bluuebunny/crossref_metadata_2025 huggingface dataset:
Inhibition of bladder overactivity by stimulation of feline pudendal nerve using transdermal amplitude‐modulated signal (TAMS)
Authors: Tai Changfeng , Shen Bing , Wang Jicheng , Liu Hailong , Subbaroyan Jeyakumar , Roppolo James R. , de Groat William C.
Published: August 2011

What's known on the subject? and What does the study add?

It is known that direct stimulation of pudenal nerve using a cuff electrode can inhibit normal bladder activity. This study further indicates that overactive bladder activity can be inhibited using non‐invasive skin surface electrodes and a transdermal amplitude‐modulated signal (TAMS).

OBJECTIVE

To develop a non‐invasive neuromodulation method targeting the pudendal nerve.

MATERIALS AND METHODS

Bladder overactivity induced by acetic acid (AA) irritation was partially suppressed by electrical stimulation of the pudendal nerve in α‐chloralose anaesthetized cats using a transdermal amplitude‐modulated signal (TAMS).

RESULTS

During cystometrography (CMG), intravesical infusion of 0.25% AA significantly decreased the mean (se) bladder capacity to 28.8 (5.9)% of the capacity measured during saline infusion.

The TAMS stimulation inhibited AA‐induced bladder overactivity at 5, 7 and 10 Hz, and significantly increased the mean (se) bladder capacity to 61.8 (9.9)%, 51.3 (14.5)%, 53.6 (14.9)%, respectively, of the control capacity during saline infusion, whereas stimulation at 20–40 Hz had no effect.

Under isovolumetric conditions at a bladder volume ranging between 130 to 160% of the bladder capacity measured during AA infusion, TAMS stimulation at all frequencies (5–40 Hz) significantly suppressed the irritation‐induced rhythmic bladder contractions, reduced the area under the bladder pressure curve, and decreased the frequency of bladder contractions. However, the amplitude of rhythmic bladder contractions was only significantly decreased at stimulation frequencies of 5–20 Hz.

At bladder volumes above the AA control capacity, TAMS stimulation with frequencies of 20–30 Hz had an excitatory effect, resulting in large amplitude (>25 cmH2O) bladder contractions.

CONCLUSIONS

TAMS stimulation targeting the cat pudendal nerve can inhibit C‐fibre afferent‐mediated bladder overactivity.

Thus, clinical research seems warranted to explore the usefulness of this technology for patients with overactive bladder symptoms.
Significance of histological prostatitis in patients with urinary retention and underlying benign prostatic hyperplasia or adenocarcinoma of the prostate
Authors: van Vuuren Stephan P.J. , Heyns Chris F. , Zarrabi Amir D.
Published: August 2011

What's known on the subject? and What does the study add?

It is known that histological prostatitis is associated with a significantly higher risk for acute urinary retention in men with BPH. This study showed that, in men with BPH, histological prostatitis was associated with urinary retention at a significantly younger age and with higher serum PSA levels. In men with ACP, histological prostatitis was associated with urinary retention at an earlier stage of cancer.

Study Type – Prognosis (individual cohort)

Level of Evidence 2b

OBJECTIVE

To compare the clinical features of patients having urinary retention and benign prostatic hyperplasia (BPH) with those having adenocarcinoma of the prostate (ACP) and to evaluate the significance of histological prostatitis.

PATIENTS AND METHODS

The clinical data and histopathology reports of patients with retention admitted to Tygerberg Hospital between September 1998 and June 2007 were evaluated.

Statistical analysis was performed with Student's t‐test, Mann–Whitney test and Fisher's exact test where appropriate and P < 0.05 was considered to indicate statistical significance.

RESULTS

Prostatic histology was available in 405 patients, 204 with BPH and 201 with ACP.

Comparing those with BPH and those with ACP showed statistically significant differences in mean age (69.5 vs 71.9 years), serum prostate‐specific antigen (PSA) level (18.6 vs 899.5 ng/mL) and histological prostatitis (48 vs 25%) but not duration of catheterization, prostate volume or urinary tract infection (UTI).

Comparing those with BPH only and those with BPH plus prostatitis showed significant differences in mean age (71.9 vs 67.1 year) and PSA level (14.6 vs 22.8 ng/mL) but not prostate volume, UTI or duration of catheterization.

Comparing those with ACP only and those with ACP plus prostatitis showed significant differences in stage T4 cancer (68.1 vs 35.4%) and PSA level (1123.4 vs 232.4 ng/mL) but not age, prostate volume, UTI or duration of catheterization.

CONCLUSIONS

Histological prostatitis was almost twice as common in patients with urinary retention associated with underlying BPH than in patients with ACP, but there was no significant difference in the duration of catheterization, prostatic volume or presence of UTI, suggesting that histological prostatitis more often contributes to the development of retention in patients with underlying BPH than in those with ACP.

In patients with BPH, histological prostatitis was associated with urinary retention at a significantly younger age and with higher serum PSA levels.

In patients with ACP, histological prostatitis was associated with urinary retention at an earlier stage of cancer.
Auditors’ going‐concern‐modified opinions after 2001: measuring reporting accuracy
Authors: Carey Peter , Kortum Stuart , Moroney Robyn
Published: August 2011

An important change in auditors’ reporting behaviour in the period after the high‐profile corporate collapses in 2001 is that auditors were more likely to issue going‐concern (GC)‐modified audit opinions. Comparing company failure rates subsequent to receiving a first‐time going‐concern (FTGC)‐modified audit opinion in the pre‐ and post‐2001 periods, we find a consistent type 1 error (misclassification) rate (the rate of survival among companies issued an FTGC opinion). Results are indicative of auditors maintaining GC reporting accuracy when comparing the 1995–1996 and 2004–2005 periods. This conclusion is supported after considering the impact of mitigating circumstances surrounding companies that received an FTGC‐modified audit report and survived.
Example‐Driven Deformations Based on Discrete Shells
Authors: Fröhlich Stefan , Botsch Mario
Published: August 2011

Despite the huge progress made in interactive physics‐based mesh deformation, manipulating a geometrically complex mesh or posing a detailed character is still a tedious and time‐consuming task. Example‐driven methods significantly simplify the modelling process by incorporating structural or anatomical knowledge learned from example poses. However, these approaches yield counter‐intuitive, non‐physical results as soon as the shape space spanned by the example poses is left. In this paper, we propose a modelling framework that is both example‐driven and physics‐based and thereby overcomes the limitations of both approaches. Based on an extension of the discrete shell energy we derive mesh deformation and mesh interpolation techniques that can be seamlessly combined into a simple and flexible mesh‐based inverse kinematics system.
A practice‐based critique of English as a Lingua Franca
Authors: PARK JOSEPH SUNG‐YUL , WEE LIONEL
Published: August 2011

ABSTRACT:  This paper identifies several key issues that have emerged through the debate over English as a Lingua Franca (ELF), and suggests a practice‐based perspective—which treats language not as a fixed system but as an emergent product of speakers’ practices—as a guide for reconsidering some fundamental assumptions of the ELF research project. In particular, this paper suggests viewing ELF not as a variety, but as an activity type, where the goal of interaction involves the need to communicate in a situation where the participants do not share the same first language. It claims that such a reconceptualization can help us explore the accommodative practices of ELF speakers with greater sensitivity to issues of power, enrich our understanding of intelligibility and how it is mediated by language ideologies, and develop a pedagogy that emphasizes greater cross‐cultural awareness and sensitivity.
Intercultural processes in accented English
Authors: RIVERS DAMIAN J.
Published: August 2011

ABSTRACT: This study assessed the attitudinal responses of 48 Japanese university students towards 10 accented English speech samples across nine evaluative criteria. Of the 10 samples, one was a Japanese‐English speech sample (the intracultural familiar), seven were non‐native‐English samples originating from a variety of Asian countries (intercultural others), and two were native‐English samples originating from America and England (preferred intercultural others). Framed within socio‐psychological intergroup theories of identity, and current debates concerning English as a Foreign Language (EFL), the results indicate that although the students favoured the native‐English speech samples, they were generally unsuccessfully in identifying where the speaker of each speech sample originated. This paper contends that the native English speech samples were afforded a kind of quasi‐ingroup status among the Japanese students, while the non‐native Asian speech samples were positioned firmly within a distant outgroup category. The results are discussed in relation to the development of positive intercultural relationships, the domestic presence of the foreigner and the implications for the future of ELT within Japan.
Asian varieties of English: Attitudes towards pronunciation
Authors: TOKUMOTO MINA , SHIBATA MIKI
Published: August 2011

ABSTRACT:  According to previous studies, Japanese EFL learners who wish to acquire American or British English pronunciation are reluctant to speak their L1‐accented English. In view of this tendency, the present study examined the attitudes of Asian learners toward their L1‐accented English. University students from Japan, South Korea, and Malaysia evaluated their English pronunciation by responding to a questionnaire. The results of the survey revealed the extent to which their acceptance of their English accents differs: the Malaysian students highly valued their accented English, while the Japanese and Koreans disapproved of their own varieties of English and indicated their preference for native English pronunciation. In particular, the Japanese participants’ negative attitude toward their Japanese‐accented English was found to be the greatest among the three groups. The distinct trend among the groups will be discussed with consideration of the historical and political backgrounds in the societies which might have impacted on the process of constructing L2 learners’ language identity. These backgrounds should have a substantial influence on current educational policy and social actions in each country. Finally, pedagogical implications for English education in Japan will be argued discussed.
English as an international language: A curriculum blueprint
Authors: MATSUDA AYA , FRIEDRICH PATRICIA
Published: August 2011

ABSTRACT:  The use of English as an international language (EIL) and its implications for teaching have attracted much scholarly attention. However, much of the discussion has remained at an abstract level and not provided pedagogical ideas that are theoretically sound, informed by research, and at the same time specific enough to be useful in the classroom. This poses a great challenge for teachers: while they receive a strong message that their current practice may be inadequate in preparing learners for using English in international encounters, they are not presented with suggestions of where to start implementing changes. The goal of this paper is to build upon the existing literature on teaching English for international communication with greater emphasis on pedagogical decisions and practices in the classroom. Using the conceptualization of EIL as a function of English as an international common language rather than a linguistic variety used uniformly in all international contexts, we explore key questions in TEIL and suggest specific ways to introduce an EIL perspective to existing English language classrooms.
Occupational Health and Safety Management in Organizations: A Review
Authors: Zanko Michael , Dawson Patrick
Published: August 2011

In examining the research literature on occupational health and safety (OHS), this paper argues that the growth in the number of specialists in OHS has resulted in an emphasis on policy and practice away from more scholastic concerns previously addressed by academics in the disciplines of psychology and sociology. A hiatus has occurred, and this is evidenced by the general absence of studies in management, even though OHS is increasingly seen as a key operational and strategic concern of business organizations. The authors call for OHS to be placed firmly on the research agenda of management scholars, and advocate the need for greater conceptual development, empirical study and theoretical reflection to complement existing pragmatic concerns of OHS specialists. In this review, the contributions of psychology, sociology, industrial relations and management studies are assessed, and five categories of specialist OHS literature are analysed, namely: prescriptive; systematic OHS management; success based; error and disaster based; and culture, climate and high‐reliability studies. The conceptual and methodological limitations of this specialist focus are discussed, and future research opportunities are highlighted, for which the authors argue that management scholars embrace a range of methodological approaches. The authors advocate the value of extended case studies which examine OHS in context and over time in particular workplace settings. There remains considerable scope to develop this field further and, in conclusion, particular attention is drawn to the value of process‐oriented contextual approaches for understanding OHS management in organizations.
The Management of Circulations: Biopolitical Variations after Foucault
Authors: Munro Iain
Published: August 2011

This paper provides a review of the reception of Foucault's later work on biopolitics within management and organization studies and contrasts this with the reception of these ideas in sister fields of research in the social sciences. In his later work, Foucault developed original conceptions of power, including ‘biopolitics’, ‘the apparatus of security’ and ‘neo‐liberal governmentality’, which marked a departure from his conception of disciplinary power. This paper explores these concepts and elaborates the implications of these ideas for management studies. The structure of this argument is divided as follows. The first section outlines Foucault's concept of biopolitics and neo‐liberal governmentality, distinguishing these systems of control clearly from the concept of disciplinary power. The second section then undertakes a synthesis and evaluation of the extent to which these ideas have been developed within the field of management and organization studies. The final section provides a discussion of how these concepts have been used within other social sciences, distinguishing between three key approaches to their development in terms of: (a) the concept of governmentality; (b) the concept of immaterial labour; and (c) the concept of biocapital. Based on this analysis, a framework is developed which can serve as a basis for future research into the significance of these new biopolitical systems of control for management studies.
Prevalence and correlation of conventional and lupus‐specific risk factors for cardiovascular disease in Chinese systemic lupus erythematosus patients
Authors: Yang L. , Tao J. , Tang X. , Wang Y. , He X. , Xu G. , Ren Y. , Tu Y.
Published: August 2011

Background  It has become clear that the morbidity and mortality of patients with lupus and cardiovascular disease (CVD) have substantially increased. Therefore, we designed a retrospective case–control study to assess the prevalence of traditional and lupus‐specific risk factors for CVD in Chinese systemic lupus erythematosus (SLE) patients.

Objective  To identify the prevalence and correlation of conventional and lupus‐specific risk factors for CVD in Chinese SLE patients.

Methods  One hundred and thirty‐nine patients with SLE were enrolled in the study. They were compared with 139 age and gender‐matched controls, who had no history of SLE or CVD. Among 139 SLE patients, there were 38 with CVD. We compared them with 38 SLE patients without CVD, matching for disease duration and age. Data regarding classic and lupus‐specific risk factors were assessed between the two groups.

Results  Hypertension, serum creatinine and diabetes mellitus were more prevalent among SLE than the controls (P < 0.05). The patients with SLE were more likely to have elevated total, low‐density lipoprotein cholesterol and triglyceride levels than the controls (P < 0.001). However, high‐density lipoprotein levels in SLE patients were lower than that in controls (P = 0.019). After being compared with SLE patients without CVD, the patients with both SLE and CVD were more likely to have elevated serum creatinine, proteinuria, the presence of anti‐Sm antibody and decreased complement 4 (C4) levels (P < 0.05). Moreover, the patients with both diseases were less likely to be treated with hydroxychloroquine (P < 0.05). In multivariable analysis, elevated serum creatinine, proteinuria, decreased C4 levels, the presence of anti‐Sm antibody and the lack of using hydroxychloroquine were independent risk factors for CVD (P < 0.05).

Conclusions  We are able to identify some conventional and lupus‐specific risk factors for CVD in Chinese SLE patients.
Acral lesions of vitiligo: why are they resistant to photochemotherapy?
Authors: Esmat S.M. , El‐Tawdy A.M. , Hafez G.A. , Zeid O.A. , Abdel Halim D.M. , Saleh M.A. , Leheta T.M. , ElMofty M.
Published: August 2011

Background  Acral lesions of vitiligo are usually resistant to conventional lines of treatment as well as surgical interventions.

Objective  To clarify causes underlying resistance of acral lesions to pigmentation in vitiligo by studying some of the factors associated with mechanisms of repigmentation following photochemotherapy.

Methods  The study included twenty patients with active vitiligo. Skin biopsies were taken from lesional and perilesional skin of areas expected to respond (trunk and proximal limb) and skin of acral areas, before and after PUVA therapy. Sections were stained with H and E, Melan‐A, MHCII, CD1a, SCF and c‐kit protein.

Results  Before treatment acral areas showed significantly lower hair follicle density, melanocyte density, Langerhans cell (LC) density, epidermal MHCII expression, lesional SCF expression and perilesional c‐kit expression. Following treatment with PUVA in both non‐responsive acral and repigmenting non‐acral lesions identical immunohistochemical changes in the form of significant decrease in LC density, epidermal MHC‐II and SCF expression were observed.

Conclusion  The surprisingly similar histochemical changes in response to PUVA in acral and non‐acral lesions did not manifest with clinical repigmentation except in non‐acral ones. Factors such as inherent lower melanocyte density, lower melanocyte stem cell reservoirs and/or lower baseline epidermal stem cell factor may be considered as possible play makers in this respect.
Pupillary responses and event‐related potentials as indices of the orienting reflex
Authors: Steiner Genevieve Z. , Barry Robert J.
Published: August 2011

This study examined skin conductance responses, the late positive complex of the event‐related potential, and pupillary dilation responses as autonomic and central correlates of the orienting reflex (OR) in the context of indifferent and significant stimuli. In particular, we aimed to clarify the inconsistencies surrounding the pupillary dilation response as an OR index. An auditory dishabituation paradigm was employed, and physiological measures were recorded from 24 participants. Response decrement to a repeated stimulus, response recovery to a change stimulus, and subsequent dishabituation were assessed. Findings confirmed expectations that the skin conductance response and the late positive complex are indices of the OR. The pupillary dilation response, however, demonstrated an unexpected sensitivity to stimulus novelty only, while the prestimulus measure of tonic pupil diameter showed the significance effect that was expected of the phasic measure. Together, these findings argue against the suggestion that the pupillary dilation response is an OR index. The diverse results obtained from this experiment contribute to our understanding of the OR, and provide impetus for further research with a variety of paradigm manipulations.
Island biogeography is not a single‐variable discipline: the small island effect debate
Authors: Triantis Kostas A. , Sfenthourakis Spyros
Published: August 2011

In some island systems, an ‘anomalous’ feature of species richness on smaller islands, in comparison with larger ones, has been observed. This has been described as the small island effect (SIE). The precise meaning of the term remains unresolved, as does the explanation for the phenomenon and even whether it exists. Dengler (2010; Diversity Distrib, 16, 256–266.) addresses a number of conceptual and methodological issues concerning the nature and the detection of the SIE but fails to settle conclusively most of the issues he raises. We contend that his approach is theoretically flawed, especially in its treatment of habitat diversity. We offer a few suggestions of what is needed to advance understanding of the SIE.
Fatigue Life Estimation of Structural Components Using Macrofibre Composite Sensors
Authors: Butrym B. A. , Kim M. H. , Inman D.
Published: August 2011

Abstract:  Recently, a number of different structural health monitoring (SHM) techniques have been developed for the online inspection of air, land and sea engineering structures. Various smart materials are employed for detecting eminent damage in situ. Fatigue cracks in structural components are the most common cause of structural failure when exposed to fatigue loading. Fatigue design of structural components is typically accomplished either using a set of stress cycle (S‐N) data obtained from prior fatigue tests or using the fracture mechanics approach. The fracture mechanics approach considers the fatigue life of structures as a summation of crack initiation life and crack propagation life. The stress intensity factor (SIF) is required for the estimation of fatigue crack propagation life from the linear elastic fracture mechanics (LEFM) perspective. However, the accurate prediction of the SIF is difficult especially when the geometry or the boundary conditions of a structure becomes complex. In this study, a SHM application of macrofibre composite (MFC) sensors is presented. A set of MFC sensors is used for the real‐time measurement of the SIF. The measured values of the SIF are later used for the prediction of the crack propagation life. The impedance‐based SHM technique using the same set of MFC sensors is employed for the detection of crack initiation life.
Greenhouse gas mitigation potential of agricultural land in Great Britain
Authors: Fitton N. , Ejerenwa C. P. , Bhogal A. , Edgington P. , Black H. , Lilly A. , Barraclough D. , Worrall F. , Hillier J. , Smith P.
Published: August 2011

The aim of this paper is to assess the greenhouse gas (GHG) mitigation potential of croplands and grasslands in Great Britain under different management practices. We consider the feasible land management options for grass and cropland using county level land‐use data with estimates of per‐area mitigation potential for individual and total GHGs, to identify the land management options with the greatest cost‐effective mitigation potential. We show that for grasslands, uncertainties still remain on the mitigation potential because of their climatic sensitivity and also their less intensive management. For croplands in Great Britain, the technical mean GHG mitigation potentials for all cropland management practices range from 17 Mt CO2‐eq. per 20 yr to 39 Mt CO2‐eq. per 20 yr. There are significant regional variation in all cases, with the greatest potentials in England, negligible potential in Wales and intermediate potential in Scotland, with country differences largely driven by the areas of cropland and grassland in each country. Practices such as agronomic improvement and nutrient management are the most promising options because of their impact on N2O emissions and also their larger potential at low cost. In terms of annual emissions from agriculture, calculated mitigation potentials are small, where the technical mitigation potential of agronomy and nutrient management strategies are ca. 4.5 and 3.8%, respectively (agricultural emissions account for ca. 9% or 47.7 Mt CO2‐eq., of total Great Britain GHG emissions, Department of Energy and Climate Change, UK). However when compared with the land use, land‐use change and forestry sector (LULUCF) emissions, nutrient management would reduce further emission reductions by approximately half of the 2005 LULUCF sink (i.e. −1.6 Mt CO2‐eq. per year).
Estimating and mapping the carbon saturation deficit of French agricultural topsoils
Authors: Angers D. A. , Arrouays D. , Saby N. P. A. , Walter C.
Published: August 2011

The concept of soil organic C (SOC) saturation suggests that the quantity of stable SOC is limited and determined by the amount of fine particles (clay + fine silt, Clay + fSilt). The difference between the theoretical SOC saturation value and the measured SOC one for the fine fraction corresponds to the soil’s saturation deficit and may represent the potential for SOC sequestration in a stable form. We calculate the saturation deficit of French arable soils based on the national soil test database and using the saturation equation. For the whole database (n = 1 454 633), the median saturation deficit was 8.1 gC/kg and this generally increased with the Clay + fSilt content to reach a maximum of 500 g/kg. National mapping of the SOC saturation deficit allowed investigation of spatial variation and controlling factors. Saturated soils were found in localities with specific land use (grassland, meadows) or farming systems (livestock production with high manure production). Smaller deficits occurred at higher altitudes, probably due to the combined effect of cooler temperature and the presence of meadows. Some very sandy soils appeared to be almost saturated, largely due to their very small fine fraction. Soils in the highly cultivated plains in the northern half of the country had a significant saturation deficit. Soils in the southern part of the country had the highest saturation deficit because of the combined effects of climatic factors (low production, high temperature) and land use (vineyards, orchards). Analysis of communal data revealed significant correlations at the national level with Clay + fSilt (r = 0.59), pH (r = 0.44) but also with the proportion of grassland in the cultivated area (r = −0.47). Some areas had apparent oversaturation which may be due to uncertainty associated with the theoretical C saturation equation because of overestimation of the stable soil C fraction. Mapping the C saturation deficit at the national scale demonstrates the influence of climate, soil parameters and land use on the SOC stabilization potential and indicates that a significant proportion of agricultural soils have potential for further SOC storage.
Earnings Volatility, Post–Earnings Announcement Drift, and Trading Frictions
Authors: CAO SEAN SHUN , NARAYANAMOORTHY GANAPATHI S.
Published: August 2011

We find that lower ex ante earnings volatility leads to higher Post–Earnings Announcement Drift (PEAD). PEAD is a function of both the magnitude of an earnings surprise and its persistence. While prior research has largely investigated market reactions to the magnitude of the earnings surprise, in this study we show that the persistence of the earnings surprise is equally important. A unique feature of the anomalous PEAD returns documented here concerns the association between abnormal returns and trading frictions. Besides demonstrating that firms with lower earnings volatility have higher abnormal returns, we also find that lower earnings volatility firms have lower trading frictions. Taken together, these findings imply that higher abnormal returns are associated with lower trading frictions. We exploit this implication to empirically demonstrate that PEAD returns due to earnings volatility are not concentrated in the firms with the largest trading frictions, which is in contrast to the findings in prior anomaly studies.
Evolving concepts in primary sclerosing cholangitis
Authors: Krones Elisabeth , Graziadei Ivo , Trauner Michael , Fickert Peter
Published: August 2011

Patients suffering from primary sclerosing cholangitis (PSC) show considerable differences regarding clinical manifestations (i.e. large duct versus small‐duct PSC, presence or absence of concomitant inflammatory bowel disease), disease progression, risk for malignancy and response to therapy, raising the question whether PSC may represent a mixed bag of diseases of different aetiologies. The growing list of secondary causes and diseases ‘mimicking’ or even overlapping with PSC (e.g. IgG4‐associated sclerosing cholangitis), which frequently causes problems in clear‐cut discrimination from classic PSC and the emerging knowledge about potential disease modifier genes (e.g. variants of CFTR, TGR5 and MDR3) support such a conceptual view. In addition, PSC in children differs significantly from PSC in adults in several aspects resulting in distinct therapeutic concepts. From a clinical perspective, appropriate categorization and careful differential diagnosis are essential for the management of concerned patients. Therefore, the aim of the current review is to summarize current and evolving pathophysiological concepts and to provide up‐to‐date perspectives including future treatment strategies for PSC.
Radiofrequency Ablation of Accessory Pathways in Children and Congenital Heart Disease Patients: Impact of a Nonfluoroscopic Navigation System
Authors: PAPAGIANNIS JOHN , AVRAMIDIS DIMOSTHENIS , ALEXOPOULOS CHRYSANTHOS , KIRVASSILIS GEORGE
Published: August 2011

Background:

We sought to assess the impact of routine use of a nonfluoroscopic navigation system in the procedural aspects of radiofrequency ablation of accessory pathways (APs) in pediatric and congenital heart disease (CHD) patients and the reduction of fluoroscopy in different pathway locations.

Methods:

This was a retrospective review of 192 patients, divided in two groups: group A (76 patients, fluoroscopic only ablation) and group B (116 patients, combined use of fluoroscopy and a nonfluoroscopic system (NavX™). Comparison of procedural aspects (procedure time, fluoroscopy time, success, complications, and recurrences) was performed.

Results:

The two groups were comparable in terms of age, AP location, and presence of CHD. The mean age was 11.34 ± 4.65 years in group A versus 10.91 ± 3.68 years in group B. The procedure duration was significantly shorter in group B than in group A (177.06 ± 62.18 vs 242.45 ± 99.07) (P < 0.001). There was a significant reduction in the fluoroscopy time in group B compared to group A (8.27 ± 8.23 vs 39.77 ± 32.65 minutes) (P < 0.001). The difference between the two groups was statistically significant in all categories of APs. The success rate was 97.4% in group A and 96.6% in group B. There were no complications directly related to the use of the nonfluoroscopic system. There was no difference in the recurrence rate.

Conclusions:

The use of a nonfluoroscopic system for catheter navigation resulted in significant reduction of total procedure and fluoroscopy time during catheter ablation of APs in pediatric and CHD patients, regardless of the location of the pathway, without a compromise in safety and efficacy. (PACE 2011; 34:1288–1296)
Sexual functioning in chronic kidney disease: The association with depression and anxiety
Authors: Theofilou Paraskevi A.
Published: August 2011

Sexual functioning is composed of both physiological and psychological factors among patients with chronic kidney disease (CKD). However, the role of depression and anxiety has not yet been studied extensively. This study aimed to investigate the relation of depressive and anxiety symptoms to sexual functioning among hemodialysis (HD) and peritoneal dialysis patients. A sample of 144 patients was recruited from three general hospitals in the broader area of Athens, consisting of 84 patients undergoing in‐center HD and 60 patients in continuous ambulatory peritoneal dialysis. Measurements were conducted with the following instruments: the World Health Organization Quality of Life instrument, the General Health Questionnaire (GHQ‐28), the State‐Trait Anxiety Inνentory (STAI 1/STAI 2), and the Center for Epidemiologic Studies Depression Scale. The results indicated that satisfaction about sexual life had negative association with all the subscales of GHQ‐28 questionnaire (somatic symptoms, anxiety/insomnia, social dysfunction, severe depression). Sexual functioning was also related negatively to depression as well as state and trait anxieties. Findings provide evidence that the presence of depressive and anxiety symptoms relates significantly to the negative evaluation of sexual functioning in patients with CKD.
Dynamic Adaptation of the Peripheral Circulation to Cold Exposure
Authors: CHEUNG STEPHEN S. , Daanen HEIN A.M.
Published: August 2011

Please cite this paper as: Cheung and Daanen (2012). Dynamic Adaptation of the Peripheral Circulation to Cold Exposure. Microcirculation 19(1), 65–77.

Humans residing or working in cold environments exhibit a stronger cold‐induced vasodilation (CIVD) reaction in the peripheral microvasculature than those living in warm regions of the world, leading to a general assumption that thermal responses to local cold exposure can be systematically improved by natural acclimatization or specific acclimation. However, it remains unclear whether this improved tolerance is actually due to systematic acclimatization, or alternately due to the genetic pre‐disposition or self‐selection for such occupations. Longitudinal studies of repeated extremity exposure to cold demonstrate only ambiguous adaptive responses. In field studies, general cold acclimation may lead to increased sympathetic activity that results in reduced finger blood flow. Laboratory studies offer more control over confounding parameters, but in most studies, no consistent changes in peripheral blood flow occur even after repeated exposure for several weeks. Most studies are performed on a limited amount of subjects only, and the variability of the CIVD response demands more subjects to obtain significant results. This review systematically surveys the trainability of CIVD, concluding that repeated local cold exposure does not alter circulatory dynamics in the peripheries, and that humans remain at risk of cold injuries even after extended stays in cold environments.
Reliability and failure modes of anterior single‐unit implant‐supported restorations
Authors: Freitas Amilcar C. , Bonfante Estevam A. , Martins Leandro M. , Silva Nelson R. F. A. , Marotta Leonard , Coelho Paulo G.
Published: August 2011

Purpose

Failures of implant‐abutment connections have been observed clinically, especially in single‐tooth replacements. This study sought to evaluate the reliability and failure modes of implant‐supported anterior crowns restored with different implant systems.

Materials and methods

Forty‐two Ti‐6Al‐4V dental implants (~4 mm diameter) were used for single anterior crown replacement and divided into two groups according to tested system: (NB) Replace Select system, Nobel Biocare (n = 21); and (IL) Internal connection system, Intra‐Lock International (n = 21). Proprietary abutments were screwed to the implants and anatomically correct maxillary central incisor metal crowns were cemented and subjected to step‐stress‐accelerated life testing in water. Use‐level probability Weibull curves and reliability for a mission of 50,000 cycles at 200 N (95% 2‐sided confidence intervals) were calculated. Polarized‐light and scanning electron microscopes were used for failure analyses.

Results

The Beta values for NB and IL (2.09 and 2.05, respectively) indicated that fatigue accelerated the failure of both groups. The calculated reliability for the NB system (0.81) was lower than for the IL system (0.96), but no significant difference was observed between groups. Screw and abutment fracture was the chief failure mode in group NB, while screw fracture was most representative in specimens of group IL.

Conclusions

Reliability of implant‐supported maxillary central incisor crowns was not significantly different between NB and IL abutments. Failure modes differed between implant systems.
Clinical, histologic and histomorphometric evaluation of socket preservation using a synthetic nanocrystalline hydroxyapatite in comparison with a bovine xenograft: a randomized clinical trial
Authors: Gholami Gholam Ali , Najafi Babak , Mashhadiabbas Fatemeh , Goetz Werner , Najafi Siamak
Published: August 2011

Objectives

The aim of this study was to compare a nanocrystalline hydroxyapatite (NCHA), NanoBone® and a deproteinized bovine bone mineral (DBBM), Bio‐Oss® with a collagen membrane on the horizontal ridge width alterations following tooth extraction, in addition to histologic aspects of the grafted extraction sockets.

Material and methods

In this randomized clinical trial, 28 symmetrical, non‐molar, extraction sockets using a split‐mouth design in 12 patients (eight women and four men; aged 21–60; mean 44.6 ± 11.4 years), were randomly selected in the first group to be grafted with DBBM granules covered with a collagen membrane and in the other group grafted with NCHA covered with a collagen membrane. Following extraction horizontal ridge width was measured using caliper and was blindly compared to the dimensions measured prior to implant placement, at the 6‐ to 8‐month follow‐up. Subsequently, a 2 × 6 mm trephine core was obtained with aid of acrylic stent and routine histologic preparation was performed on the specimens.

Results

The width of the DBBM group decreased from 7.75 ± 1.55 to 6.68 ± 1.85 mm (P < 0.05), whereas the width of the NCHA group decreased from 7.36 ± 1.94 to 6.43 ± 2.08 mm (P < 0.05). The mean between‐group difference did not reach statistical significance (P = 0.62). Furthermore, histologic and histomorphometric analyses revealed 28.63 ± 12.53% vital bone in NCHA group vs. 27.35 ± 12.39% in DBBM group, and no statistically significant difference between the groups (P = 0.68).

Conclusion

Socket preservation using either NCHA or DBBM in combination with collagen membrane, results in similar, limited horizontal ridge width alterations following tooth extraction.
Induction of interleukin (IL)‐1β, IL‐10, IL‐8 and immunoglobulin G by Porphyromonas gingivalis HmuY in humans
Authors: Trindade S. C. , Olczak T. , Gomes‐Filho I. S. , Moura‐Costa L. F. , Cerqueira E. M. M. , Galdino‐Neto M. , Alves H. , Carvalho‐Filho P. C. , Xavier M. T. , Meyer R.
Published: August 2011

Trindade SC, Olczak T, Gomes‐Filho IS, Moura‐Costa LF, Cerqueira EMM, Galdino‐Neto M, Alves H, Carvalho‐Filho PC, Xavier MT, Meyer R. Induction of interleukin (IL)‐1β, IL‐10, IL‐8 and immunoglobulin G by Porphyromonas gingivalis HmuY in humans. J Periodont Res 2012; 47: 27–32. © 2011 John Wiley & Sons A/S

Background and Objective:  Porphyromonas gingivalis, an anaerobic gram‐negative bacterium, is associated with chronic periodontitis. This study was undertaken to evaluate the production of interleukin (IL)‐1β, IL‐8 and IL‐10 by human peripheral blood mononuclear cells (PBMC) stimulated with P. gingivalis antigens and to assess the levels of serum immunoglobulin (Ig)G, IgA and IgG subclasses raised against P. gingivalis HmuY protein.

Material and Methods:  PBMC from patients with chronic periodontitis (CP) and from nonperiodontitis (NP) control subjects were stimulated with P. gingivalis antigens, and the cytokine levels in the culture supernatants were determined by ELISA. The specificity of serum antibodies raised against HmuY was analyzed by Western blotting and by ELISA.

Results:  Compared with the NP controls, the CP patients produced higher levels of total serum IgG and IgG1 specific for P. gingivalis HmuY. No differences were found between CP and NP groups in the production of IL‐1β and IL‐8 by PBMC stimulated with total P. gingivalis antigens. Only P. gingivalis lipopolysaccharide (LPS) induced higher levels of IL‐10 in the CP group. Higher levels of IL‐1β and IL‐10 were induced by HmuY than by other antigens derived from the wild‐type P. gingivalis strains. In contrast, total antigens derived from the hmuY‐deletion mutant strain induced the production of significantly higher levels of IL‐8 and significantly lower levels of IL‐1β.

Conclusion:  Our data suggest that P. gingivalis HmuY may be considered an immunogenic protein associated with host–pathogen interactions.
Expression of toll‐like receptors 2, 4 and 9 is increased in gingival tissue from patients with type 2 diabetes and chronic periodontitis
Authors: Rojo‐Botello N. R. , García‐Hernández A. L. , Moreno‐Fierros L.
Published: August 2011

Rojo‐Botello NR, García‐Hernández AL, Moreno‐Fierros L. Expression of toll‐like receptors 2, 4 and 9 is increased in gingival tissue from patients with type 2 diabetes and chronic periodontitis. J Periodont Res 2012; 47: 62–73. © 2011 John Wiley & Sons A/S

Background and Objective: Broad evidence indicates that diabetes both increases the risk and hastens the progression of periodontal disease. Likewise, chronic inflammation or infections seem to provoke insulin resistance and thereby contribute to the development of diabetes and its complications. Innate immune responses, which appear to be altered in individuals with diabetes, are usually mediated by the recognition of pathogens through toll‐like receptors (TLRs). The constitutive expression of some TLRs has been reported in healthy human gingival tissue. Interestingly, the expression of TLRs 2 and 4 is increased with the severity of periodontal disease. Considering that the inflammatory reaction is exacerbated in individuals with diabetes and periodontitis, we suspected that the expression of some TLRs might be increased in gingival tissue in these patients.

Material and Methods: In this study, we analyzed, by immunofluorescence, the expression of TLRs 2, 3, 4 and 9 in gingival tissues from healthy individuals and from periodontal patients with or without type 2 diabetes.

Results: We found that the expression levels of TLRs 2, 3, 4 and 9 were higher in all periodontal patients than in healthy individuals. The expression of some TLRs was increased in subjects with periodontitis and diabetes relative to subjects with periodontitis but without diabetes; this increase in expression was found particularly in TLR2 and TLR9 in the connective tissue and in TLR4 at the epithelial region.

Conclusion: These data suggest that the expression of these TLRs 2, 3, 4 and 9 in gingival tissue is higher in individuals with diabetes because its inflammatory reaction is exacerbated. Additionally, the expression of these TLRS is positively regulated with the severity of periodontal disease.
Structural, biochemical, cellular, and functional changes in skeletal muscle extracellular matrix with aging
Authors: Kragstrup T. W. , Kjaer M. , Mackey A. L.
Published: August 2011

The extracellular matrix (ECM) of skeletal muscle is critical for force transmission and for the passive elastic response of skeletal muscle. Structural, biochemical, cellular, and functional changes in skeletal muscle ECM contribute to the deterioration in muscle mechanical properties with aging. Structural changes include an increase in the collagen concentration, a change in the elastic fiber system, and an increase in fat infiltration of skeletal muscle. Biochemical changes include a decreased turnover of collagen with potential accumulation of enzymatically mediated collagen cross‐links and a buildup of advanced glycation end‐product cross‐links. Altered mechanotransduction, poorer activation of satellite cells, poorer chemotactic and delayed inflammatory responses, and a change in modulators of the ECM are important cellular changes. It is possible that the structural and biochemical changes in skeletal muscle ECM contribute to the increased stiffness and impairment in force generated by the contracting muscle fibers seen with aging. The cellular interactions provide and potentially coordinate an adaptation to mechanical loading and ensure successful regeneration after muscle injury. Some of the changes in skeletal muscle ECM with aging may be preventable with resistance or weight training, but it is clear that more human studies are needed on the topic.
Involvement of upper cheek sagging in nasolabial fold formation
Authors: Ezure Tomonobu , Amano Satoshi
Published: August 2011

Background:

Nasolabial folds are a well‐known feature of aging, but the mechanism of their formation remains unclear.

Objectives:

To clarify the mechanism of nasolabial fold formation, we established grading criteria for severity and explored the influence of dermal elasticity and subcutaneous adipose mass. We also investigated the involvement of facial morphological changes, such as wrinkling and sagging.

Methods:

Faces of 108 healthy Japanese female volunteers (age range: 20–60) were photographed at the angle of 45°, and a six‐grade photograph‐based grading scheme for nasolabial fold severity was established and evaluated. In 70 Japanese female volunteers (middle‐aged: 30–50), dermal elasticity was measured with a Cutometer MPA 580® and subcutaneous adipose layer thickness was measured by ultrasound using a Prosound alpha 5®.

Results:

Nasolabial fold severity was significantly and positively correlated with age in subjects in their twenties to sixties (R = 0.777, P < 0.001). Nasolabial folds were drastically reduced, or disappeared, when the facial position was changed (subjects lay down instead of sitting) to reduce sagging; only 13.8% of subjects showed fixed wrinkles at the positions of the nasolabial folds after the facial position change. Nasolabial fold severity in middle‐aged volunteers was significantly and negatively correlated with dermal elasticity parameters, i.e., net elasticity excluding viscoelastic creep (Ur/Ue), overall elasticity including creep and creep recovery (Ua/Uf), ratio of elastic recovery to total deformation (Ur/Uf), and the negative value of the amount of deformation that did not recover to the original state [−Uf−Ua)], all of which were significantly and negatively correlated with age. Subcutaneous adipose layer thickness was significantly and negatively correlated with dermal elasticity parameter Ua/Uf, and also significantly and positively related to nasolabial fold severity (R = 0.285, P < 0.017).

Conclusions:

Nasolabial fold severity increases with decreasing dermal elasticity and with increment of the subcutaneous adipose layer. These changes might induce sagging formation in the upper cheek area, promoting fold formation at the border between the inner and outer nasolabial areas.
Aquinas on the Passion of Despair
Authors: Miller Michael R.
Published: August 2011

St. Thomas Aquinas argues that all of the passions, including hatred, anger, sorrow and despair, are morally neutral. That is, Thomas Aquinas argues that the manner in which a person responds to a particular passion determines the morality of the passion, and not the passion itself. Hatred, for example, can lead one to a good end, as when one comes to hate his sin. Likewise, Aquinas notes that even the passion of despair is not necessarily evil, since when felt rightly it can move one to some good end. Aquinas, however, fails to recognize that according to his own account despair so stupefies the soul that it cannot lead to any good end. Unlike hope or love, or any of the other passions, despair paralyzes the soul and thus must always be avoided.