bluuebunny/crossref_metadata_2025 huggingface dataset:
Light-dark oscillations in the lung transcriptome: implications for lung homeostasis, repair, metabolism, disease, and drug action
Authors: Sukumaran Siddharth , Jusko William J. , DuBois Debra C. , Almon Richard R.
Published: March 2011

Diurnal-nocturnal, or circadian-like, rhythms are 24-h variations in biological processes, evolved for the efficient functioning of living organisms. Such oscillations and their regulation in many peripheral tissues are still unclear. In this study, we used Affymetrix gene chips in a rich time-series experiment involving 54 animals killed at 18 time points within the 24-h cycle to examine light-dark cycle patterns of gene expression in rat lungs. Data mining identified 646 genes (represented by 1,006 probe sets) showing robust oscillations in expression in lung that were parsed into 8 distinct temporal clusters. Surprisingly, more than two-thirds of the probe sets showing cyclic expression peaked during the animal's light/inactive period. Six core clock genes and nine clock-related genes showed rhythmic oscillations in their expression in lung. Many of the genes that peaked during the inactive period included genes related to extracellular matrix, cytoskeleton, and protein processing and trafficking, which appear to be mainly involved in the repair and remodeling of the organ. Genes coding for growth factor ligands and their receptors, which play important roles in maintaining normal lung function, also showed rhythmic expression. In addition, genes involved in the metabolism and transport of endogenous compounds, xenobiotics, and therapeutic drugs, along with genes that are biomarkers or potential therapeutic targets for many lung diseases, also exhibited 24-h cyclic oscillations, suggesting an important role for such rhythms in regulating various aspects of the physiology and pathophysiology of lung.
Vitamin D3 Inhibits Hedgehog Signaling and Proliferation in Murine Basal Cell Carcinomas
Authors: Tang Jean Y. , Xiao Tony Zheng , Oda Yuko , Chang Kris S. , Shpall Elana , Wu Angela , So Po-Lin , Hebert Jennifer , Bikle Daniel , Epstein Ervin H.
Published: March 2011

Constitutive Hedgehog (HH) signaling underlies several human tumors, including basal cell carcinoma (BCC). Recently, Bijlsma and colleagues reported a new biologic function for vitamin D3 in suppressing HH signaling in an in vitro model system. On the basis of that work, we have assessed effects of vitamin D3 on HH signaling and proliferation of murine BCCs in vitro and in vivo. We find that indeed in BCC cells, vitamin D3 blocks both proliferation and HH signaling as assessed by mRNA expression of the HH target gene Gli1. These effects of vitamin D3 on Gli1 expression and on BCC cell proliferation are comparable to the effects of cyclopamine, a known inhibitor of the HH pathway. These results are specific for vitamin D3, because the precursor 7-dehydrocholesterol and the downstream products 25-hydroxy vitamin D3 [25(OH)D] and 1,25-dihydroxy vitamin D3 [1,25(OH)2D] are considerably less effective in reducing either Gli1 mRNA or cellular proliferation. Moreover, these effects seem to be independent of the vitamin D receptor (VDR) because short hairpin RNA knockdown of VDR does not abrogate the anti-HH effects of D3 despite reducing expression of the VDR target gene 24-hydroxylase. Finally, topical vitamin D3 treatment of existing murine BCC tumors significantly decreases Gli1 and Ki67 staining. Thus, topical vitamin D3 acting via its HH inhibiting effect may hold promise as an effective anti-BCC agent. Cancer Prev Res; 4(5); 744–51. ©2011 AACR.
Regulación homeostática del hierro y su papel en el estado normal y anormal de hierro en la lactancia y la infancia
Authors: Lönnerdal Bo , Hernell Olle
Published: March 2011

El hierro es importante en el desarrollo neural y la función cognitiva y, en conjunto, previene la deficiencia de hierro; y la anemia por carencia de hierro sigue siendo una prioridad fundamental. Los lactantes a término alimentados con leche materna y los lactantes alimentados con leche enriquecida con hierro presentan habitualmente un estado de hierro satisfactorio durante los seis primeros meses de vida; No obstante, todavía existen ambigüedades en la evaluación del estado de hierro en lactantes y en cómo satisfacer adecuadamente sus necesidades de hierro. Esto resulta particularmente evidente en el caso de los lactantes prematuros, que nacen con depósitos de hierro bajos y para quienes las recomendaciones sobre la provisión de hierro varían considerablemente. En parte, esto puede deberse a la inmadurez de la regulación de la homeostasis del hierro en lactantes pequeños. Mientras que los lactantes de 9 meses edad parecen capaces de regular por disminución la absorción de hierro cuando están repletos de este nutriente, los lactantes de 6 meses carecen de esta capacidad. Aunque el hierro puede administrarse en forma de gotas o de productos enriquecidos con hierro, las formas suministradas pueden ser metabolizadas de manera diferente, y el exceso de hierro en gotas puede causar efectos adversos, posiblemente debido a una capacidad limitada para regular la absorción de hierro por parte de lactantes pequeños. Los efectos adversos se manifiestan mediante un retraso en el crecimiento: en lactantes bien nutridos por disminución en la ganancia de longitud, en poblaciones nutridas deficientemente por una menor ganancia de peso. Se desconoce el mecanismo que subyace al retraso en el crecimiento, pero pueden participar efectos mediados por radicales libres de hierro o una interacción con la absorción y la homeostasis del cinc. En consecuencia, parece que no deben administrarse gotas de hierro a lactantes repletos del mismo.
Carencia de hierro en la infancia: Causas y consecuencias para el desarrollo infantil
Authors: Grantham-McGregor Sally , Baker-Henningham Helen
Published: March 2011

Se comentan brevemente las causas principales de la carencia de hierro (CH), seguido de un examen de los estudios sobre la CH y el desarrollo y comportamiento cognitivos y motores del niño para probar un vínculo causal, clasificando dichos estudios por su diseño. La anemia por carencia de hierro (ACH) se asocia a numerosos inconvenientes psicosociales y económicos que pueden afectar al desarrollo infantil y explicar la relación, frecuentemente demostrada, de la ACH con un desarrollo precario y diferencias en el comportamiento. Existen datos de alteraciones en la función cerebral en lactantes con ACH. Varios ensayos terapéuticos carecen de potencia estadística, debido a muestras reducidas, incluyendo a niños sin CH en el muestreo, o a las escasas o nulas diferencias del tratamiento con hierro sobre el estado del mismo entre el grupo placebo y el grupo tratado. En niños afectados de ACH menores de 3 años, los ensayos aleatorios indican que el aporte complementario de hierro suele ser beneficioso para el desarrollo motor, si bien el efecto sobre el desarrollo mental no es uniforme. El aporte complementario de hierro produce también un efecto beneficioso sobre la función cognitiva de niños en edad escolar con ACH. Aunque las pruebas a favor de un nivel umbral de CH en el cual es influido el desarrollo del niño son incoherentes, los niños afectados de ACH tienen una probabilidad máxima de beneficiarse del aporte complementario de hierro. Cuando se elaboran programas y políticas es necesario considerar posibles efectos nocivos del aporte complementario de hierro sobre el crecimiento y la morbilidad en niños repletos de este nutriente.
Enalaprilat-Mediated Activation of Kinin B1 Receptors and Vasodilation in the Rat Isolated Perfused Kidney
Authors: Bautista-Pérez Rocio , Arellano Abraham , Franco Martha , Osorio Horacio , Coronel Israel
Published: March 2011

The present study evaluated whether enalaprilat (the active form of enalapril, an angiotensin-converting enzyme inhibitor) activates B1 receptors. We observed that the levels of B1 receptor mRNA and protein expression were upregulated in the kidneys of diabetic rats. Bradykinin (BK)-induced renal vasodilation decreased in isolated perfused kidneys of diabetic rats, but des-Arg9-BK-induced renal vasodilation increased. Enalaprilat also produced vasodilation in the isolated perfused kidneys of control and diabetic rats. The response to des-Arg9-BK or enalaprilat was blocked by Lys-(des-Arg9, Leu8)-BK (a B1 receptor antagonist) and N-nitro-L-arginine methyl ester (an inhibitor of nitric oxide synthase). These results suggest that enalaprilat activates B1 receptors and stimulates the production of nitric oxide in the kidneys of both control and diabetic rats.
Effects of Risperidone on Learning and Memory in Naive and MK-801-Treated Rats
Authors: Celikyurt Ipek Komsuoglu , Akar Furuzan Yildiz , Ulak Guner , Mutlu Oguz , Erden Faruk
Published: March 2011

Background/Aims: The aim of this study was to investigate the effects of an atypical antipsychotic risperidone (RIS; 0.06, 0.125 or 0.25 mg/kg, intraperitoneal, i.p.) on learning and memory processes, both in naive and MK-801-treated (0.15 mg/kg, i.p.) rats. Methods: Modified elevated plus maze (mEPM), passive avoidance (PA) and Morris water maze (MWM) tasks were used. Results: In the mEPM test, RIS (0.125 or 0.25 mg/kg) significantly decreased the transfer latency and reversed MK-801-induced prolongation in the transfer latency of rats on the 2nd day. In the PA test, RIS (0.125 or 0.25 mg/kg) slightly decreased step-through latency (retention latency) but this finding did not reach statistical significance in naive rats. RIS had no effect on MK-801-induced reduction of retention latency. In the MWM test, RIS (0.06, 0.125 or 0.25 mg/kg, i.p.) neither affected the time spent in the escape platform quadrant, nor the distance to the platform in naive rats. It (0.125 mg/kg) tended to increase MK-801-induced reduction of time spent in the escape platform quadrant, but this finding was insignificant. RIS (0.125 mg/kg) significantly shortened MK-801-induced elongation in the distance to the platform. RIS had no effect on the swimming speed of the animals. Conclusion: RIS might be effective in treating cognitive dysfunctions associated with schizophrenia.
Antipyretic and Analgesic Effects of Zaltoprofen for the Treatment of Acute Upper Respiratory Tract Infection: Verification of a Noninferiority Hypothesis Using Loxoprofen Sodium
Authors: Azuma Arata , Kudoh Shoji , Nakashima Mitsuyoshi , Nagatake Tsuyoshi
Published: March 2011

A multicenter, placebo-controlled, double-dummy, randomized, parallel-group, double-blind study was conducted to verify the hypothesis of noninferiority for single-dose administration of zaltoprofen 160 mg, a nonsteroidal anti-inflammatory drug, compared with loxoprofen sodium 60 mg (loxoprofen), in terms of antipyretic and analgesic effects in patients with acute upper respiratory tract infection. The eligible 330 patients were assigned to one of 3 groups: zaltoprofen 160 mg, loxoprofen 60 mg and placebo. The analysis set consisted of 322 patients. Antipyretic effects were assessed by measuring body temperature, and analgesic effects were evaluated using a visual analog scale (VAS) for 4 h under the control of study staff. A detection kit for influenza virus A and B antigens was used to determine the presence of influenza virus infection. Compared with immediately before administration and with the placebo group, significant decreases in body temperature and summary VAS pain scores were noted in both the zaltoprofen and loxoprofen groups at 4 h after drug administration. Based on the degree of decrease in body temperature and the summary VAS pain scores up to 4 h after administration, noninferiority in terms of antipyretic and analgesic effects of zaltoprofen compared with those of loxoprofen was confirmed after single administration. Similar antipyretic and analgesic effects were also confirmed in influenza virus antigen-positive patients (73 patients). No clinical concerns were identified regarding safety. Zaltoprofen and loxoprofen are confirmed to be safe and useful for patients with acute upper respiratory tract infection, including those with influenza infection.
Management of Bullous Pemphigoid with Topical Steroids in the Clinical Practice of a Single Center: Outcome at 6 and 12 Months
Authors: Ingen-Housz-Oro S. , Valeyrie-Allanore L. , Ortonne N. , Roujeau J.C. , Wolkenstein P. , Chosidow O.
Published: March 2011

Background: The efficacy of topical steroids in bullous pemphigoid (BP) was assessed by prospective therapeutic trials. Systemic corticosteroids and immunosuppressant agents are indicated in situations of failure or relapses. Objectives: To report our experience in the management of BP outside therapeutic trials focusing on the outcome of the patients at 6 and 12 months, compliance and follow-up difficulties. Methods: Monocenter retrospective study with collection of clinical, therapeutic and follow-up data after 6 and 12 months. Results: Ninety-six patients, mean age 84 years, 65 females, 54% had neurological impairment. The initial dose of clobetasol propionate was 30 g/day, followed by a progressive decrease. In the first 6 months, 14% were lost to follow-up and 17.7% died; 62% were controlled with topical steroids alone, and 25% had adjunctive systemic treatment. Difficulties of compliance were mentioned in 34.4%, without significant difference between controlled and noncontrolled patients. After 12 months, 23% were lost to follow-up and 27.1% died. The mean duration of the treatment was 11.7 ± 8.4 months. After the stop, 18.9% of patients relapsed within 3 months. Conclusion: We emphasize the frequent recourse to systemic treatments in the first few months, the difficulties of compliance and of follow-up in our day-to-day experience.
Uric Acid Levels Predict Future Development of Chronic Kidney Disease
Authors: Sonoda Hiroo , Takase Hiroyuki , Dohi Yasuaki , Kimura Genjiro
Published: March 2011

Aims: Increased uric acid levels are associated with kidney dysfunction. We tested the hypothesis that uric acid level predicts future development of chronic kidney disease (CKD) in the general population. Methods: For this study, we enrolled 7,078 consecutive subjects with normal estimated glomerular filtration rates (eGFR; ≧60 ml/min/1.73 m2) who visited our hospital for a yearly health checkup (age: 52.8 ± 10.7 years; female: 35.8%). Subjects underwent a routine physical examination and laboratory assessment of cardiovascular disease risk factors at enrollment, and were followed up for 1,694 days (median) with the endpoint being the development of CKD (eGFR <60 ml/min/1.73 m2). The impact of uric acid and other cardiovascular risk factors at baseline on the future development of CKD were assessed. Results: During the follow-up period, 417 male (9.2%) and 151 female subjects (6.0%) developed CKD. Univariate logistic regression analysis revealed a significant association between the onset of CKD and age, male gender, body mass index, blood pressure, fasting plasma glucose, dyslipidemia and uric acid. Multiple logistic regression analysis revealed that new-onset CKD was independently correlated with the baseline uric acid level after adjustment for possible factors. Subanalysis showed similar results in subjects with normal uric acid levels (male: ≤7.0 mg/dl; female: ≤6.0 mg/dl; n = 6,223). Conclusion: Uric acid is an independent predictor of future development of CKD. Whether preventing an increase in uric acid levels reduces the incidence of CKD must be clarified by prospective follow-up studies.
Efficacy and safety of a new generation von Willebrand factor/factor VIII concentrate (Wilate®) in the management of perioperative haemostasis in von Willebrand disease patients undergoing surgery
Authors: Depka-Prondzinski Mario von , Windyga Jerzy ,   the European Wilate® Study Group
Published: March 2011

The aim of this study was to assess the efficacy of Wilate®, a new generation, plasma-derived, high-purity, double virus-inactivated von Willebrand factor (VWF) and factor VIII (FVIII) concentrate (ratio close to physiological 1:1) in the perioperative management of haemostasis in von Willebrand disease (VWD). Data for VWD patients who received Wilate® for perioperative management were obtained from four European, prospective, open-label, non-controlled, non-randomised, multicentre phase II or III clinical trials. A total of 57 surgical procedures were performed (major: n = 27; minor n = 30) in 32 patients. The majority of patients (n = 19, 59.4%) had type 3 VWD, 9 (28.1%) had type 2 VWD and four (12.5%) had type 1 VWD. During major surgery, median daily FVIII dose and mean number of infusions were 25 IU•kg-1 FVIII (VWF:RCô23 IU•kg-1) and 11.0, respectively. Corresponding values for minor surgery were 35 IU•kg-1 (VWF:RCo ~32 IU•kg-1) and 1.5. The efficacy of Wilate® was rated by the investigator as excellent or good in 51 of 53 (96%) procedures. Tolerability was rated as very good or good in 100% of major surgeries (27 of 27) and minor surgeries (29 of 29). Wilate® is an effective and well-tolerated VWF/FVIII replacement therapy in the perioperative management of haemostasis in patients with VWD. It can be administered at a similar FVIII dose, but at a lower VWF dose, as compared to older generation products. Clinical benefits were shown in a population with a high proportion of type 3 VWD patients.
Intravital imaging of phagocyte recruitment
Authors: Kemmerich Klaus , Pyta Juergen , Weber Christian , Megens Remco , Soehnlein Oliver
Published: March 2011

Extravasation of neutrophils and monocytes is a hallmark event in acute and chronic inflammation. Owing to recent improvements in optical imaging techniques, the classical leukocyte extravasation cascade has been refined with intermediate steps being added. Further studies have shown tissue specific leukocyte recruitment patterns, thus allowing for more selective targeting. Here we focus on recent advances in intravital imaging of leukocyte recruitment by means of optical imaging techniques and emphasise the translation thereof into tissue-specific recruitment to the lungs, the liver and large arteries.
Disrupting the EMMPRIN (CD147)–Cyclophilin A Interaction Reduces Infarct Size and Preserves Systolic Function After Myocardial Ischemia and Reperfusion
Authors: Seizer Peter , Ochmann Carmen , Schönberger Tanja , Zach Sebastian , Rose Melanie , Borst Oliver , Klingel Karin , Kandolf Reinhard , MacDonald H. Robson , Nowak Romana A. , Engelhardt Stefan , Lang Florian , Gawaz Meinrad , May Andreas E.
Published: March 2011

Objective—

Inflammation and proteolysis crucially contribute to myocardial ischemia and reperfusion injury. The extracellular matrix metalloproteinase inducer EMMPRIN (CD147) and its ligand cyclophilin A (CyPA) may be involved in both processes. The aim of the study was to characterize the role of the CD147 and CyPA interplay in myocardial ischemia/reperfusion (I/R) injury.

Methods and Results—

Immunohistochemistry showed enhanced expression of CD147 and CyPA in myocardial sections from human autopsies of patients who had died from acute myocardial infarction and from mice at 24 hours after I/R. At 24 hours and 7 days after I/R, the infarct size was reduced in CD147
+/−
mice vs CD147
+/+
mice (C57Bl/6), in mice (C57Bl/6) treated with monoclonal antibody anti-CD147 vs control monoclonal antibody, and in CyPA
−/−
mice vs CyPA
+/+
mice (129S6/SvEv), all of which are associated with reduced monocyte and neutrophil recruitment at 24 hours and with a preserved systolic function at 7 days. The combination of CyPA
−/−
mice with anti-CD147 treatment did not yield further protection compared with either inhibition strategy alone. In vitro, treatment with CyPA induced monocyte chemotaxis in a CD147- and phosphatidylinositol 3-kinase–dependent manner and induced monocyte rolling and adhesion to endothelium (human umbilical vein endothelial cells) under flow in a CD147-dependent manner.

Conclusion—

CD147 and its ligand CyPA are inflammatory mediators after myocardial ischemia and reperfusion and represent potential targets to prevent myocardial I/R injury.
Ultrasound-Enhanced Thrombolytic Effect of Tissue Plasminogen Activator–Loaded Echogenic Liposomes in an In Vivo Rabbit Aorta Thrombus Model—Brief Report
Authors: Laing Susan T. , Moody Melanie , Smulevitz Beverly , Kim Hyunggun , Kee Patrick , Huang Shaoling , Holland Christy K. , McPherson David D.
Published: March 2011

Objective—

Ultrasound enhances thrombolysis when combined with a thrombolytic and a contrast agent. This study aimed to evaluate the thrombolytic effect of our tissue plasminogen activator (tPA)–loaded echogenic liposomes (ELIP) in an in vivo clot model, with and without ultrasound treatment.

Methods and Results—

The femoral arteries of New Zealand White rabbits (n=4 per group) were cannulated. The abdominal aortas were denuded, and thrombi were created using a solution of sodium ricinoleate plus thrombin. Rabbits were then randomly selected to receive tPA-loaded ELIP (200 μg of tPA/5 mg of lipid) or empty ELIP with or without pulsed (color) Doppler ultrasound (5.7 MHz) for 2 minutes. Thrombus was imaged and echogenicity analyzed before and after ELIP injection. Blood flow velocities were measured at baseline, after clot formation, and serially after treatment up to 15 minutes. tPA-loaded ELIP highlighted thrombus in the abdominal aorta more effectively than empty ELIP (
P
<0.05). Ultrasound enhanced the thrombolytic effect of tPA-loaded ELIP, resulting in earlier and more complete recanalization rates (
P
<0.001).

Conclusion—

This study demonstrates effective highlighting of clots and thrombolytic effect of tPA-loaded ELIP in an in vivo rabbit aorta clot model. Doppler ultrasound treatment enhances this thrombolytic effect, resulting in earlier and more complete recanalization rates.
Superficial Femoral Artery Plaque, the Ankle-Brachial Index, and Leg Symptoms in Peripheral Arterial Disease
Authors: McDermott Mary M. , Liu Kiang , Carr James , Criqui Michael H. , Tian Lu , Li Debiao , Ferrucci Luigi , Guralnik Jack M. , Kramer Christopher M. , Yuan Chun , Kibbe Melina , Pearce William H. , Berry Jarett , McCarthy Walter , Liao Yihua , Xu Dongxiang , Orozco Jennifer , Carroll Timothy J.
Published: March 2011

Background—

The clinical significance of magnetic resonance–imaged plaque characteristics in the superficial femoral artery (SFA) is not well established. We studied associations of the ankle-brachial index (ABI) and leg symptoms with MRI-measured plaque area and percent lumen area in the SFA in participants with and without lower-extremity peripheral arterial disease (PAD).

Methods and Results—

Four hundred twenty-seven participants (393 with PAD) underwent plaque imaging of the first 30 mm of the SFA. Twelve 2.5-mm cross-sectional images of the SFA were obtained. Outcomes were normalized plaque area, adjusted for artery size (0 to 1 scale, 1=greatest plaque), and lumen area, expressed as a percent of the total artery area. Adjusting for age, sex, race, smoking, statins, cholesterol, and other covariates, lower ABI values were associated with higher normalized mean plaque area (ABI <0.50:0.79; ABI 0.50 to 0.69:0.73; ABI 0.70 to 0.89:0.65; ABI 0.90 to 0.99:0.62; ABI 1.00 to 1.09:0.48; ABI 1.10 to 1.30:0.47 (
P
trend <0.001)) and smaller mean percent lumen area (
P
trend <0.001). Compared with PAD participants with intermittent claudication, asymptomatic PAD participants had lower normalized mean plaque area (0.72 versus 0.65,
P
=0.005) and larger mean percent lumen area (0.30 versus 0.36,
P
=0.01), adjusting for the ABI and other confounders.

Conclusions—

Lower ABI values are associated with greater MRI-measured plaque burden and smaller lumen area in the first 30 mm of the SFA. Compared with PAD participants with claudication, asymptomatic PAD participants have smaller plaque area and larger lumen area in the SFA.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00520312.
Diffusion Tensor MRI Reveals Chronic Alterations in White Matter Despite the Absence of a Visible Ischemic Lesion on Conventional MRI
Authors: Bihel Ebeline , Roussel Simon , Toutain Jérôme , Bernaudin Myriam , Touzani Omar
Published: March 2011

Background and Purpose—

The impact of stroke on white matter is poorly described in preclinical investigations mainly based on rodents with a low white (WM)/gray matter ratio. Using diffusion tensor imaging, we evaluated WM alterations and correlated them with sensorimotor deficits after stroke in the marmoset, a nonhuman primate that displays a WM/gray matter ratio close to that of humans.

Methods—

Marmosets underwent a transient brain ischemia (3-hour). Eight serial MRI examinations were made during ischemia and up to 45 days after reperfusion. The sensorimotor deficits were evaluated weekly over 45 days. To assess WM alterations, the SD of the angle of the first eigenvector projection was calculated in the cortex and in the internal and external capsules. The fiber-tracking approach was used to measure the number and the length of bundles.

Results—

Changes in the apparent diffusion coefficient and the fractional anisotropy values were similar during the temporal evolution of the lesion in the marmoset model of ischemia to that reported in patients with stroke. Despite an absence of visible lesions on T2-MRI and diffusion tensor imaging at the chronic stage, diffusion tensor MRI evidenced alterations in WM by the increase in the standard deviation of the angle of the first eigenvector projection in the cortex, internal and external capsules, and the decrease in the number of bundles of fibers tracked. The disruption of WM was strongly correlated with the chronic sensorimotor deficits.

Conclusions—

Despite an absence of a visible ischemic lesion at the chronic stage, diffusion tensor MRI revealed disorganization of WM, which probably underlies the persistence of functional deficits.
Cerebral Perfusion Pressure Thresholds for Brain Tissue Hypoxia and Metabolic Crisis After Poor-Grade Subarachnoid Hemorrhage
Authors: Schmidt J. Michael , Ko Sang-Bae , Helbok Raimund , Kurtz Pedro , Stuart R. Morgan , Presciutti Mary , Fernandez Luis , Lee Kiwon , Badjatia Neeraj , Connolly E. Sander , Claassen Jan , Mayer Stephan A.
Published: March 2011

Background and Purpose—

To identify a minimally acceptable cerebral perfusion pressure threshold above which the risks of brain tissue hypoxia (BTH) and oxidative metabolic crisis are reduced for patients with subarachnoid hemorrhage (SAH).

Methods—

We studied 30 poor-grade SAH patients who underwent brain multimodality monitoring (3042 hours). Physiological measures were averaged over 60 minutes for each collected microdialysis sample. Metabolic crisis was defined as a lactate/pyruvate ratio >40 with a brain glucose concentration ≤0.7 mmol/L. BTH was defined as P
bt
O
2
<20 mm Hg. Outcome was assessed at 3 months with the Modified Rankin Scale.

Results—

Multivariable analyses adjusting for admission Hunt-Hess grade, intraventricular hemorrhage, systemic glucose, and end-tidal CO
2
revealed that cerebral perfusion pressure ≤70 mm Hg was significantly associated with an increased risk of BTH (OR, 2.0; 95% CI, 1.2–3.3;
P
=0.007) and metabolic crisis (OR, 2.1; 95% CI, 1.2–3.7;
P
=0.007). Death or severe disability at 3 months was significantly associated with metabolic crisis (OR, 5.4; 95% CI, 1.8–16;
P
=0.002) and BTH (OR, 5.1; 95% CI, 1.2–23;
P
=0.03) after adjusting for admission Hunt-Hess grade.

Conclusions—

Metabolic crisis and BTH are associated with mortality and poor functional recovery after SAH. Cerebral perfusion pressure levels <70 mm Hg was associated with metabolic crisis and BTH, and may increase the risk of secondary brain injury in poor-grade SAH patients.
Self-Reported Long-Term Needs After Stroke
Authors: McKevitt Christopher , Fudge Nina , Redfern Judith , Sheldenkar Anita , Crichton Siobhan , Rudd Anthony R. , Forster Ann , Young John , Nazareth Irwin , Silver Louise E. , Rothwell Peter M. , Wolfe Charles D.A.
Published: March 2011

Background and Purpose—

Development of interventions to manage patients with stroke after discharge from the hospital requires estimates of need. This study estimates the prevalence of self-reported need in community-dwelling stroke survivors across the United Kingdom.

Methods—

We conducted a survey of stroke survivors 1 to 5 years poststroke recruited through Medical Research Council General Practice Research Framework general practices and 2 population-based stroke registers. Levels and type of need were calculated with comparisons among sociodemographic groups, disability level, and cognitive status using the χ
2
test or Fisher exact test, as appropriate.

Results—

From 1251 participants, response rates were 60% (national sample) and 78% (population registers sample) with few differences in levels of reported need between the 2 samples. Over half (51%) reported no unmet needs; among the remainder, the median number of unmet needs was 3 (range, 1 to 13). Proportions reporting unmet clinical needs ranged from 15% to 59%; 54% reported an unmet need for stroke information; 52% reported reduction in or loss of work activities, significantly more from black ethnic groups (
P
=0.006); 18% reported a loss in income and 31% an increase in expenses with differences by age, ethnic group, and deprivation score. In multivariable analysis, ethnicity (
P
=0.032) and disability (
P
=0.014) were associated with total number of unmet needs.

Conclusions—

Multiple long-term clinical and social needs remain unmet long after incident stroke. Higher levels of unmet need were reported by people with disabilities, from ethnic minority groups, and from those living in the most deprived areas. Development and testing of novel methods to meet unmet needs are required.
Outcomes of Mechanical Endovascular Therapy for Acute Ischemic Stroke
Authors: Rouchaud Aymeric , Mazighi Mikael , Labreuche Julien , Meseguer Elena , Serfaty Jean-Michel , Laissy Jean-Pierre , Lavallée Philippa C. , Cabrejo Lucie , Guidoux Céline , Lapergue Bertrand , Klein Isabelle F. , Olivot Jean-Marc , Abboud Halim , Simon Olivier , Schouman-Claeys Elisabeth , Amarenco Pierre
Published: March 2011

Background and Purpose—

Recanalization is a powerful predictor of stroke outcome in patients with arterial occlusion. Intravenous recombinant tissue plasminogen activator is limited by its recanalization rate, which may be improved with mechanical endovascular therapy (MET). However, the benefit and safety of MET remain to be determined. The aim of this study was to give reliable estimates of efficacy and safety outcomes of MET.

Methods—

We analyzed data from our prospective clinical registry and conducted a systematic review of all previous studies using MET published between January 1966 and November 2009.

Results—

From April 2007 to November 2009, 47 patients with acute stroke were treated with MET at Bichat Hospital. The literature search identified 31 previous studies involving a total of 1066 subjects. In the meta-analysis, including our registry data, the overall recanalization rate was 79% (95% CI, 73–84). Meta-analysis of clinical outcomes showed a pooled estimate of 40% (95% CI, 34–46; 27 studies) for favorable outcome, 28% (95% CI, 23–33; 28 studies) for mortality, and 8% (95% CI, 6–10; 27 studies) for symptomatic intracranial hemorrhage. The likelihood of a favorable outcome increased with the use of thrombolysis (OR, 1.99; 95% CI, 1.23–3.22) and with proportion of patients with isolated middle cerebral artery occlusion (OR per 10% increase, 1.14; 95% CI, 1.04–1.25).

Conclusions—

MET is associated with acceptable safety and efficacy in stroke patients, and it may be a therapeutic option in those presenting with isolated middle cerebral artery occlusion.
Helicopter Transport of Stroke Patients and Its Influence on Thrombolysis Rates
Authors: Reiner-Deitemyer Veronika , Teuschl Yvonne , Matz Karl , Reiter Martina , Eckhardt Raoul , Seyfang Leonhard , Tatschl Claudia , Brainin Michael ,   for the Austrian Stroke Unit Registry Collaborators
Published: March 2011

Background and Purpose—

Acute stroke management requires minimization of prehospital time. This study addresses the value of helicopter transport compared with other means of transportation to a stroke unit and compares their rates of thrombolysis on a nationwide basis.

Methods—

Prospective data collection and prespecified evaluation of data from 32 stroke units between 2003 and 2009 were used. We distinguished between patients transported either directly to a stroke unit or transferred indirectly via a peripheral hospital. Thus, there were 6 transport groups: helicopter emergency service (HEMS) direct and indirect, ambulance accompanied by an emergency physician direct and indirect, and ambulance without physician direct and indirect. Demographic and clinical factors, time delays, and rates of thrombolysis of patients transported by helicopter were compared with factors of patients transported otherwise.

Results—

Of 21 712 ischemic stroke patients, 905 patients (4.1%) were transported by helicopter. Of these, 752 patients (3.4%) were transported by direct HEMS, and 153 patients (0.7%) were transported by indirect HEMS. Thrombolysis rates were highest for HEMS (24% direct, 29% indirect) transport, followed by ambulance accompanied by an emergency physician (18% direct, 15% indirect). The probability of receiving thrombolysis was highest for indirect HEMS transport (OR 3.6, 2.2–6.0), followed by indirect ambulance accompanied by an emergency physician transport (OR 1.5, 1.1–1.9). The shortest times, 90 minutes or less from stroke onset to hospital arrival, were achieved with direct AMBP and direct HEMS transport.

Conclusions—

The shortest hospital arrival times and highest thrombolysis rates were seen in ischemic stroke patients transported by helicopter.
Effect of Age on Outcomes of Treatment of Unruptured Cerebral Aneurysms
Authors: Brinjikji Waleed , Rabinstein Alejandro A. , Lanzino Giuseppe , Kallmes David F. , Cloft Harry J.
Published: March 2011

Background and Purpose—

Age might differentially affect outcomes in patients treated for unruptured cerebral aneurysms with surgical clipping versus endovascular coil therapy. We evaluated a large administrative database to determine the effect of age on outcomes in patients treated for unruptured cerebral aneurysm.

Methods—

Using the National Inpatient Sample, we evaluated morbidity (discharge to long-term facility) and mortality of patients undergoing clipping or coiling of unruptured cerebral aneurysms in the United States between 2001 and 2008. Outcomes were evaluated in relation to four age strata: younger than 50 years; 50 to 64 years; 65 to 79 years; and patients 80 years or older.

Results—

Patients younger than 50 years old undergoing coiling had significantly lower morbidity rates when compared to patients who underwent clipping (3.5% versus 8.1%;
P
<0.0001), but no difference in mortality (0.6% versus 0.6%;
P
=0.72). Patients between 50 and 64 years old undergoing coiling had significantly decreased morbidity (4.0% versus 13.7%;
P
<0.0001) and mortality (0.5% versus 1.1%;
P
<0.0001) when compared to patients who underwent clipping. Coiled patients 65 to 79 years old had lower morbidity (6.9% versus 26.8%;
P
<0.0001) and mortality (0.8% versus 2.0%;
P
<0.0001) compared to patients who underwent clipping. Patients aged 80 years or older undergoing coiling also had lower morbidity (9.8% versus 33.5%;
P
<0.0001) and mortality (2.4% versus 21.4%;
P
<0.0001) when compared to patients who have undergone clipping.

Conclusions—

Patients treated with endovascular coiling have significantly less morbidity and mortality than those treated with surgical clipping, and these differences become more pronounced with age.
Occipital Bone Abnormality Causing Recurrent Posterior Circulation Strokes
Authors: Cronin Carolyn A. , Aldrich E. Francois , Kittner Steven J.
Published: March 2011

We report the case of a young man with recurrent posterior circulation strokes over the course of 6 years. Standard stroke evaluation was unremarkable until careful review of catheter angiogram and CT angiogram images revealed a bony protuberance from the occiput impinging on the left vertebral artery. Local vessel injury with thrombosis and distal embolization is the presumed etiology of the recurrent infarcts. Surgical removal of this developmental anomaly was accomplished, with no subsequent neurological events.
Effects of Political Advertising in the 2008 Presidential Campaign
Authors: Lee Kaid Lynda , Fernandes Juliana , Painter David
Published: March 2011

Political advertising remains the communication format that dominates presidential campaign budgets. In 2008 Obama’s success in fund-raising resulted in record expenditures on political television advertising. This experimental study tested the effects of viewing a sample of Obama and McCain ads with 1,165 young citizens at 19 locations throughout the United States. Results indicated young citizens learned significantly more about the issue positions of both McCain and Obama than they learned about their personal qualities when viewing the ads. Whereas viewing the ads also resulted in a significant increase in the evaluation of Obama, evaluations of McCain significantly decreased after viewing. Viewing the ads significantly increased levels of political information efficacy, making young citizens more confident that they possessed the information and knowledge necessary to participate in the political system. The experiments also isolated gender differences that suggested young female citizens learned more about the candidates’ issues and personal qualities than did males.
Change: How Young Voters Interpreted the Messages Sent During the 2008 Presidential Election Season
Authors: Levine Kenneth J. , Clark Naeemah , Haygood Daniel M. , Muenchen Robert A.
Published: March 2011

Change became the mantra of the 2008 presidential campaign. During the primaries, Senators Clinton, McCain and Obama, as well as Governor Huckabee, all used the idea of change as part of their campaign rhetoric. During the general election campaign, both Obama and McCain continued using change as their slogan. This study sought to determine what the youth vote believed that change meant, both in an overall sense and as attributed to each of the candidates. The data for Study 1 were conducted before the March 4, 2008, primary, and the data for Study 2 were collected in October 2008. In Study 1, 784 undergraduates from six states and nine colleges and universities participated. In Study 2, there were 260 undergraduates who participated. The findings in both studies reveal that the candidates were effective in their use of the word change , as the respondents were able to differentiate between the different campaign messages. Analysis of the open-ended data found several overall categories of change, and subsequent analysis found that these categories were more relevant to certain demographics than others. A discussion of the findings as well as ideas for future research is discussed.
China and Japan’s Energy Security Approaches in the Central Asia
Authors: Koolaee Elaheh , Tishehyar Mandana
Published: March 2011

Japan and China’s expanding global outreach is not entirely the result of their growing reliance on imported oil and their efforts to secure supplies globally. Rather, it is consistent with both countries’ overall economic growth and enhanced political standing. The build-up of closer ties with the developing world, and China and Japan’s growing presence should be seen in the context of Beijing and Tokyo’s expanding economic interests world-wide and growing international political influence, not simply as a symptom of their pursuit for energy. In short, energy has influenced Chinese and Japanese international behaviour but not transformed their foreign policy. This article presents the argument that while energy is an important factor in Japanese and Chinese foreign policy, the impact of their energy needs on their international behaviour is only one dimension, and must be analysed in the context of their multiple and competing policy priorities. A better understanding of the impact of energy on Chinese and Japanese foreign policy requires a more comprehensive approach with an in-depth examination of their interactions over energy related matters with other countries. This article is an effort in addressing the role of energy in the wider context of Japanese and Chinese foreign policy in the Central Asia region from a comparative perspective.
Limitations of India–China Economic Engagement
Authors: Singh Swaran
Published: March 2011

The current global economic meltdown offers historic opportunities for China and India to catapult their respective positions in the international system. The increasing recognition of their roles in global academic debates, and more recently by the G20 summits, remain both the cause as also the consequence of their expanding mutual economic engagements. However, their border trade has fallen drastically from $ 52 billion for 2008 to $ 43 billion for 2009. This is result of their expanding trade deficit, abysmally low mutual investments, lacklustre border trade and stagnant border negotiations, all allude to their lack of appreciation of the systemic bottleneck threatening to undermine this most reliable pillar of their rapprochement. This calls for deeper and urgent examination of the structural bottlenecks so as to ensure their continued robust economic engagement which is essential if China and India have to play a pivotal role in regional and global economic stabilisation and upturn. Such an outcome remains intertwined with their own peaceful rise as major stakeholders of the rapidly transforming international system.
Status of China in Science and Technology as Reflected in its Publications Output, 1997–2007
Authors: Gupta B.M. , Gupta Namita , Gupta R.P.
Published: March 2011

The study examines China’s performance in science and technology (S&T) during 1997–2007, based on several parameters including the country’s annual average growth rate, global publication share and rank, strong and weak subject areas (in terms of national priority, international collaborative share and global share), institutional profiles of select top institutions, the overall international collaboration profile and major collaborative partners, patterns of communication in national and international journals and characteristics of its top highly cited papers. The study also compares similarities of China’s research profile with nineteen other top productive countries.
Households’ Stories of Their Encounters With a Plug-In Hybrid Electric Vehicle
Authors: Caperello Nicolette D. , Kurani Kenneth S.
Published: March 2011

One way to progress toward greenhouse gas reductions is for people to drive plug-in hybrid electric vehicles (PHEVs). Households in this study participated in a 4- to 6-week PHEV driving trial. A narrative of each household’s encounter with the PHEV was constructed by the researchers from multiple in-home interviews, questionnaires completed by each household at the start and end of their 4- to 6-week PHEV demonstration period, and quantitative measures of driving and recharging behavior from the data systems onboard the vehicles. Thematic analysis was used to create themes from the narratives. Bridging from the idiosyncratic experience of each household toward a societal narrative, the authors describe the following themes: confusion, recharging habits and etiquette, changing driving behavior, payback analysis, saving money, expectations, and the future. No theme explicitly identified global warming, indicating a gap between lay and expert understandings of both the technology and motivations. The themes lead to suggestions for education, information, marketing, and direct experience.
Does Intelligibility Affect Place Legibility? Understanding the Relationship Between Objective and Subjective Evaluations of the Urban Environment
Authors: Long Yixiang , Baran Perver K.
Published: March 2011

Lynch has defined place legibility as the ease with which people understand the layout of a place. The concept essentially represents the composite mental image of a place. Alternatively, space-syntax literature has objectively defined the concept of intelligibility as the capacity of a space to give clues to the understanding of the system as a whole. This study contributes to understanding space-syntax theory as applied to spatial cognition by examining the effect of spatial configuration, measured by intelligibility, on place legibility, measured by sketch maps, recognition tests, and surveys. The results of the experimental study showed that the intelligibility of neighborhood layout influences place legibility. The findings of this study suggest that the space-syntax methodology could be used by urban designers and policy makers to understand and quantitatively manipulate one aspect of the environment, that is, intelligibility, which contributes to improved legibility.
Dimensionality of the New Ecological Paradigm
Authors: Amburgey Jonathan W. , Thoman Dustin B.
Published: March 2011

Dunlap and colleagues’ New Ecological Paradigm (NEP) scale is widely used and, thus, merits testing to determine whether it should be treated as one scale, a set of independent scales, or a set of correlated subscales. The authors test for all three possibilities using confirmatory factor analysis (CFA) and find that a second-order factor structure with five interrelated dimensions provides a better fit for the data than a single factor structure or five independent factors structure. Results show that, as Dunlap originally assumed, the NEP is best represented as correlated scales involving five facets. The authors recommend that future research with the NEP use CFA within a structural equation modeling approach to accurately represent the five interrelated facets structure, and if CFA is unavailable, treating the scale as five correlated subscales is preferred over treating the NEP as a single score reflecting environmental concern.
Evaluation of the MindMatters buddy support scheme in southwest Sydney: Strategies, achievements and challenges
Authors: Khan Raquiba J , Bedford Karen , Williams Mandy
Published: March 2011

Objective: Assessing the strategies, achievements and challenges of implementing MindMatters and the views of partner schools towards the buddy support scheme.

Design: The MindMatters buddy support scheme (2007–2008) was designed to increase the capacity of secondary schools to adopt a whole-school approach to improving health and well-being of the school community. Fourteen schools received support from health workers and funding.

Setting: Secondary schools in southwest Sydney.

Method: The scheme was evaluated qualitatively through face-to-face interviews with a representative from each school and thematic analysis of the information.

Results: Participants believed that external support is needed to run additional programmes, as schools have competing priorities. They understood the link between the well-being of students and staff and good mental health. The achievements identified included less bullying and more student participation, connectedness, networking with outside agencies and increased confidence in showcasing their programmes. The challenges included: engaging culturally and linguistically diverse and indigenous communities; resources; support from the school executive; and staff transitions, time, skills and motivation. Factors that enabled schools to achieve positive outcomes were: partnership with the health service; MindMatters training; a positive staff attitude; and support from within the school.

Conclusion: The partnership scheme contributed to strengthening staff confidence in implementing MindMatters. Health workers helped to bridge the gap between schools and state representatives. The capability of schools, the significance of the scheme and the usefulness of MindMatters training collectively contributed to the main achievements of incorporating a student voice, engaging community and building relationships with other agencies.