bluuebunny/crossref_metadata_2025 huggingface dataset:
IMPACT-CABG Trial: Implantation of CD133+Stem Cells in Patients Undergoing Coronary Bypass Surgery—Presentation of the First Treated Patient
Authors: Forcillo Jessica , Stevens Louis-Mathieu , Mansour Samer , Prieto Ignacio , Roy Denis-Claude , Noiseux Nicolas
Published: June 2011

The IMPACT-CABG study is the first Canadian randomized-controlled phase II clinical trial aiming to assess the effect of intramyocardial (IM) injections of CD133+-selected stem cells in patients referred for coronary artery bypass graft (CABG) with a “chronic” myocardial infarction and persistent left ventricular dysfunction. Patients are followed for 2 years with different imaging techniques including the stress magnetic resonance to evaluate the global and regional myocardial viability. Before the beginning of the randomization, the 5 first patients are treated in an open-label fashion to assess safety and feasibility of the IM CD133+injections. Herein, we report the first Canadian patient treated with IM injection of CD133+cells during CABG surgery as part of the IMPACT-CABG trial.
Geometry of Hamiltonian Dynamics with Conformal Eisenhart Metric
Authors: Peng Linyu , Sun Huafei , Sun Xiao
Published: June 2011

We characterize the geometry of the Hamiltonian
dynamics with a conformal metric. After investigating the Eisenhart metric, we study
the corresponding conformal metric and obtain the geometric structure of the classical
Hamiltonian dynamics. Furthermore, the equations for the conformal geodesics, for the
Jacobi field along the geodesics, and the equations for a certain flow constrained in a family
of conformal equivalent nondegenerate metrics are obtained. At last the conformal curvatures,
the geodesic equations, the Jacobi equations, and the equations for the flow of the
famous models, an N degrees of freedom linear Hamiltonian system and the Hénon‐Heiles
model are given, and in a special case, numerical solutions of the conformal geodesics, the
generalized momenta, and the Jacobi field along the geodesics of the Hénon‐Heiles model
are obtained. And the numerical results for the Hénon‐Heiles model show us the instability
of the associated geodesic spreads.
Design and Characterization of a Centrifugal Compressor Surge Test Rig
Authors: Lim Kin Tien , Yoon Se Young , Goyne Christopher P. , Lin Zongli , Allaire Paul E.
Published: June 2011

A detailed description of a new centrifugal compressor surge test rig is presented. The objective of the design and development of the rig is to study the surge phenomenon in centrifugal compression systems and to investigate a novel method of surge control by active magnetic bearing servo actuation of the impeller axial tip clearance. In this paper, we focus on the design, initial setup, and testing of the rig. The latter two include the commissioning of the rig and the experimental characterization of the compressor performance. The behavior of the compressor during surge is analyzed by driving the experimental setup into surge. Two fundamental frequencies, 21 Hz and 7 Hz, connected to the surge oscillation in the test rig are identified, and the observed instability is categorized according to the intensity of pressure fluctuations. Based on the test results, the excited pressure waves are clearly the result of surge and not stall. Also, they exhibit the characteristics of mild and classic surge instead of deep surge. Finally, the change in the compressor performance due to variation in the impeller tip clearance is experimentally examined, and the results support the potential of the tip clearance modulation for the control of compressor surge. This is the first such demonstration of the feasibility of surge control of a compressor using active magnetic bearings.
Rheumatoid Factor and Its Interference with Cytokine Measurements: Problems and Solutions
Authors: Bartels Else Marie , Falbe Wätjen Inger , Littrup Andersen Eva , Danneskiold-Samsøe Bente , Bliddal Henning , Ribel-Madsen Søren
Published: June 2011

Use of cytokines as biomarkers for disease is getting more widespread. Cytokines are conveniently determined by immunoassay, but interference from present antibodies is known to cause problems. In rheumatoid arthritis (RA), interference of rheumatoid factor (RF) may be problematic. RF covers a group of autoantibodies from immunoglobulin subclasses and is present in 65–80% of RA patients. Partly removal of RF is possible by precipitation. This study aims at determining the effects of presence of RF in blood and synovial fluid on cytokine measurements in samples from RA patients and finding possible solutions for recognized problems. IL-1β, IL-4, IL-6, and IL-8 were determined with multiplex immunoassays (MIA) in samples from RA patients prior to and after polyethylene glycol (PEG 6000) precipitation. Presence of RF does interfere with MIA. PEG 6000 precipitation abolishes this RF interference. We recommend PEG precipitation for all immunoassay measurements of plasma samples from RA patients.
Obesity and the Incidence of Bladder Injury and Urinary Retention Following Tension-Free Vaginal Tape Procedure: Retrospective Cohort Study
Authors: Revicky Vladimir , Mukhopadhyay Sambit , de Boer Frances , Morris Edward P.
Published: June 2011

Background/Aims. Aim of the study was to establish an effect of obesity on the incidence of bladder injury or urinary retention following tension-free vaginal tape (TVT) procedure.Methods. This was a retrospective cohort study based at the Norfolk and Norwich University Hospital in the UK. Study population included 342 cases of TVT procedures. Incidence of bladder injury was 4.7% (16/342). Rate of urinary retention was 9% (31/342). Body mass index (BMI), age, type of analgesia, concomitant prolapse repair, and previous surgery were factors studied. Univariate analysis was performed to establish a relationship between BMI and complications, followed by a multivariable regression analysis to adjust for age, concomitant surgery, type of analgesia, and previous surgery.Results. Neither univariate analysis nor multivariate regression analysis revealed any statistically significant influence of obesity on the incidence of bladder injury or urinary retention. Unadjusted odds ratios and adjusted odds ratios for bladder injury and urinary retention by BMI groups were OR 1.7296 CI 0.4818–6.2097; OR 1.3745 CI 0.5718–3.3043 and adj. OR 2.885 CI 0.603–13.8; adj. OR 1.299 CI 0.502–3.365.Conclusion. Obesity does not appear to influence the rate of bladder injury or urinary retention following TVT procedure.
Diameter- and Shape-Controlled ZnS/Si Nanocables and Si Nanotubes for SERS and Photocatalytic Applications
Authors: Chen Xue , Lee Chun-Sing , Meng Xiangmin , Zhang Wenjun
Published: June 2011

ZnS/Si nanocables were synthesized via a simple two-step thermal evaporation method. The shape and diameter of the ZnS/Si nanocables can be controlled by adjusting the morphologies of the ZnS nanostructures (nanowire or nanoribbon) obtained in the first step and the deposition time of the Si shell in the second step, respectively. Furthermore, we obtained polycrystalline Si nanotubes with different shapes and diameters by etching away the inner ZnS core. The as-prepared Si nanotubes were employed as SERS-active substrates, which exhibited a high sensitivity for the detection of R6G. The Si nanotubes also showed effective photocatalytic activity on the decomposition of R6G under the irradiation of visible light.
Quantification of Lansoprazole in Oral Suspension by Ultra-High-Performance Liquid Chromatography Hybrid Ion-Trap Time-of-Flight Mass Spectrometry
Authors: Brown Stacy D. , Connor Justin D. , Smallwood Nicholas C. , Lugo Ralph A.
Published: June 2011

An LC-MS/MS method was developed and validated to be used as a stability indicating assay for the study of a 3 mg/mL lansoprazole oral suspension. The method utilizes a UPLC (ultra-performance liquid chromatography) column and unique mass spectrometric detection (ion-trap time-of-flight (IT-TOF)) to achieve a sensitive (LOD 2 ng/mL), accurate, and reproducible quantification of lansoprazole. This method reports an intraday and interday coefficient of variation of 2.98 ± 2.17% (n=5for each concentration for each day) and 3.07 ± 0.89% (n=20for each concentration), respectively. Calibration curves (5–25 μg/mL) were found to be linear with anR2value ranging from 0.9972 to 0.9991 on 4 different days. Accuracy of the assay, expressed as % error, ranged from 0.30 to 5.22%. This method is useful for monitoring the stability of lansoprazole in oral suspension.
Clinical Validation of an Office-Based14C-UBT (Heliprobe) forH. pyloriDiagnosis in Iranian Dyspeptic Patients
Authors: Mansour-Ghanaei Fariborz , Sanaei Omid , Joukar Farahnaz
Published: June 2011

Background. We encountered repeatedly, in our clinical practice, discordant results between UBT and histopathology aboutH. pyloriinfection.Goal. To study the diagnostic accuracy of Heliprobe14C-urea breath test (14C-UBT) for detection ofH. pyloriinfection in an Iranian population.Study. We enrolled 125 dyspeptic patients in our study. All of them underwent gastroscopy, and four gastric biopsies (three from the antrum and one from the corpus) were obtained. One of the antral biopsies was utilized for a rapid urease test (RUT), and three others were evaluated under microscopic examination. Sera from all patients were investigated for the presence ofH. pyloriIgG antibodies. The14C-UBT was performed on all subjects using Heliprobe kit, and results were analyzed against the following gold standard (GS):H. pyloriinfection considered positive when any two of three diagnostic methods (histopathology, RUT, serology) are positive.Results. According to data analysis, the Heliprobe14C-UBT had 94% sensitivity, 100% specificity, 93% negative predictive value (NPV), 100% positive predictive value (PPV), and 97% accuracy, compared with GS.Conclusion. The Heliprobe14C-UBT is an easy-to-perform, rapid-response, and accurate test forH. pyloridiagnosis, suitable for office use.
Downregulation of Filamin A Interacting Protein 1-Like is Associated with Promoter Methylation and Induces an Invasive Phenotype in Ovarian Cancer
Authors: Burton Elizabeth R. , Gaffar Aneesa , Lee Soo Jin , Adeshuko Folashade , Whitney Kathleen D. , Chung Joon-Yong , Hewitt Stephen M. , Huang Gloria S. , Goldberg Gary L. , Libutti Steven K. , Kwon Mijung
Published: June 2011

Ovarian cancer is the most lethal gynecologic malignancy with a five-year survival rate below 25% for patients with stages III and IV disease. Identifying key mediators of ovarian cancer invasion and metastasis is critical to the development of more effective therapeutic interventions. We previously identified Filamin A interacting protein 1-like (FILIP1L) as an important mediator of cell proliferation and migration. In addition, targeted expression of FILIP1L in tumors inhibited tumor growth in vivo. In our present study, we confirmed that both mRNA and protein expression of FILIP1L were downregulated in ovarian cancer cells compared with normal ovarian epithelial cells. FILIP1L expression was inversely correlated with the invasive potential of ovarian cancer cell lines and clinical ovarian cancer specimens. We also provide evidence that DNA methylation is a mechanism by which FILIP1L is downregulated in ovarian cancer. The CpG island in the FILIP1L promoter was heavily methylated in ovarian cancer cells. Methylation status of the FILIP1L promoter was inversely correlated with FILIP1L expression in ovarian cell lines and clinical ovarian specimens. Reduced methylation in the FILIP1L promoter following treatment with a DNA demethylating agent was associated with restoration of FILIP1L expression in ovarian cancer cells. A transcription activator, cAMP-responsive element binding protein (CREB) was shown to bind to the CREB/ATF site in the CpG island of the FILIP1L promoter. Overall, these findings suggest that downregulation of FILIP1L associated with DNA methylation is related with the invasive phenotype in ovarian cancer and that modulation of FILIP1L expression has the potential to be a target for ovarian cancer therapy. Mol Cancer Res; 9(8); 1126–38. ©2011 AACR.
Vitreous Vascular Endothelial Growth Factor Concentrations in Proliferative Diabetic Retinopathy versus Proliferative Vitreoretinopathy
Authors: Citirik Mehmet , Kabatas Emrah Utku , Batman Cosar , Akin Kadir Okhan , Kabatas Naciye
Published: June 2011

Purpose: To assess vitreous vascular endothelial growth factor (VEGF) concentrations in proliferative diabetic retinopathy (PDR) in comparison to proliferative vitreoretinopathy (PVR). Patients and Methods: Vitreous samples were collected from 69 eyes of 69 patients with traumatic lens dislocation (n = 10), grade B PVR with rhegmatogenous retinal detachment (n = 13), grade C PVR with rhegmatogenous retinal detachment (n = 14), PDR with vitreous hemorrhage (n = 18), and PDR with vitreous hemorrhage and tractional retinal detachment (n = 14). Vitreous fluid samples were obtained at vitrectomy, and the levels of VEGF were measured by enzyme-linked immunosorbent assay. Results: The mean vitreous level of VEGF was 15.14 ± 5.22 pg/ml in eyes with grade B PVR, 99.15 ± 38.58 pg/ml in eyes with grade C PVR, 4,534.01 ± 1,193.28 pg/ml in eyes with vitreous hemorrhage secondary to PDR, 5,157.29 ± 969.44 pg/ml in eyes with vitreous hemorrhage and tractional retinal detachment secondary to PDR, and 16.19 ± 5.76 pg/ml in eyes of the control group with traumatic lens dislocation. Vitreous VEGF concentrations were significantly higher in the patients with grade C PVR, PDR with vitreous hemorrhage and PDR with vitreous hemorrhage and tractional retinal detachment in comparison to the control patients (p < 0.05). A significant alteration was not observed in patients with grade B PVR (p = 0.55). Conclusions: Vitreous VEGF concentrations are increased in PDR and grade C PVR. The high VEGF concentrations could suggest a possible effect of VEGF on advanced PVR.
Cerebral Oxygenation during Different Treatment Strategies for a Patent Ductus Arteriosus
Authors: Chock Valerie Y. , Ramamoorthy Chandra , Van Meurs Krisa P.
Published: June 2011

Background: Preterm infants with a hemodynamically significant patent ductus arteriosus (hsPDA) are at risk for fluctuations in cerebral blood flow, but it is unclear how different hsPDA treatment strategies may affect cerebral oxygenation. Objective: To compare regional cerebral oxygen saturation (rSO2) as measured by near-infrared spectroscopy (NIRS) in very low birth weight (VLBW) infants with a hsPDA treated with conservative management, indomethacin, or surgical ligation. Methods: This prospective observational study enrolled 33 VLBW infants with a hsPDA diagnosed by echocardiogram and 12 control VLBW infants without a hsPDA. Infants had NIRS cerebral monitoring applied prior to conservative treatment, indomethacin, or surgical ligation. Cranial ultrasound and magnetic resonance imaging data were also collected. Results: Infants undergoing surgical ligation had a greater time period with >20% change in rSO2 from baseline (30%) compared to those receiving indomethacin (7.4%, p = 0.001) or control infants without a hsPDA (2.6%, p = 0.0004). NIRS measures were not associated with abnormal neuroimaging in this small cohort. Conclusion:These findings suggest that infants requiring surgical ligation for a hsPDA are at high risk for significant changes in cerebral oxygenation, whereas those receiving either indomethacin or conservative management maintain relatively stable cerebral oxygenation levels. Additional research is necessary to determine if NIRS monitoring identifies infants with a hsPDA at highest risk for brain injury.
Increased Postnatal Inflammation in Mechanically Ventilated Preterm Infants Born to Mothers with Early-Onset Preeclampsia
Authors: Turunen Riikka , Andersson Sture , Laivuori Hannele , Kajantie Eero , Siitonen Sanna , Repo Heikki , Nupponen Irmeli
Published: June 2011

Background: Preeclampsia and preterm labor often underlie preterm birth, and are associated with maternal inflammation. In preterm infants, respiratory distress syndrome (RDS) and mechanical ventilation are associated with systemic inflammation. Objective: We aimed to study whether early-onset preeclampsia or preterm labor modulate the systemic inflammation affecting preterm infants with RDS. Methods: We recruited mechanically ventilated infants with gestational ages <32 weeks; 11 infants were born after early-onset preeclampsia and 25 after preterm labor. Blood was drawn during postnatal days 1–7, and the mean values of days 1–2, 3–4 and 5–6 were used. Phagocyte CD11b expression was analyzed with flow cytometry, and plasma C-reactive protein (CRP) concentrations with immunoturbidimetry. Results: As compared with infants born after preterm labor, infants born after early-onset preeclampsia had higher CD11b expression on days 1–6 on both neutrophils and monocytes. In addition, infants born after early-onset preeclampsia had higher CRP concentrations on days 2–6 (all p < 0.05). Conclusions: As compared with infants born after preterm labor to mothers without preeclampsia, infants born after early-onset preeclampsia presented with a stronger postnatal systemic inflammatory reaction. Antenatal exposure to preeclampsia may induce fetal leukocyte priming and regulation of inflammation, and thereby modify postnatal inflammatory reactions and morbidity.
Intestinal Absorption of Lipid Emulsion in Premature Infants: A Pilot Study
Authors: Janvier A. , Beaumier L. , Barrington K.J.
Published: June 2011

Background: Adequate nutritional intake is essential in the very-low-birth-weight infant, but difficult to achieve in the first few postnatal days. Can lipids be given enterally in the first few days of life in sick preterm infants? Objective: To determine tolerance and absorption of lipid emulsion when fed enterally to very-low-birth-weight infants. Design/Methods: Infants had a birth weight <1,500 g, an appropriate weight for gestational age, and were receiving parenteral nutrition. We performed a progressive series of studies, enrolling 5 infants in each group. Group 1 infants were fed enteral lipid emulsion at 1 g/kg/day for 4 days, starting when 60 ml/kg/day of breast milk was tolerated enterally. Simultaneously, a matched control group which received no oral lipid emulsion was enrolled. We then enrolled group 2 infants who were fed 3 g/kg/day with the same protocol as group 1. Group 3 infants were fed enteral lipid emulsion starting in the first 72 h of life. The infants were fed 1, 2 and 3 g/kg/day subsequently for 48 h each. Fat absorption was measured. Results: Gestational age was 24.6–30.8 weeks and birth weight was 620–1,400 g. One infant (group 1) developed necrotizing enterocolitis 1 week after the study. There were no other adverse clinical findings. On average, enteral lipid emulsion was started on day 8 of life in groups 1 and 2, and on day 2 in group 3. The intestinal lipid absorption was 93.6% (min. = 76%). There was no difference in fat absorption between the 4 groups (p > 0.05). Conclusions: Lipid emulsions are an isotonic high-calorie source which can be given safely enterally instead of intravenously in the immediate neonatal period of very-low-birth-weight infants without clinical adverse effects and with almost complete absorption. There are potential advantages to oral administration of a lipid emulsion starting in early life which require further investigation.
Role of Inferior Orbital Wall Morphologic Properties in Isolated Orbital Blow-Out Fracture
Authors: Park Jong-Seo , Lew Helen , Lee Sang-Yeul
Published: June 2011

Purpose: To compare inferior orbital wall morphology between isolated inferior and medial orbital wall fracture patients. Methods: The morphologic properties of patients with isolated blow-out fractures involving the medial wall or inferior wall treated from August 2004 to August 2009 were reviewed. The cross-sectional area, thickness, gradient, and curvature of the inferior wall were measured via orbital CT in the opposite non-traumatized eye. Results: Patients with isolated inferior wall fractures (n = 77) and isolated medial wall fractures (n = 78) evidenced no differences in sex, age, etiology of trauma, laterality of trauma, and associated concomitant intraocular injuries. The cross-sectional area, thickness, and gradient of the inferior wall did not differ significantly between the 2 groups. However, the coefficient of curvature was significantly greater in patients with inferior wall fracture than in patients with medial wall fracture (0.016 ± 0.006 vs. 0.006 ± 0.002, respectively; p = 0.000). Conclusion: Patients with more convex and steep inferior walls are more likely to incur isolated inferior wall fractures than isolated medial wall fractures.
Mutation Analysis of PAX6 in a Chinese Family and a Patient with a Presumed Sporadic Case of Congenital Aniridia
Authors: Luo Fei , Zhou Linlin , Ma Xu , He Yan , Zou Liuhe , Jie Ying , Liu Jing , Pan Zhiqiang
Published: June 2011

Aims: Mutations in the PAX6 are the major cause of congenital aniridia. The objective of this study was to analyze genetic mutations in PAX6 in Chinese patients with congenital aniridia. Methods: Total genomic DNA was isolated from the peripheral blood of the aniridia patients, all healthy family members and 100 healthy volunteers. The 14 exons (including alternatively spliced exon 5a) of the PAX6 gene were amplified by polymerase chain reaction, and the products were sequenced to identify the mutation. Results: Two mutations of PAX6 were detected in exon 11 in the congenital aniridia patients. One mutation was caused by the duplication of the 4 nucleic acids CTCC (c.1286insCTCC), which would lead to a frameshift. The other mutation was caused by a transition from C to T (c.1311C → T), which would generate a stop codon. Neither mutation was present in the healthy family members or 100 healthy volunteers. Conclusion: We examined the exon sequence of the PAX6 gene in a Chinese family and an unrelated individual with aniridia. The predicted outcome of both mutations is premature termination. The mutation found in the unrelated individual has not previously been reported and represents a new addition to the spectrum of mutations in PAX6.
Influence of Hyperbaric Oxygen Therapy on Central Corneal Thickness
Authors: Ayata Ali , Uzun Gunalp , Mutluoglu Mesut , Unal Melih , Yildiz Senol , Ersanli Dilaver
Published: June 2011

Background/Aims: Hyperbaric oxygen (HBO) therapy is used in the treatment of several disorders. Little is known about the effects of HBO treatment on corneal thickness. The aim of this study was to investigate the effect of HBO treatment on central corneal thickness. Methods: Thirty-two subjects (18 males and 14 females, mean age 57.3 ± 16.7 years) undergoing HBO treatment were consecutively enrolled. The subjects were assigned into diabetic (n = 16) and nondiabetic groups (n = 16). Best-corrected visual acuity was recorded before HBO treatment, and anterior and posterior segment examinations were performed on a slit lamp biomicrosope. Central corneal thickness was measured with an ultrasonic pachymeter before and immediately after HBO treatment, which lasted 120 min at 2.4 atmospheres absolute with three 30-min oxygen and two 5-min air breathing periods. Results: HBO treatment did not change the central corneal thickness in diabetic subjects (547.6 ± 34.5 vs. 548.6 ± 34.6 µm; p = 0.606). In nondiabetic subjects, however, the central corneal thickness was significantly reduced after HBO treatment (576.5 ± 34.8 vs. 569.0 ± 34.8 µm; p < 0.001). Conclusion: A single exposure to HBO treatment reduced the central corneal thickness in nondiabetic subjects but not in diabetic subjects. However, the change in central corneal thickness was minor.
Relationship between Cardiovascular Risk Factors and Adipokines in Adolescents
Authors: Rubin Daniela A. , McMurray Robert G. , Hackney Anthony C. , Harrell Joanne S.
Published: June 2011

This study evaluated the associations of adipokines with cardiovascular risk factors. Subjects/Methods: 60 normal weight (BMI ≤75th percentile) and 60 overweight (BMI ≧95th percentile) adolescents aged 10–14 years. Resting systolic and diastolic blood pressures (SBP, DBP) and waist circumference were obtained in duplicate. Circulating adiponectin, resistin, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), total cholesterol (TC), high-density lipoprotein (HDL), and triglycerides (TG) were measured from fasting plasma samples. Results: Simple correlations showed that SBP was significantly related (p < 0.05) to adiponectin (r = –0.185), resistin (r = 0.207), and IL-6 (r = 0.238); HDL was significantly related to adiponectin (r = 0.398) and TNF-α (r = –0.227). TG was only related to adiponectin (r = –0.292, p < 0.05). Multiple regression models controlling for puberty and ethnicity indicated that adiponectin (R2 = 0.152, p < 0.05), resistin (R2 = 0.152, p < 0.05), and IL-6 (R2 = 0.170, p < 0.05) were associated with SBP. The association between adiponectin and HDL was stronger in normal weight versus overweight adolescents (R2 = 0.336, p < 0.05). None of the other models showed differences in the associations by weight status. Conclusions: In adolescents, SBP but not DBP was associated with most adipokines. HDL, but not TC, was also associated with some adipokines. TG were only associated with adiponectin. Associations were mostly related to adiposity.
The Use of Bone Age in Clinical Practice – Part 1
Authors: Martin David D. , Wit Jan M. , Hochberg Ze’ev , Sävendahl Lars , van Rijn Rick R. , Fricke Oliver , Cameron Noël , Caliebe Janina , Hertel Thomas , Kiepe Daniela , Albertsson-Wikland Kerstin , Thodberg Hans Henrik , Binder Gerhard , Ranke Michael B.
Published: June 2011

This review examines the role of skeletal maturity (‘bone age’, BA) assessment in clinical practice. BA is mainly used in children with the following conditions: short stature (addressed in part 1 of this review), tall stature, early or late puberty, and congenital adrenal hyperplasia (all addressed in part 2). Various manual and automatic methods of BA assessment have been developed. Healthy tall children tend to have advanced BA and healthy short children tend to have delayed BA in comparison to chronological age. Growth hormone (GH) treatment of children with GH deficiency leads to a catch-up in BA that is usually appropriate for the height of the child. Response to GH is dependent on BA delay in young children with idiopathic short stature, and GH dosage appears to affect BA acceleration. In chronic renal failure, BA is delayed until puberty but then increases due to increased sensitivity of the growth plate to sex steroids, thus further impairing adult height. The assessment of BA provides an important contribution to the diagnostic workup and management of children with short stature.
The Use of Bone Age in Clinical Practice – Part 2
Authors: Martin David D. , Wit Jan M. , Hochberg Ze’ev , van Rijn Rick R. , Fricke Oliver , Werther George , Cameron Noël , Hertel Thomas , Wudy Stefan A. , Butler Gary , Thodberg Hans Henrik , Binder Gerhard , Ranke Michael B.
Published: June 2011

If height-limiting treatment is being considered for a child with tall stature, skeletal maturity is invaluable in the selection of appropriate patients for treatment, determining appropriate age of treatment commencement, monitoring progress of treatment, and determining the expected treatment effect on adult height. In precocious puberty, bone maturation can be usefully assessed at initial diagnosis and start of treatment and at regular intervals thereafter during treatment monitoring. Together with height, bone maturation is an essential parameter for long-term treatment monitoring in congenital adrenal hyperplasia. Bone age (BA) determination in children with skeletal dysplasia is only feasible in a few disorders and estimations should be treated with caution. Radiographs of the left hand and wrist are, however, essential in the diagnosis of many skeletal disorders. Bone mineralization and measures of bone lengths, width, thickness and cortical thickness should always be evaluated in relation to a child’s height and BA, especially around puberty. The use of skeletal maturity, assessed on a radiograph alone to estimate chronological age for immigration authorities or criminal courts is not recommended.
Assessment of Coronary Reperfusion After Thrombolysis With a Model Combining Myoglobin, Creatine Kinase–MB, and Clinical Variables
Authors: Christenson Robert H. , Ohman E. Magnus , Topol Eric J. , Peck Steven , Newby L. Kristin , Duh Show-Hong , Kereiakes Dean J. , Worley Seth J. , Alosozana Gladys L. , Wall Thomas C. , Califf Robert M. , 7 Study Group ;
Published: June 2011

Background
Several biochemical markers have been investigated for the noninvasive assessment of reperfusion after myocardial infarction. Because myoglobin is released very soon after myocardial injury and clears rapidly after reperfusion, it may prove to be an excellent marker of occlusion and reperfusion.

Methods and Results
We examined the relation between various myoglobin measures and Thrombolysis In Myocardial Infarction (TIMI) flow grade in 96 patients enrolled in a study of front-loaded thrombolysis who underwent 90-minute angiography. We also combined myoglobin measures with models that include clinical and creatine kinase–MB variables. The myoglobin level measured within 10 minutes of acute angiography showed the best overall performance and was used for later analyses. Of the clinical variables examined, only time from symptom onset to thrombolysis and chest pain grade at angiography discriminated among TIMI flow grades. Combining the 90-minute myoglobin level and these clinical variables showed a significant difference (
P
<.0001) between both TIMI 3 versus TIMI 0 through 2 and TIMI 2 or 3 versus TIMI 0 or 1 flow. When the 90-minute myoglobin level was added to an established predictive model containing clinical variables and creatine kinase–MB measures, its contribution remained significant (
P
=.044). The area under the receiver operator characteristic curve for this combined model was .88.

Conclusions
A single myoglobin measurement obtained 90 minutes after the start of thrombolysis, combined with select clinical variables and creatine kinase–MB levels, enhances the noninvasive prediction of reperfusion after myocardial infarction.
Risk Factors for Death After Adult Congenital Heart Surgery in Pediatric Hospitals
Authors: Kim Yuli Y. , Gauvreau Kimberlee , Bacha Emile A. , Landzberg Michael J. , Benavidez Oscar J.
Published: June 2011

Background—

Despite the central role that pediatric hospitals play in the surgical treatment of congenital heart disease, little is known about outcomes of adult congenital cardiac surgical care in pediatric hospitals. Risk factors for inpatient death, including adult congenital heart (ACH) surgery volume, are poorly described.

Methods and Results—

We obtained inpatient data from 42 free-standing pediatric hospitals using the Pediatric Health Information System data base 2000 to 2008 and selected ACH surgery admissions (ages 18 to 49 years). We examined admission characteristics and hospital surgery volume. Of 97 563 total (pediatric and adult) congenital heart surgery admissions, 3061 (3.1%) were ACH surgery admissions. Median adult age was 22 years and 39% were between ages 25 to 49 years. Most frequent surgical procedures were pulmonary valve replacement, secundum atrial septal defect repair, and aortic valve replacement. Adult mortality rate was 2.2% at discharge. Multivariable analyses identified the following risk factors for death: age 25 to 34 years (adjusted odds ratio [AOR], 2.1;
P
=0.009), age 35 to 49 years (AOR, 3.2;
P
=0.001), male sex (AOR, 1.8;
P
=0.04), government-sponsored insurance (AOR, 1.8;
P
=0.03), and higher surgical risk categories 4+ (AOR, 21.5;
P
=0.001). After adjusting for case mix, pediatric hospitals with high ACH surgery volume had reduced odds for death (AOR, 0.4;
P
=0.003). There was no relationship between total congenital heart surgery volume and ACH inpatient mortality.

Conclusions—

Older adults, male sex, government-sponsored insurance, and greater surgical case complexity have the highest likelihood of in-hospital death when adult congenital surgery is performed in free-standing pediatric hospitals. After risk-adjustment, pediatric hospitals with high ACH surgery volume have the lowest inpatient mortality.
Cost-Effectiveness of Drug-Eluting Stents Versus Bare Metal Stents in Clinical Practice
Authors: Schafer Pascha E. , Sacrinty Matthew T. , Cohen David J. , Kutcher Michael A. , Gandhi Sanjay K. , Santos Renato M. , Little William C. , Applegate Robert J.
Published: June 2011

Background—

Drug-eluting stents (DES) reduce the need for repeat target revascularization (TVR) compared with bare metal stents (BMS) but are more costly. The objective was to evaluate the cost-effectiveness of DES versus BMS.

Methods and Results—

We evaluated clinical outcomes and costs of care over 3 years in 1147 undergoing BMS before the availability of DES and 1247 DES patients at Wake Forest University Baptist Medical Center from 2002 to 2005. Costs for index stenting, TVR, and clopidogrel use were assessed. The 2 groups were well matched for baseline characteristics. Index stenting costs were $1846 higher per patient for DES versus BMS ($1737 more to $1950 more). At 3 years, absolute TVR rates were 15.2 per 100 DES patients and 24.1 per 100 BMS patients, and as a result, cumulative TVR-related costs were $2065 less per patient for DES versus BMS ($3001 less to $1134 less). Including the cost of clopidogrel, the incremental cost-effectiveness ratio per TVR avoided with DES was $4731 through 1 year, $4703 through 2 years, and $6379 through 3 years.

Conclusions—

At 3 years, the higher index cost of DES versus BMS was completely offset by lower TVR-related costs. However, because of extended clopidogrel use for DES, the incremental cost-effectiveness ratio per TVR avoided ranged from $4703 to $6379 over 3 years. These unadjusted observational findings provide support for the continued use of DES in routine practice but highlight the important impact of prolonged dual antiplatelet use on the cost-effectiveness of this technology.
Changes in Duration-Related Characteristics of Late-Summer Precipitation over Eastern China in the Past 40 Years
Authors: Li Jian , Yu Rucong , Yuan Weihua , Chen Haoming
Published: June 2011

Duration is a key feature of rainfall events that is closely related to rainfall mechanisms and influences. This study analyzes the decadal change in the duration-related characteristics of late-summer (July–August) precipitation over eastern China during 1966–2005. Accompanying the southern-flooding and northern-drought (SFND) pattern of rainfall amount over the eastern China in recent decades, the duration-related rainfall structure also experienced significant changes. In North China, the frequency of short duration rainfall events decreased and their intensity increased. The decadal decreases of rainfall amount over North China are largely contributed by long duration rainfall events, especially those occurring between midnight and morning. In the mid-to-lower reaches of the Yangtze River valley, both the frequency and amount of long duration precipitation have significantly increased. The mean and maximum duration time of late-summer precipitation has increased 0.85 and 7.61 h, respectively. Considerable increases of rainfall amount of two kinds of precipitation, the short and medium duration rainfall events in the late afternoon and the long duration rainfall events in the early morning, contribute to the “southern-flooding.” Despite the differences between the northern and southern region, there is a common feature of their decadal precipitation changes that the intensity of short duration rainfall in the late afternoon has shown an increasing trend.
The Caribbean Low-Level Jet and Its Relationship with Precipitation in IPCC AR4 Models
Authors: Martin Elinor R. , Schumacher Courtney
Published: June 2011

A census of 19 coupled and 12 uncoupled model runs from the Intergovernmental Panel on Climate Change (IPCC) Fourth Assessment Report (AR4) shows that all models have the ability to simulate the location and height of the Caribbean low-level jet (CLLJ); however, the observed semiannual cycle of the CLLJ magnitude was a challenge for the models to reproduce. In particular, model means failed to capture the strong July CLLJ peak as a result of the lack of westward and southward expansion of the North Atlantic subtropical high (NASH) between May and July. The NASH was also found to be too strong, particularly during the first 6 months of the year in the coupled model runs, which led to increased meridional sea level pressure gradients across the southern Caribbean and, hence, an overly strong CLLJ. The ability of the models to simulate the correlation between the CLLJ and regional precipitation varied based on season and region. During summer months, the negative correlation between the CLLJ and Caribbean precipitation anomalies was reproduced in the majority of models, with uncoupled models outperforming coupled models. The positive correlation between the CLLJ and the central U.S. precipitation during February was more challenging for the models, with the uncoupled models failing to reproduce a significant relationship. This may be a result of overactive convective parameterizations raining out too much moisture in the Caribbean meaning less is available for transport northward, or due to incorrect moisture fluxes over the Gulf of Mexico. The representation of the CLLJ in general circulation models has important consequences for accurate predictions and projections of future climate in the Caribbean and surrounding regions.
Faroe Bank Channel Overflow: Mesoscale Variability*
Authors: Darelius Elin , Fer Ilker , Quadfasel Detlef
Published: June 2011

The Faroe Bank Channel is the deepest connection through the Greenland–Scotland Ridge, where dense water formed north of the ridge flows southward over the sill crest, contributing to the formation of North Atlantic Deep Water. The overflow region is characterized by high mesoscale variability and energetic oscillations, accompanied by a high degree of sea surface level variability. Here, 2-month-long time series of velocity and temperature from 12 moorings deployed in May 2008 are analyzed to describe the oscillations and explore their generation and propagation. The observed 2.5–5-day oscillations in velocity and temperature are highly coherent both horizontally and vertically, and they are associated with 100–200-m-thick boluses of cold plume water flowing along the slope. A positive correlation between temperature and relative vorticity and the distribution of clockwise/counterclockwise rotation across the slope suggest a train of alternating warm cyclonic and cold anticyclonic eddies, where the maximum plume thickness is located downslope of the eddy center. The along-slope phase velocity is found to be 25–60 cm s−1, corresponding to a wavelength of 75–180 km, while the vertical phase propagation is downward. The oscillations are present already in the sill region. The observations do not match predictions for eddies generated either by vortex stretching or baroclinic instability but agree broadly with properties of topographic Rossby waves.
Raman Lidar Profiling of Tropospheric Water Vapor over Kangerlussuaq, Greenland
Authors: Neely Ryan Reynolds , Thayer Jeffrey P.
Published: June 2011

A new measurement capability has been implemented in the Arctic Lidar Technology (ARCLITE) system at the Sondrestrom upper-atmosphere research facility near Kangerlussuaq, Greenland (67.0°N, 50.9°W), enabling estimates of atmospheric water vapor through the troposphere. A balloon campaign was simultaneously conducted to calibrate and validate the new lidar water vapor measurements. Initial results show that height-resolved profiles up to 10 km with better than 10% error are obtained with 30-min integration and 250-m height resolution. Comparison of the lidar observations with water vapor profiles retrieved by the Atmospheric Infrared Sounder (AIRS) instrument on board the Aqua satellite agree within the error associated with each measurement. These new observations offer more routine measurements of water vapor in the Arctic to complement measurements related to the Arctic’s hydrologic cycle.
A Quality-Control and Bias-Correction Method Developed for Irregularly Spaced Time Series of Observational Pressure Data
Authors: Sperka Stefan , Steinacker Reinhold
Published: June 2011

This paper presents a method to detect and correct occurring biases in observational mean sea level pressure (MSLP) data, which was developed within the Mesoscale Alpine Climate Dataset [MESOCLIM; i.e., 3-hourly MSLP, potential and equivalent potential temperature Vienna Enhanced Resolution Analysis (VERA) analyses for a 3000 km × 3000 km area centered over the Alps during 1971–2005] project. There are many reasons for a change of a measurement site’s performance, for example, a change in the instrumentation, a slight modification of the site’s place or position, or a different way of data processing (pressure reduction). To get an estimate for these artificial influences in the data, deviations for each reporting station at each point of time were calculated, using a piecewise functional fitting approach that is based on a variational algorithm. In this algorithm first- and second-order spatial derivatives are minimized using the tested stations neighbor stations and furthermore their neighbors. The resulting time series of deviations for each station were then tested with a “standard normal homogeneity test” to detect changes in the mean deviation. With the knowledge of these “break points,” bias-correction estimates for each station were calculated. These correction estimates are constant between the detected break points because the method does not detect different slopes in trends. Application of these correction estimates yields in smoother fields and a more homogenous distribution of trends.
Patrimonial Alliances and Failures of State Penetration
Authors: Collins Randall
Published: June 2011

The historical shift from patrimonialism to bureaucracy is the key organizational transformation of the past thousand years. Classically, patrimonialism was organization based on private households, plus alliances among them. But there are two types of patrimonial organization: expanded households and patrimonial alliances or pseudo-tribes. The latter include ad hoc warrior coalitions, frequently organized as fictive kin. The main historical cause of the shift from patrimonialism to bureaucracy was the military-fiscal revolution and ensuing state penetration into society. But patrimonial politics did not entirely disappear. In some areas, the state fails to penetrate, leaving the possibility of mafia-style organization. Elsewhere, political machines are a mixed form of incomplete bureaucracy. Gangs are patrimonial organizations, growing in dialectical conflict with bureaucratic penetration and efforts at control. Through a comparison of American, Sicilian, and Russian mafias, the questions considered are whether crime organization recapitulates the history of the state, why some gangs become bigger than others, and why organized crime succeeds or fails in varying degrees.
The Legacies of Patrimonial Patriarchalism
Authors: Thomas Gwynn
Published: June 2011

In Chile, how citizens and political leaders have understood, incorporated, and contested the relationship between the familial and the political has been central to the development of their society. The author examines the ideological influence that familial beliefs had on the process of delegitimizing the presidency of Salvador Allende and legitimizing the military coup through an analysis of political rhetoric surrounding the mobilization of women in the March of the Empty Pots and Pans. The author argues that the march was a pivotal moment in which generalized beliefs about the state’s responsibility for familial welfare, including protecting men’s and women’s familial roles, were transformed into a powerful critique against Allende and his government. The author shows how the arguments put forward by Allende’s opponents drew on embedded beliefs about the relationship between families and politics to frame the emerging debate about the political legitimacy of President Allende.
Central and Local Patrimonialism
Authors: Charrad Mounira M.
Published: June 2011

How useful is the concept of patrimonialism to analyze state formation and political dynamics in postcolonial nation-states? Using Tunisia, Morocco, and Iraq during critical periods of state-building following the end of colonial rule, the author considers this question. The purpose of the article is to build on Max Weber by exploring how patrimonialism operates in kin-based social contexts where power on the basis of kinship ties is exerted not only by a central authority but also by leaders of local communities organized along lines of real or fictive kinship—as was the case in the three countries in the period under examination. Suggesting that Weber undertheorized the way in which central authority relates to local collectivities in his analysis of patrimonialism, the author identifies three patterns in the strategies used by central power toward local patrimonial networks: marginalization, integration, and shifts between marginalization and integration. The article argues that central patrimonialism can be accommodated with all three strategies directed toward local patrimonialism.
Mapping the Competing Historical Analogies of the War on Terrorism
Authors: Angstrom Jan
Published: June 2011

This article maps the historical analogies of the war on terrorism used by the Bush administration. It identifies four historical analogies of the war on terrorism present in the US political and academic discourse since the attacks on 11 September 2001. These are the war on terrorism as: (a) the Second World War; (b) the Crusades; (c) the Vietnam War; and (d) the Cold War. These analogies have been a constant presence in the US discourse, although the analogy with the Crusades has been more prominent in the academic discourse than in the political. There is, moreover, no conclusive pattern of when and how these analogies have been used, suggesting that we cannot use them to evaluate how well the war on terrorism is progressing. This also indicates that the Bush administration, with one exception, was not successful in framing the policy agenda in a certain direction regarding the war on terrorism. Understanding the war on terrorism as a new Cold War, for example, still implies different policy measures such as roll-back and containment.