bluuebunny/crossref_metadata_2025 huggingface dataset:
Two‐week treatment with the β3‐adrenoceptor antagonist SR59230A normalizes the increased pancreatic islet blood flow in type 2 diabetic GK rats
Authors: Pettersson U. S. , Sandberg M. , Jansson L.
Published: May 2012

The Goto‐Kakizaki (GK) rat, a type 2 diabetes model, has increased pancreatic islet and white adipose tissue (WAT) blood flow, and this can be normalized by acute administration of SR59230A, a β3‐adrenoceptor antagonist. We now implanted osmotic pumps which allowed a constant release of saline or SR59230A (0.6 mg/kg × day) for 2 weeks. A decrease in islet blood flow was seen also after 2 weeks of continuous SR59230A treatment in the GK rat. However, no improvement in glucose tolerance was seen in the GK rats. Neither did SR59230A affect insulin secretion from isolated islets in vitro. WAT blood flow was not affected by the 2‐week SR59230A treatment. Thus, the increased islet blood flow seen in the GK rat can be normalized for up to 2 weeks, which opens the possibilities for further studies on the long‐term functional role on the islet blood flow increase in this type 2 diabetes model.
A review of outcomes of an intracavernosal injection therapy programme
Authors: Coombs Peter G. , Heck Mathias , Guhring Patricia , Narus Joseph , Mulhall John P.
Published: May 2012

Study Type – Therapy (outcomes research)

Level of Evidence 2b

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

Intracavernosal injection (ICI) therapy is an important treatment option for erectile dysfunction. However, high discontinuation rates have been reported for ICI therapy, and a risk of priapism has long been a concern. There has never been a large sample study performed with multivariate analysis to characterise outcomes of ICI therapy.

The present paper reviews ICI therapy outcomes in a very large population of men at a tertiary care Sexual Medicine Clinic over 5 years. Multivariate analysis was used to further characterise these outcomes. The present study shows that for a large percentage of our sample of patients, ICI therapy is a successful treatment strategy. And, while discontinuation rates are still high, many of those not continuing ICI therapy achieved success with phosphodiesterase inhibitors. Also, the incidence of priapism was less in the present study than previously reported.

OBJECTIVES

To review the outcomes, adverse events and discontinuation rates of intracavernosal injection (ICI) therapy in men with erectile dysfunction (ED) in a sexual medicine practice over a 5‐year period at a tertiary referral centre.

Since 1983, ICI has become a staple therapeutic option and high success rates have been reported. However, priapism is a significant concern and discontinuation rates are estimated to be >50%.

PATIENTS AND METHODS

Men presenting with ED who were enrolled in our ICI programme between September 2002 and August 2006 were followed at least annually.

Patient demographic information, agents used, erectile function outcomes and adverse events were recorded.

Failure was defined as the inability to have penetrative sex. Discontinuation was defined as patient declaration of such, failure to attend an annual follow‐up visit or failure to call for a repeat prescription.

Multivariable analysis was used to define predictors of failure to respond to ICI therapy, as well as predictors of discontinuation within 36 months of starting ICI in those patients responding.

RESULTS

In all, 1412 patients had complete data and constituted the study population. Most patients were using Trimix and 89% of Trimix users were capable of having sexual intercourse.

Response rates were lower in pelvic radiation and diabetic patients.

However, the discontinuation rate was significant; it was lower in men who had not undergone radical prostatectomy (RP). Of note, many RP patients discontinued ICI because of recovery of natural or phosphodiesterase type 5 inhibitor‐assisted erections.

CONCLUSIONS

ICI therapy is associated with very high success rates even in men with high comorbidity profiles; however, the discontinuation rates, even in men who had not undergone RP, by the end of the third year are significant.

Of note, the recorded priapism rate was extremely low (0.5%).
The relationship of postoperative complications with in‐hospital outcomes and costs after renal surgery for kidney cancer
Authors: Kim Simon P. , Leibovich Bradley C. , Shah Nilay D. , Weight Christopher J. , Borah Bijan J. , Han Leona C. , Boorjian Stephen A. , Thompson R. Houston
Published: May 2012

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

Postoperative complications for open radical nephrectomy (ORN), laparoscopic radical nephrectomy (LRN), and open partial nephrectomy (OPN) and its relationship with hospitalisation costs and mortality remain poorly described.

The present population‐based study suggests modest differences in postoperative complications estimated at 27%, 23%, and 24% among patients with kidney cancer undergoing ORN, LRN, and OPN, respectively. Moreover, postoperative complications were associated with higher mortality, length of stay and total costs of hospitalisation.

Objectives

The association of complications after renal surgery for renal cell carcinoma (RCC) with in‐hospital mortality and costs remains to be defined.

To describe the incidence of complications after open radical nephrectomy (ORN), laparoscopic RN (LRN), and open partial nephrectomy (OPN); and to evaluate its relationship with in‐hospital mortality and total costs.

Patients and Methods

We identified 49 983 individuals who underwent ORN (35 712), LRN (5327), or OPN (8944) for RCC at 2037 hospitals from the Nationwide Inpatient Sample 2001–2008.

The outcomes assessed were in‐hospital mortality and total hospitalisation costs.

Multivariable logistic regression and generalised estimating equations were used to test the associations between complications and in‐hospital mortality and total costs.

Results

With 26.0% of patients experiencing postoperative complications, there were modest differences in the proportion of patients with complications after ORN, LRN, and OPN at 27.0%, 22.6%, and 24.0%, respectively (P < 0.001).

After adjusting for patient and hospital variables, postoperative complications resulted in higher odds of in‐hospital death for ORN (odds ratio [OR] 7.20; P < 0.001), LRN (OR 12.04; P < 0.001), and OPN (OR 7.82; P < 0.001).

Adjusted total costs also rose significantly with the presence of any postoperative complications compared with those without any complications for ORN ($21 242 vs $13 183; P < 0.001), LRN ($19 548 vs $12 555; P < 0.001), and OPN ($18 883 vs $12 098; P < 0.001).

Conclusions

With about a quarter of patients experiencing postoperative complications, adverse events for ORN, LRN, and OPN carry a significant risk of in‐hospital death and higher total costs.

Efforts to reduce postoperative complications may correlate with substantial reductions in hospital mortality and total costs.
Supine percutaneous nephrolithotomy (PCNL): ‘in vogue’ but in which position?
Authors: Kumar Priyadarshi , Bach Christian , Kachrilas Stephanos , Papatsoris Athanasios G. , Buchholz Noor , Masood Junaid
Published: May 2012

Study Type – Therapy (case series)

Level of Evidence 4

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

Supine percutaneous nephrolithotomy (PCNL) has been described for over a decade and has equivalent success rates when compared with the more widely used prone position. The supine position offers a shorter operative duration with better access to the airway for the anaesthetist and also allows for simultaneous retrograde intra‐renal surgery (RIRS). Various supine positions have been described but there is little data regarding their differing benefits and disadvantages.

The present study looks at the different supine PCNL positions and compares the strengths and weaknesses of each. Each of the previously described supine PCNL positions have some limitations, e.g. ease of puncture under image guidance, the ability and ease of making and dilating multiple tracts, and allowing simultaneous RIRS. The new ‘Barts flank‐free modified supine position’ is described, which seems to offer a good compromise and addresses some of these issues. It is important to highlight that one supine position does not fit all and the endourologist should familiarise themselves with these positions so the appropriate position can be used for the right patient and stone burden.

OBJECTIVE

To discuss the relative merits of the different described supine positions for percutaneous nephrolithotomy (PCNL) and highlight the new ‘Barts flank‐free modified supine position’, as the last decade has seen the emergence of various supine positions for PCNL.

MATERIALS AND METHODS

We reviewed English publications on supine PCNL to look at the different positions being used to carry out PCNL and their relative merits.

We describe the new ‘Barts flank‐free modified supine position’, which we think will add significantly to the armamentarium of the endourologist.

RESULTS

Five different supine positions are discussed.

These include the complete supine, the Valdivia, the Galdakao modified Valdivia, the Barts modified Valdivia and the herein described Barts flank‐free modified supine position

These positions all differ in regard to ease of puncture under image guidance, operative field availability, ability to make multiple tracts and the ease of combining retrograde intra‐renal surgery.

CONCLUSIONS

All of the supine positions decrease operative duration, as there is no need for repositioning and allow quick access to the airway for the anaesthetist.

However, one supine position does not fit all and the right one must be chosen for the right patient with the right stone burden. It is important for endourologists of today to familiarise themselves with these positions to be able to make these judgements.
Minimax optimality of CUSUM for an autoregressive model
Authors: Knoth Sven , Frisén Marianne
Published: May 2012

Different change point models for AR(1) processes are reviewed. For some models, the change is in the distribution conditional on earlier observations. For others, the change is in the unconditional distribution. Some models include an observation before the first possible change time – others not. Earlier and new CUSUM type methods are given, and minimax optimality is examined. For the conditional model with an observation before the possible change, there are sharp results of optimality in the literature. The unconditional model with possible change at (or before) the first observation is of interest for applications. We examined this case and derived new variants of four earlier suggestions. By numerical methods and Monte Carlo simulations, it was demonstrated that the new variants dominate the original ones. However, none of the methods is uniformly minimax optimal.
Simulating non‐normal distributions with specifiedL‐moments andL‐correlations
Authors: Headrick Todd C. , Pant Mohan D.
Published: May 2012

This paper derives a procedure for simulating continuous non‐normal distributions with specifiedL‐moments andL‐correlations in the context of power method polynomials of order three. It is demonstrated that the proposed procedure has computational advantages over the traditional product‐moment procedure in terms of solving for intermediate correlations. Simulation results also demonstrate that the proposedL‐moment‐based procedure is an attractive alternative to the traditional procedure when distributions with more severe departures from normality are considered. Specifically, estimates ofL‐skew andL‐kurtosis are superior to the conventional estimates of skew and kurtosis in terms of both relative bias and relative standard error. Further, theL‐correlation also demonstrated to be less biased and more stable than the Pearson correlation. It is also shown how the proposedL‐moment‐based procedure can be extended to the larger class of power method distributions associated with polynomials of order five.
Close association between metal allergy and nail lichen planus: detection of causative metals in nail lesions
Authors: Nishizawa A. , Satoh T. , Yokozeki H.
Published: May 2012

Background  Lichen planus (LP) is a common skin disorder of unknown aetiology that affects the skin, mucous membranes and nails. Although metal allergies have been implicated in the development of oral LP (OLP), the contribution of these allergies to nail LP (NLP) has yet to be studied in detail.

Objective  To elucidate the link between metal allergy and NLP.

Methods  We retrospectively analysed 115 LP patients with respect to the contribution of metals to either NLP or OLP. We also attempted to detect the specific metals involved in these nail lesions.

Results  Of the 79 patients that received a metal patch test (PT), 24 (30%) were positive for at least one of the metal compounds tested. Notably, the prevalence of positive reactions to metals in the NLP patients was significantly higher as compared with the OLP patients (59% vs. 27%, P < 0.05). Among the 10 PT‐positive patients with NLP, improvement of the skin lesions was seen in six of the patients after removal of dental materials containing causative metals or systemic disodium cromoglycate therapy. On the other hand, only 3 of 16 PT‐positive patients with OLP exhibited improvement after the removal of dental materials. Causative metals in the dental fillings/braces were detected in the involved nail tissues.

Conclusion  This study suggests that metal allergies are more closely associated with NLP vs. OLP, and that deposited metals in the nail apparatus contribute to the development of lichenoid tissue reactions in the nail bed and matrix.
Association between psoriasis and viral infections in the United States: focusing on hepatitis B, hepatitis C and human immunodeficiency virus
Authors: Kanada K.N. , Schupp C.W. , Armstrong A.W.
Published: May 2012

Background  No published data in the U.S. population regarding an association between viral infections and psoriasis are currently available. Assessment of infection and immunosuppression risk is critical in managing psoriasis patients.

Objectives  To examine the association between psoriasis and viral infections including hepatitis B, hepatitis C and human immunodeficiency viral infections in the general U.S. population.

Methods  Population data representative of the U.S. cohort were analysed from the National Health and Nutrition Examination Survey (NHANES), 2003–2006. Hepatitis B, hepatitis C, and human immunodeficiency antibodies status were ascertained from laboratory evaluations. Univariate and multivariate analyses were performed to assess the associations between psoriasis and these viral infections.

Results  Among 6532 participants aged 20–59 years who provided responses to their psoriasis status, 162 patients reported having psoriasis. Based on multivariate regression analyses, psoriasis was not significantly associated with positive serology for hepatitis B core [odds ratio (OR), 0.83; 95% confidence interval (CI), 0.32–2.17; P = 0.7060], hepatitis B surface [OR, 7.89; CI, 0.52–119; P = 0.1355], hepatitis C [OR, 0.24; CI, 0.03–2.01; P = 0.1915], or human immunodeficiency virus [OR, 0.73; CI, 0.09–5.93; P = 0.7646] antibodies, after adjusting for age, gender, race and smoking status.

Conclusions  From the limited sample of the NHANES database on psoriasis and viral infections, psoriasis does not appear to be associated with an increased risk of hepatitis B, hepatitis C, or HIV infection in the U.S. population. Epidemiology of these viral infections in psoriasis needs to be continually studied and updated given their importance in management considerations.
Cortical processing of unplanned movement sequences involving hands and feet: Evidence from event‐related potentials
Authors: Miller Jeff , Buchlak Quinlan
Published: May 2012

The neural processes underlying an unplanned shift in movement control across limb systems were studied by recording event‐related potentials (ERPs) as participants made a left or right hand movement followed by a left or right foot movement or vice versa. ERPs associated with both first and second movements replicated a recent finding that Cz is more positive before hand than foot responses. Lateralized readiness potentials (LRPs) associated with the first movement replicated patterns observed previously with single movements, but LRPs leading up to the second movement depended strongly on the side of the first movement, possibly because of residual lateralization from it. Overall, the results suggest that the motor processes associated with limb system selection can be fully reset prior to a switch between hand and foot movements, but the processes associated with side selection may not be.
How reward modulates mimicry: EMG evidence of greater facial mimicry of more rewarding happy faces
Authors: Sims Thomas B. , Van Reekum Carien M. , Johnstone Tom , Chakrabarti Bhismadev
Published: May 2012

Spontaneous mimicry is a marker of empathy. Conditions characterized by reduced spontaneous mimicry (e.g., autism) also display deficits in sensitivity to social rewards. We tested if spontaneous mimicry of socially rewarding stimuli (happy faces) depends on the reward value of stimuli in 32 typical participants. An evaluative conditioning paradigm was used to associate different reward values with neutral target faces. Subsequently, electromyographic activity over the Zygomaticus Major was measured whilst participants watched video clips of the faces making happy expressions. Higher Zygomaticus Major activity was found in response to happy faces conditioned with high reward versus low reward. Moreover, autistic traits in the general population modulated the extent of spontaneous mimicry of happy faces. This suggests a link between reward and spontaneous mimicry and provides a possible underlying mechanism for the reduced response to social rewards seen in autism.
ERPs across arithmetic operations in a delayed answer verification task
Authors: Jasinski Emily C. , Coch Donna
Published: May 2012

In order to compare processing across operations, we recorded event‐related potentials (ERPs) elicited by both problems and solutions in addition, subtraction, multiplication, and division conditions in a delayed answer verification task. Amplitudes of an early negativity, P300, and late positive component (LPC) elicited by solutions were sensitive to the correctness of the presented answers within operations and differed across operations only for incorrect solutions. The early negativity resembled an N270 rather than an N400. The amplitude of an N300 elicited by problem presentations also differed across operations. Our results indicate that ERPs are sensitive to differences in processing across arithmetic operations in an answer verification task both during presentation of the problems, when production/retrieval processes occur, and during comparison of incorrect presented solutions with expected solutions.
The deployment of visual attention during temporal integration: An electrophysiological investigation
Authors: Akyürek Elkan G. , Meijerink Steven K.
Published: May 2012

The deployment of attention during temporal integration was investigated with event‐related potentials. Attentional selection of an integrated percept and an actual singleton were examined. Integration performance was related to modulations of the N2pc, N2, and P3 components. Singleton localization performance was reflected in N2pc and P3 only. Of note, the singleton N2pc developed and subsided earlier than the integration N2pc. The singleton P3 seemed to develop in a single deflection, while the integration P3 showed two more distinct deflections. Physical stimulus differences could not explain these results. The N2pc and N2 modulations showed that attending to an integrated percept is not slower per se, but does differ from attending to a singleton. Integrated percepts furthermore have special correlates in late stages of perception (i.e., the P3). These differences are linked to the unique demand to combine and represent successive stimuli.
RGS10 exerts a neuroprotective role through the PKA/c‐AMP response‐element (CREB) pathway in dopaminergic neuron‐like cells
Authors: Lee Jae‐Kyung , Chung Jaegwon , Druey Kirk M. , Tansey Malú G.
Published: May 2012

J. Neurochem. (2012) 122, 333–343.

Regulator of G‐protein signaling‐10 (RGS10) is a GTPase activating protein for Gαi/q/z subunits that is highly expressed in the immune system and in a broad range of brain regions including the hippocampus, striatum, dorsal raphe, and ventral midbrain. Previously, we reported that RGS10‐null mice display increased vulnerability to chronic systemic inflammation‐induced degeneration of nigral dopaminergic (DA) neurons. Given that RGS10 is expressed in DA neurons, we investigated the extent to which RGS10 regulates cell survival under conditions of inflammatory stress. Because of the inherent limitations associated with use of primary DA neurons for biochemical analyses, we employed a well‐characterized ventral mesencephalon DA neuroblastoma cell line (MN9D) for our studies. We found that stable over‐expression of RGS10 rendered them resistant to TNF‐induced cytotoxicity; whereas MN9D cells expressing mutant RGS10‐S168A (which is resistant to phosphorylation by protein kinase A at a serine residue that promotes its nuclear translocation) showed similar sensitivity to TNF as the parental MN9D cells. Using biochemical and pharmacologic approaches, we identified protein kinase A and the downstream phospho‐cAMP response element‐binding signaling pathway (and ruled out ERK 1/2, JNK, and NFkB) as key mediators of the neuroprotective effect of RGS10 against inflammatory stress.
Distinct molecular mechanisms of acquired resistance to temozolomide in glioblastoma cells
Authors: Happold Caroline , Roth Patrick , Wick Wolfgang , Schmidt Natalie , Florea Ana‐Maria , Silginer Manuela , Reifenberger Guido , Weller Michael
Published: May 2012

J. Neurochem. (2012) 122, 444–455.

Temozolomide (TMZ) is an alkylating chemotherapeutic agent that prolongs the survival of patients with glioblastoma. Clinical benefit is more prominent in patients with methylation of the O6‐methyl‐guanine DNA methyltransferase (MGMT) promoter. However, all patients eventually suffer from tumor progression because their tumors become resistant to TMZ. Here, we modeled acquired TMZ resistance in glioma cells in vitro to identify underlying molecular mechanisms. To this end, the glioma cell lines LNT‐229, LN‐308, and LN‐18 were exposed repetitively to increasing concentrations of TMZ to induce a stable resistant phenotype (R) defined by clonogenic survival assays. The molecular mechanisms mediating acquired resistance were assessed by immunoblot, PCR, and flow cytometry. Rescue experiments were performed with siRNA‐mediated candidate gene silencing. We found in LN‐18 cells constitutively expressing MGMT a strong up‐regulation of MGMT levels in TMZ‐resistant cells. TMZ resistance in the MGMT‐negative cell lines LNT‐229 and LN‐308 was not associated with de novo expression of MGMT. Instead, we found a down‐regulation of several DNA mismatch‐repair proteins in resistant LNT‐229 cells. A TMZ‐resistant phenotype was also achieved by silencing selected DNA mismatch repair proteins in parental LNT‐229 cells. No obvious mechanism of resistance was identified in the third cell line, LN‐308, except for reduced methylation of LINE‐1 repetitive elements. In conclusion, we demonstrate that different molecular mechanisms may contribute to the development of acquired TMZ resistance in glioma cells, indicating the need to develop distinct strategies to overcome resistance.
NITROGEN LIMITATION INCREASES BREVETOXINS IN KARENIA BREVIS (DINOPHYCEAE): IMPLICATIONS FOR BLOOM TOXICITY1
Authors: Ransom Hardison D. , Sunda William G. , Wayne Litaker R. , Shea Damian , Tester Patricia A.
Published: May 2012

Laboratory and field measurements of the toxin content in Karenia brevis cells vary by >4‐fold. These differences have been largely attributed to genotypic variations in toxin production among strains. We hypothesized that nutrient limitation of growth rate is equally or more important in controlling the toxicity of K. brevis, as has been documented for other toxic algae. To test this hypothesis, we measured cellular growth rate, chlorophyll a, cellular carbon and nitrogen, cell volume, and brevetoxins in four strains of K. brevis grown in nutrient‐replete and nitrogen (N)‐limited semi‐continuous cultures. N‐limitation resulted in reductions of chlorophyll a, growth rate, volume per cell and nirtogen:carbon (N:C) ratios as well as a two‐fold increase (1%–4% to 5%–9%) in the percentage of cellular carbon present as brevetoxins. The increase in cellular brevetoxin concentrations was consistent among genetically distinct strains. Normalizing brevetoxins to cellular volume instead of per cell eliminated much of the commonly reported toxin variability among strains. These results suggest that genetically linked differences in cellular volume may affect the toxin content of K. brevis cells as much or more than innate genotypic differences in cellular toxin content per unit of biomass. Our data suggest at least some of the >4‐fold difference in toxicity per cell reported from field studies can be explained by limitation by nitrogen or other nutrients and by differences in cell size. The observed increase in brevetoxins in nitrogen limited cells is consistent with the carbon:nutrient balance hypothesis for increases in toxins and other plant defenses under nutrient limitation.
A MORPHOLOGICAL AND MOLECULAR STUDY OF AUSTRAL SARGASSUM (FUCALES, PHAEOPHYCEAE) SUPPORTS THE RECOGNITION OF PHYLLOTRICHA AT GENUS LEVEL, WITH FURTHER ADDITIONS TO THE GENUS SARGASSOPSIS1
Authors: Dixon Rainbo R. M. , Huisman John M. , Buchanan Joe , Gurgel Carlos Frederico D. , Spencer Peter
Published: May 2012

Sargassum subgenus Phyllotricha currently includes seven species restricted to Australian and New Zealand coasts. A recent study of Cystoseira and other Sargassaceae genera based on mitochondrial 23S DNA and chloroplast‐encoded psbA sequences resulted in the most widely distributed species of subgenus Phyllotricha, Sargassum decurrens, being transferred to the reinstated monospecific Sargassopsis Trevisan. The fate of the residual six Phyllotricha species, however, was not considered. The present study examines these Phyllotricha species, alongside other Sargassum subgenera, Sargassopsis, Sirophysalis trinodis (formerly Cystoseira trinodis) and the New Zealand endemic Carpophyllum Greville, using morphological evidence and the molecular phylogenetic markers cox3, ITS‐2 and the rbcL–S spacer. Our results suggest both the genus Sargassum and Sargassum subgenus Phyllotricha are polyphyletic as currently circumscribed. Four S. subgen. Phyllotricha species, i.e. S. sonderi, S. decipiens, S. varians and S. verruculosum, form a monophyletic group sister to the genus Carpophyllum, and S. peronii is genetically identical to S. decurrens with regard to all three loci. We propose the resurrection of the genus Phyllotricha Areschoug, with type species Phyllotricha sonderi, and include the new combinations Phyllotricha decipiens, Phyllotricha varians and Phyllotricha verruculosum. Sargassum peronii, S. heteromorphum and S. kendrickii are transferred to Sargassopsis and Sargassum peronii is considered a synonym of Sargassopsis decurrens.
Developmental Trajectory and Environmental Moderation of the Effect of ALDH2 Polymorphism on Alcohol Use
Authors: Irons Daniel E. , Iacono William G. , Oetting William S. , McGue Matt
Published: May 2012

Background

In the aldehyde dehydrogenase 2 (ALDH2) gene, the ALDH2*2 allele, prevalent in East Asian populations, encodes an enzyme with severely reduced activity, thereby disrupting the normal metabolism of alcohol. Possession of the ALDH2*2 allele has been repeatedly shown to be associated with lower risk for alcohol dependence and reduced alcohol use. However, relatively few studies have considered whether the magnitude of the effect of ALDH2 polymorphism upon drinking is related to developmental stage or varies by environmental context.

Methods

In a longitudinally assessed sample of 356 adopted adolescents and young adults of East Asian descent, we examined the progression over time of the relationship between ALDH2 genotype and multiple measures of drinking behavior. We also sought to determine whether the environmental influences of nonbiological parent and elder sibling alcohol use and misuse, as well as deviant peer behavior, moderated the effect of ALDH2 genotype upon alcohol use.

Results

Across all measures of alcohol use, the association between ALDH2*2 allele possession and reduced drinking went from negligible to moderate between mid‐adolescence and early adulthood. A combined index of adoptive parent alcohol use and misuse consistently moderated the protective effect of the ALDH2*2 allele across the measures of quantity and frequency of alcohol use, and symptomology, such that high parental alcohol use and misuse reduced the protective effect of the ALDH2*2 allele, while low parental alcohol use and misuse enhanced the effect of the allele. Neither a combined index of elder sibling alcohol use and misuse, nor deviant peer behavior was consistently related to the effect of ALDH2 genotype.

Conclusions

The protective effect of the ALDH2*2 allele increases over the course of adolescence and young adulthood and is modified by the environmental influence of parental alcohol use and misuse. As such, ALDH2 provides a model system for exploring the nature of gene–environment interplay across development.
Acute Ethanol Exposure Increases Firing and Induces Oscillations in Cerebellar Golgi Cells of Freely Moving Rats
Authors: Huang Jian‐Jia , Yen Chen‐Tung , Tsai Meng‐Li , Valenzuela Carlos F. , Huang Chiming
Published: May 2012

Background

Alcohol is a widely abused substance and is responsible for significant morbidity and mortality worldwide. The precise mechanisms underlying ethanol (EtOH)'s actions in the central nervous system (CNS) remain elusive. In vitro studies suggest that GABAergic interneurons are important targets of EtOH action in the CNS. Although EtOH generally acts to inhibit CNS neurons, it appears to cause an increase in GABAergic interneuron excitability. However, it has yet to be demonstrated that EtOH produces this effect in the brain of behaving animals. Here, we demonstrate for the first time that acute EtOH exposure excites a subtype of GABAergic interneuron (cerebellar Golgi cell [GoC]) in a freely moving animal.

Methods

Electrophysiological recordings were made from microwire arrays implanted in the anterior cerebellum of freely moving rats.

Results

Cerebellar GoCs display a slow, irregular, spontaneous action potential firing pattern under control conditions. EtOH caused dramatic and consistent increases in the rate and regularity of GoC discharges, including a redistribution of the power in the GoC spike train, such that power became concentrated in the 26.7 ± 7.3 Hz region.

Conclusions

Taken together with our previous findings, these data suggest that a major mechanism of EtOH actions on cerebellar function is an EtOH‐induced de‐afferentation at the input stage of the cerebellar cortex in the form of granule cell inhibition, and that this inhibition is caused by an increase in GoC firing. It is likely that GoCs may play a significant role both in the gating of information transmission to granule cells and in the modulation of the overall excitability of the cerebellum by tonically controlling granule cell activity.
Laparoscopic‐Assisted Colpotomy for Ovariectomy in the Mare
Authors: Tate Lloyd P. , Fogle Callie A. , Bailey C. Scott , Tate Kathryn B. , Davis John W.
Published: May 2012

Objective

To describe a technique for ovariectomy through a colpotomy using a chain écraseur with laparoscopic guidance and report outcome in 4 mares.

Study Design

Case series.

Method

After insertion of a laparoscope into the abdomen through the left flank, colpotomy was performed to allow introduction of an écraseur into the caudal aspect of the abdomen. Grasping and removal of the ovary and evaluation of the pedicle was observed via the laparoscope. The laparoscope was then inserted in the right flank for right ovariectomy. The colpotomy was closed in a continuous suture pattern using laparoscopic or long needle holders.

Results

Insertion of a laparoscope allowed ready identification of the ovaries and capture within an écraseur, including assurance that no other tissues were contained within écraseur chain. The mesovarial pedicles were easily be examined for hemorrhage. Surgical time for ovariectomy was 10–15 minutes with no postsurgical complications. Closure of the colpotomy healed without complications.

Conclusion

Laparoscopic‐assisted écraseur ovariectomy is inexpensive, rapid, and a safe alternative to other methods of open and laparoscopic ovariectomy.
The Development of Risk Analysis: A Personal Perspective
Authors: Wilson Richard
Published: May 2012

This article reflects on my experiences observing and participating in the development of risk analysis for environmental and health hazards since the 1970s with emphasis on its critical role in informing decisions with potentially high consequences, even for very low probability events once ignored or simply viewed as “acts of God.” I discuss how modern society wants to protect itself from hazards with limited or no immediate historical precedent such that prediction and protective actions must depend on models that offer varying degrees of reliability. I believe that we must invest in understanding risks and risk models to ensure health in the future and protect ourselves from large challenges, including climate change, whether anthropogenic or otherwise, terrorism, and perhaps even cosmic change.
Using Expert Judgments to Explore Robust Alternatives for Forest Management under Climate Change
Authors: McDaniels Timothy , Mills Tamsin , Gregory Robin , Ohlson Dan
Published: May 2012

We develop and apply a judgment‐based approach to selectingrobustalternatives, which are defined here asreasonably likely to achieve objectives, over a range of uncertainties. The intent is to develop an approach that is more practical in terms of data and analysis requirements than current approaches, informed by the literature and experience with probability elicitation and judgmental forecasting. The context involves decisions about managing forest lands that have been severely affected by mountain pine beetles in British Columbia, a pest infestation that is climate‐exacerbated. A forest management decision was developed as the basis for the context, objectives, and alternatives for land management actions, to frame and condition the judgments. A wide range of climate forecasts, taken to represent the 10–90% levels on cumulative distributions for future climate, were developed to condition judgments. An elicitation instrument was developed, tested, and revised to serve as the basis for eliciting probabilistic three‐point distributions regarding the performance of selected alternatives, over a set of relevant objectives, in the short and long term. The elicitations were conducted in a workshop comprising 14 regional forest management specialists. We employed the concept ofstochastic dominanceto help identify robust alternatives. We used extensive sensitivity analysis to explore the patterns in the judgments, and also considered the preferred alternatives for each individual expert. The results show that two alternatives that are more flexible than the current policies are judged more likely to perform better than the current alternatives on average in terms of stochastic dominance. The results suggest judgmental approaches to robust decision making deserve greater attention and testing.
Deliberative Disjunction: Expert and Public Understanding of Outcome Uncertainty
Authors: Gregory Robin , Dieckmann Nathan , Peters Ellen , Failing Lee , Long Graham , Tusler Martin
Published: May 2012

Many environmental and risk management decisions are made jointly by technical experts and members of the public. Frequently, their task is to select from among management alternatives whose outcomes are subject to varying degrees of uncertainty. Although it is recognized that how this uncertainty is interpreted can significantly affect decision‐making processes and choices, little research has examined similarities and differences between expert and public understandings of uncertainty. We present results from a web‐based survey that directly compares expert and lay interpretations and understandings of different expressions of uncertainty in the context of evaluating the consequences of proposed environmental management actions. Participants responded to two hypothetical but realistic scenarios involving trade‐offs between environmental and other objectives and were asked a series of questions about their comprehension of the uncertainty information, their preferred choice among the alternatives, and the associated difficulty and amount of effort. Results demonstrate that experts and laypersons tend to use presentations of numerical ranges and evaluative labels differently; interestingly, the observed differences between the two groups were not explained by differences in numeracy or concerns for the predicted environmental losses. These findings question many of the usual presumptions about how uncertainty should be presented as part of deliberative risk‐ and environmental‐management processes.
Ventricular Tachycardia from Remote Blunt Chest Trauma: Combined Epicardial‐Endocardial Right Ventricular Substrate Characterization
Authors: MICHOWITZ YOAV , TUNG RODERICK , ATHILL CHARLES , SHIVKUMAR KALYANAM
Published: May 2012

Ventricular tachycardia as a late complication of blunt chest trauma has never been reported. We present a case of combined endocardial and epicardial delineation of the right ventricular arrhythmogenic substrate, where other causes of cardiomyopathy were excluded. The epicardial scar was more extensive than endocardial scar, and the central isthmus was likely intramural. A history of blunt chest trauma should be considered in patients with right ventricular cardiomyopathy. (PACE 2012; 35:e127–e130)
Idiopathic Ventricular Fibrillation Originating from the Moderator Band
Authors: ANTER ELAD , BUXTON ALFRED E. , SILVERSTEIN JOSHUA R. , JOSEPHSON MARK E.
Published: May 2012

Idiopathic VF Originating from the Moderator Band. We report a case of a 59‐year‐old man with idiopathic ventricular fibrillation storm. Ventricular fibrillation was pause‐dependent and triggered by an early‐coupled right ventricular premature complex. The characteristic premature beat was mapped and successfully ablated from Purkinje fibers of the moderator band. (J Cardiovasc Electrophysiol, Vol. 24, pp. 97‐100, January 2013)
Implantation Feasibility, Procedure‐Related Adverse Events and Lead Performance During 1‐Year Follow‐Up in Patients Undergoing Triple‐Site Cardiac Resynchronization Therapy: A Substudy of TRUST CRT Randomized Trial
Authors: LENARCZYK RADOSŁAW , KOWALSKI OSKAR , SREDNIAWA BEATA , PRUSZKOWSKA‐SKRZEP PATRYCJA , MAZUREK MICHAŁ , JĘDRZEJCZYK‐PATEJ EWA , WOŹNIAK ALEKSANDRA , PLUTA SŁAWOMIR , GŁOWACKI JAN , KALARUS ZBIGNIEW
Published: May 2012

Feasibility and Safety of Triple‐Site CRT. Introduction: This substudy was to assess implantation feasibility and long‐term safety of triple‐site resynchronization therapy (CRT) in a series of consecutive patients included in a randomized trial.

Methods and results: One hundred consecutive patients enrolled into Triple‐Site Versus Standard Cardiac Resynchronization Therapy Randomized Trial were analyzed. Eligibility criteria included NYHA class III‐IV, sinus rhythm, QRS ≥ 120 milliseconds, left ventricular ejection fraction ≤35%, and significant mechanical dyssynchrony. Patients were randomized in a 1:1 ratio to conventional or triple‐site CRT with defibrillator–cardioverter. After 12 months of resynchronization 30% of patients with conventional resynchronization and 12.5% with triple‐site CRT were in NYHA functional class III or IV (P < 0.05). Implantation of triple‐site systems was significantly longer (median 125 minutes vs 96 minutes; P < 0.001), with higher fluoroscopic exposure, especially in patients with very enlarged left ventricle or pulmonary hypertension. Implantation success‐rate was similar in the triple‐site and conventional group (94% vs 98%; P = NS); however, additional techniques had to be used in a greater proportion of the triple‐site patients (33.3% vs 16%; P < 0.05). Long‐term lead performance tests revealed significantly higher pacing threshold and lower impedance in the triple‐site group. The 1‐year incidence of serious, CRT‐related adverse events was similar in triple‐site and conventional group (20.8% vs 30%; P = NS).

Conclusions: Triple‐site CRT is associated with more pronounced functional improvement than standard resynchronization. This form of pacing is equally safe and feasible as the conventional CRT. However, triple‐site procedure is more time‐consuming, associated with higher radiation exposure and the need to use additional techniques. Triple‐site resynchronization is associated with less favorable electrical lead characteristics. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1228–1236, November 2012)
Comparative Climate Change Policy and Federalism: An Overview
Authors: Brown Douglas M.
Published: May 2012

This commentary provides an overview of the four papers in this issue of Review of Policy Research on the politics of climate change. The papers all address in one way or another aspects of how federal‐type systems are dealing with the collective action and multilevel governance issues of climate change policy. The comparative study of federal systems provides insight into how domestic authority is so often overlapping and divided when dealing with greenhouse gas emissions and climate change. Federal arrangements offer a rich array of norms, institutions, and practices for tackling these problems. Federal systems grapple continuously with the kinds of issues that are the most intractable in the climate change case, such as overcoming interregional differences of interests and values. A common federal feature is competition among subnational governments and between them and national or federated governments over climate change policy, which has been especially significant in the United States and in Canada in the relative absence of national action––although soberingly, the whole is as yet nowhere near as great as the sum of the parts. More significant, but rarer is the achievement of tighter coordination in federal systems achieved through intergovernmental co‐decision, as seen in the European Community and Australia. This has been accomplished in large part due to a consensus among all intergovernmental parties on the nature of the problem and congruence with the existing international regime, characteristics missing in the North American context.
Carbon Taxation and Policy Labeling: Experience from American States and Canadian Provinces
Authors: Rabe Barry G. , Borick Christopher P.
Published: May 2012

A vast economics literature embraces taxation of the carbon content of fossil fuels as the superior policy approach for reducing greenhouse gas emissions. However, experience around the world suggests that carbon taxes face exceedingly difficult political hurdles. Federal experience in the United States and in Canada confirms this pattern. This article reviews sub‐federal policy development among American states and Canadian provinces, a great many of which have pursued climate policy development. With one major exception, explicit carbon taxation appears to remain a political nonstarter. At the same time, states and provinces have been placing indirect carbon prices on fossil fuel use through a wide range of policies. These tend to strategically alter labeling, avoiding the terms of “tax” and “carbon” in imposing costs. The article offers a framework for considering such strategies and examines common design features, including direct linkage between cost imposition and fund usage to build political support.
A Tale of Two Taxes: The Fate of Environmental Tax Reform in Canada
Authors: Harrison Kathryn
Published: May 2012

Policy makers who embrace market‐based approaches to environmental regulation, typically eschew carbon taxes in favor of the political advantages of cap and trade, which offers lower visibility of costs to consumers and the opportunity to allocate valuable permits freely to industry. Against this backdrop, the article examines two surprising proposals for carbon taxes, by the government of British Columbia (BC) and by the federal Liberal Party of Canada. Both reflected a triumph of party leaders' normative “good policy” motives over “good politics.” The BC tax alone succeeded first because it was adopted by a party already in government. Second, the onset of a recession before the next elections shifted voters' attention to the economy, which advantaged the BC Liberals but disadvantaged their federal counterparts. However, proposals for carbon taxes were unpopular in both jurisdictions, offering a cautionary tale concerning the fate of politicians' normative commitments absent electoral backing.
Brain Tumor Symptoms as Antecedents to Uncertainty: An Integrative Review
Authors: Cahill Jennifer , LoBiondo‐Wood Geri , Bergstrom Nancy , Armstrong Terri
Published: May 2012

Purpose: Uncertainty is a common experience within human cancer. For brain tumor patients, irregular symptom pattern and presentation may promote uncertainties about treatment response, prognosis, and life quality. We sought to identify the somatic symptom experience associated with primary and secondary brain tumors and the potential impact on illness‐related uncertainty.

Methods: An integrative literature search of Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed. Symptom data were excerpted into tables and reviewed critically against the broader uncertainty‐focused oncology literature.

Results: Twenty‐one studies investigated a diverse range of brain tumor symptoms that persist through the now‐expanding, post‐treatment survival. While symptoms such as fatigue were common, antecedents and patterns were poorly characterized and inconsistent between and within categories of tumor.

Conclusions and Implications: Symptom investigation is an emerging and rapidly developing area of neuro‐oncology. The extent to which symptoms are familiar, predictable, and understandable can mitigate uncertainty. The unstable nature of symptoms across the trajectory of a brain tumor may be a significant corollary to illness‐related uncertainty.

Clinical Relevance: Because the majority of brain tumor patients cannot be cured of their cancer, understanding the symptom expanse and potential to promote uncertainty could inform alternative nursing strategies to reduce anxiety and distress, and to preserve life quality where cure is often unattainable.