bluuebunny/crossref_metadata_2025 huggingface dataset:
Zinc ions block H+/OH‐ channels in Chara australis
Authors: AL KHAZAALY SABAH , BEILBY MARY J.
Published: February 2012

Chara australis cells exposed to media of pH 10 and above exhibit high conductance, arising from the opening of H+/OH‐ channels in the plasma membrane. This high conductance can be totally inhibited by 1.0 mm ZnCl2 and restored by 0.5 mm 2‐mercaptoethanol (ME). Important for carbon fixation, H+/OH‐ channels play a key role in cell pH banding. Banding was also shown to be abolished by 1.0 mm ZnCl2 and restored in some cells by ME. The proton pump is also involved in banding, but was little affected by ZnCl2 over the periods needed for the inhibition of H+/OH‐ channels. Previously, we postulated that H+/OH‐ channels open transiently at the onset of saline stress in salt‐sensitive C. australis, causing membrane potential difference (PD) noise; and remain open in latter stages of saline stress, contributing to cell deterioration. ZnCl2 totally inhibited the saline noise and the upwardly concave I/V characteristics associated with the putative H+/OH‐ currents. Again, ME reversed both these effects. We discuss the mode of action of zinc ions and ME with reference to animal voltage‐gated H+ channels and water channels.
ENTIRE and GOBLET promote leaflet development in tomato by modulating auxin response
Authors: Ben‐Gera Hadas , Shwartz Ido , Shao Mon‐Ray , Shani Eilon , Estelle Mark , Ori Naomi
Published: February 2012

Compound leaves produce leaflets in a highly controlled yet flexible pattern. Here, we investigate the interaction between auxin, the putative auxin response inhibitor ENTIRE (E, SlIAA9) and the CUC transcription factor GOBLET (GOB) in compound‐leaf development in tomato (Solanum lycopersicum). Auxin maxima, monitored by the auxin response sensor DR5, marked and preceded leaflet and lobe initiation. The DR5 signal increased, but maxima were partially retained in response to the external or internal elevation of auxin levels. E directly interacted with the auxin receptors SlTIR1 and SlAFB6. Furthermore, E was stabilized by a mutation in domain II of the protein and by the inhibition of auxin or proteasome activity, implying that E is subjected to auxin‐mediated degradation. In e mutants the DR5 signal expanded to include the complete leaf margin, and leaf‐specific overexpression of a stabilized form of E inhibited the DR5 signal and lamina expansion. Genetic manipulation of GOB activity altered the distribution of the DR5 signal, and the inhibition of auxin transport or activity suppressed the GOB overexpression phenotype, suggesting that auxin mediates GOB‐regulated leaf patterning. Whereas leaves of single e or gob mutants developed only primary leaflets, the downregulation of both E and GOB resulted in the complete abolishment of leaflet initiation, and in a strong DR5 signal throughout the leaf margin. These results suggest that E and GOB modulate auxin response and leaflet morphogenesis via partly redundant pathways, and that proper leaflet initiation and separation requires distinct boundaries between regions of lamina growth and adjacent regions in which growth is inhibited.
Expression of myostatin, myostatin receptors and follistatin in diabetic rats submitted to exercise
Authors: Dutra Daniela B , Bueno Patrícia G , Silva Rafaella N , Nakahara Natália H , Selistre‐Araújo Heloísa S , Nonaka Keico O , Leal Angela MO
Published: February 2012

Myostatin (MSTN) has been implicated in metabolic adaptation to physiological stimuli, such as physical exercise, which is linked to improved glucose homeostasis.

The aim of the present study was to evaluate the influence of exercise on the expression of MSTN, MSTN receptors (ActRIIB and ALK4) and follistatin (FS) in the muscle and fat of streptozotocin‐induced diabetic rats.

Control and diabetic rats were randomly assigned to a swimming training group (EC and ED, respectively) and a sedentary group (SC and SD, respectively). Exercising animals swam for 45 min at 0900 and 1700 hours, 5 day/week, for 4 weeks. The mRNA expression of MSTN, ActRIIB, ALK4 and FS
mRNA was quantified by real‐time reverse transcription–polymerase chain reaction.

Expression of MSTN and FS
mRNA increased in the muscle and subcutaneous fat of SD compared with SC rats. Expression of ActRIIB
mRNA was increased in the muscle, mesenteric fat and brown adipose tissue (BAT) of SD compared with SC rats, whereas ALK4
mRNA expression was only increased in the BAT of SD compared with SC rats. After training, MSTN and ActRIIB expression was lower in the BAT of EC compared with SC rats. Expression of MSTN
mRNA increased in the mesenteric fat of ED compared with SD rats, whereas FS
mRNA expression decreased in the muscle, mesenteric and subcutaneous fat and BAT. Lower ALK4
mRNA expression was noted in the BAT of ED compared with SD rats.

These results indicate that MSTN, its receptors and FS expression change in both the muscle and fat of diabetic rats and that the expression of these factors can be modulated by exercise in diabetes.
Clinical applications of lung function tests: A revisit
Authors: LIANG BIN‐MIAO , LAM DAVID C.L. , FENG YU‐LIN
Published: February 2012

The development and clinical application of lung function tests have a long history, and the various components of lung function tests provide very important tools for the clinical evaluation of respiratory health and disease. Spirometry, measurement of the diffusion factor, bronchial provocation tests and forced oscillation techniques have found diverse clinical applications in the diagnosis and monitoring of respiratory diseases, such as chronic obstructive pulmonary disease, interstitial lung diseases and asthma. However, there are some practical issues to be resolved, including the establishment of reference values for individual test parameters and the roles of these tests in preoperative risk assessment and pulmonary rehabilitation. Novel measurements, including negative expiratory pressure, the fraction of exhaled nitric oxide and analysis of exhaled breath condensate, may provide new insights into physiological abnormalities or airway inflammation in respiratory diseases, but their clinical applications need to be further evaluated. The clinical application of lung function tests continues to face challenges, which may be overcome by further improvement of conventional techniques for lung function testing and further specification of new testing techniques.
Health according to the experiences of Iranian women with diabetes: A phenomenological study
Authors: Aghamohammadi‐Kalkhoran Masoumeh , Valizadeh Sousan , Mohammadi Eesa , Ebrahimi Hossein , Karimollahi Mansoureh
Published: February 2012

This study explores the meaning of health among Iranian women with diabetes using hermeneutic phenomenology based on Van Manen's approach. A total of 19 women with diabetes who were referred to the Diabetes Center of Imam Khomeini hospital in Ardabil, Iran were recruited using a purposive sampling method. Data were gathered through semi‐structured interviews. Each interview was transcribed verbatim and analyzed simultaneously. Data analysis led to the emergence of five main themes: a God‐centered life, health as a precious possession, health as wellbeing, independence, and acceptance. Patients often described coping with their illnesses and pursuing lifestyle changes by applying their spiritual and religious beliefs. The findings of this study can be used by healthcare teams to revise their opinions about patients with diabetes according to the culture of their patients.
A diabetes scorecard does not improve HbA1c, blood pressure, lipids, aspirin usage, exercise and diabetes knowledge over 9 months: a randomized controlled trial
Authors: Irwig M. S. , Sood P. , Ni D. , Amass T. , Khurana P. S. , Jayanthi V. V. , Wang L. , Adler S.M
Published: February 2012

Diabet. Med. 29, 1206–1212 (2012)

Aims  To test (1) whether a diabetes scorecard can improve glycaemic control, blood pressure control, LDL cholesterol, aspirin usage and exercise; (2) if the scorecard will motivate and/or educate patients to improve their scores for subsequent visits; and (3) whether the scorecard will improve rates of clinical inertia.

Methods  Five physicians enrolled 103 patients ≥ 40 years old with uncontrolled Type 2 diabetes [HbA1c≥ 64 mmol/mol (8.0%)] to randomly receive either a diabetes scorecard or not during four clinical visits over a 9‐month period. The population was predominantly urban with a disproportionately higher percentage of black people than the general population. Our scorecard assigned points to six clinical variables, with a perfect total score of 100 points corresponding to meeting all targets. The primary outcomes were total scores and HbA1c in the scorecard and control groups at 9 months.

Results  There were no significant differences between the control and scorecard groups at visits 1 and 4 in total score, HbA1c, blood pressure, LDL cholesterol, aspirin usage, exercise or knowledge about diabetic targets. By visit 4 both the control and scorecard groups had statistically significant improvements with their mean total score (9 and 7 points, respectively), HbA1c [−9 mmol/mol (–0.8%) and −15 mmol/mol (–1.4%), respectively] and aspirin usage (33% increase and 16% increase, respectively). Rates of clinical inertia were low throughout the study.

Conclusions  A diabetes scorecard did not improve glycaemic control, blood pressure control, LDL cholesterol, aspirin usage, exercise or diabetic knowledge in an urban population with uncontrolled Type 2 diabetes.
Serum 1,5‐anhydroglucitol is associated with diabetic retinopathy in Type 2 diabetes
Authors: Kim W. J. , Park C. Y. , Park S. E. , Rhee E. J. , Lee W. Y. , Oh K. W. , Park S. W. , Kim S. W. , Park H. S. , Kim Y. J. , Song S. J. , Ahn H. Y.
Published: February 2012

Diabet. Med. 29, 1184‐1190 (2012)

Aims  To determine whether there is a relationship between 1,5‐anhydroglucitol (1,5‐AG), a marker of postprandial hyperglycaemia and glycaemic variability, and the presence of diabetic retinopathy and albuminuria in patients with Type 2 diabetes.

Methods  Five hundred and sixty‐seven patients with Type 2 diabetes (serum creatinine < 133 μmol/l), who were enrolled in the Seoul Metro‐City Diabetes Prevention Program (SMC‐DPP), were cross‐sectionally assessed by multivariate logistic regression analysis.

Results  After controlling for age, sex, binary HbA1c levels, duration of diabetes, triglyceride, systolic blood pressure, smoking status, history of hypertension and dyslipidaemia, and the use of angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker medication, the odds ratios (95% CI) of diabetic retinopathy were 2.86 (1.12–7.25) for the first (lowest) quartile of 1,5‐anhydroglucitol, 2.87 (1.25–6.61) for the second quartile and 0.88 (0.35–2.22) for the third quartile compared with the fourth quartile (P for trend = 0.010). Conversely, the associations between 1,5‐anhydroglucitol and clinical albuminuria were non‐significant after adjustment. Subjects with low 1,5‐anhydroglucitol (< 10.0 μg/ml) were more likely to experience diabetic retinopathy than those with high 1,5‐anhydroglucitol (≥ 10.0 μg/ml) under moderate glucose control (HbA1c < 8%, 64 mmol/mol) and there were no significant differences in the prevalence of diabetic retinopathy between the subgroup with HbA1c < 8% (64 mmol/mol) and low 1,5‐anhydroglucitol and the subgroup with HbA1c ≥ 8% (64 mmol/mol).

Conclusions  1,5‐Anhydroglucitol levels show close associations with diabetic retinopathy, especially among patients under moderate glucose control, but not with albuminuria. These results suggest that 1,5‐anhydroglucitol might be a complementary marker for targeting higher risk group.
Rolling‐leaf14 is a 2OG‐Fe (II) oxygenase family protein that modulates rice leaf rolling by affecting secondary cell wall formation in leaves
Authors: Fang Likui , Zhao Fangming , Cong Yunfei , Sang Xianchun , Du Qing , Wang Dezhong , Li Yunfeng , Ling Yinghua , Yang Zhenglin , He Guanghua
Published: February 2012

As an important agronomic trait, leaf rolling in rice (Oryza sativa L.) has attracted much attention from plant biologists and breeders. Moderate leaf rolling increases the amount of photosynthesis in cultivars and hence raises grain yield. Here, we describe the map‐based cloning of the gene RL14, which was found to encode a 2OG‐Fe (II) oxygenase of unknown function. rl14 mutant plants had incurved leaves because of the shrinkage of bulliform cells on the adaxial side. In addition, rl14 mutant plants displayed smaller stomatal complexes and decreased transpiration rates, as compared with the wild type. Defective development could be rescued functionally by the expression of wild‐type RL14. RL14 was transcribed in sclerenchymatous cells in leaves that remained wrapped inside the sheath. In mature leaves, RL14 accumulated mainly in the mesophyll cells that surround the vasculature. Expression of genes related to secondary cell wall formation was affected in rl14‐1 mutants, and cellulose and lignin content were altered in rl14‐1 leaves. These results reveal that the RL14 gene affects water transport in leaves by affecting the composition of the secondary cell wall. This change in water transport results in water deficiency, which is the major reason for the abnormal shape of the bulliform cells.
Ideology Matters: Party Competition, Ideological Positioning and the Case of the Conservative Party under David Cameron
Authors: Buckler Steve , Dolowitz David
Published: February 2012

This article argues that ideology and ideological difference remain central features of modern British politics, and that ideological positioning is an important concern for political parties and is a phenomenon in need of some modelling. It engages in an analysis of ideological repositioning that parties sometimes undertake as part of the democratic competition and suggests a model that seeks to explicate the dynamics of this process. The model, codifying imperatives that need to be met by a party seeking to reposition, also highlights potential contextual considerations that affect the repositioning process. By way of illustration, the model will be employed to examine the dynamics of ideological positioning in the case of the Conservative party under the leadership of David Cameron.
Coming untied? Narrative accounts of social network dynamics from first‐time mental health clients
Authors: Perry Brea L.
Published: February 2012

Existing research demonstrates a relationship between mental illness and social network attrition over time – a pattern attributed to dysfunctional psychosocial and interpersonal processes and rejection. Yet, according to the social network perspective, personal network dynamics naturally accompany important biographical transitions or events, suggesting that our current understanding of mechanisms underlying network instability in mental illness may be incomplete. This research uses data from the Indianapolis Network Mental Health Study, a longitudinal study of social network dynamics spanning five years. It focuses on in‐depth interviews with 135 individuals making their first major contact with the mental health treatment system. First, levels of tie attrition and replacement in the core discussion networks of individuals with mental illness are compared to a sample with no self‐reported history of mental illness. Second, using open‐ended responses describing why specific individuals mentioned in previous waves were not listed again, respondents’ explanations of attrition are analysed qualitatively. In addition to providing support for existing perspectives, the themes suggest a need to also consider: (i) interaction strategies that maximise the supportiveness of social networks and minimise burden and (ii) changing life circumstances external to social networks that influence opportunities for social interaction.
Bodily changes among people living with physical impairments and chronic illnesses: biographical disruption or normal illness?
Authors: Larsson Annika Taghizadeh , Grassman Eva Jeppsson
Published: February 2012

This article focuses on individuals who are growing old with chronic illnesses and early onset impairments. Their experience of illness complications, bodily and functional losses is similar to what Bury has referred to as a biographical disruption. However, whereas Bury argues that a chronic illness amounts to a critical situation for the individual, partly due to its unexpected nature, this does not apply to the participants in our two studies. A second difference concerns Bury’s implicit suggestion that the disruption is a single event that is characteristic of the early stage of a chronic illness. Repeated disruptions seemed to shape the lives of several of those interviewed. At the same time, this article challenges studies which suggest that the notion of disruption is less relevant to people in later life and to those who have experienced difficult lives, and also questions the argument that continuity rather than change characterises the lives of people who have had chronic conditions since their early years. In its approach, the article responds to Williams’ request for studies in the sociology of chronic illness that extend the predominant biographical focus on the middle years of life to both ends of the life course.
Human disturbance is a major determinant of wildlife distribution in Himalayan midhill landscapes of Nepal
Authors: Paudel P. K. , Kindlmann P.
Published: February 2012

Forest landscapes in the midhills of western Nepal are not adequately conserved within a protected area network. The species and ecosystems in these human‐dominated landscapes are highly endangered. Understanding the effects of human activities on wildlife is therefore important for devising an appropriate conservation strategy in this region. Here, we show, using data on spatial structure of three endangered mountain ungulates, that presence of these species is determined by the level of human disturbance and habitat requirements. We show that species preferring flat areas covered by dense forest are exposed to more intensive human disturbances, and even an adaptation to rugged areas does not imply less human disturbance. Abundance of all species studied declined with the number of villages in the vicinity and increased with distance to nearest village. Therefore, increasing human population may contribute to a decrease of wildlife population in the region. To prevent this, community forestry program enabling local people to protect forest near villages and land‐use strategy aimed at reducing further encroachment of forest in higher altitudes should be immediately launched in the region.
Influence of gestational age and postnatal age on speech sound processing in NICU infants
Authors: Key Alexandra P. F. , Lambert E. Warren , Aschner Judy L. , Maitre Nathalie L.
Published: February 2012

The study examined the effect of gestational (GA) and postnatal (PNA) age on speech sound perception in infants. Auditory event‐related potentials (ERPs) were recorded in response to speech sounds (syllables) in 50 infant NICU patients (born at 24–40 weeks gestation) prior to discharge. Efficiency of speech perception was quantified as absolute difference in mean amplitudes of ERPs in response to vowel (/a/‐/u/) and consonant (/b/‐/g/, /d/‐/g/) contrasts within 150–250, 250–400, 400–700 ms after stimulus onset. Results indicated that both GA and PNA affected speech sound processing. These effects were more pronounced for consonant than vowel contrasts. Increasing PNA was associated with greater sound discrimination in infants born at or after 30 weeks GA, while minimal PNA‐related changes were observed for infants with GA less than 30 weeks. Our findings suggest that a certain level of brain maturity at birth is necessary to benefit from postnatal experience in the first 4 months of life, and both gestational and postnatal ages need to be considered when evaluating infant brain responses.
Describing the interplay between anxiety and cognition: From impaired performance under low cognitive load to reduced anxiety under high load
Authors: Vytal Katherine , Cornwell Brian , Arkin Nicole , Grillon Christian
Published: February 2012

Anxiety impairs the ability to think and concentrate, suggesting that the interaction between emotion and cognition may elucidate the debilitating nature of pathological anxiety. Using a verbal n‐back task that parametrically modulated cognitive load, we explored the effect of experimentally induced anxiety on task performance and the startle reflex. Findings suggest there is a crucial inflection point between moderate and high cognitive load, where resources shift from anxious apprehension to focus on task demands. Specifically, we demonstrate that anxiety impairs performance under low load, but is reduced when subjects engage in a difficult task that occupies executive resources. We propose a two‐component model of anxiety that describes a cognitive mechanism behind performance impairment and an automatic response that supports sustained anxiety‐potentiated startle. Implications for therapeutic interventions and emotional pathology are discussed.
The thickness and volume of LLETZ specimens can predict the relative risk of pregnancy‐related morbidity
Authors: Khalid S , Dimitriou E , Conroy R , Paraskevaidis E , Kyrgiou M , Harrity C , Arbyn M , Prendiville W
Published: February 2012

Please cite this paper as: Khalid S, Dimitriou E, Conroy R, Paraskevaidis E, Kyrgiou M, Harrity C, Arbyn M, Prendiville W. The thickness and volume of LLETZ specimens can predict the relative risk of pregnancy‐related morbidity. BJOG 2012;119:685–691.

Objective  The aim of this study was to determine if the individual physical characteristics of the extirpated transformation zone after large loop excision of the transformation zone (LLETZ) might predict the relative risk of adverse obstetric outcome, specifically preterm labour (PTL).

Design  A retrospective observational study.

Setting  University teaching hospital in Dublin (Coombe Women & Infants University Hospital, CWIUH).

Population  Women who had LLETZ treatment for cervical intraepithelial neoplasia (CIN) in the colposcopy service between 1999 and 2002, and who subsequently had a pregnancy at the CWIUH.

Methods  Case records and histology reports for eligible women were examined. Age, parity, smoking history, pregnancy complications and CIN grade were recorded. Exclusion criteria were age >42 years, previous treatment for CIN, previous premature labour or twin pregnancies. The Student’s t‐test, Mann–Whitney U‐test, analysis of variants (ANOVA) and logistic regression were employed to analyse the data.

Main outcome measures  Gestational age at birth, PTL (i.e. <37 weeks of gestation) and miscarriage rate (<24 weeks of gestation).

Results  Out of 1808 women who underwent LLETZ treatment, a total of 353 women were identified who subsequently had a pregnancy at the CWIUH, with 321 being eligible for inclusion in the study. Of these, 76.3% delivered at term, 9.1% delivered at <37 weeks of gestation and 14.6% miscarried at <24 weeks of gestation. There was a three‐fold increase in the risk of PTL if the excision volume exceeded 6 cm3 (RR = 3.00; 95% CI 1.45–5.92), or when the thickness of the excised tissue was greater than 12 mm (RR = 2.98; 95% CI 1.27–7.01). The time interval between LLETZ and pregnancy did not appear to have an effect on PTL rates. We found no association between the grade of CIN and the risk of PTL.

Conclusions  This study reveals that the thickness and the total volume of the excised transformation zone are associated with an increased risk of PTL. Excisions thicker than 1.2 cm and larger than 6 cm3 carry a three times greater risk for PTL.
A novel variant of human superoxide dismutase 1 harboring amyotrophic lateral sclerosis‐associated and experimental mutations in metal‐binding residues and free cysteines lacks toxicity in vivo
Authors: Prudencio Mercedes , Lelie Herman , Brown Hilda H. , Whitelegge Julian P. , Valentine Joan S. , Borchelt David R.
Published: February 2012

J. Neurochem. (2012) 121, 475–485.

Mutations in superoxide dismutase 1 (SOD1) cause familial amyotrophic lateral sclerosis. The Cu‐binding capacity of SOD1 has spawned hypotheses that implicate metal‐mediated production of reactive species as a potential mechanism of toxicity. In past experiments, we have tested such hypotheses by mutating residues in SOD1 that normally coordinate the binding of Cu, finding that such mutants retain the capacity to induce motor neuron disease. We now describe the lack of disease in mice that express a variant of human SOD1 in which residues that coordinate the binding of Cu and Zn have been mutated (SODMD). SODMD encodes three disease‐causing and four experimental mutations that ultimately eliminate all histidines involved in the binding of metals; and includes one disease‐causing and one experimental mutation that eliminate secondary metal binding at C6 and C111. We show that the combined effect of these mutations produces a protein that is unstable but does not aggregate on its own, is not toxic, and does not induce disease when co‐expressed with high levels of wild‐type SOD1. In cell culture models, we determine that the combined mutation of C6 and C111 to G and S, respectively, dramatically reduces the aggregation propensity of SODMD and may account for the lack of toxicity for this mutant.
Up‐regulation of GLT1 reverses the deficit in cortically evoked striatal ascorbate efflux in the R6/2 mouse model of Huntington’s disease
Authors: Miller Benjamin R. , Dorner Jenelle L. , Bunner Kendra D. , Gaither Thomas W. , Klein Emma L. , Barton Scott J. , Rebec George V.
Published: February 2012

J. Neurochem. (2012) 121, 629–638.

A corticostriatal‐dependent deficit in the release of ascorbate (AA), an antioxidant vitamin and neuromodulator, occurs concurrently in striatum with dysfunctional GLT1‐dependent uptake of glutamate in the R6/2 mouse model of Huntington’s disease (HD), an autosomal dominant condition characterized by overt corticostriatal dysfunction. To determine if deficient striatal AA release into extracellular fluid is related to altered GLT1 activity in HD, symptomatic R6/2 mice between 6 and 9 weeks of age and age‐matched wild‐type (WT) mice received single daily injections of 200 mg/kg ceftriaxone, a β‐lactam antibiotic that elevates the functional expression of GLT1, or saline vehicle for five consecutive days. On the following day, in vivo voltammetry was coupled with corticostriatal afferent stimulation to monitor evoked release of AA into striatum. In saline‐treated mice, we found a marked decrease in evoked extracellular AA in striatum of R6/2 relative to WT. Ceftriaxone, in contrast, restored striatal AA in R6/2 mice to WT levels. In addition, intra‐striatal infusion of either the GLT1 inhibitor dihydrokainic acid or dl‐threo‐beta‐benzyloxyaspartate blocked evoked striatal AA release. Collectively, our results provide compelling evidence for a link between GLT1 activation and release of AA into the striatal extracellular fluid, and suggest that dysfunction of this system is a key component of HD pathophysiology.
Evolution of Wernicke‐Korsakoff Syndrome in Self‐Neglecting Alcoholics: Preliminary Results of Relation with Wernicke‐Delirium and Diabetes Mellitus
Authors: Wijnia Jan W. , van de Wetering Ben J. M. , Zwart Elles , Nieuwenhuis K. Gerrit A. , Anne Goossensen M.
Published: February 2012

We present a descriptive, retrospective study of initial symptoms, comorbidity, and alcohol withdrawal in 73 alcoholic patients with subsequent Korsakoff syndrome. In 25/73 (35%) of the patients the classic triad of Wernicke's encephalopathy with ocular symptoms, ataxia and confusion, was found. In at least 6/35 (17%) of the initial deliria (95% confidence interval: 10–25%) we observed no other underlying causes, thus excluding other somatic causes, medication, (recent) alcohol withdrawal, or intoxication. We suggest that these deliria may have been representing Wernicke's encephalopathy. A high frequency (15%) of diabetics may reflect a contributing factor of diabetes mellitus in the evolution of the Wernicke‐Korsakoff syndrome. (Am J Addict 2012;21:104–110)
Smoking Cue Reactivity in Adult Smokers with and without Depression: A Pilot Study
Authors: Weinberger Andrea H. , McKee Sherry A. , George Tony P.
Published: February 2012

Little is known about the relationship between Major Depressive Disorder (MDD) and smoking‐related behaviors such as cue‐induced urges to smoke. The purpose of this pilot study was to examine: (1) differences in smoking cue reactivity by MDD history and (2) the association of a diagnosis of MDD, current depressive symptoms, and smoking variables to cue‐induced urges to smoke. Participants (N = 52) were n = 31 smokers with no MDD history and n = 21 smokers with past MDD. Participants completed a 2‐hour laboratory session during which they were exposed to neutral (eg, pencils) and smoking cues (eg, cigarettes) after smoking one of their preferred brand cigarettes (Satiated Condition) and when it had been 1 hour since they smoked (Brief Deprivation Condition). Cue‐induced urges increased with exposure to smoking cues and this increase did not significantly differ by diagnosis group. Current symptoms of depression, but not a diagnosis of MDD, were significantly and positively related to cue‐induced cravings in satiated adult smokers. The association between depression symptoms and smoking urges was not significant in the Brief Deprivation Condition. Smoking cue reactivity may be a useful procedure for studying aspects of smoking behavior in adults with depression. (Am J Addict 2012;21:136–144)
Does Alexithymia Explain Variation in Cue‐Elicited Craving Reported by Methamphetamine‐Dependent Individuals?
Authors: Saladin Michael E. , Santa Ana Elizabeth J. , LaRowe Steven D. , Simpson Annie N. , Tolliver Bryan K. , Price Kimber L. , McRae‐Clark Aimee L. , Brady Kathleen T.
Published: February 2012

Drug craving is an important motivational phenomenon among addicted individuals, and successful management of craving is essential to both the initiation and maintenance of abstinence. Although craving in response to drug cues is common in drug‐dependent individuals, it is not universal. At the present time, it is not known why approximately 20–30% of all addicted persons fail to report appreciable craving in laboratory‐based cue reactivity studies. This study examined the possibility that alexithymia, a personality attribute characterized by a difficulty identifying and describing emotions, may contribute to the impoverished cue‐elicited craving experienced by some addicts. Specifically, we tested the hypothesis that alexithymia, as measured by the Toronto Alexithymia Scale (TAS), would be inversely related to the magnitude of cue‐elicited craving obtained in a cue reactivity protocol. Forty methamphetamine‐dependent individuals completed the TAS and provided craving ratings for methamphetamine after presentation of methamphetamine‐associated cues. Thirteen participants (32%) reported no methamphetamine cue‐elicited craving. Contrary to expectation, TAS factor 1 (a measure of difficulty identifying feelings) scores were positively associated with cue‐elicited craving. Thus, the results suggest that increasing difficulty‐identifying feelings may be associated with higher cue‐elicited craving. Clinical implications for this finding are discussed. (Am J Addict 2012:21:130–135)
Understanding the host inflammatory response to wound infection: An in vivo study of Klebsiella pneumoniae in a rabbit ear wound model
Authors: Seth Akhil K. , Geringer Matthew R. , Gurjala Anandev N. , Abercrombie Johnathan A. , Chen Ping , You Tao , Hong Seok J. , Galiano Robert D. , Mustoe Thomas A. , Leung Kai P.
Published: February 2012

Wound infection development is critically dependent on the complex interactions between bacteria and host. Klebsiella pneumoniae has become an increasingly common wound pathogen, but its natural history within wounds has never been studied. Using a validated, in vivo rabbit ear model, wounds were inoculated with K. pneumoniae at different concentrations (102–107 colony‐forming units) with measurement of viable and nonviable bacterial counts, histological wound‐healing parameters, and host inflammatory gene expression at multiple time points postinoculation (48, 96, and 240 hours). Bacteria and wound morphologies were evaluated with scanning electron microscopy. Comparable experiments were performed in ischemic ears to model immune response impairment. All wounds, despite different inoculants, equilibrated to similar bacterial concentrations by 96 hours. With a 106 colony‐forming units inoculant, wounds at 240 hours showed decreased bacterial counts (p < 0.01), with a corresponding improvement in healing (p < 0.01) and a decrease in inflammatory response (p < 0.05). In contrast, ischemic wounds revealed impaired inflammatory gene expression (p < 0.05) resulting in higher steady‐state bacterial concentrations (p < 0.01), impaired healing (p < 0.05), and biofilm formation on scanning electron microscopy. We conclude that a normal inflammatory response can effectively stabilize and overcome a K. pneumoniae wound infection. An impaired host cannot control this bacterial burden, preventing adequate healing while allowing bacteria to establish a chronic presence. Our novel study quantitatively validates the host immune response as integral to wound infection dynamics.
The relationship between skin stretching/contraction and pathologic scarring: The important role of mechanical forces in keloid generation
Authors: Ogawa Rei , Okai Kazuhisa , Tokumura Fumio , Mori Kazuyuki , Ohmori Yasutaka , Huang Chenyu , Hyakusoku Hiko , Akaishi Satoshi
Published: February 2012

Keloids tend to occur on highly mobile sites with high tension. This study was designed to determine whether body surface areas exposed to large strain during normal activities correlate with areas that show high rates of keloid generation after wounding. Eight adult Japanese volunteers were enrolled to study the skin stretching/contraction rates of nine different body sites. Skin stretching/contraction was measured by marking eight points on each region and measuring the change in location of the marked points after typical movements. The distribution of 1,500 keloids on 483 Japanese patients was mapped. The parietal region and anterior lower leg were associated with the least stretching/contraction, while the suprapubic region had the highest stretching/contraction rate. With regard to keloid distribution, there were 733 on the anterior chest region (48.9%) and 403 on the scapular regions (26.9%). No keloids were reported on the scalp or anterior lower leg. Because these sites are rarely subjected to skin stretching/contraction, it appears that mechanical force is an important trigger that drives keloid generation even in patients who are genetically predisposed to keloids. Thus, mechanotransduction studies are useful for developing clinical approaches that reduce the skin tension around wounds or scars for the prevention and treatment of not only keloids but also hypertrophic scars.
E‐mail management of the Modified Atkins Diet for adults with epilepsy is feasible and effective
Authors: Cervenka Mackenzie C. , Terao Natalie N. , Bosarge Jennifer L. , Henry Bobbie J. , Klees Angela A. , Morrison Peter F. , Kossoff Eric H.
Published: February 2012

Purpose:  The modified Atkins Diet (MAD) is an effective dietary treatment for children with epilepsy. However, adults may have limited access to this therapy because of lack of availability of dietitian or nutrition support or familiarity with the diet by their treating neurologist. This study was designed to investigate the tolerability and efficacy of the MAD administered solely via e‐mail to adults with pharmacoresistant epilepsy.

Methods:  A prospective, open‐label, proof‐of‐principle 3‐month study design was employed. Adults were enrolled, instructed on how to self‐administer a 20 g carbohydrate per day MAD, and followed by the investigators only via e‐mail. There were no clinic visits or dietitian contacts during the study period.

Key Findings:  Twenty‐five participants (median age 30 years [range 18–66 years], 68% female) consented and 22 started the MAD. The median prior anticonvulsants was 5 (range 2–10) and seizure frequency was 5 per week (range 1–140). Urinary ketosis was achieved in 21 participants (95%), of which 16 (76%) reported at least 40 mg/dl (moderate). Twenty‐one participants (95%) remained on the MAD at 1 month and 14 (64%) at 3 months. After 1 month, 9 (41%) had >50% seizure reduction including one (5%) with >90% seizure reduction using intent‐to‐treat analysis. After 3 months, 6 (27%) had >50% seizure reduction including 3 (14%) with >90% seizure reduction. The mean ketogenic ratio was 1.1:1 (fat:carbohydrates and protein) for those who provided a MAD food record at follow‐up. Over the study period, the median number of e‐mails sent by the participants was 6 (range 1–19). The most frequent side effect was weight loss.

Significance:  E‐mail administration of the MAD to adults with refractory epilepsy appears to be feasible and effective. Therefore, when dietitian or physician support is limited for adult patients with epilepsy, remote access via telemedicine could provide an alternative.
Defective visual inhibition in photosensitive idiopathic generalized epilepsy
Authors: Strigaro Gionata , Prandi Paolo , Varrasi Claudia , Monaco Francesco , Cantello Roberto
Published: February 2012

Purpose:  To assess the visual system excitability of photosensitive patients with idiopathic generalized epilepsy (IGE) with the paired‐pulse flash‐evoked potential (paired F‐VEP) technique.

Methods:  We studied 19 photosensitive patients with IGE (16 women) showing a photoparoxysmal electroencephalographic (EEG) response (PPR). Twenty‐two normal subjects of similar age and sex acted as controls (17 women). We recorded F‐VEPs from occipital and central electrodes. Stimuli were single flashes, intermingled to flash pairs at the interstimulus interval (ISI) of 333, 125, 62.5, 50, 33, and 16.5 msec (i.e., at the internal frequency of 3, 8, 16, 20, 30, and 60 Hz). Recordings were done both with closed and open eyes. The single F‐VEP was split into a “main complex” and a “late response,” which were measured separately. As to paired stimuli, the “test” F‐VEP emerged from electronic subtraction of the single F‐VEP to the paired F‐VEP. Grouped data were analyzed by means of nonparametric analyses of variance (ANOVAs).

Key Findings:  In patients, the single F‐VEP showed some enhanced components in its early “main complex.” Then, the “test” F‐VEP behaved differently than controls, particularly if recorded with closed eyes, when the normal inhibition was abolished at given ISIs, corresponding to an internal frequency of 16–30 Hz. In patients with a posterior PPR, impaired inhibition was evident over the occipital region only, but in those with a widespread PPR, it also involved the central areas.

Significance:  The paired F‐VEP technique documents a defective inhibition in the visual system of photosensitive patients with IGE, whose features and timing likely underlie the PPR origin.
Finding Dementia in Primary Care: The Results of a Clinical Demonstration Project
Authors: Riley McCarten John , Anderson Pauline , Kuskowski Michael A. , McPherson Susan E. , Borson Soo , Dysken Maurice W.
Published: February 2012

Objectives

To assess the effect of screening on diagnosing cognitive impairment.

Design

Quality improvement initiative.

Setting

Seven Veterans Affairs Medical Centers.

Participants

Veterans aged 70 or older without a prior diagnosis of cognitive impairment.

Measurements

Veterans failing a brief cognitive screen (Mini‐Cog score <4/5) at a routine primary care visit were offered a further, comprehensive evaluation with an advance practice registered nurse trained in dementia care and integrated into the primary care clinic. Veterans completing the evaluation were reviewed in a consensus conference and assigned a diagnosis of dementia; cognitive impairment, no dementia; or no cognitive impairment. Total numbers of screens, associated scores (0–5), and the consensus diagnoses were tallied. New cognitive impairment diagnoses were also tracked for veterans who passed the screen but requested further evaluation, failed but declined further evaluation, or were not screened. Primary care provider satisfaction with the program also was assessed.

Results

Of 8,342 veterans offered screening, 8,063 (97%) accepted, 2,081 (26%) failed the screen, 580 (28%) agreed to further evaluation, and 540 (93%) were diagnosed with cognitive impairment, including 432 (75%) with dementia. For screen passes requesting further evaluation, 87% (103/118) had cognitive impairment, including 70% (82/118) with dementia. Screen failures declining further evaluation had 17% (259/1,501) incident cognitive impairment diagnosed through standard care, bringing the total newly documented cognitive impairment in all screens to 11% (902/8,063), versus 4% (1,242/28,349) in similar clinics without this program. Eighty‐two percent of primary care providers in clinics with this program agreed that it provided a useful service.

Conclusion

Screening combined with offering further evaluation increased new diagnoses of cognitive impairment in older veterans two to three times. Veterans accepted screening well, and providers found the program useful.
Flu, Risks, and Videotape: Escalating Fear and Avoidance
Authors: Rosoff Heather , John Richard S. , Prager Fynnwin
Published: February 2012

While extensive risk perception research has focused on emotions, cognitions, and behavior at static points in time, less attention has been paid to how these variables might change over time. This study assesses how negative affect, threat beliefs, perceived risk, and intended avoidance behavior change over the course of an escalating biological disaster. A scenario simulation methodology was used that presents respondents with a video simulation of a 15‐day series of local news reports to immerse respondents in the developing details of the disaster. Systemic manipulation of the virus's causal origin (terrorist attack, medical lab accident, unknown) and the respondent's proximity to the virus (local vs. opposite coast) allowed us to investigate the dynamics of public response. The unfolding scenario was presented in discrete episodes, allowing responses to be tracked over the episodes. The sample includes 600 respondents equally split by sex and by location, with half in the Washington, DC area, and half in the Los Angeles area. The results showed respondents’ reactions to the flu epidemic increased as the disaster escalated. More importantly, there was considerable consistency across respondents’ emotional, cognitive, and behavioral responses to the epidemic over the episodes. In addition, the reactions of respondents proximally closer to the epidemic increased more rapidly and with greater intensity than their distant counterparts. Finally, as the flu epidemic escalated, both terrorist and accidental flu releases were perceived as being less risky and were less likely to lead to avoidance behavior compared to the unknown flu release.
Tissue Doppler, Triplane Echocardiography, and Speckle Tracking Echocardiography: Different Ways of Measuring Longitudinal Myocardial Velocity and Deformation Parameters. A Comparative Clinical Study
Authors: Fontana Antonella , Zambon Antonella , Cesana Francesca , Giannattasio Cristina , Trocino Giuseppe
Published: February 2012

Aims: The aim of our study was to compare global and segmental longitudinal myocardial velocity and deformation obtained from three different echocardiographic techniques of postprocessing analysis (two‐dimensional tissue Doppler imaging (2D TDI), triplane tissue Doppler imaging (3D TDI), and speckle tracking echocardiography (STE)), in a group of consecutive subjects referred to echocardiography with different clinical indications, and to assess their reproducibility. Methods and results: Standard echocardiograms with high frame rate gray‐scale images and color coded TDI apical views, and a single beat TDI triplane apical section of the left ventricle were acquired at two different times. Longitudinal velocity and deformation parameters were obtained in postprocessing in 103 subjects from TDI and STE derived curves, and absolute values were compared to test the variability of the three techniques. All the measures were repeated twice, for a test–retest study. The times to peak velocity and deformation were similar by TDI and STE; other parameters showed significant difference (P < 0.05), both for global and segmental analysis. Reproducibility (expressed by the coefficient of variation and the coefficient of correlation r, in a large part of cases > 0.9) was acceptable, meaning that measures obtained at two different times did not differ significantly in between. Conclusion: TDI and speckle tracking are both feasible and reproducible. Myocardial velocity and deformation parameters obtained with them are significantly different. STE is the most reproducible technique, whereas TDI based measurements are lower reproducible. STE can easily be used during clinical follow up for its feasibility and high reproducibility. (Echocardiography 2012;29:428‐437)
Efficacy of Longitudinal Speckle Tracking Strain in Conjunction with Isometric Handgrip Stress Test for Detection of Ischemic Myocardial Segments
Authors: Ryo Keiko , Tanaka Hidekazu , Kaneko Akihiro , Fukuda Yuko , Onishi Tetsuari , Kawai Hiroya , Hirata Ken‐ichi
Published: February 2012

Background: Isometric handgrip stress test is a simple method for detecting coronary artery disease (CAD). However, the value of this method alone is limited by relatively low sensitivity. This study thus aimed to investigate the usefulness of two‐dimensional speckle‐tracking strain combined with handgrip for CAD patients. Method: We studied 35 patients with stable angina pectoris who underwent percutaneous coronary intervention (PCI). Longitudinal (L‐ɛ) and transverse peak systolic (T‐ɛ) strains were measured from three standard apical views before and 1 month after PCI. Segments corresponded to perfusion territories of coronary arteries were divided into two groups based on coronary angiography results: stenotic (S) and nonstenotic (NS) segment. Results: L‐ɛ in S segments increased significantly after PCI, from −15.8% to −17.6% (P < 0.01), but not in NS segments. Moreover, L‐ɛ in S segments increased significantly during handgrip before PCI, from −15.8% to −17.6% (P < 0.01), but decreased after PCI, from −17.6% to −16.7% (P = 0.02). In contrast, L‐ɛ in NS segments decreased significantly during the isometric handgrip stress test before and after PCI (P < 0.05). Especially noteworthy is that a relative change in L‐ɛ of >1.2% during handgrip before PCI could detect significant coronary stenosis with a sensitivity of 80%, specificity of 66%, and area under the curve of 0.77 (P < 0.001). On the other hand, no significant changes were observed in either T‐ɛ segments during handgrip either before or after PCI. Conclusion: Longitudinal speckle‐tracking strain combined with handgrip may constitute a valuable tool for detection of ischemic myocardial segments and prediction of improvement of regional contraction after revascularization. (Echocardiography 2012;29:411‐418)