bluuebunny/crossref_metadata_2025 huggingface dataset:
Variation in 5' Promoter Region of the APOE gene Contributes to Predicting Ischemic Heart Disease (IHD) in the Population at Large: the Copenhagen City Heart Study
Authors: Stengård J. H. , Frikke‐Schmidt R. , Tybjærg‐Hansen A. , Nordestgaard B.G. , Sing C.F.
Published: May 2007

The objective of this study was to evaluate whether an increased hazard of developing ischemic heart disease (IHD) is associated with any of the three genotypes A560T832/A560T832, A560T832/A560G832 and A560T832/T560T832, defined by variations in two non‐coding SNPs in the 5′ promoter region of the apolipoprotein E (APOE) gene. These genotypes were selected because they distinguished between high and low levels of HDL‐C, TG and/or T‐C in our earlier study of multiple samples defined by gender and population. We found a significant increase (p<0.05) in the hazard of IHD in females with the A560T832/T560T832 genotype that remained significant after fitting the effects of dyslipidemia, other established risk factors, and the structural isoform variations of the ApoE molecule. We discuss why this statistically significant genetic predictor may not be an appropriate screening test for IHD in the Danish population at large.
THE SMITHSONIAN–NIST PARTNERSHIP: THE APPLICATION OF INSTRUMENTAL NEUTRON ACTIVATION ANALYSIS TO ARCHAEOLOGY
Authors: BLACKMAN M. J. , BISHOP R. L.
Published: May 2007

The history and procedures of the Smithsonian–NIST programme in the application of instrumental neutron activation to the study of archaeological materials are reviewed. Statistical processing of the resulting analytical data is a major focus of the programme, with attention called to processes of initial group formation. Specific areas of current research emphasis are presented, which build upon the strength of accumulated databases.
NEUTRON ACTIVATION ANALYSIS OF ARCHAEOLOGICAL MATERIALS: AN OVERVIEW OF THE ITN NAA LABORATORY, PORTUGAL
Authors: DIAS M. I. , PRUDÊNCIO M. I.
Published: May 2007

Instrumental neutron activation analysis (INAA) has been applied to archaeological samples at the Portuguese Research Reactor (RPI) since 1973, and the number of samples analysed has increased steadily since the mid‐1990s. Archaeometric applications of INAA at RPI include the analysis of archaeological ceramics and the stones used in monumental architecture (menhirs) and other historical monuments. A programme of analysis also exists for measuring the precision of and contributing to the certified values of geochemical reference samples. In addition, the study of interference factors is performed to obtain better accuracy in the determination of concentrations of some elements (e.g., corrections for spectral interferences from uranium fission products in the determination of barium, rare earth elements and zirconium).
Double Allee Effects and Extinction in the Island Fox
Authors: ANGULO ELENA , ROEMER GARY W. , BEREC LUDĚK , GASCOIGNE JOANNA , COURCHAMP FRANCK
Published: May 2007

Abstract:  An Allee effect (AE) occurs in populations when individuals suffer a decrease in fitness at low densities. If a fitness component is reduced (component AE), per capita population growth rates may decline as a consequence (demographic AE) and extinction risk is increased. The island fox (Urocyon littoralis) is endemic to six of the eight California Channel Islands. Population crashes have coincided with an increase in predation by Golden Eagles (Aquila chrysaetos). We propose that AEs could render fox populations more sensitive and may be a likely explanation for their sharp decline. We analyzed demographic data collected between 1988 and 2000 to test whether fox density (1) influences survival and reproductive rates; (2) interacts with eagle presence and affects fox fitness parameters; and (3) influences per capita fox population trends. A double component AE simultaneously influenced survival (of adults and pups) and proportion of breeding adult females. The adult survival AE was driven by predation by eagles. These component AEs led to a demographic AE. Multiple‐component AEs, a predation‐driven AE, and the simultaneous occurrence of both component and demographic AEs in a mammal are all previously unreported processes. Populations below 7 foxes/km2 could have suboptimal population growth rates due to the demographic AE, and AEs may have contributed to the dramatic declines in three fox populations. Because fox densities in critically endangered populations are well below this level, removing Golden Eagles appears necessary to prevent a predation‐driven AE. Conservationists should also be aware of AEs when planning the release of captive foxes. More generally, our findings highlight the danger of overlooking AEs in the conservation of populations of rare or threatened species.
Long‐Distance Dispersal of Plants by Vehicles as a Driver of Plant Invasions
Authors: VON DER LIPPE MORITZ , KOWARIK INGO
Published: May 2007

Abstract:  Roadsides are preferential migration corridors for invasive plant species and can act as starting points for plant invasions into adjacent habitats. Rapid spread and interrupted distribution patterns of introduced plant species indicate long‐distance dispersal along roads. The extent to which this process is due to species' migration along linear habitats or, alternatively, to seed transport by vehicles has not yet been tested systematically. We tested this by sampling seeds inside long motorway tunnels to exclude nontraffic dispersal. Vehicles transported large amounts of seeds. The annual seed rain caused by vehicles on the roadsides of five different tunnel lanes within three tunnels along a single urban motorway in Berlin, Germany, ranged from 635 to 1579 seeds/m2/year. Seeds of non‐native species accounted for 50.0% of the 204 species and 54.4% of the total 11,818 seeds trapped inside the tunnels. Among the samples were 39 (19.1%) highly invasive species that exhibit detrimental effects on native biodiversity in some parts of the world. By comparing the flora in the tunnel with that adjacent to the tunnel entrances we confirmed long‐distance dispersal events (>250 m) for 32.3% of the sampled species. Seed sources in a radius of 100 m around the entrances of the tunnels had no significant effect on species richness and species composition of seed samples from inside the tunnels, indicating a strong effect of long‐distance dispersal by vehicles. Consistently, the species composition of the tunnel seeds was more similar to the regional roadside flora of Berlin than to the local flora around the tunnel entrances. Long‐distance dispersal occurred significantly more frequently in seeds of non‐native (mean share 38.5%) than native species (mean share 4.1%). Our results showed that long‐distance dispersal by vehicles was a routine rather than an occasional mechanism. Dispersal of plants by vehicles will thus accelerate plant invasions and induce rapid changes in biodiversity patterns.
Preparation for Discharge, Maternal Satisfaction, and Newborn Readmission for Jaundice: Comparing Postpartum Models of Care
Authors: Goulet Lise , Fall Aïssatou , D’Amour Danielle , Pineault Raynald
Published: May 2007

ABSTRACT:  Background:
Physiological jaundice generally appears between the third and fifth days of life. The danger of hyperbilirubinemia is therefore a major challenge when postpartum hospital stays are short, and part of the responsibility for screening for signs of jaundice is assumed by the mother. The objective of this study was to identify the model of postnatal continuity of care most likely to prepare mothers for discharge, to reduce newborn readmission for jaundice, and to enhance maternal satisfaction.
Methods:
An epidemiological study was conducted in regions operating under 3 different models of postnatal continuity of care. Eligible mothers were those who had spent less than 60 hours in hospital after an uncomplicated vaginal delivery. Of this group, 70.8 percent participated in telephone interviews conducted 1 month after their deliveries (n = 1,096). Newborns who had presented with signs of jaundice were identified through statements from their mothers.
Results:
Of the participating newborns, 45.5 percent presented with signs of jaundice, and 3.2 percent were readmitted for jaundice during the first week of life. The follow‐up procedures used in regions operating under a community‐based model most closely followed the recommendations of health authorities and featured a high level of mothers’ satisfaction. In the region operating under a mixed hospital model, mothers reported signs of jaundice significantly more often, and postdischarge services received by mothers were less effective at allaying their fears compared with other models. Phototherapy was offered in the home only in the region operating under a mixed ambulatory model, and no readmissions for jaundice were recorded in this region.
Conclusions:
An effective coordination between community‐based perinatal services and hospital‐linked home phototherapy in the form of an integrated network appears to be an essential condition for improved monitoring of newborns’ health since it fosters a follow‐up that is focused not only on jaundice but also on mothers’ and newborns’ needs while reducing the costs generated by newborn readmissions. (BIRTH 34:2 June 2007)
Tanning Device Usage: What Are Parents Thinking?
Authors: Magee Kristin H. , Poorsattar Solmaz , Seidel Kristy D. , Hornung Robin L.
Published: May 2007

Abstract:  Tanning device usage is prevalent among adolescents. Few studies have assessed the role of parental influence on children's use of indoor tanning facilities. Our objective was to determine if children's tanning device usage is affected by parental knowledge of risks of indoor tanning or by parental tanning practices. A survey was administered to 160 parents of 328 children at a general pediatrics clinic and 204 parents of 367 children at a pediatric dermatology clinic (parents n = 364, children n = 695). Over half of all parents and 17% of all teenagers queried had previously used tanning devices. The level of parental knowledge did not predict tanning device usage by their children. However, parental tanning device usage was associated with increased usage by children (p < 0.05). Children began using tanning devices on average more than 4 years earlier than their parents. Most parents (69%) never wanted their children to use tanning devices, but only 15% of parents had discussed them with their children. Therefore, health providers can provide an important service by initiating discussions about tanning devices. Additional measures, including legislation requiring parental consent for indoor tanning, are needed to reduce tanning device usage by minors.
Localized Hypertrichosis in a Pediatric Patient—What Is the Mechanism for Excess Hair Growth?
Authors: Wagamon Kyle , Mirmirani Paradi
Published: May 2007

Abstract:  Localized hypertrichosis is an uncommon complaint among pediatric dermatology patients. We highlight an instance of localized hypertrichosis due to an underlying diffuse neurofibroma in a patient with known neurofibromatosis 1. The classification and possible underlying pathogenic mechanisms of localized hypertriehosis in pediatric patients is discussed.
Acquired Mucosal Indeterminate Cell Histiocytoma
Authors: Ferran Marta , Toll Agustí , Gilaberte Montserrat , Barranco Carlos , Lloreta Josep , Pujol Ramon M.
Published: May 2007

Abstract:  Indeterminate cell histiocytosis is an exceptional and controversial entity with variable clinical, histopathologic or immunohistochemical findings, sharing morphologic and immunophenotypic features from both Langerhans and non‐Langerhans cell histiocytoses. Neoplastic cells express S‐100 and CD1a antigens, but lack Birbeck granules. It has been reported in both adults and children, as solitary or multiple cutaneous lesions with rare extracutaneous involvement. We describe a 12‐year‐old boy with an indeterminate cell histiocytosis manifesting as a solitary verrucous papule on the mucosa of the glans penis. The morphologic features and diagnostic criteria of cutaneous indeterminate cell histiocytic proliferations are reviewed. The possible relationship between indeterminate cell and Langerhans cell histiocytoses is discussed.
Prurigo Pigmentosa Associated with an Atopic Diathesis in a 13‐Year‐Old Girl
Authors: Cota Carlo , Donati Pietro , Amantea Ada
Published: May 2007

Abstract:  We report an Italian prepubescent girl with the typical clinical and histologic features of prurigo pigmentosa associated with an atopic diathesis. The dermatitis disappeared after treatment with minocycline, leaving a brown, reticulated hyperpigmentation, with no recurrence. The association with an atopic diathesis could justify, in this instance, the major susceptibility to environmental factors claimed by some authors as triggering factors for prurigo pigmentosa. To our knowledge, this is only the second occurrence of this disease in a prepubescent patient reported in the literature.
Synthetic Tannins in Dermatology—A Therapeutic Option in a Variety of Pediatric Dermatoses
Authors: Fölster‐Holst Regina , Latussek Eva
Published: May 2007

Abstract:  Synthetic tannins are established adjuvants in the therapy of itchy, inflamed, weeping, superficial skin diseases. The therapeutic effects of synthetic tannins are based on their tanning action as well as on their antimicrobial, anti‐inflammatory, and antipruritic effects. In terms of pharmacology and clinical applicability, synthetic tannins are particularly versatile substances. They have also been used as steroid‐free, anti‐inflammatory treatment alternatives, especially in pediatric dermatoses. Systemic absorption is not to be expected. Because of their high safety profile and good tolerance, they are appropriate for the treatment of all age groups. Thus, synthetic tannins can be safely used for infants and children and also during pregnancy and lactation.
Mucocutaneous Findings in 100 Children with Down Syndrome
Authors: DANESHPAZHOOH MARYAM , MOHAMMAD‐JAVAD NAZEMI T. , BIGDELOO LEYLA , YOOSEFI MARYAM
Published: May 2007

Abstract: Down syndrome is the most common chromosomal abnormality affecting numerous organs, including the skin. Our aim was to study mucocutaneous findings in this syndrome. To do so, 100 children with Down syndrome attending Schools for Children with Special Educational Needs and centers affiliated to the Welfare and Rehabilitation Organization in two provinces of Iran were thoroughly examined for skin and mucosal lesions. Their mean age was 11.2 years (3–20 years). Mucocutaneous findings were noted in 61. These were as follows (in decreasing order)—fissured tongue 28%, hypertrophy of tongue papilla 22%, premature graying 14%, cheilitis 13%, xerosis 12%, alopecia areata 11%, palmoplantar hyperkeratosis 10%, syringoma 6%, keratosis pilaris 4%, geographic tongue 4%, trichotillomania 4%, vitiligo 3%, seborrheic dermatitis 3%, livedo reticularis 2%. No instances of atopic dermatitis or skin infections and infestations were noted. The lack of atopic dermatitis in our series was in concordance with its low prevalence reported in recent articles. Improved hygiene due to patient care at home may underlie the absence of infections. With the increasing survival rate of those with Down syndrome, physicians should be more aware of the skin findings seen so frequently in this genetic disorder.
Psoriasiform Lesions and Abscesses as Initial Manifestations of Severe Hypothyroidism in a Previously Healthy 15‐Year‐Old Girl
Authors: KWINTER JENNIFER , WEINSTEIN MIRIAM , BARGMAN HOWARD
Published: May 2007

Abstract:  Hypothyroidism is associated with many characteristic cutaneous manifestations; however, to the best of our knowledge, it has not previously been linked to psoriasiform lesions or multiple abscesses. We describe a previously healthy 15‐year‐old girl with psoriasiform lesions, abscesses, and extremely severe hypothyroidism, all presenting simultaneously. The pathophysiology of the connection is unclear, but several hypotheses are discussed. The temporal relationship of these conditions and the significant improvement of the skin lesions upon normalization of T4 levels following initiation of thyroid supplementation illustrate a direct association. It is probable that the extreme severity of hypothyroidism in our patient is implicated in the etiology of these skin lesions. This unique case illustrates that novel cutaneous manifestations may sometimes act as an early presenting sign of hypothyroidism and may be associated with more severe forms of the disorder.
Evaluating the impact of public health notification of suspected transfusion‐transmissible hepatitis C virus infection and effectiveness of lookback and traceback investigations by Canadian Blood Services in British Columbia, Canada, August 2002 through February 2005
Authors: Whitlock Mandy , Lord Sandra , Buxton Jane A. , Doyle Patrick , Bigham Mark
Published: May 2007

BACKGROUND:Suspected transfusion‐transmissible infections (TTIs) have been reported to public health (PH) in British Columbia (BC) since August 2002. The impact of PH notification of suspected transfusion‐transmissible hepatitis C virus (TT‐HCV) infection over the first 2.5 years and the effectiveness of HCV lookback (LB) and traceback (TB) investigations conducted by Canadian Blood Services (CBS) in BC were evaluated.

STUDY DESIGN AND METHODS:Suspected TT‐HCV cases reported to CBS in BC between August 28, 2002, and February 28, 2005, were analyzed. The incremental yield of plausible TTIs from PH‐reported suspected TTIs was calculated. The effectiveness of LB and TB investigations was assessed with respect to the impact of improved anti‐HCV donor screening, the number of newly recognized HCV infections, and the timeliness of initiating investigations.

RESULTS:Nine of 553 (1.6%) investigations were initiated after PH reporting, yielding an additional 2 of 237 (i.e., 0.8%) plausible TTIs. Ninety‐two percent of investigations with transfused units involved transfusions before implementing second‐generation anti‐HCV enzyme immunoassay (EIA) donor screening. Almost one‐third of HCV‐infected persons in linked investigations (i.e., LB triggered by a TB and vice versa) were newly identified. Recently tested, PH‐reported cases incurred a mean delay exceeding 6 months until initiating a LB or TB investigation.

CONCLUSION:PH reporting of TTIs and investigating transfusions after second‐generation anti‐HCV EIA donor screening identified few plausible TT‐HCV infections. Many HCV‐infected recipients or lapsed donors first became aware of their infection status as a result of CBS investigations. The current process of reporting suspected TTIs incurs significant time delay.
Mapping of Epicardial Activation in a Rabbit Model of Chronic Myocardial Infarction:
Authors: WALKER NICOLA L. , BURTON FRANCIS L. , KETTLEWELL SARAH , SMITH GODFREY L. , COBBE STUART M.
Published: May 2007

Introduction: This study examines the consequences of a large transmural apical infarct on the epicardial electrical activity in isolated rabbit hearts.

Methods and Results: Hearts were isolated 8 weeks after coronary artery ligation. Membrane voltage from the epicardial surface of the left ventricle (LV) including the infarct was monitored using the voltage sensitive dye RH237. Optical action potentials were detected from the epicardial surface of the infarct; the signal amplitude was ∼20% of those in the noninfarcted zone (NZ). Epicardial activation mapping of the LV free wall showed that during right atrial (RA) pacing, the activation sequence was not significantly different between infarcted and sham‐operated groups. However, direct stimulation of the epicardium in the NZ revealed an area of slow conduction velocity (CV ∼5 cm/s−1, ∼10% of normal values) at the margin of the infarct zone (IZ). Within the IZ, CV was ∼50% of normal. A prominent endocardial rim of myocardium in the infarct was not the source of epicardial optical signals because chemical ablation of the endocardium did not affect the epicardial activation pattern.

Concluson: Therefore, remnant groups of myocytes in the mid‐wall and epicardium of the infarct scar support normal electrical activation during RA pacing. Areas of delayed conduction emerge only on epicardial stimulation.
Prospective Randomized Comparison of 8‐mm Gold‐Tip, Externally Irrigated‐Tip and 8‐mm Platinum‐Iridium Tip Catheters for Cavotricuspid Isthmus Ablation
Authors: SACHER FRÉDÉRIC , O'NEILL MARK D. , JAIS PIERRE , HUFFER LINDA L. , LABORDERIE JULIEN , DERVAL NICOLAS , DEPLAGNE ANTOINE , TAKAHASHI YOSHIHIDE , JONNSON ANDERS , HOCINI MELEZE , CLEMENTY JACQUES , HAISSAGUERRE MICHEL
Published: May 2007

Introduction: Radiofrequency (RF) ablation of the cavotricuspid isthmus (CTI) can be performed using different types of ablation catheter. Gold tip electrodes have the theoretical advantage of creating bigger lesions than standard platinum‐iridium electrode. This prospective, randomized study compares the clinical efficacy of 8‐mm gold tip catheter, externally irrigated and 8‐mm platinum‐iridium tip (Pt tip) catheters.

Methods and Results: Sixty consecutive patients (51 men, 60 ± 10 years) undergoing de novo CTI ablation for documented typical atrial flutter were randomized to one of the following ablation catheters: 8‐mm gold tip catheter, an externally irrigated‐tip (Irr. tip) catheter, or an 8‐mm Pt tip catheter. The procedural endpoint was achievement of bidirectional isthmus conduction block with ≤ 20 minutes of RF energy application. The latter was achieved equally with the 3 catheters (95% for gold tip, 100% for irrigated tip, 95% for Pt tip) and the durations of RF (10 ± 6, 10 ± 4, 13 ± 8 minutes), fluoroscopy (12 ± 6, 12 ± 7, 15 ± 12 minutes) and the procedure (34 ± 23, 38 ± 24, 40 ± 30 minutes) were similar in all groups. The maximal targeted power could not be reached in at least one location in 40% of patients with gold tip and in 35% of patients with Pt tip catheters whereas it was always achieved with an Irr. tip catheter (P = 0.003, P = 0.008). The reduction in impedance during RF delivery was greater with Irr. tip (11 ± 7 Ω) than with gold (7 ± 4 Ω, P = 0.02) or Pt tip (5 ± 3 Ω, P = 0.001) catheters.

Conclusion: This study demonstrates equivalent efficacies of gold, platinum‐iridium and externally Irr. tip catheters for successful de novo ablation of the CTI.
Velocity Vector Imaging in Assessing the Regional Systolic Function of Patients with Post Myocardial Infarction
Authors: Chen Junhong , Cao Tiesheng , Duan Yunyou , Yuan Lijun , Yang Yong
Published: May 2007

Purpose: To assess the regional systolic function in patients with post myocardial infarction (PMI), using the velocity vector imaging (VVI) technique, a new two‐dimensional echocardiographic method. Methods: Two‐dimensional images of apical four, two chambers and apical long‐axis view were obtained in 20 patients with PMI and 15 normal controls. The segmental myocardial systolic peak strain (ε), strain rate (SRs), and segmental ejection fraction (SEF) were analyzed with VVI offline software. The result of ε in middle segments of the normal control analyzed by VVI was compared with that by tissue Doppler imaging (DTI). Results: The segmental ε, SRs, and SEF were significantly lower in infarct segments than in the corresponding segments of the normal controls. There were significant difference in average ε, SRs, and SEF among infarct, noninfarct, and normal control segments. The segmental ε, SRs, and SEF did not vary significantly from basal to apical segments in the normal control subjects. There was a good correlation on ε in middle segments between VVI and DTI (r = 0.710, P < 0.01). The interobserver variability was 4.6% and the intraobserver variability was 7.0%, respectively. Conclusions: The regional systolic function decreased in infarct segments compared with the adjacent noninfarct segments and normal control segments. The systolic function of adjacent noninfarct area was also affected by infarct areas. VVI could recognize and quantify the abnormality of infarct segments and therefore could be a useful tool in assessing the myocardial regional systolic function.
Does the Morphology of Atrial Septal Aneurysm Influence Cerebral Arterial Embolus Occurrence?
Authors: Kurzawski Jacek , Janion Marianna , Sielski Janusz
Published: May 2007

Background and Purpose: Atrial septal aneurysm (ASA) is a rare heart defect regarded as a source of arterial emboli. The main objective of the study was to assess the role of ASA morphology in the etiology of embolism.
Methods: Eighty‐eight subjects were included after transthoracic echocardiography positive for ASA. Medical history of embolic events was obtained in 13 patients (14.8%). Magnitude, location, size of aneurysm, oscillation, direction of bulging, the presence of interatrial shunt and source of any potential cardiac embolus material were assessed, and the size of the left atrium, the area of both atria, and the presence of any valve prolapse syndrome were recorded. The occurrence of atrial fibrillation or flutter and the presence of concomitant diseases and other clinical features were also estimated.
Results: The occurrence of arterial emboli was not related to ASA morphology. Coexisting diseases, smoking and left atrial dimension were significantly correlated with the occurrence of arterial emboli.
Conclusions: Ischemic events were not significantly correlated with the ASA presence. The present findings suggest other causes of vascular events in patients with ASA.
A Comparison between QLAB and TomTec Full Volume Reconstruction for Real Time Three‐Dimensional Echocardiographic Quantification of Left Ventricular Volumes
Authors: Soliman Osama I.I. , Krenning Boudewijn J. , Geleijnse Marcel L. , Nemes Attila , van Geuns Robert‐Jan , Baks Timo , Anwar Ashraf M. , Galema Tjebbe W. , Vletter Wim B. , Cate Folkert J. Ten
Published: May 2007

Objectives: To compare the interobserver variability and accuracy of two different real time three‐dimensional echocardiography (RT3DE) analyzing programs. Methods: Forty‐one patients (mean age 56 ± 11 years, 28 men) in sinus rhythm with a cardiomyopathy and adequate 2D image quality underwent RT3DE and magnetic resonance imaging (MRI) within one day. Off‐line left ventricular (LV) volume analysis was performed with QLAB V4.2 (semiautomated border detection with biplane projections) and TomTec 4D LV analysis V2.0 (primarily manual tracking with triplane projections and semiautomated border detection). Results: Excellent correlations (R2 > 0.98) were found between MRI and RT3DE. Bland–Altman analysis revealed an underestimated LV end‐diastolic volume (LV‐EDV) for both TomTec (−9.4 ± 8.7 mL) and QLAB (−16.4 ± 13.1 ml). Also, an underestimated LV end‐systolic volume (LV‐ESV) for both TomTec (−4.8 ± 9.9 mL) and QLAB (−8.5 ± 14.2 mL) was found. LV‐EDV and LV‐ESV were significantly more underestimated with QLAB software. Both programs accurately calculated LV ejection fraction (LV‐EF) without a bias. Interobserver variability was 6.4 ± 7.8% vs. 12.2 ± 10.1% for LV‐EDV, 7.8 ± 9.7% vs. 13.6 ± 11.2% for LV‐ESV, and 7.1 ± 6.9% vs. 9.7 ± 8.8% for LV‐EF for TomTec vs. QLAB, respectively. The analysis time was shorter with QLAB (4 ± 2 minutes vs. 6 ± 2 minutes, P < 0.05). Conclusions: RT3DE with TomTec or QLAB software analysis provides accurate LV‐EF assessment in cardiomyopathic patients with distorted LV geometry and adequate 2D image quality. However, LV volumes may be somewhat more underestimated with the current QLAB software version.
Effusive Constrictive Pericarditis: 2D, 3D Echocardiography and MRI Imaging
Authors: Zagol Brian , Minderman Daniel , Munir Ahmad , D'Cruz Ivan
Published: May 2007

The entity of effusive constrictive pericarditis (ECP) combines clinical and echocardiographic features of pericardial effusion and constrictive pericarditis. We describe a case of ECP, of probable tuberculous etiology, with typical hemodynamic findings of pericardial constriction, which persisted after the pericardial effusion was drained. Thickening of parietal and visceral pericardium was seen on 2D and 3D echo, and on MRI. Two important variations of ECP—due to tuberculous and to staphylococcal etiology, respectively—show some important differences that are relevant to management of therapy.
Right Ventricular Function Assessment: Comparison of Geometric and Visual Method to Short‐Axis Slice Summation Method
Authors: Drake Daniel , Gupta Ritesh , Lloyd Steven G. , Gupta Himanshu
Published: May 2007

Background: Short‐axis summation (SAS) method applied for right ventricular (RV) volumes and right ventricular ejection fraction (RVEF) measurement with cardiac MRI is time consuming and cumbersome to use. A simplified RVEF measurement is desirable. We compare two such methods, a simplified ellipsoid geometric method (GM) and visual estimate, to the SAS method to determine their accuracy and reproducibility. Methods: Forty patients undergoing cine cardiac MRI scan were enrolled. The images acquired were analyzed by the SAS method, the GM (area and length measurement from two orthogonal planes) and visual estimate. RVEF was calculated using all three methods and RV volumes using the SAS and GM. Bland–Altman analysis was applied to test the agreement between the various measurements. Results: Mean RVEF was 49 ± 12% measured by SAS method, 54 ± 12% by the GM, and 49 ± 11% by visual estimate. There were similar bias and limits of agreement between the visual estimate and the GM compared to SAS. The interobserver variability showed a bias close to zero with limits of agreement within ±10% absolute increments of RVEF in 35 of the patients. The RV end‐diastolic volume by GM showed wider limits of agreement. The RV end‐systolic volume by GM was underestimated by around 10 ml compared to SAS. Conclusion: Both the visual estimate and the GM had similar bias and limits of agreement when compared to SAS. Though the end‐systolic measurement is somewhat underestimated, the geometric method may be useful for serial volume measurements.
Plasma‐Resistant Dense Yttrium Oxide Film Prepared by Aerosol Deposition Process
Authors: Iwasawa Junichi , Nishimizu Ryoichi , Tokita Masahiro , Kiyohara Masakatsu , Uematsu Keizo
Published: May 2007

Dense yttrium oxide film was prepared on a quartz substrate by the aerosol deposition process at the room temperature. The deposition rate was very high, 60 m/h. Thick film of 10 m was easily achievable on the quartz substrate. Transmission electron microscopy showed that the film was highly dense without voids and was composed of randomly oriented Y2O3 crystallites of sizes smaller than 20 nm. The interface between the film layer and the quartz substrate was homogeneous. The film (2‐m thick) had a high transmittance (55–85%) in the wavelength region of 250‐800 nm. The mechanical properties of the film were very good. The adhesion force of the interface between the Y2O3 layer and the quartz substrate was over 80 MPa. The Vickers hardness of the film was 7.7 GPa. The film also had an excellent plasma resistance in a gas mixture of CF4/O2. Outstanding results were noted in eroded depth, surface roughness, nanostructure, and transmittance change after plasma exposure of the film.
Surface Phase Transformation During Grinding of Y‐TZP
Authors: Juy Alberto , Anglada Marc
Published: May 2007

Phase transformation by grinding has been studied in heat‐treated 2.5% molar Y‐TZP with a duplex tetragonal–cubic microstructure developed by exposure at 1650°C for different times as well as in specimens with a large amount of monoclinic phase induced by prior aging at 300°C in air. For the grinding process used, it is shown that no monoclinic phase is detected in high transformable microstructures with a relatively large tetragonal grain size. Additional experiments are discussed in which it is shown that, by grinding previously aged specimens with large fractions of monoclinic phase, the amount of this phase is strongly reduced after grinding.
Microstructure and Dielectric Properties of Barium Strontium Titanate Thick Films and Ceramics With a Concrete‐Like Structure
Authors: Zhang Hongfang , Yao Xi , Zhang Liangying
Published: May 2007

Barium strontium titanate (Ba0.6Sr0.4TiO3, BST) thick films and ceramics with a concrete‐like structure were fabricated by a novel sol–gel‐based route. In this process, well‐crystallized nano‐sized or micrometer‐sized BST powders or their combinations are dispersed into a sol–gel matrix. Crack‐free thick films and dense BST ceramics have been fabricated at a low sintering temperature with a very inhomogeneous concrete‐like structure. The dielectric properties of such thick films and ceramics have been investigated. The results show that the dielectric constant and loss tangent of the thick films are 1209 and 0.016, respectively, at 0°C, 10 kHz, and those of the bulk BST ceramics are 5510 and 0.02, respectively, at 0°C, 10 kHz.
Ion‐Exchanged Glass Laminates that Exhibit a Threshold Strength
Authors: Fillery Scott P. , Lange Frederick F.
Published: May 2007

Glass laminates, fabricated to include periodic thin layers containing biaxial compressive stresses, exhibit a threshold strength, i.e., a stress below which failure will not occur. Ion‐exchange treatments in KNO3 at 350°–450°C for periods of 3–72 h were used to create residual compressive stresses at the surface of soda lime silicate glass sheets. Wafer direct bonding of the ion‐exchanged glass sheets resulted in glass laminates with thin layers of compressive stress adjacent to the glass interface and perpendicular to the laminate top surface. Critical strain energy release measurements of the bonded interface were used to optimize the bonding temperature/time to avoid significant relaxation of the stress produced by ion exchange. Stress profiles, determined via the wafer curvature measurement method, showed a residual compressive stress maximum of 328 MPa for an ion exchange temperature of 450°C. The threshold flexural strength of the ion exchanged glass laminates was determined to be 112 MPa after the introduction of indentation cracks with indent loads ranging from 1 to 5 kg. In contrast to similar ceramic laminates, where cracks either propagate across the compressive layer or bifurcate within the compressive layer, the cracks in the glass laminates were deflected along the interface between the bonded sheets.
Impact of sleep and circadian disturbances in urinary 6‐sulphatoxymelatonin levels, on cognitive function after major surgery
Authors: Gögenur Ismail , Middleton Benita , Burgdorf Stefan , Rasmussen Lars Simon , Skene Debra J. , Rosenberg Jacob
Published: May 2007

Abstract:  Sleep and circadian disturbances may underlie cognitive dysfunction after major surgery. The aim of this study was to examine the association between sleep and circadian disturbances (as assessed by changes in the melatonin rhythm) and postoperative cognitive dysfunction (POCD). We measured subjective and objective sleep quality, excretion of the major metabolite of melatonin, 6‐sulphatoxymelatonin (aMT6s) in urine and cognitive function before and 4 days after major abdominal surgery in 36 patients. Subjective sleep quality was measured by visual analogue scale, objective sleep quality was measured by actigraphy, and cognitive function was assessed by neuropsychological testing. Eighteen patients (50%) had POCD on day 4 after surgery. At that time, the excretion of aMT6s was disturbed with significantly higher daytime excretion and a reduced night/day ratio compared with the preoperative measure (P = 0.05). Patients with POCD had significantly worse sleep quality and more night awakenings (P < 0.05) but we found no significant differences in day time (06:00–22:00 hr), night‐time (22:00–06:00 hr) or total aMT6s excretion (μg/24 hr). A significant correlation was found between the total excretion of aMT6s and actigraphically measured sleep efficiency (rs = 0.45, P = 0.03) and wakefulness after sleep onset (rs = −0.44, P = 0.04). In conclusion, POCD was associated with worse subjective sleep quality and more awakenings. Circadian rhythmicity as assessed by aMT6s excretion was disturbed after surgery but we were unable to show an association with POCD. Strategies to improve postoperative sleep quality should be investigated in the future.
Current state of vitiligo therapy – evidence‐based analysis of the literature
Authors: Forschner Tobias , Buchholtz Stefan , Stockfleth Eggert
Published: May 2007

Vitiligo is a skin disease with a worldwide prevalence ranging from 0.5% to 4%. Conservative therapies include photochemotherapy, phototherapy with UVB radiation (broadband UVB 290–320 nm, narrow band UVB 311 nm), systemic steroids and pseudocatalase. Modern therapeutic options include treatment with topical immunomodulators (tacrolimus, pimecrolimus), analogues of vitamin D3, excimer laser and surgery/transplantation. Our analysis compares these therapies for vitiligo and the evidence levels supporting their effectiveness.

Conclusions: The face and neck respond best to all therapeutic approaches, while the acral areas are least responsive. For generalized vitiligo, phototherapy with UVB radiation is most effective with the fewest side effects; PUVA is the second best choice.Topical corticosteroids are the preferred drugs for localized vitiligo. They may be replaced by topical immunomodulators which display comparable effectiveness and fewer side effects.The effectiveness of vitamin D analogues is controversial with limited data. Surgical therapy can be very successful, but requires an experienced surgeon and is very demanding of time and facilities, thus limiting its widespread use. L‐phenylalanine therapy appears effective on the face but enjoys neither widespread use nor extensive data support. No single therapy for vitiligo can be regarded as the most effective as the success of each treatment modality depends on the type and location of vitiligo.
Cryosurgical treatment of lentigo maligna
Authors: De Moraes Aparecida Machado , Pavarin Lilian Bianchi , Herreros Fernanda , De Aguiar Michelman Fábia , Velho Paulo Eduardo Neves Ferreira , De Souza Elemir Macedo
Published: May 2007

Background: Lentigo maligna (LM) is a common melanocytic malignancy which requires therapy because of the risk of progression to invasive lentigo maligna melanoma which a much worse prognosis.

Patients and Methods: 18 patients with clinical and histopathological diagnosis of LM were treated with cryosurgery.The patients were older Caucasians (mean age 59.5 years) and 11 were male. They were chosen for cryosurgery because the lesion posed a surgical challenge or the patient was not a good surgical candidate. They were treated with two freeze‐thaw cycles of liquid nitrogen under local anesthesia in a single sitting. Lesions larger than 2 cm2 were divided into smaller segments for freezing.

Results: The lesions resolved clinically in all cases, with no recurrence or metas‐tasis detected during a mean follow‐up of 75.5 months. Some patients developed hypopigmented scars.

Conclusions: Cryosurgery with liquid nitrogen is an efficient, safe and in most cases aesthetically acceptable alternative method to treat LM.
Granulomatous jellyfish dermatitis
Authors: Ulrich Heidi , Landthaler Michael , Vogt Thomas
Published: May 2007

The induction of a granulomatous inflammation by jellyfish toxins is rare. More typically, acute toxic and urticarial reactions are seen. An 11‐year‐old boy developed a striated urticarial erythema on the left cheek after contact with a gelatinous mass while swimming in the sea in Croatia. After initial erosion, a striated induration developed in the area of contact. Histological examination revealed a granulomatous inflammation with some eosinophils. While topical steroid‐based antiinflammatory and antibacterial therapy over several weeks was not effective, topical therapy with tacrolimus 0.1% for two two‐week treatment periods led to healing of the skin changes with a slight scar. There was no clinical recurrence after 5 month of follow‐up.
A Realist View of Aging, Mortality, and Future Longevity
Authors: Carnes Bruce A. , Olshansky S. Jay
Published: May 2007

Differences in methodology and philosophy have led scientists analyzing the same mortality data to arrive at very different conclusions about the behavior of mortality trajectories, the nature of aging, and the future of human longevity. This note describes the authors’views on these issues, which taken together can be termed a “realist” position. In this view, life expectancy is unlikely to exceed an average of 85 years absent significant advances in the control of aging. We identify a number of myths that have been attached to our work: 1) Reaching an average life expectancy of 85 years is a pessimistic outlook for human longevity, 2) Species possess an intrinsic mortality schedule that cannot be modified by human intervention, 3) Realist scenarios of the future course of human longevity are based on notions of biological determinism, 4) Realists assert that there is an age beyond which there can be no survivors, 5) Hypothesized biological barriers to longer life spans have been scientifically studied and refuted, and 6) Realists claim that life expectancy at birth cannot exceed 85 years. In dispelling these myths, we hope to provide a more accurate representation of our school of biodemographic thought.
Becoming Aware of What You Know or Need to Know: Gathering Client and Context Characteristics in Day Services for Persons With Profound Intellectual and Multiple Disabilities
Authors: Vlaskamp C. , Hiemstra S. J. , Wiersma L. A.
Published: May 2007

Abstract  Persons with profound and multiple disabilities (PIMD) are dependent on staff to be sufficiently knowledgeable as to provide them with appropriate day services. One important determinant of the appropriateness and adequacy of a day support program is the level to which staff have detailed and specific knowledge about the functional abilities and the sensory and contextual preferences of their clients, and use this information when providing day activity center services. The authors conducted a study designed to determine what staff know about their clients’ capabilities and functioning and whether they applied this knowledge to the delivery of day services. Thirty‐three direct care activity center staff members from seven different residential facilities throughout the Netherlands were involved in the research. The study used a questionnaire designed as a flow chart, which parsed knowledge within nine categories, five related to the client’s functional abilities and four related to the client’s sensory and contextual preferences. Results indicate that staff generally lacked specific information on the adults in their day activity center, and this impaired their ability to select and provide appropriate activities. The authors concluded that a relatively simple and easy‐to‐design questionnaire can provide a good overview of the special training that is needed by staff who are responsible for offering activities to persons with PIMD.
The autophagic response to nutrient deprivation in the hl‐1 cardiac myocyte is modulated by Bcl‐2 and sarco/endoplasmic reticulum calcium stores
Authors: Brady Nathan R. , Hamacher‐Brady Anne , Yuan Hua , Gottlieb Roberta A.
Published: May 2007

Macroautophagy is a vital process in the cardiac myocyte: it plays a protective role in the response to ischemic injury, and chronic perturbation is causative in heart disease. Recent findings evidence a link between the apoptotic and autophagic pathways through the interaction of the antiapoptotic proteins Bcl‐2 and Bcl‐XL with Beclin 1. However, the nature of the interaction, either in promoting or blocking autophagy, remains unclear. Here, using a highly sensitive, macroautophagy‐specific flux assay allowing for the distinction between enhanced autophagosome production and suppressed autophagosome degradation, we investigated the control of Beclin 1 and Bcl‐2 on nutrient deprivation‐activated macroautophagy. We found that in HL‐1 cardiac myocytes the relationship between Beclin 1 and Bcl‐2 is subtle: Beclin 1 mutant lacking the Bcl‐2‐binding domain significantly reduced autophagic activity, indicating that Beclin 1‐mediated autophagy required an interaction with Bcl‐2. Overexpression of Bcl‐2 had no effect on the autophagic response to nutrient deprivation; however, targeting Bcl‐2 to the sarco/endoplasmic reticulum (S/ER) significantly suppressed autophagy. The suppressive effect of S/ER‐targeted Bcl‐2 was in part due to the depletion of S/ER calcium stores. Intracellular scavenging of calcium by BAPTA‐AM significantly blocked autophagy, and thapsigargin, an inhibitor of sarco/endoplasmic reticulum calcium ATPase, reduced autophagic activity by ∼ 50%. In cells expressing Bcl‐2–ER, thapsigargin maximally reduced autophagic flux. Thus, our results demonstrate that Bcl‐2 negatively regulated the autophagic response at the level of S/ER calcium content rather than via direct interaction with Beclin 1. Moreover, we identify calcium homeostasis as an essential component of the autophagic response to nutrient deprivation.
Is It Time for a New Category of Nursing Diagnosis?
Authors: Meyer Geralyn A. , Lavin Mary Ann , Perry Anne G.
Published: May 2007

Professional vigilance, the art of “watching out,” is the essence of nursing. Vigilance is the mental process that makes the informed nursing actions of assessment, diagnosis, intervention, and evaluation possible and meaningful. Nursing vigilance must be described in our nursing terminology or it risks remaining invisible to others. We propose that the current definition of nursing diagnosis be expanded to include surveillance diagnoses for which the nurse has the responsibility for problem identification and ongoing monitoring. Inclusion of surveillance diagnoses in the NANDA International taxonomy will better reflect the breadth and depth of nursing practice.
Sex and Season Affect Individual‐Level Diet Variation in the Neotropical Marsupial Gracilinanus microtarsus (Didelphidae)
Authors: Martins Eduardo Guimarães , Araújo Márcio Silva , Bonato Vinícius , Reis Sérgio Furtado dos
Published: May 2007

Individual‐level diet variation was investigated in Gracilinanus microtarsus, an insectivorous marsupial whose diet is affected by sex and season in the highly seasonal Brazilian Cerrado. To measure individual‐level diet variation, the diets of individual males and females were compared to that of their population in the warm‐wet and cool‐dry seasons using the proportional similarity index (PSi). This index varies from 1 (complete overlap between the individual i 's and population's diets) toward 0 (decreasing overlap). Mean PSi values were computed as a measure of the degree of interindividual diet variation (the larger the mean PSi value, the smaller the variation among individuals’ diets). Interindividual diet variation among females was similar between seasons, whereas among males it decreased from the warm‐wet to the cool‐dry season. Diet variation among males is probably reduced in the cool‐dry season because of constraints on food consumption generated by interactions between endogenous (physiological needs associated with high rates of body mass growth) and exogenous (food limitation) factors.