample spinning and Fourier transform infrared spectroscopy using a diamond anvil cell, are employed to give information about the organic functional groups present in charred and non‐charred solid organic residues and to give an insight into the degree of condensation of the chars. Residues were preserved in ceramic vessels recovered from the indigenous settlement of Uitgeest–Groot Dorregeest, dating back to the Roman period. In addition, the application of these solid‐state techniques is used for verification of earlier results obtained in analytical pyrolysis studies and to clarify the relationship between the already thermally degraded charred residues and the controlled heating fragmentation taking place during analytical pyrolysis and direct temperature‐resolved mass spectrometry.
A TECHNOLOGICAL EXAMINATION OF NINTH–TENTH CENTURY AD ABBASID BLUE‐AND‐WHITE WARE FROM IRAQ, AND ITS COMPARISON WITH EIGHTH CENTURY AD CHINESE BLUE‐AND‐WHITE SANCAI WARE*
Authors: WOOD N. , TITE M. S. , DOHERTY C. , GILMORE B.
Published: August 2007

Eight sherds of ninth–tenth century ad Abbaesid blue‐and‐white glazed earthenware, excavated in 1931 at Hira in western Iraq, were analysed using, variously, quantitative wavelength‐dispersive spectrometry (WDS) and energy‐dispersive spectrometry (EDS) in association with scanning electron microscopes (SEM), and semi‐quantitative X‐ray fluorescence spectrometry (XRF). In order to compare the compositions of the cobalt pigments used, the glazes of seven complete vessels of eighth century ad Chinese Tang blue‐and‐white sancai were also analysed semi‐quantitatively using XRF. The Abbasid wares were shown to have used traditional Mesopotamian alkali–lime glazes applied to calcareous clay bodies. Half the glazes examined were opacified with tin oxide. Three types of blue decoration (i.e., raised; spreading; and flat, non‐spreading) were produced using a variety of formulations, including a mixture of cobalt pigment with lead oxide. The sources of the ores used for the cobalt pigments have not been identified. However, the analytical data showed that the cobalt ore used for the Abbasid blue‐and‐white ware could be distinguished from that used for the Tang blue‐and‐white sancai by its higher iron content and by the presence of a significant amount of zinc. The use of cobalt‐blue decoration on the ninth–tenth century ad Abbasid ware was anticipated in China by eighth century ad Tang blue‐and‐white sancai wares. However, whether its introduction by the Abbasid potters should be seen as an independent invention that followed the introduction of tin‐opacified glazes in Iraq, or whether it was influenced in some way by Chinese originals, is still unresolved.
THE ANALYSIS OF SEA TURTLE AND BOVID KERATIN ARTEFACTS USING DRIFT SPECTROSCOPY AND DISCRIMINANT ANALYSIS*
Authors: ESPINOZA E. O. , BAKER B. W. , BERRY C. A.
Published: August 2007

We investigated the utility of diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) for the analysis and identification of sea turtle (Family Cheloniidae) and bovid (Family Bovidae) keratins, commonly used to manufacture historic artefacts. Spectral libraries are helpful in determining the class of the material (i.e., keratin versus plastics), but do not allow for inferences about the species source of keratin. Mathematical post‐processing of the spectra employing discriminant analysis provided a useful statistical tool to differentiate tortoiseshell from bovid horn keratin. All keratin standards used in this study (n = 35 Bovidae; n = 24 Cheloniidae) were correctly classified with the discriminant analysis. A resulting performance index of 95.7% shows that DRIFTS, combined with discriminant analysis, is a powerful quantitative technique for distinguishing sea turtle and bovid keratins commonly encountered in museum collections and the modern wildlife trade.
CALCAREOUS MICROFOSSILS IN BRONZE AGE AEGEAN CERAMICS: ILLUMINATING TECHNOLOGY AND PROVENANCE*
Authors: QUINN P. S. , DAY P. M.
Published: August 2007

The calcareous skeletal remains of various microscopic organisms such as foraminifera and ostracods are a striking feature of thin sections of many archaeological ceramics from the Aegean Bronze Age. While the presence of these calcareous microfossils in pottery has been noted for some time, attempts to utilize them to further the aims of ceramic compositional analysis have been few in number. In the following paper, we take a first detailed look at the occurrence and utility of calcareous microfossils in archaeological ceramics. By presenting selected case studies from the Bronze Age of Crete, we demonstrate the potential of calcareous microfossils, especially the extremely small ‘nannofossils’ and the highly contextual geological information that they contain, in terms of the characterization and grouping of ceramics, the determination of their provenance and the reconstruction of ancient technology.
Meeting the Need for Personal Care among the Elderly: Does Medicaid Home Care Spending Matter?
Authors: Kemper Peter , Weaver France , Short Pamela Farley , Shea Dennis , Kang Hyojin
Published: August 2007

Objective. To determine whether Medicaid home care spending reduces the proportion of the disabled elderly population who do not get help with personal care.

Data Sources. Data on Medicaid home care spending per poor elderly person in each state is merged with data from the Medicare Current Beneficiary Survey for 1992, 1996, and 2000. The sample (n=6,067) includes elderly persons living in the community who have at least one limitation in activities of daily living (ADLs).

Study Design. Using a repeated cross‐section analysis, the probability of not getting help with an ADL is estimated as a function of Medicaid home care spending, individual income, interactions between income and spending, and a set of individual characteristics. Because Medicaid home care spending is targeted at the low‐income population, it is not expected to affect the population with higher incomes. We exploit this difference by using higher‐income groups as comparison groups to assess whether unobserved state characteristics bias the estimates.

Principal Findings. Among the low‐income disabled elderly, the probability of not receiving help with an ADL limitation is about 10 percentage points lower in states in the top quartile of per capita Medicaid home care spending than in other states. No such association is observed in higher‐income groups. These results are robust to a set of sensitivity analyses of the methods.

Conclusion. These findings should reassure state and federal policymakers considering expanding Medicaid home care programs that they do deliver services to low‐income people with long‐term care needs and reduce the percent of those who are not getting help.
Inpatient Hospital Utilization among the Uninsured Near Elderly: Data and Policy Implications for West Virginia
Authors: Spencer Donna L. , Richardson Sally K. , McCormick Melissa Kolb
Published: August 2007

Objective. To inform state policy discussions about the insurance coverage of the near elderly in West Virginia (WV) and the impact of the uninsured near elderly on hospitals in the state.

Data Sources. 2003 West Virginia Uniform Bill (UB) hospital discharge data. The data represent all adult inpatient discharges in the state during the year.

Study Design. We compare the near elderly with other adults and examine differences by insurance status. Key variables include volume of discharges, health insurance coverage, patient characteristics, and charges incurred.

Findings. The near elderly constitute the largest group of nonelderly adult inpatient hospital discharges. They are more likely than younger adults to be admitted for emergency conditions; have comorbidities and complications; have longer hospital stays; and incur higher charges on average. Although the near elderly are least likely to be uninsured, they represent the second largest group of uninsured discharges and incur the most in uninsured charges.

Conclusions. The specific needs of the near elderly warrant consideration in WV's (and other states') ongoing development and evaluation of policies aimed at reducing uncompensated care costs, including programs to expand access to health insurance and primary and mental health care among the uninsured.
Impact of Medicaid Reimbursement on Mental Health Quality Indicators
Authors: Bellows Nicole M. , Halpin Helen A.
Published: August 2007

Objective. To examine the relationship between the use of the Minimum Data Set (MDS) for determining Medicaid reimbursement to nursing facilities and the MDS Quality Indicators examining nursing facility residents' mental health.

Data Sources. The 2004 National MDS facility Quality Indicator reports served as the dependent variables. Explanatory variables were based on the 2004 Online Survey Certification and Reporting system (OSCAR) and an examination of existing reports, a review of the State Medicaid Plans, and State Medicaid personnel.

Study Design. Multilevel regression models were used to account for the hierarchical structure of the data.

Data Collection. MDS and OSCAR data were linked by facility identifiers and subsequently linked with state‐level variables.

Principal Findings. The use of the MDS for determining Medicaid reimbursement was associated with higher (poorer) quality indicator values for all four mental health quality indicators examined. This effect was not found in four comparison quality indicators.

Conclusions. The findings indicate that documentation of mental health symptoms may be influenced by economic incentives. Policy makers should be cautioned from using these measures as the basis for decision making, such as with pay‐for‐performance initiatives.
Assessing Potential Enrollment and Budgetary Effects of SCHIP Premiums: Findings from Arizona and Kentucky
Authors: Kenney Genevieve , Marton James , McFeeters Joshua , Costich Julia
Published: August 2007

Objective. To assess whether new premiums in SCHIP affect rates of disenrollment and reenrollment in SCHIP and whether they have spillover enrollment effects on Medicaid.

Data Source. We used SCHIP administrative enrollment data from Arizona and Kentucky. The enrollment data covered July 2001 to December 2005 in Arizona and November 2001 to August 2004 in Kentucky.

Study Design. We used administrative data from two states, Arizona and Kentucky, which introduced new premiums for certain income categories in their SCHIP programs in 2004 and 2003, respectively. We used multivariate hazard models to study rates of disenrollment and re‐enrollment for the recipients who had been enrolled in the categories of SCHIP in which the new premiums were implemented. Competing hazard models were used to determine if recipients leaving SCHIP following the introduction of the premium were obtaining other public coverage or exiting public insurance entirely at higher rates. We also used time‐series models to measure the effect of premiums on changes in caseloads in premium‐paying SCHIP and other categories of public coverage and we assessed the budgetary implications of imposing premiums.

Principal Findings. In both states, the new premiums increased the rate of disenrollment and decreased the rate of re‐enrollment in premium‐paying SCHIP among the children who were enrolled in those categories before the premiums were implemented. The competing hazard models indicated that almost all of the increased disenrollment is caused by recipients leaving public insurance entirely. The time‐series models indicated that the new premium reduced caseloads in premium‐paying SCHIP, but that it might have increased caseloads for other types of public coverage. The amount of premiums collected net of the costs associated with administering premiums is small in both states. Estimating the full budgetary effects with certainty was not possible given the imprecision of the key time‐series estimates.

Conclusion. These results suggest that the new premium reduced enrollment in the premium‐paying group by 18 percent (over 3,000 children) in Kentucky and by 5 percent (over 1,000 children) in Arizona, with some of these children apparently leaving public coverage altogether. While most children enrolled in these categories did not appear to be directly affected by the imposition of $10–$20 monthly premiums, the premiums may have caused some children to go without health insurance coverage, which in turn could have adverse effects on their access to care. Imposing nominal premiums may reduce state spending, but projected savings appear to be small relative to total state SCHIP spending and resulting increases in enrollment in other public programs and in uninsurance rates could offset those savings.
γ‐Glutamyltransferase and rapid virological response as predictors of successful treatment with experimental or standard peginterferon‐α‐2b in chronic hepatitis C non‐responders
Authors: Bergmann Jilling F. , Vrolijk Jan M. , Van Der Schaar Peter , Vroom Brigitte , Van Hoek Bart , Van Der Sluys Veer Annet , De Vries Richard A. , Verhey Elke , Hansen Bettina E. , Brouwer Johannes T. , Janssen Harry L. A. , Schalm Solko W. , De Knegt Robert J.
Published: August 2007

Background: High‐dose peginterferon‐α (PegIFN‐α) induction and prolongation of therapy may be an option to improve sustained virological response (SVR) rates among hepatitis C virus (HCV) non‐responders, although a higher and a longer dosing of PegIFN‐α may intensify side effects.

Methods: We randomized 53 patients, who previously failed with standard IFN‐α±ribavirin, to a high‐dose induction and an extended regimen with PegIFN‐α‐2b [3.0 μg/kg once weekly (q.w.) 12 weeks→2.0 μg/kg q.w. 12 weeks→1.5 μg/kg q.w. 48 weeks] or a standard regimen (1.5 μg/kg q.w. 48 weeks). All patients received daily weight‐based ribavirin (800–1200 mg/day). The short‐form 36 health survey was used to evaluate health‐related quality of life (HRQL).

Results: Intention‐to‐treat analysis showed no significant difference in SVR rate (44% vs. 37%, P=0.62) and relapse rate (9% vs. 31%, P=0.17) between experimental and standard treatment. Overall, 80% of the [positive predictive value (PPV)] patients with rapid virological response (RVR, HCV‐RNA negativity at week 4) achieved SVR. No significant dose‐related differences in HRQL were seen between both groups. At baseline, genotype 2 or 3 [odds ratio (OR): 7.4, 95% confidence interval (CI): 1.4–33.3, P=0.01] and γ‐glutamyltransferase (GGT) levels <2 × ULN (upper limit of normal) (OR: 6.76, 95% CI: 1.5–31.3, P=0.009) were significantly associated with SVR. Multivariate logistic regression at week 4 showed that only baseline GGT <2 × ULN (OR: 7.3, 95% CI: 1.4–38.5, P=0.01) and RVR (OR: 15.6, 95% CI: 3.2–76.9, P<0.001) were independently predictive for SVR.

Conclusion: Retreatment with PegIFN‐α‐2b and ribavirin for a minimum of 48 weeks should be considered in all patients unresponsive to previous IFN‐based therapies. Baseline GGT values and RVR are highly predictive for retreatment outcome.
Fulminant liver failure secondary to haemorrhagic dengue in an international traveller
Authors: Gasperino James , Yunen Jose , Guh Alice , Tanaka Kathryn E. , Kvetan Vladimir , Doyle Howard
Published: August 2007

Dengue infections are caused by a single‐stranded RNA virus, which has four serotypes (DEN 1–4); mosquitoes of the genus Aedes serve as vectors of transmission. Risk factors for dengue infection are related to both the host and virus. Age, gender, immune status, and genetic background of the host all contribute to the severity of dengue infection. Recently, international travel to endemic areas has also been identified as a major risk factor for both primary and secondary dengue infection. Dengue remains a diagnostic challenge, given its protean nature, ranging from mild febrile illness to profound shock. The most severe manifestation of dengue infection is dengue shock syndrome, which has an estimated mortality rate close to 50%. Dengue shock syndrome typically presents with increased anion gap metabolic acidosis, disseminated intravascular coagulation, severe hypotension, and jaundice. Liver involvement appears to occur more frequently when infections involve DEN‐3 and DEN‐4 serotypes. While hepatocellular damage has been reported previously in dengue infection, acute liver failure is an extremely rare occurrence in adults. We report a patient with dengue shock syndrome who presented with acute liver failure and hepatic encephalopathy after recent travel to an endemic area.
Personal Digital Assistant‐based, Internet‐enabled Remote Communication System for a Wearable Pneumatic Biventricular Assist Device
Authors: Nam Kyoung Won , Lee Jung Joo , Hwang Chang Mo , Choi Seong Wook , Son Ho Sung , Sun Kyung
Published: August 2007

Abstract:  Currently, personal mobile communication devices have become quite common, and the applications of such devices have expanded quickly. Remote communication systems might be employed for the telemonitoring of patients or the operating status of their medical devices. In this article, we describe the development of a mobile‐based artificial heart telemanagement system for use in a wearable extracorporeal pneumatic biventricular assist device, which is capable of telemonitoring and telecontrolling the operating status of the ventricular assist device from any site. The system developed herein utilized small mobile phones for the client device and adopted a standard transmission control protocol/Internet protocol communication protocol for the purposes of telecommunication. The results of in vitro and animal experiments showed that the telemanagement system developed herein operated in accordance with the desired parameters.
Combined Impella and Intra‐aortic Balloon Pump Support to Improve Both Ventricular Unloading and Coronary Blood Flow for Myocardial Recovery: An Experimental Study
Authors: Sauren Loes D. C. , Accord Ryan E. , Hamzeh Khaled , De Jong Monique , Van Der Nagel Theo , Van Der Veen Frederik H. , Maessen Jos G.
Published: August 2007

Abstract:  Some patients in need of hemodynamic support do not respond to intra‐aortic balloon pump (IABP) therapy. Hemodynamic stability can then be obtained by a more potent cardiac assist device, like the Impella catheter pump. Whether additional IABP support additional to Impella support can provide more optimal hemodynamic myocardial conditions is examined in this study. Seven sheep were implemented with IABP and Impella. An acute myocardial infarction was induced. Hemodynamic performance was assessed during baseline, during Impella support and IABP support individually, and during the combined Impella plus IABP support. The Impella support provided a reduction of afterload with 30% and an increase of coronary artery flow with 47%. The IABP increased coronary artery flow (13%), carotid artery flow (16%), and aortic ascending blood pressure (6%); a similar (but stronger) effect was provided when using the IABP support additional to Impella support and, respectively, increases of 33, 21, and 19% were established. The oxygen demand–supply ratio decreased by 25% due to the extra use of the IABP. A combination of IABP and Impella provides the most optimal hemodynamic myocardial conditions compared to either stand‐alone support.
Assessment of Endothelial Function in Alzheimer's Disease: Is Alzheimer's Disease a Vascular Disease?
Authors: Dede Didem Sener , Yavuz Bunyamin , Yavuz Burcu Balam , Cankurtaran Mustafa , Halil Meltem , Ulger Zekeriya , Cankurtaran Eylem Sahin , Aytemir Kudret , Kabakci Giray , Ariogul Servet
Published: August 2007

OBJECTIVES: To compare endothelial function of people with Alzheimer's disease (AD) with that of people without.

DESIGN: Case‐control study.

SETTING: Geriatric medicine outpatient clinic of a university hospital.

PARTICIPANTS: Twenty‐five patients with AD who were free of vascular risk factors and 24 healthy elderly controls were enrolled. Exclusion criteria were diabetes mellitus, hypertension, dyslipidemia, evident stroke, smoking, documented coronary artery disease, history of myocardial infarction, heart failure, acute or chronic infection, malignancy, peripheral artery disease, renal disease, rheumatologic diseases, alcohol abuse, and certain drugs that may affect endothelial function. Both groups underwent comprehensive geriatric assessment and neuropsychiatric assessment.

MEASUREMENTS: Endothelial function was evaluated according to flow‐mediated dilation (FMD) from the brachial artery.

RESULTS: Mean age ± standard deviation was 78 ± 5.9 in the group with AD (11 female and 14 male) and 72.1 ± 5.8 in the control group (9 female and 11 male). Multiple linear regression analysis revealed that FMD was significantly lower in patients with AD (median 3.45, range 0–7) than controls (median 8.41, range 1–14) (P < .001), independent of age. It was also found that FMD values were inversely correlated with the stage of the disease as determined according to the Clinical Dementia Rating scale (r=−0.603, P < .001).

CONCLUSION: Endothelial function is impaired in patients with AD. Endothelial function was worse in patients with severe AD. These findings provide evidence that vascular factors have a role in the pathogenesis of AD.
Nonmalignant Chronic Pain Evaluation in the Turkish Population as Measured by the McGill Pain Questionnaire
Authors: Oksuz Ergun , Mutlu Esra Tuba , Malhan Simten
Published: August 2007

Background:  The purpose of this study was to explore how Turkish nonmalignant pain patients described their pain and how the language of pain used by Turkish patients compares to the language found in common pain assessment tools.

Objective:  Pain is influenced by a combination of ethnic, cultural, psychological, and social variants. In the Turkish language, six words are central to pain‐like experiences: ağrı (pain), acı (suffering), sızı (aching), sancı (colic), ıstırap (agony), and dert (torture). We assessed discriminant characteristics of the Turkish translation of the McGill Pain Questionnaire (MPQ).

Methods:  Chronic clinical nonmalignant pain patients (n = 319, 35.7% males, 64.3% females) were questioned with the Turkish translation of the MPQ. Pain symptoms were categorized as headache (33.5%), musculoskeletal pain (33.2%), visceral pain (18.8%), and low back pain (14.5%).

Results:  The visceral pain group had the highest mean value in the evaluative subscale (2.6 ± 1.9). Descriptions used for sensory subscale included throbbing, sharp, aching, and tingling, while affective subscale words included tiring, suffocating, sickening, cruel, and wretched. In all pain groups, frequently chosen words for the miscellaneous subscale were nagging and penetrating.

Conclusion:  Pain descriptors were identified for each type of pain. This is, to our knowledge, the first assessment of the Turkish translation of the MPQ in nonmalignant pain patients.
Prospective, Randomized, Single‐Blind, Sham Treatment‐Controlled Study of the Safety and Efficacy of an Electromagnetic Field Device for the Treatment of Chronic Low Back Pain: A Pilot Study
Authors: Harden R. N. , Remble T. A. , Houle T. T. , Long J. F. , Markov M. S. , Gallizzi M. A.
Published: August 2007

Objectives:  To evaluate the efficacy and safety of therapeutic electromagnetic fields (TEMF) on chronic low back pain. Secondary objectives included the investigation of the effects of TEMF on psychometric measures.

Setting:  Pain Research center in an Urban Academic Rehabilitation Facility.

Design:  Prospective, randomized, single‐blind, placebo (sham) treatment‐controlled design in which participants were evaluated over a 6‐week period. A total of 40 subjects were randomly assigned: 20 subjects to 15 milliTESLA (mT) treatment using a prototype electromagnetic field device and 20 to sham treatment.

Interventions:  After a 2‐week baseline period, eligible individuals were randomized to one of the treatment groups (sham or 15 mT) for six 30‐minute treatments over 2 weeks, then a 2‐week follow‐up period.

Outcome Measures:  The primary outcome measure was the self‐report of pain severity using a 100 mm visual analog scale collected using a twice daily McGill Pain Questionnaire—Short Form. Several secondary measures were assessed.

Results:  Both groups (15 mT and sham) improved over time (P < 0.05). Although groups were similar during the treatment period, treated subjects (TEMF of 15 mT) improved significantly over sham treatment during the 2‐week follow‐up period (20.5% reduction in pain; F1,34 = 10.62, P = 0.003). There were no reported serious adverse events.

Conclusions:  This study demonstrates that TEMF may be an effective and safe modality for the treatment of chronic low back pain disorders. More studies are needed to test this hypothesis.
The Home Purchase Mortgage Preferences of Low‐ and Moderate‐Income Households
Authors: LaCour‐Little Michael
Published: August 2007

Housing policy in the United States has long supported homeownership, yet variation persists across income groups. This article employs recent mortgage origination data to focus on the revealed preferences of low‐ and moderate‐income (LMI) households in home purchase mortgage choice. I identify the factors associated with conventional conforming, FHA, nonprime and specially targeted programs. Empirical results show that individual credit characteristics and financial factors, including pricing, generally drive product choice, with some variation evident when loans are originated through brokers. Results also indicate that targeted conventional programs effectively compete with government‐insured products in the LMI segment.
Increasing Gap Junction Coupling Reduces Transmural Dispersion of Repolarization and Prevents Torsade de Pointes in Rabbit LQT3 Model
Authors: QUAN XIAO‐QING , BAI RONG , LIU NIAN , CHEN BO‐DI , ZHANG CUN‐TAI
Published: August 2007

Introduction:
Increased transmural dispersion of repolarization (TDR) contributes importantly to the development of torsades de pointes (TdP) in long QT syndrome (LQTS). Intercellular electrical coupling via gap junctions plays an important role in maintaining TDR in both normal and diseased hearts. This study examined the effects of antiarrhythmic peptide AAP10, a gap junction enhancer, on TDR and induction of TdP in a rabbit LQT3 model.

Methods and Results:
An arterially perfused rabbit left ventricular preparation and sea anemone toxin II (ATX‐II, 20 nM) were used to establish a LQT3 model. Transmural ECG as well as action potentials from both endocardium and epicardium were simultaneously recorded. Changes in nonphosphorylated connexin43 (Cx43) were measured by immunoblotting. Compared with the control group, the QT interval, TDR, early afterdepolariztion (EAD), R‐on‐T extrasystole, and TdP increased sharply with augmented nonphosphorylated Cx43 in the LQT3 group (P < 0.001 for both). Interestingly, compared with the LQT3 group, 500 nM AAP10 reduced QT interval, TDR (P < 0.001 for both), and prevented EAD, R‐on‐T extrasystole, and TdP (P = 0.003, P = 0.001, P = 0.02) with a parallel decrease in nonphosphorylated Cx43 in the presence of ATX‐II (P < 0.001).

Conclusion:
Gap junction enhancer AAP10 is capable of abbreviating the QT interval, reducing TDR, and suppressing TdP in a rabbit LQT3 model probably via its effect by preventing dephosphorylation of Cx43. These data suggest that increasing intercellular coupling may reduce TDR and, therefore, prevent TdP in LQTS.
Validation of the Frequency Spectra Obtained from the Noncontact Unipolar Electrograms During Atrial Fibrillation
Authors: LIN YENN‐JIANG , HIGA SATOSHI , KAO TSAIR , TSO HAN‐WEN , TAI CHING‐TAI , CHANG SHIH‐LIN , LO LI‐WEI , WONGCHAROEN WANWARANG , CHEN SHIH‐ANN
Published: August 2007

Introduction:
Noncontact mapping (NCM) can record virtual unipolar electrograms (Egs) from multiple sites simultaneously; therefore, it has the potential to perform simultaneous frequency mapping during atrial fibrillation (AF). The aim of this study was to validate the frequency spectra of the noncontact unipolar Egs in both atria.

Methods:
This study enrolled 12 patients (age = 61 ± 16 years) with paroxysmal or persistent AF who underwent catheter ablation guided by NCM. Noncontact and contact unipolar Egs were recorded simultaneously. The cross‐correlation of the Eg morphology, activation time difference of the time‐domain signals, and resultant frequency spectra were compared via dominant frequency (DF) and magnitude‐squared coherence (MSC).

Results:
A total of 159 sites were analyzed during AF. The variables that independently predicted a higher correlation between the contact and noncontact electrogram morphology were a smaller activation timing difference P < 0.01), smaller distance of the mapping sites to the array center (P = 0.01), and higher atrial voltage (P = 0.03). However, the average MSC of the frequency band within the physiologic range of AF (2 to 15 Hz) was only affected by the activation timing difference (P = 0.002). The DF value between the contact and noncontact unipolar signals correlated well with each other throughout the right atria and left atria in 94% of the mapping sites (r = 0.87, P < 0.001).

Conclusion:
The accuracy of the noncontact unipolar Eg morphology decreased when the mapping sites harbored a smaller atrial voltage and longer distance to the array center. The DF difference between the contact and noncontact unipolar Eg was not affected by the distance to the array center.
Focal Arrhythmia Confined Within the Coronary Sinus and Maintaining Atrial Fibrillation
Authors: KNECHT SÉBASTIEN , O'NEILL MARK D. , MATSUO SEIICHIRO , LIM KANG‐TENG , ARANTES LEONARDO , DERVAL NICOLAS , KLEIN GEORGES J. , HOCINI MÉLÈZE , JAÏS PIERRE , CLÉMENTY JACQUES , HAÏSSAGUERRE MICHEL
Published: August 2007

Introduction: The coronary sinus (CS) is a complex structure comprising a mesh of circumferential muscular fibers with oblique connections to both atria. We describe further evidence for the clinical importance of CS arrhythmogenicity in maintaining atrial fibrillation (AF) in humans.

Methods: Since January 2004, following a sequential approach, the CS and the inferior left atrium were ablated in 144 patients with symptomatic drug refractory AF. Patients were included for analysis when this step resulted in the electrical dissociation of the CS from both atria with restoration of sinus rhythm, but with continued arrhythmic activity in the CS. The electrophysiologic mechanism of the confined arrhythmia was considered as focal activity (automaticity or triggered activity) by the presence of electrograms spanning less than 75% of the cycle length in the CS.

Results: After restoration of sinus rhythm, four male patients (3% of the patients, three persistent and one permanent AF) were identified in whom arrhythmia continued within the CS. Repetitive activity confined to the disconnected CS was inconsistent in occurrence, as well as in duration (1 sec to 15 min) and cycle length (from 158 to 380 ms). For all four patients, electrogram mapping of the entire CS was compatible with a focal mechanism. In two patients, bursts alternating with slow dissociated activity suggested automaticity. In one patient, local activity consistently coupled to the previous sinus beat favored triggered activity.

Conclusions: This study provides evidence that the CS may be a potential source of focal rapid activity maintaining AF.
Autonomic and Pharmacological Responses of Idiopathic Ventricular Tachycardia Arising from the Left Ventricular Outflow Tract
Authors: YAMAWAKE NORIYOSHI , NISHIZAKI MITSUHIRO , HAYASHI TATSUYA , NIKI SAORI , MAEDA SHINGO , TANAKA YASUAKI , FUJII HIROYUKI , ASHIKAGA TAKASHI , SAKURADA HARUMIZU , HIRAOKA MASAYASU
Published: August 2007

Background: It is well recognized that the mechanism of idiopathic ventricular tachycardia (VT) arising from the right ventricular outflow tract (RVOT) is mostly due to cyclic AMP‐mediated triggered activity. The mechanism of VT arising from the left ventricular outflow tract (LVOT) has not been well clarified whether it is the same as VT of RVOT.

Methods: We studied autonomic modulations and pharmacological interventions on VT/premature ventricular contractions (PVCs) from LVOT to explore its possible mechanism in six patients (age: 49 ± 14, three males). None of them had structural heart diseases.

Results: Isoproterenol application easily induced VT and/or PVCs from LVOT. Valsalva maneuvers suppressed isoproterenol‐induced VT in two and PVCs in two, and carotid sinus massage (CSM) suppressed PVCs in one patient. Adenosine triphosphate inhibited both VT and PVCs in all six patients. Propranolol, lidocaine, and procainamide eliminated VT/PVCs in four, three, and four patients, respectively. Verapamil terminated VT in one and PVCs in another one patient, but aggravated PVCs to VT in one patient.

Conclusion: The results suggest that the mechanism of VT from LVOT is mostly due to cAMP‐mediated triggered activity as similar to that in VT from RVOT.