bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanisms of Ca2+-Dependent Calcineurin Activation in Mechanical Stretch-Induced Hypertrophy
Authors: Zobel Carsten , Rana Obaida R. , Saygili Erol , Bölck Birgit , Saygili Esra , Diedrichs Holger , Reuter Hannes , Frank Konrad , Müller-Ehmsen Jochen , Pfitzer Gabriele , Schwinger Robert H.G.
Published: February 2007

Pressure overload is the major stimulus for cardiac hypertrophy. Accumulating evidence suggests an important role for calcium-induced activation of calcineurin in mediating hypertrophic signaling. Hypertrophy is an important risk factor for cardiovascular morbidity and mortality. We therefore employed an in vitro mechanical stretch model of cultured neonatal cardiomyocytes to evaluate proposed mechanisms of calcium-induced calcineurin activation in terms of inhibition of calcineurin activity and hypertrophy. The protein/DNA ratio and ANP gene expression were used as markers for stretch-induced hypertrophy. Stretch increased the calcineurin activity, MCIP1 gene expression and DNA binding of NFATc as well as the protein/DNA ratio and ANP mRNA in a significant manner. The specific inhibitor of calcineurin, cyclosporin A, inhibited the stretch-induced increase in calcineurin activity, MCIP1 gene expression and hypertrophy. The L-type Ca2+ channel blocker nifedipine and a blocker of the Na+/H+ exchanger (cariporide) both suppressed stretch-dependent enhanced calcineurin activity and hypertrophy. Also application of a blocker of the Na+/Ca2+ exchanger (KB-R7943) was effective in preventing calcineurin activation and increases in the protein/DNA ratio. Inhibition of capacitative Ca2+ entry with SKF 96365 was also sufficient to abrogate calcineurin activation and hypertrophy. The blocker of stretch-activated ion channels, streptomycin, was without effect on stretch-induced hypertrophy and calcineurin activity. The present work suggests that of the proposed mechanisms for the calcium-induced activation of calcineurin (L-type Ca2+ channels, capacitative Ca2+ entry, Na+/H+ exchanger, Na+/Ca2+ exchanger and stretch-activated channels) all but stretch-activated channels are possible targets for the inhibition of hypertrophy.
Oral Hypoglycemics: Increased Postoperative Mortality in Coronary Risk Patients
Authors: Jeger Raban V. , Seeberger Manfred D. , Keller Ulrich , Pfisterer Matthias E. , Filipovic Miodrag
Published: February 2007

Background: Diabetes mellitus (DM), particularly if insulin-dependent, is a predictor of increased perioperative risk, whereas stringent metabolic control with insulin is beneficial in the critically ill. Methods: The impact of oral hypoglycemics (OH) vs. insulin on outcome was determined as a secondary retrospective analysis of a cohort study in patients with coronary artery disease (CAD) and DM undergoing major non-cardiac surgery. Primary end-point was 2-year all-cause mortality; secondary endpoints were perioperative myocardial ischemia and 2-year cardiac mortality. Results: Of 173 patients, DM was diagnosed in 42 (24%) based on pre-existing treatment with OH (15%) or insulin (9%). During follow-up, 40/173 (23%) patients died. All-cause mortality was similar in the non-diabetic (20%) and insulin groups (19%) but significantly higher in the OH group (42%; p = 0.025). Cardiac mortality tended to be higher in the OH group compared with the insulin and non-diabetic groups (27 vs. 19% and 11%, respectively; p = 0.066). Multivariate analysis revealed renal failure (odds ratio [OR] = 4.9, 95% confidence interval [CI] = 1.8–13.0), treatment with OH (OR = 3.3, 95% CI = 1.2–9.0), peripheral vascular surgery (OR = 2.7, 95% CI = 1.2–6.0), and prior diuretic therapy (OR = 2.6, 95% CI = 1.1–5.7) being independently associated with 2-year all-cause death. No difference existed in postoperative ischemia among the different groups. Conclusions: Long-term mortality after major non-cardiac surgery is elevated in patients with CAD and diabetes mellitus only if they are treated with OH, but not if they are treated with insulin. Further evaluation of the impact of perioperative anti-diabetic treatment on morbidity and mortality in CAD is warranted.
Effect of Homocysteine-Induced Oxidative Stress on Endothelial Function in Coronary Slow-Flow
Authors: Tanriverdi Halil , Evrengul Harun , Enli Yasar , Kuru Omur , Seleci Deniz , Tanriverdi Seyhan , Tuzun Nurullah , Kaftan H. Asuman , Karabulut Nevzat
Published: February 2007

Background and Objective: Coronary slow-flow (CSF) phenomenon is characterized by delayed opacification of vessels in a normal coronary angiogram, but its etiopathogenesis remains unclear. Plasma homocysteine (Hcy) level can severely disturb vascular endothelial function and may play a role in the pathogenesis of CSF. In our study, endothelial function in patients with CSF and their relationship with Hcy and oxidative stress parameters are investigated. Method: Forty-four patients with angiographically proven CSF and 44 cases with normal coronary flow pattern with similar risk profile were enrolled in the study. Coronary flow patterns of the cases are determined by Thrombolysis in Myocardial Infarction (TIMI) frame count method. Endothelium dependent flow mediated dilatation (FMD) and independent vasodilatation characteristics are evaluated by high frequency ultrasound over the brachial artery. Superoxide dismutase (SOD) and reduced glutathione (GSH) and reduction of oxidative material in the body and the end product of lipid peroxidation, malondialdehyde (MDA) are measured as oxidative stress markers in blood samples. Results: Plasma Hcy level (µmol/l) of patients with CSF was found to be significantly higher than in controls (12.2 ± 4.9 vs. 8.5 ± 2.8, p = 0.0001). FMD was 7.87 ± 2.0% in controls and 4.98 ± 1.1% in patients with CSF (p = 0.0001). GSH was reduced in patients with CSF. SOD and MDA activity were found higher in patients with CSF than control subjects. Plasma Hcy level was significantly positively correlated with mean TIMI frame count and negatively correlated with FMD in correlation analysis (r = 0.58, p = 0.0001; r = –0.41, p = 0.022; respectively). Conclusion: The present findings allow us to conclude that patients with CSF have increased levels of Hcy and oxidative stress markers and impaired endothelial cell function.
Timing of Clinically Significant Microembolism after Carotid Endarterectomy
Authors: Abbott A.L. , Levi C.R. , Stork J.L. , Donnan G.A. , Chambers B.R.
Published: February 2007

Purpose: Post-operatively detected transcranial Doppler (TCD) embolic signals (ES) are associated with an increased risk of carotid endarterectomy (CEA) stroke/TIA. The aims here were to quantify this risk and determine the most efficient monitoring protocol. Methods: Sequential patients undergoing CEA (enrolled in a randomised, blinded, placebo-controlled trial of peri-operative dextran therapy) had 30-min TCD monitoring in the first post-operative hour. 30-min monitoring was also performed 2–3, 4–6 and 24–36 h post-operatively. First post-operative hour ES counts were correlated with peri-operative ipsilateral carotid stroke/TIA to determine the size of a clinically significant ES load and the magnitude of the associated risk. The exact Cochran-Armitage test for trend in proportions was used to determine when a clinically significant ES load was first detected. Results: 141 patients (mean age 69.3 years, 72% male) were monitored during the first post-operative hour. An ES count >10 per recording was identified as the best overall predictor of ipsilateral stroke/TIA (sensitivity 72%, specificity 89%). 3/119 (2.5%) patients with 0–10 ES had ipsilateral carotid events compared to 8/22 (36.4%) patients with 11–115 ES (OR = 22.1, 95% CI 4.5, 138.4, p < 0.0001). 13/18 (72%) of subjects with >10 ES were identified in the first post-operative hour with no significant increase in the number of new cases over the subsequent 24–36 post-operative h (p = 0.354). Conclusion: Patients with clinically significant post-operative microembolism had an approximately 15 times higher risk of ipsilateral stroke/TIA and most were identified during a 30-min study in the first post-operative hour.
Paediatric Salivary Gland Epithelial Neoplasms
Authors: Bradley Patrick , McClelland Lisha , Mehta Deepak
Published: February 2007

Salivary gland epithelial neoplasms in children are rare. Clinicians of all disciplines need to have a high level of suspicion when a non-inflammatory single mass lesion presents in the parotid or submandibular glands. There is high likelihood of malignancy when such a mass presents. Surgery is the primary treatment of choice in the majority of cases, with the addition of adjuvant radiotherapy ± chemotherapy when the diagnosis is a high-grade tumour and/or when the malignancy presents as a large mass or is associated with local tissue invasion. Minor salivary gland neoplasms also present, the oral cavity is most frequent, with pleomorphic adenoma and mucoepidermoid carcinoma being most common, other malignant neoplasms have been reported in other sites.
Predictive Value of Maternal Angiogenic Factors in Second Trimester Pregnancies With Abnormal Uterine Perfusion
Authors: Stepan Holger , Unversucht Angela , Wessel Niels , Faber Renaldo
Published: February 2007

Angiogenic factors like placental growth factor and its antiangiogenic antagonist soluble fms-like tyrosine kinase 1 (sFlt1) are closely related to the pathogenesis of preeclampsia and intrauterine growth restriction. Because it is known that altered maternal sFlt1 and placental growth factor levels are detectable weeks before the onset of these pregnancy complications, it was the aim of the study to investigate the predictive value of these markers in high-risk second trimester pregnancies characterized by abnormal uterine perfusion. This prospective study includes 63 second trimester pregnant women with abnormal uterine perfusion. Twenty five of them developed a later complication (12 with preeclampsia, 11 with intrauterine growth restriction, and 2 with intrauterine death), whereas 38 had a normal course of pregnancy. Pregnancies with adverse pregnancy outcome showed in the second trimester significantly higher sFlt1 (1403.6±555 versus 451.8±42 pg/mL;
P
<0.05) and lower placental growth factor (139.6±24 versus 184.1±21 pg/mL) levels compared with those with normal outcome. These alterations were more pronounced in pregnancies with subsequent preeclampsia compared with intrauterine growth restriction and early onset diseases (delivery <34 weeks) compared with late-onset diseases. The combination of Doppler and sFlt1 increases the sensitivity of Doppler alone for iatrogenic preterm delivery from 64% up to 79% and the specificity from 63% up to 80%. Using both factors, sFlt1 and placental growth factor, early onset preeclampsia can be predicted with 83% sensitivity and 95% specificity. We conclude that the concurrent measurement of uterine perfusion and angiogenic factors allows an efficient prediction of early onset pregnancy complications, particularly preeclampsia.
Asymmetric Dimethylarginine and Reduced Nitric Oxide Bioavailability in Young Black African Men
Authors: Melikian Narbeh , Wheatcroft Stephen B. , Ogah Okechukwu S. , Murphy Cliona , Chowienczyk Phillip J. , Wierzbicki Anthony S. , Sanders Thomas A.B. , Jiang Benyu , Duncan Edward R. , Shah Ajay M. , Kearney Mark T.
Published: February 2007

Black Africans have a higher incidence of cardiovascular disease than white Europeans. We explored potential mechanisms of this excess risk by assessing endothelium function, inflammatory status (C-reactive protein), oxidative stress (isoprostane-F2α), and plasma asymmetrical dimethyl arginine (ADMA; an endogenous competitive inhibitor of NO synthase) in each ethnic group. Thirty healthy black Africans and 28 well-matched white European male subjects were studied (mean age±SE: 32.2±0.9 and 29.2±1.2 years, respectively;
P
=0.07). High-resolution ultrasound was used to assess vascular function in the brachial artery by measuring flow mediated dilatation ([percentage of change]; endothelium-dependent function) and glyceryltrinitrate dilatation ([percentage of change]; endothelium-independent function). Blood pressure, fasting lipids, glucose, and estimated glomerular filtration rate levels were similar in both groups. There was no difference in C-reactive protein (black Africans: 0.8±0.1 mg/L; white Europeans: 0.6±0.1 mg/L;
P
=0.22), isoprostane-F2α (black Africans: 42.9±1.5 pg/mL; white Europeans: 39.2±1.5 pg/mL;
P
=0.23), and leptin (black Africans: 64.1±10.2 ng/mL; white Europeans: 47.8±9.8 ng/mL;
P
=0.37) levels between the 2 ethnic groups. However, compared with white Europeans, plasma ADMA levels were significantly higher in black Africans (0.34±0.02 μmol/L and 0.25±0.03 μmol/L;
P
=0.03). There was no difference in the percentage of glyceryltrinitrate dilatation (
P
=0.7), but the percentage of flow-mediated dilatation was significantly lower in black Africans (black Africans: 5.2±0.3; white Europeans: 6.3±0.4;
P
=0.02). In a stepwise multiple regression model, ADMA level was the only independent determinant of flow-mediated dilatation (
P
=0.02). In turn, race was the only independent determinant of ADMA levels (
P
=0.03). Our findings indicate that circulating ADMA levels are significantly higher in healthy black African males than in white European males. This may contribute to the lower NO bioavailability and higher incidence of cardiovascular disease seen in black Africans.
Blood-Brain Barrier Genomics
Authors: Pardridge William M.
Published: February 2007

Blood-brain barrier (BBB) genomics begins with the isolation of capillaries from fresh animal or human brain and is followed on the same day with the purification of capillary-derived RNA. The identification of microvascular-enriched genes from a whole brain gene microarray is unlikely because the brain capillary endothelial volume is <0.1% of total brain. Libraries of partial cDNAs corresponding to genes that are selectively expressed at the BBB are generated with polymerase chain reaction-based approaches such as subtractive suppressive hybridization. The availability of these partial cDNAs, in conjunction with production of animal or human BBB cDNA libraries, enables the cloning of the full-length cDNAs and a functional analysis of the BBB-enriched genes. The development of BBB genomics technologies enables the acquisition of a large body of new knowledge about the BBB and the brain microvasculature.
Perinatal Ischemic Stroke
Authors: Nelson Karin B.
Published: February 2007

Perinatal ischemic stroke is not rare in term and near-term infants and is an important antecedent of long-term neurological disability, including congenital hemiplegia (hemiplegic cerebral palsy) and seizure and cognitive disorders. Changes in maternal hemostasis occur in pregnancy and are amplified in the period immediately surrounding birth; stroke and other thromboembolic events are more frequent in both mother and infant in this period. The vasculature and hemostatic mechanisms of placenta as well as brain are likely to be important in the pathobiology of perinatal stroke. Maternal and infant thrombophilias, genetic and acquired, play a role. Rarely is >1 child in a sibship affected, and environmental factors—substantially less studied, to date—are likely to be key determinants of risk.
Advances in Surgical Treatment of Atrial Fibrillation
Authors: Gillinov A. Marc
Published: February 2007

Atrial fibrillation (AF) is the most common sustained arrhythmia. It is associated with increased risks of death and stroke; most strokes in AF patients are thought to arise from thrombi in the left atrial appendage. Surgical ablation of AF includes excision of the left atrial appendage and is an effective means of treating this arrhythmia, with the classic Maze procedure curing AF in >90% of patients and virtually eliminating the risk of late stroke. A complex but safe operation, the Maze procedure has been applied by relatively few surgeons. However, recent advances in the understanding of the pathogenesis of AF and development of new ablation technologies enable surgeons to perform pulmonary vein ablation, create linear left atrial lesions, and remove the left atrial appendage rapidly and safely. Lesions are created under direct vision, minimizing the risk of damage to the pulmonary veins and adjacent mediastinal structures. The majority of surgical ablation procedures have been performed in conjunction with mitral valve surgery, with the combination of mitral valve repair and cure of AF enabling patients to avoid lifelong anticoagulation. Recently developed surgical instrumentation now enables thoracoscopic and keyhole approaches, facilitating extension of epicardial AF ablation and excision of the left atrial appendage to patients with isolated AF and no other indication for cardiac surgery. In addition, novel devices designed specifically for minimally invasive epicardial exclusion of the left atrial appendage will broaden the range of treatment options for patients with AF, possibly eliminating the need for anticoagulation in selected patients.
Recombinant Activated Factor VII for Acute Intracerebral Hemorrhage
Authors: Mayer Stephan A.
Published: February 2007

Intracerebral hemorrhage is the least treatable form of stroke and is associated with 30% to 50% mortality rate. Early hematoma growth occurs in 18% to 38% of patients scanned within 3 hours of intracerebral hemorrhage onset, and hematoma volume is an important predictor of poor outcome. Recombinant activated factor VII, a potent initiator of hemostasis, is currently approved for the treatment of bleeding in hemophilia patients with inhibitors and has also been shown to promote hemostasis in patients with normal coagulation. A recent phase IIB randomized, double-blind, placebo-controlled, dose-ranging “proof-of-concept” trial enrolled 399 intracerebral hemorrhage patients to determine whether recombinant activated factor VII can limit ongoing bleeding and improve outcome. An approximate 50% relative reduction in hematoma growth was evident with all 3 doses that were tested (40, 80, and 160 μg/kg), which translated into an average reduction in absolute intracerebral hemorrhage volume growth of ≈5 milliliters. More importantly, recombinant activated factor VII was associated with a 38% relative reduction in mortality and significantly improved functional outcome among survivors, despite a 5% frequency of arterial thromboembolic events (primarily ischemic stroke and myocardial infarction). A large phase III trial (the FAST trial [
F
actor Seven for
A
cute Hemorrhagic
S
troke
T
reatment]) is now in progress to confirm these findings.
Introduction to Neural Stem Cells
Authors: Kornblum Harley I.
Published: February 2007

Neural stem cells self-renew and give rise to neurons, astrocytes and oligodendrocytes. These cells hold great promise for neural repair after injury or disease. However, a great deal of information needs to be gathered before optimally using neural stem cells for neural repair. This brief review provides an introduction to neural stem cells and briefly describes some advances in neural stem-cell biology and biotechnology.
Peroxisome Proliferator–Activated Receptors as Transcriptional Nodal Points and Therapeutic Targets
Authors: Brown Jonathan D. , Plutzky Jorge
Published: February 2007

Peroxisome proliferator–activated receptors (PPARs) are ligand-activated transcription factors involved in the transcriptional regulation of key metabolic pathways such as lipid metabolism, adipogenesis, and insulin sensitivity. More recent work implicates all 3 PPAR isotypes (α, γ, and δ, also known as β or β/δ) in inflammatory and atherosclerotic pathways. Because these nuclear receptors are activated by extracellular signals and control multiple gene targets, PPARs can be seen as nodes that control multiple inputs and outputs involved in energy balance, providing insight into how metabolism and the vasculature may be integrated. The ongoing clinical use of fibrates, which activate PPARα, and thiazolidinediones, which activate PPARγ, establishes these receptors as viable drug targets, whereas considerable in vitro animal model and human surrogate marker studies suggest that PPAR activation may limit inflammation and atherosclerosis. Together, these various observations have stimulated intense interest in PPARs as therapeutic targets and led to large-scale cardiovascular end-point trials with PPAR agonists. The first of these studies has generated mixed results that require careful review, especially in anticipation of additional clinical trial data and ongoing attempts to develop novel PPAR modulators. Such analysis of the existing PPAR data, the appropriate use of currently approved PPAR agonists, and continued progress in PPAR therapeutics will be predicated on a better understanding of PPAR biology.
Indications for Heart Transplantation in Pediatric Heart Disease
Authors: Canter Charles E. , Shaddy Robert E. , Bernstein Daniel , Hsu Daphne T. , Chrisant Maryanne R.K. , Kirklin James K. , Kanter Kirk R. , Higgins Robert S.D. , Blume Elizabeth D. , Rosenthal David N. , Boucek Mark M. , Uzark Karen C. , Friedman Alan H. , Young James K.
Published: February 2007

Background—

Since the initial utilization of heart transplantation as therapy for end-stage pediatric heart disease, improvements have occurred in outcomes with heart transplantation and surgical therapies for congenital heart disease along with the application of medical therapies to pediatric heart failure that have improved outcomes in adults. These events justify a reevaluation of the indications for heart transplantation in congenital heart disease and other causes of pediatric heart failure.

Methods and Results—

A working group was commissioned to review accumulated experience with pediatric heart transplantation and its use in patients with unrepaired and/or previously repaired or palliated congenital heart disease (children and adults), in patients with pediatric cardiomyopathies, and in pediatric patients with prior heart transplantation. Evidence-based guidelines for the indications for heart transplantation or retransplantation for these conditions were developed.

Conclusions—

This evaluation has led to the development and refinement of indications for heart transplantation for patients with congenital heart disease and pediatric cardiomyopathies in addition to indications for pediatric heart retransplantation.
Insulin-Resistant Heart Exhibits a Mitochondrial Biogenic Response Driven by the Peroxisome Proliferator-Activated Receptor-α/PGC-1α Gene Regulatory Pathway
Authors: Duncan Jennifer G. , Fong Juliet L. , Medeiros Denis M. , Finck Brian N. , Kelly Daniel P.
Published: February 2007

Background—

Obesity and diabetes mellitus are complex metabolic problems of pandemic proportion, contributing to significant cardiovascular mortality. Recent studies have shown altered mitochondrial function in the hearts of diabetic animals. We hypothesized that regulatory events involved in the control of mitochondrial function are activated in the prediabetic, insulin-resistant stage.

Methods and Results—

Morphometric analyses demonstrated that cardiac myocyte mitochondrial volume density was increased in insulin-resistant uncoupling protein-diptheria toxin A (UCP-DTA) transgenic mice, a murine model of metabolic syndrome, compared with littermate controls. Mitochondrial DNA content and expression of genes involved in multiple mitochondrial pathways were also increased in insulin-resistant UCP-DTA hearts. The nuclear receptor, peroxisome proliferator-activated receptor-α (PPARα), is known to activate metabolic genes in the diabetic heart. Therefore, we evaluated the role of PPARα in the observed mitochondrial biogenesis response in the insulin-resistant heart. Insulin-resistant UCP-DTA mice crossed into a PPARα-null background did not exhibit evidence of mitochondrial biogenesis or induction of mitochondrial gene expression. Conversely, transgenic mice with cardiac-specific overexpression of PPARα exhibited signatures of cardiac mitochondrial biogenesis. A screen for candidate mediators of the PPARα-driven mitochondrial biogenic response revealed that expression of PPARγ coactivator-1α (PGC-1α), a known regulator of mitochondrial biogenesis, was activated in wild-type UCP-DTA mice but not in PPARα-deficient UCP-DTA mice.

Conclusions—

These results demonstrate that mitochondrial biogenesis occurs early in the development of diabetic cardiac dysfunction through a transcriptional regulatory circuit that involves activation of PGC-1α gene expression by the fatty acid–activated nuclear receptor PPARα.
How Elementary Principals’ Beliefs and Actions Influence New Teachers’ Experiences
Authors: Youngs Peter
Published: February 2007

Purpose: The purpose of the study was to examine (a) ways in which elementary principals in Connecticut influenced the induction experiences of new teachers and (b) how school leaders’ professional backgrounds and beliefs affected their approaches to induction.

Research Methods: The study included six elementary principals from three Connecticut districts, and 1st- and 2nd-year teachers, mentors, and other teachers from the principals’ schools. Data collection in 2000-01 involved interviewing principals, beginning teachers, mentors, and other educators; and observing principals’ meetings with new teachers, mentor-mentee meetings, and other induction activities.

Findings: The study found that three of the principals strongly promoted new teachers’ instructional growth in their direct interactions with them and by facilitating their work with mentors and grade team members; in contrast, the other three school leaders did not have as much positive impact on new teachers. The article provides evidence that these differences in beginning teachers’ experiences seemed related to variations in the principals’ professional backgrounds; their beliefs and actions regarding leadership, induction, and teacher evaluation; and their responses to district and state policy.

Implications: The implications of the study findings are (a) that principals should promote school cultures in which experienced teachers are actively involved in induction; (b) that researchers should examine how school leaders construct their understandings of induction, teacher development, and district and state policy; and (c) that there is a need for quantitative researchers to employ principal leadership as an independent variable that can affect mentor-mentee matches and new teachers’ experiences and retention decisions.
Comparison of different energy densities of extracorporeal shock wave therapy (ESWT) for the management of chronic heel pain
Authors: Chow Intonia H W , Cheing Gladys LY
Published: February 2007

Objective: To compare the effectiveness of different energy densities of extracorporeal shock wave therapy (ESWT) for managing chronic heel pain.

Design: A randomized clinical trial.

Setting: Hospital-based practice.

Subjects: Fifty-seven patients with chronic heel pain were recruited; eight patients withdrew from the study.

Interventions: Subjects were randomized into three groups receiving: (1) a ‘fixed’ energy density, (2) ‘maximum tolerable’ energy density, or (3) control treatment once a week for three weeks.

Outcome measures: Pain on palpation, pain on tension, maximum tolerable walking/standing duration and Foot Function Index were assessed before treatment in each treatment session and at the three-week follow-up.

Results: By week 3, the ‘maximum tolerable’ energy density group experienced a 66% cumulative reduction in pain from tension, a 65% reduction on palpation and a 112% cumulative increase in maximum tolerable walking/standing duration. The ‘fixed’ energy density group experienced a 45% cumulative reduction in pain from tension, a 32% reduction in pain on palpation, and a 45% increase in walking/standing tolerance. The ‘maximum tolerable’ energy density group also showed a significantly greater reduction in Foot Function Index scores than the other two groups. Therapeutic effects were maintained at least up to the three-week follow-up period. The control group had no significant changes in any outcome measures across time periods.

Conclusion: The delivery of ESWT with a maximum tolerable energy density is a more effective treatment protocol than a fixed energy density in terms of relieving pain and restoring the functional activity of people suffering from chronic heel pain. The analgesic effects were maintained at least up to the three-week follow-up.
A systematic review of the Human Activity Profile
Authors: Davidson Megan , de Morton Natalie
Published: February 2007

Objective: To review the measurement properties (reliability, validity, responsiveness) of the Human Activity Profile (HAP), a self-report measure of energy expenditure or physical fitness.

Data sources: MEDLINE, CINAHL and EMBASE were searched up to September 2005 and the reference lists of included studies were checked for additional relevant studies.

Review method: Studies were included that reported Human Activity Profile scores, test-retest reliability, correlations with other measures, or responsiveness (sensitivity to change). Of 83 potentially relevant articles, 39 articles were included plus the test manual. Two independent reviewers extracted data from the included studies.

Results: The Human Activity Profile has been used to evaluate physical activity in a wide variety of clinical populations and in healthy individuals. The change in score required to be 90% confident that change is beyond measurement error was estimated to be 7.8 for the Maximum Activity Score and 6.8 for the Adjusted Activity Score. The construct validity of the Human Activity Profile was supported by a large number of studies, although evidence for criterion validity was limited to four studies. No studies have investigated a priori the responsiveness or minimum clinically important difference of the Human Activity Profile.

Conclusion: The Human Activity Profile appears to be a useful indicator of physical activity levels in people with chronic pain, arthritis, renal failure, various neurological and cardiorespiratory conditions, as well as in healthy older people.
Effects of home-based sensory and motor amplitude electrical stimulation on arm dysfunction in chronic stroke
Authors: Sullivan Jane E , Hedman Lois D
Published: February 2007

Objective: To examine the effects of a home-based arm exercise programme of sensory and motor amplitude electrical stimulation.

Design: Non-concurrent, multiple-baseline, single-subject design.

Subjects: Ten adults with chronic arm hemiparesis following stroke. Subjects ranged in age from 38 to 74 years and were 2-16 years post stroke. Three subjects had right-sided involvement; seven had left.

Intervention: Subjects completed an eight-week, individualized, home programme of neuromuscular and sensory amplitude electrical stimulation. All subjects engaged in stimulation-assisted task-specific exercises for 15 minutes 2 -3 times daily. Participants with sensory deficits received an additional 15 minutes of sensory amplitude stimulation twice daily. The Action Research Arm Test was used to examine arm function; the Stroke Rehabilitation Assessment of Movement was used to examine movement quality; and the Modified Ashworth Assessment of Spasticity was used to examine muscle tone.

Results: A statistically significant improvement was demonstrated by six of the 10 subjects on the Action Research Arm Test, and five subjects on the Stroke Rehabilitation Assessment of Movement. Four subjects had ≥ 10% improvement on the Modified Ashworth Assessment of Spasticity. Two subjects demonstrated significant improvement on all three outcome measures; six subjects improved on two or more measures; and seven subjects improved on one or more measure. Subjects who improved on two or more measures tended to have had more recent onset of stroke, were older and had higher baseline motor and functional capacity.

Conclusion: Subjects with chronic stroke can experience impairment and functional improvements following a home-based programme of motor and sensory amplitude electrical stimulation.
Denying Rumours
Authors: Renard Jean-Bruno
Published: February 2007

We can construct a typology of rumours - defined broadly as unverified news - according to their relation to reality after their degree of veracity has been established, at least in the current state of knowledge, by experts (historians, scientists, police officers, journalists, and so on). If a rumour turns out to be correct it becomes an item of information. If a rumour is untrue it comes into the categories of affirming or denying rumours. Affirming rumours, which are the most common type, state the reality of imaginary facts, for instance the rumour claiming that bananas from Costa Rica pass on to people flesh-eating bacteria that cause general necrosis. Denying rumours, which are rarer, deny the reality of established facts, for example rumours claiming that Elvis Presley is not dead or that Americans have never walked on the moon.

It seems useful to distinguish various terms indicating negation. Rumours will be termed negative when they state facts associated with fear or hostility, whereas positive rumours evoke happy, welcome events. French researchers, who assign colours to rumours, talk about ‘black’ rumours or ‘rose-tinted’ ones. Specialists agree that there are around nine black rumours for every rose-tinted one. Rouquette (1975, 1990) has thoroughly studied this ‘bias towards negativity’, which is one of the main features of rumours. I shall talk about denying rumours and ideas when they deny commonly accepted events. These rumours are not necessarily negative: for instance survival legends often express the wish that a loved person were not dead. Finally, among denying rumours and ideas, we shall reserve the word negationist for revisionist claims that the gas chambers did not exist, or that a Nazi did not plan to exterminate the Jews during the Second World War.
Mothering Under Difficult Circumstances
Authors: Krane Julia , Davies Linda
Published: February 2007

This article explores challenges to understanding mothering under difficult and unusual circumstances—that is, in the context of a shelter for battered women and their children. Drawing on participant observation and interviews with staff at a local battered woman’s shelter, the authors suggest that mothering is largely invisible and subject to idealized constructions. When mothers are rendered visible in the shelter, they are observed through a lens of heightened sensitivity to abusive relations that are marked by unacceptable use of power and control. This lens is distorted in relation to mothering, and an understanding of the emotional complexities and challenges of everyday mothering is a prerequisite for practice with women with children. The article concludes with a discussion of implications for theory and practice that center on the concepts of power and maternal subjectivity in relation to battered women as mothers in shelters.
“It’s Not Scary”
Authors: Holley Lynn C. , Risley-Curtiss Christina , Stott Tonia , Jackson Diane R. , Nelson Russell
Published: February 2007

To increase their research skills and confidence, students in a nonresearch-focused elective MSW course gathered qualitative data through cross-ethnic interviews for a formal research project. Qualitative findings from a focus group of students were used to examine the perspectives of the students, all but one of whom were women, about (a) changes in their knowledge of and attitudes toward research, (b) the struggles they experienced, and (c) whether such projects should be integrated into other courses. Implications for social work educators who are seeking to empower social work students, especially women, to conduct research are discussed.
The Importance of Perceived Consumption Delay in Internet Shopping
Authors: Park Jihye , Kim Jihyun
Published: February 2007

This study examines the effect of delivery-time–related information (stock availability and shipping/handling cycle) on perceived consumption delay, perceived time risk, attitude toward the Web site, and online purchase intention. In addition, the authors examine the interrelationships among dependent variables using a causal model analysis. Participants (213 female undergraduates) evaluated a mock Web site under four treatment conditions. The findings indicate statistically significant main effects for time-related information on all four dependent variables and support the causal relationships among dependent variables. Based on the results, Internet apparel retailers may benefit from establishing a prompt restocking system to reduce the waiting time for apparel products and in turn, perceptions of consumption delay.
Leadership and the white-faced ewe
Authors: Kirkham Glynn
Published: February 2007

The observation of persistent behaviour in a hungry sheep stimulates thought about the nature of leadership. Some discussion follows concerning traits exhibited by historical leaders.
Evidence of Concurrent Validity of SII Scores for Asian American College Students
Authors: Hansen Jo-Ida C. , Lee W. Vanessa
Published: February 2007

The validity of scores on the Strong Interest Inventory (SII) for Asian American college students has not been thoroughly investigated. This study examined the evidence of validity of the SII Occupational Scale scores for predicting college major choices of Asian American women and men and White women and men. The sample included 186 female and 133 male college students. Forty-six percent of the sample was Asian American and 54% was White. Acculturation also was tested for its moderating effect on predictive accuracy of the SII scores for Asian American participants. In aggregate the results support the use of the SII with Asian American college students.
Thirty-Year Stability and Predictive Validity of Vocational Interests
Authors: Rottinghaus Patrick J. , Coon Kristin L. , Gaffey Abigail R. , Zytowski Donald G.
Published: February 2007

This study reports a 30-year follow-up of 107 former high school juniors and seniors from a rural Midwestern community who completed the Kuder Occupational Interest Survey (KOIS) in 1975 and 2005.Absolute, intra-individual, and test-retest stability of interests, and predictive validity of occupations were examined. Results showed minor absolute (mean) changes, moderate intra-individual stability (Spearman rho = .54), and scale test-retest correlations ranging from .10 to .76. This study corroborates earlier stability studies and extends our understanding of why some individuals show unstable interest patterns. Several Time 1 KOIS interest scores correlated with intra-individual stability itself. Comparisons between 1975 KOIS scores and 2005 occupation using the Brown-Gore C-index demonstrated predictive validity by yielding fit indices for women and men exceeding the theoretical mean. Findings inform our understanding of midlife career development and have implications for career counseling practice.
Perceived Barriers and Postsecondary Plans in Mexican American and White Adolescents
Authors: McWhirter Ellen Hawley , Torres Danielle M. , Salgado Susana , Valdez Marina
Published: February 2007

The authors examined perceived internal and external barriers to postsecondary educational plans among 140 Mexican American and 296 White high school students, attending to sex, socioeconomic, ethnic differences. Parent education was associated with educational plans. Girls anticipated encountering more barriers associated with financing postsecondary education than their male counterparts. Mexican American students anticipated encountering more postsecondary education barriers associated with ability, preparation, motivation, support, and separation, and expected those barriers to be more difficult to overcome, than their White counterparts. Implications for research and practice are discussed.
Prevalence of multiple sclerosis in Santiago de Compostela (Galicia, Spain)
Authors: Ares B , Prieto Jm , Lema M , Dapena D , Arias M , Noya M
Published: February 2007

Introduction

Multiple sclerosis (MS) is the most common central nervous system disease in young adults, and one of the leading causes of disability in this age group.

Objectives

To establish the prevalence and incidence of MS in Santiago de Compostela (Spain).

Material and methods

We performed a prospective, case-finding study on >90188 inhabitants, from 1 January 1998 to 15 September 2003, selected as day of prevalence. Sources of information were the University Clinical Hospital of Santiago, the hospitals and private clinics of the city, rehabilitators, pediatricians, ophthalmologists, psychiatrists, neurosurgeons, specialists in internal medicine, primary care physicians, association of patients of MS, social services and nongovernmental and religious associations. Informative days were programmed for the susceptible population, and campaigns were carried out in the media. All patients with Poser diagnostic criteria for MS, on the census of Santiago de Compostela as of 15 September 2003, were included in the study.

Results

On the day of prevalence, 71 patients with MS were registered on the census of Santiago de Compostela, therefore, the prevalence was 79 cases per 100000 inhabitants. The incidence of the disease in the study period was 5.3 cases per 100000 inhabitants and year.

Conclusions

The prevalence and incidence rates of MS found in Santiago de Compostela are the highest reported, to date, in Spain. Multiple Sclerosis 2007; 13: 262–264. http://msj.sagepub.com
Predictors of well-being among significant others of persons with multiple sclerosis
Authors: Sherman Te , Rapport Lj , Hanks Ra , Ryan Ka , Keenan Pa , Khan O , Lisak Rp
Published: February 2007

Objective

To examine patient and significant other characteristics as predictors of significant other well-being.

Methods

A total of 74 persons with multiple sclerosis (MS) and their significant others participated. Executive functioning was measured using neuropsychological tests. Awareness of cognitive deficit was measured as the discrepancy between the patient's reports of their abilities and objective test results. Awareness of functional deficit was measured as the discrepancy between the patient's and significant other's reports of the patient's functional abilities. Patient neurobehavioral disturbance was measured using a significant-other rated questionnaire. Significant other perceived social support and well-being (ie, psychological distress, life satisfaction, and general health status) were assessed using questionnaires filled out by the significant other.

Results

Executive dysfunction, neurobehavioral disturbance, and lack of awareness of functional deficits in patients were associated with poor well-being outcomes; whereas, lack of awareness of cognitive deficits was only weakly related to well-being. Social support was associated with positive well-being outcomes.

Conclusions

Diminished insight regarding functional limitations may increase significant others’ supervisory burden as patients attempt activities independently, whereas lack of awareness of cognitive deficits may not be directly associated with behavior-relevant impairments that significant others find distressing. Social support appears to be a powerful aid in diffusing the distress among significant others of MS patients. Multiple Sclerosis 2007; 13: 238–249. http://msj.sagepub.com
Relationship of triple dose contrast enhanced lesions with clinical measures and brain atrophy in early relapsing-remitting multiple sclerosis: a two-year longitudinal study
Authors: Rashid W , Davies Gr , Chard Dt , Griffin Cm , Altmann DR , Thompson Aj , Miller Dh
Published: February 2007

Gadolinium (Gd) enhancement of lesions indicates inflammatory lesion activity in multiple sclerosis (MS). The question arises whether early inflammatory lesion activity – measured sensitively using triple dose Gd – is related to the future clinical course, or to the development of brain atrophy that is thought to reflect the underlying pathological progression of the disease. In this study, 26 patients with early relapsing-remitting (RR) MS (median disease duration: 1.7 years) were followed up over two years. Associations were explored between their levels of Gd-lesion enhancement in the first six months and later clinical (Expanded Disability Status Scale (EDSS) and MS Functional Composite Score (MSFC)) and magnetic resonance imaging (MRI) (brain volume, T2 and T1 lesion volumes) measures. The extent of Gd-enhancement in the first six months correlated weakly with concurrent relapses (P = 0.041), but there was no consistent correlation with clinical and MRI outcomes at two years. More prolonged follow-up is warranted to clarify the relationship between early inflammatory lesions and long-term clinical course. Multiple Sclerosis 2007; 13: 178–185. http://msj.sagepub.com
An exploratory study on interferon beta dose effect in reducing size of enhancing lesions in multiple sclerosis
Authors: Di Rezze S. , Gupta S. , Durastanti V. , Millefiorini E. , Pozzilli C. , Bagnato F.
Published: February 2007

Sixty-two patients with multiple sclerosis (MS) were imaged monthly over a six-month (ie, seven monthly magnetic resonance images [MRI]) natural history period (NHP). Thereafter, patients were randomized to receive 11 or 33 μg of subcutaneously injected interferon beta 1a (IFNp-1 a) with imaging monthly for nine months and at months 12, 18 and 24 of therapy phase (TP). In the present exploratory post hoc analysis, the authors evaluated IFNβ-1a dose effect on reducing the size of contrast-enhancing lesions (CELs). MRIs performed at months 0, 3 and 6 of NHP and at months 3, 6, 9, 18 and 24 of TP were analysed. While a significant reduction in mean number of CELs was observed in both treatment groups of patients, the mean total volume and size of CELs was reduced only in patients undergoing therapy with 33 μg of IFNβ-1a. The latter suggests a significant dose effect exerted by IFNβ-1a in the evolution of CELs' dimensions during therapy. Multiple Sclerosis 2007; 13: 343-347. http://msj.sagepub.com
Predicting beta-interferon failure in relapsing-remitting multiple sclerosis
Authors: O'Rourke K. , Walsh C. , Antonelli G. , Hutchinson M.
Published: February 2007

Proposed beta-interferon (IFNβ) treatment failure criteria for patients with relapsing-remitting multiple sclerosis (RRMS) have not been validated in clinical practice. This study aimed to establish (a) whether IFNβ attenuated accumulation of fixed disability in comparison to a cohort of matched historical control subjects from the Sylvia Lawry centre for MS research, and (b) whether relapse-based treatment failure criteria or clinical and demographic variables had predictive value for the accumulation of fixed disability. Of the 175 IFNβ-treated RRMS patients, 60 (34%) developed accumulation of fixed disability over a median of five years follow-up, which was significantly less than the rate of accumulation of fixed disability in the control group (P<0.0001). Any relapse in the treatment period predicted accumulation of fixed disability with a sensitivity of 80% and specificity of 43%; patients totally relapse free were less likely to develop accumulation of fixed disability (P <0.002). Multivariate analysis confirmed that a greater risk of accumulation of fixed disability was conferred by a higher Expanded Disability Status Scale (EDSS) score starting IFNβ (P=0.02), and by failure of IFNβ to completely suppress relapses (P=0.004). In conclusion, IFNβ therapy reduced the accumulation of fixed disability in a cohort of RRMS patients, followed for a median of five years. Higher baseline EDSS and failure of complete relapse suppression were associated with a significantly greater likelihood of accumulation of fixed disability. Multiple Sclerosis 2007; 13: 336-342. http://msj.sagepub.com