bluuebunny/crossref_metadata_2025 huggingface dataset:
From Amino Acid to Glucosinolate Biosynthesis: Protein Sequence Changes in the Evolution of Methylthioalkylmalate Synthase in Arabidopsis
Authors: de Kraker Jan-Willem , Gershenzon Jonathan
Published: January 2011

Methylthioalkylmalate synthase (MAM) catalyzes the committed step in the side chain elongation of Met, yielding important precursors for glucosinolate biosynthesis in Arabidopsis thaliana and other Brassicaceae species. MAM is believed to have evolved from isopropylmalate synthase (IPMS), an enzyme involved in Leu biosynthesis, based on phylogenetic analyses and an overlap of catalytic abilities. Here, we investigated the changes in protein structure that have occurred during the recruitment of IPMS from amino acid to glucosinolate metabolism. The major sequence difference between IPMS and MAM is the absence of 120 amino acids at the C-terminal end of MAM that constitute a regulatory domain for Leu-mediated feedback inhibition. Truncation of this domain in Arabidopsis IPMS2 results in loss of Leu feedback inhibition and quaternary structure, two features common to MAM enzymes, plus an 8.4-fold increase in the k  cat/K  m for a MAM substrate. Additional exchange of two amino acids in the active site resulted in a MAM-like enzyme that had little residual IPMS activity. Hence, combination of the loss of the regulatory domain and a few additional amino acid exchanges can explain the evolution of MAM from IPMS during its recruitment from primary to secondary metabolism.
Combined lung‐sound and reflux‐monitoring: a pilot study of a novel approach to detect nocturnal respiratory symptoms in gastro‐oesophageal reflux disease
Authors: Kunsch S. , Gross V. , Neesse A. , Sohrabi K. , Nell C. , Gress T. M. , Ellenrieder V. , Koehler U.
Published: January 2011

Aliment Pharmacol Ther 2011; 33: 592–600

Background  Increased prevalence of respiratory symptoms has been commonly reported in patients with gastro‐oesophageal reflux disease (GERD).

Aim  To introduce a novel Lung‐Sound‐Monitoring device that allows simultaneous measurement of both nocturnal respiratory symptoms and episodes of acidic and biliary refluxes.

Methods  Nocturnal respiratory symptoms (coughing and wheezing) were continuously recorded in 20 healthy subjects and 30 reflux patients with respiratory symptoms in parallel to combined pH‐monitoring and Bilitec measurement.

Results  Analysis could be completed in 20 healthy subjects and in 25 patients with reflux. A clear temporal correlation to reflux phases was detected in 49% of coughing and 41% of wheezing events, respectively. Moreover, 89% of the coughing and 100% of the wheezing events succeeded reflux episodes. Finally, the technique was capable of assessing a statistically significant difference between patients and controls regarding the occurrence of these symptoms.

Conclusions  Our pilot study establishes the Lung‐Sound‐Monitoring system as a unique tool to measure objectively the temporal correlation between gastroesophageal reflux and the appearance of respiratory symptoms. It represents a useful technique to identify patients with respiratory symptoms due to reflux, and therefore allows one to determine and quantify the impact of therapeutic interventions such as antireflux therapy on respiratory symptoms.
Impact of postgraduate education on physician practice for community‐acquired pneumonia
Authors: Ikai Hiroshi , Morimoto Takeshi , Shimbo Takuro , Imanaka Yuichi , Koike Kaoru
Published: January 2011

Background  Clinical practice guidelines on community‐acquired pneumonia (CAP) are widely recognized by hospitals in Japan; however, little is known about the effect of postgraduate education on physicians' adherence to the guidelines or on patient outcomes.

Method  We conducted a chart review of inpatient CAP cases at a single teaching hospital in Japan from 2003 to 2005, during which the educational programme for residents was gradually reinforced by the introduction of multifaceted education and training in the management of infectious diseases. To assess the effects of this educational programme, we measured process indicators such as usage of diagnostic tests, choice of antibiotics, and clinical outcomes, including length of antibiotic treatment, length of stay, and mortality.

Results  Several improvements were observed after educational intervention: (1) more frequent blood, sputum cultures, and Gram stain tests; (2) less frequent use of broad‐spectrum antibiotics as the initial empiric therapy (from 50% to 12%) and on hospital day 5 (from 66.7% to 10%); and (3) median length of stay was shorter after intervention (16.5 days to 13 days).

Conclusions  Our findings suggest that multifaceted educational intervention for residents focused on diagnostic efforts, including Gram stain and cultures, choice of antibiotics with the appropriate spectrum, and de‐escalation of antibiotics, can increase adherence to CAP guidelines as well as improve clinical outcomes.
A description of adaptive and maladaptive behaviour in children and adolescents with Cri‐du‐chat syndrome
Authors: Teixeira M. C. T. V. , Emerich D. R. , Orsati F. T. , Rimério R. C. , Gatto K. R. , Chappaz I. O. , Kim C. A.
Published: January 2011

Background Psychological tests can be useful to record adaptive and maladaptive behaviours of children with intellectual disability. The objective of this study was to describe the adaptive and maladaptive behaviour of children and adolescents with Cri‐du‐chat syndrome.

Methods The sample consisted of 10 children and adolescents with Cri‐du‐chat syndrome (mean chronological age = 11.3 years, mean mental age = 18 months). The developmental quotient was calculated through the Psychoeducational Profile – Revised. An observational protocol was used to record adaptive and maladaptive behaviours.

Results The number of maladaptive behaviours observed was different among participants. However, all of them had high rates of adaptive behaviours, such as rule‐following.

Conclusions These results, though preliminary, justify that we continue to think about the need for psychoeducational interventions aimed at stimulating the repertoire of adaptive behaviours, in people with Cri‐du‐chat syndrome.
HIV/AIDS awareness in those diagnosed with mental illness
Authors: NGWENA J.
Published: January 2011

Accessible summary

People diagnosed with mental illness are at risk of acquiring and transmitting HIV.

This research looked into HIV/AIDS awareness in those with mental illness. It revealed a lack of understanding in the way in which HIV is transmitted and acquired. Those with dual diagnosis (mental illness and substance or alcohol abuse) are even at higher risk because of the influence of drugs and alcohol on behaviour.

Healthcare professionals such as doctors and nurses seem to pay lip service in matters relating to HIV and sexual health, especially when dealing with the mentally ill.

The study recommends an integration of active sex education in mental health service provision and an in‐depth assessment on sexual behaviour at the first or subsequent points of contact with service users. It also recommends educating nurses especially on HIV/AIDS matters so they can counsel those at risk.

The spread of human immunodeficiency virus (HIV) continues to increase among the general population. Previous studies in this field focused mainly on the ‘at‐risk’ groups such as homosexuals, prostitutes, intravenous drug users, bisexual men and women. Mentally ill men and women remain one of the subgroups understudied and yet continue to show disproportionately high levels of seroprevalence. The purpose of this study was to elucidate awareness of the risk factors associated with HIV transmission and development of AIDS in those diagnosed with mental illness. Using questionnaires, information regarding HIV method of transmission, knowledge on HIV/AIDS and at‐risk behaviour awareness was obtained from 30 subjects in an acute psychiatric mental health unit (13 women and 17 men). Significant association between different variables was determined at 95.5% confidence level (P = 0.05). Assessment of HIV/AIDS awareness and at‐risk behaviour awareness revealed significant knowledge deficit among this subject group. The outcome of this study underscores the need to introduce intervention programmes tailored to individual needs of the mentally ill. Measures such as ‘at‐risk sexual’ behaviours should be incorporated into the current assessment process or profile so that accurate information and informed judgement can be reached regarding client or patient sexual behaviour.
Prevalence and correlates of seclusion with or without restraint in a Canadian psychiatric hospital: a 2‐year retrospective audit
Authors: DUMAIS A. , LARUE C. , DRAPEAU A. , MÉNARD G. , GIGUÈRE ALLARD M.
Published: January 2011

Accessible summary

This paper assesses the prevalence and associated clinical factors of seclusion and restraint in a Canadian psychiatric hospital.

The prevalence of seclusion with or without restraint is high, and patients with bipolar and personality disorders are more likely than those with other psychiatric disorders to be secluded with and without restraint during their stay in this hospital.

Implementing a comprehensive record‐keeping system that tracks patient risk factors and seclusion and restraint episodes would enhance the capacity to identify complex cases that present risks.

Seclusion with or without restraint is a measure used to manage patients with challenging behaviours. Although controversial, the intervention remains poorly documented, especially in Canadian psychiatric hospitals. The purpose of this study is to assess the prevalence of the measure and identify any correlated demographic characteristics and psychiatric disorders. Episodes of seclusion with or without restraint were extracted from a computerized, hospital‐based system introduced specifically to track such interventions. Of 2721 patients hospitalized during that time, 23.2% (n = 632) were secluded with or without restraint, and 17.5% (n = 476) were secluded with restraint. Younger age, schizophrenia or other psychosis, bipolar and personality disorder, and longer stay in hospital are predictors of an episode of seclusion with or without restraint. Younger age, bipolar and personality disorders and a longer stay in hospital are predictors of an episode of seclusion with restraint. For patients who spent longer in seclusion and under restraint, there is a positive association with longer stay in hospital. In this inpatient psychiatric facility, seclusion with or without restraint thus appears to be common. More research is warranted to better identify the principal factors associated with seclusion and restraint and help reduce resort to these measures.
Hydroxylated ornithine lipids increase stress tolerance in Rhizobium tropici CIAT899
Authors: Vences‐Guzmán Miguel Á. , Guan Ziqiang , Ormeño‐Orrillo Ernesto , González‐Silva Napoleón , López‐Lara Isabel M. , Martínez‐Romero Esperanza , Geiger Otto , Sohlenkamp Christian
Published: January 2011

Ornithine lipids (OLs) are widespread among Gram‐negative bacteria. Their basic structure consists of a 3‐hydroxy fatty acyl group attached in amide linkage to the α‐amino group of ornithine and a second fatty acyl group ester‐linked to the 3‐hydroxy position of the first fatty acid. OLs can be hydroxylated within the secondary fatty acyl moiety and this modification has been related to increased stress tolerance. Rhizobium tropici, a nodule‐forming α‐proteobacterium known for its stress tolerance, forms four different OLs. Studies of the function of these OLs have been hampered due to lack of knowledge about their biosynthesis. Here we describe that OL biosynthesis increases under acid stress and that OLs are enriched in the outer membrane. Using a functional expression screen, the OL hydroxylase OlsE was identified, which in combination with the OL hydroxylase OlsC is responsible for the synthesis of modified OLs in R. tropici. Unlike described OL hydroxylations, the OlsE‐catalysed hydroxylation occurs within the ornithine moiety. Mutants deficient in OlsE or OlsC and double mutants deficient in OlsC/OlsE were characterized. R. tropici mutants deficient in OlsC‐mediated OL hydroxylation are more susceptible to acid and temperature stress. All three mutants lacking OL hydroxylases are affected during symbiosis.
Ageing well from an urban Indigenous Australian perspective
Authors: Waugh Elizabeth , Mackenzie Lynette
Published: January 2011

Introduction: The poor health status of Indigenous Australians as demonstrated by high rates of morbidity and mortality compared with non‐Indigenous Australians has been of concern to health providers for decades. Largely because of low life expectancy, Indigenous Australians are considered to be ageing from the age of 45 years. However, little is known about the needs and views of this unique group as they age. The aim of the study was to explore perspectives of older Indigenous Australians about their health and wellbeing.

Methods: A qualitative study was conducted using data from face‐to‐face interviews with six Indigenous people aged over 45 years living in southwest Sydney, Australia. Data were analysed using a phenomenological approach.

Results: Participants described important considerations for ageing well that related to the four main themes of: personal identity, family, community and perception of health and ageing.

Discussion: Engaging in meaningful occupations to support culturally valued roles were key elements in strengthening identity and facilitating personal, family and community health. Health and wellbeing were perceived as multidimensional concepts by participants, which did not always match available services primarily developed for non‐Indigenous populations. Culturally sensitive health services are needed to meet the needs of older Indigenous people. Ageing well was associated with participating in family and community roles, connection with community networks and managing the effects of chronic health problems. Further research is needed to determine how health services can support, identity and promote health for older Indigenous Australians.
‘Off your Face(book)’: Alcohol in online social identity construction and its relation to problem drinking in university students
Authors: RIDOUT BRAD , CAMPBELL ANDREW , ELLIS LOUISE
Published: January 2011

Introduction and Aims. Alcohol is a key component of identity exploration for many young people, yet few studies have investigated identity construction in relation to problematic drinking. Increases in youth alcohol consumption have coincided with expanding use of communications technologies, particularly social networking sites (SNS), which have altered traditional conditions of identity construction. It has been found young people often engage with alcohol in the SNS environment by portraying themselves as binge drinkers. The current study applied an innovative approach to identity construction (the photographic essay) to provide insight into the portrayal of ‘alcohol‐identity’ on Facebook.

Design and Methods. One hundred and fifty‐eight university students completed a range of alcohol measures before providing access for researchers to view their Facebook profiles to operationalise their alcohol‐identity according to autophotographic methodology.

Results. Participants utilised a variety of photographic and textual material to present alcohol as a component of their identity on Facebook, with over half having selected an alcohol‐related profile image. Alcohol‐identity predicted alcohol consumption and problematic alcohol‐related behaviours as measured by questionnaires used to reliably identify alcohol‐related problems in university students. Almost 60% reported potentially problematic alcohol use according to the Alcohol Use Disorders Identification Test.

Discussion and Conclusions. Findings suggest that portraying oneself as a drinker is considered by many young people to be a socially desirable component of identity in the SNS environment, perpetuating an online culture that normalises binge drinking. Ready‐made Facebook photo essays provide an alternate method of accessing problematic alcohol use, supplementing self‐report measures.[Ridout B, Campbell A, Ellis L. ‘Off your Face(book)’: Alcohol in online social identity construction and its relation to problem drinking in university students. Drug Alcohol Rev 2012;31:20–26]
STRATEGIC INFORMATION DISCLOSURE: THE CASE OF MULTIATTRIBUTE PRODUCTS WITH HETEROGENEOUS CONSUMERS
Authors: HOTZ V. JOSEPH , XIAO MO
Published: January 2011

We examine the incentives for firms to voluntarily disclose otherwise private information about the quality attributes of their products. In particular, we focus on the case of differentiated products with multiple attributes and heterogeneous consumers. We show that there exist certain configurations of consumers' multidimensional preferences under which a firm, no matter whether producing a high‐ or low‐quality product, may choose not to reveal the quality even with zero disclosure costs. The failure of information unraveling arises when providing consumers with more information results in more elastic demand, which triggers more intensive price competition and leads to lower prices and profits for competing firms. As a result, the equilibrium in which disclosure is voluntary may diverge from that in which disclosure is mandatory. (JEL L15, L5)
FINANCIAL DEVELOPMENT AND WAGE INEQUALITY: THEORY AND EVIDENCE
Authors: JERZMANOWSKI MICHAL , NABAR MALHAR
Published: January 2011

We argue that financial market development contributed to the rise in the skill premium and residual wage inequality in the United States since the 1980s. We present an endogenous growth model with imperfect credit markets and establish how improving the efficiency of these markets affects modes of production, innovation, and wage dispersion between skilled and unskilled workers. The experience of U.S. states following banking deregulation provides empirical support for our hypothesis. We find that wages of skilled workers increased by between 0.5% and 6.3% following deregulation while those of unskilled workers fell by between 3.5% and 8.7%. Similarly, residual (or within‐group) inequality increased; the 90–50 percentile ratio of residuals from a Mincerian wage regression and their standard deviation increased by 4.2% and 1.7%, respectively. (JEL E25, J31, G24)
Materialist State Theory and the Transnationalization of the Capitalist State
Authors: Demirović Alex
Published: January 2011

Abstract:  In contrast to assertions that the capitalist state is either losing control or that it has returned, this article argues that during the last two decades the state itself has been reshaped. To understand the processes that the capitalist state is exposed to it is necessary to conceive of it as a series of form‐specific practices. Which practices form “the state” is not a result of pre‐given institutions but of conflicts and struggles. The capitalist state, separated as it is from the relations of production, must not be made synonymous with the national state. Only as a result of certain relations of force does bourgeois rule acquire the form of the national state. These relations between classes are currently being dissolved by the ruling classes. The capitalist state is being reorganized and is constructing new elements of a transnational network state, whilst the state itself is governed through new techniques—that is, those of governance.
Screening and Brief Intervention of Detainees for Alcohol Use: A Social Crime Prevention Approach to Combating Alcohol‐Related Crime?
Authors: BARTON ADRIAN
Published: January 2011

Abstract: Irresponsible and excessive consumption of alcohol and the associated problems it carries in its wake have become one of the key concerns for central government in terms of community safety, especially in the night‐time economy. In response to the Alcohol Harm Reduction Strategy for England (Department of Health 2007), the Department of Health (DoH) has announced a series of measures of which one is to pilot screening and intervention for alcohol use in a variety of locations, including criminal justice settings. This article reports on the findings of a project that pre‐empts the DoH initiatives, thus providing the opening comments in what will be sure to be a debate about a new strategic and evidence‐based approach to dealing with alcohol‐related crime and disorder. The article provides data and discussions on the Screening and Brief Intervention (SBI) project that screened 3,900 detainees in a busy custody suite in the south of England during the period March 2007 to March 2008.
Networking sisterhood, from the informal to the global: AkiDwA, the African and Migrant Women's Network, Ireland
Authors: DE TONA CARLA , LENTIN RONIT
Published: January 2011

In this article we document the networking strategies of Ireland's leading migrant women's organization, AkiDwA – the African and Migrant Women's Network. We begin by positing networking as a process of agency and transformation and argue for the heuristic potential of ‘network’ in unpacking the gendered experiences of migration. Employing theoretical and ethnographic tools, we position AkiDwA as key to understanding how migrant women have been addressing discrimination, isolation, exclusion, violence and racism, through promoting gendered and culturally sensitive services and policies. We outline three phases in AkiDwA's development since the onset of immigration in the 1990s, from the informal to the global, situating it as the hub of overlapping national and global networks of migrant women, spanning Ireland, Europe and beyond. We conclude by suggesting that network analysis, rather than being a general grand theory, allows us to develop the micro‐macro links that, as Robert Holton argues, bring together small worlds with larger structures.
Unilateral Acrokeratoelastoidosis—Second Reported Case
Authors: Klekowski Nicole , Shwayder Tor
Published: January 2011

Abstract:  Acrokeratoelastoidosis (AKE) is a rare disease that manifests as wartlike papules along the dorsal palmar junction. It is characterized by orthohyperkeratosis in the horny layer and elastorrhexis in the reticular dermis. Both sporadic and familial cases following autosomal dominant inheritance have been reported. Currently, no effective treatments exist for AKE, which can have a significant cosmetic impact. Here we present the second reported case of unilateral AKE in a 5‐year‐old African American girl and hypothesize that the mechanism for the unilateral nature of AKE in this patient is genetic mosaicism.
Straight Screw‐In Atrial Leads “J‐Post Shaped” in Right Appendage Versus J‐Shaped Systems for Permanent Atrial Pacing: A Safety Comparison
Authors: ZOPPO FRANCO , ZERBO FRANCESCA , BRANDOLINO GLAUCO , BACCHIEGA ENRICO , LUPO ANTONIO , BERTAGLIA EMANUELE
Published: January 2011

Background and Objectives: The reliability of active‐fixation atrial leads has been compared with that of passive‐fixation leads; comparisons have also been made between straight and J‐shaped screw‐in lead systems. However, few data are available on procedural and short‐term safety. This retrospective study compared the procedural safety of non‐pre‐shaped screw‐in leads with that of passive‐ and active‐fixation J‐shaped leads.

Patients and Methods: From January 2004 to January 2010, 1,464 patients underwent new pacemaker/implantable cardioverter‐defibrillator implantation. Of these, 915 (study population) received a passive‐ or active‐fixation pre‐J‐shaped lead, or a straight screw‐in atrial lead; the remaining 549 patients, who received only a ventricular lead, were excluded. The three study groups were: Group S‐FIX (165 patients, 18%), receiving a straight screw‐in atrial lead (postshaped in the right appendage); Group J‐PASS (690 patients, 75.4%), receiving a passive‐fixation J‐shaped atrial lead; and Group J‐FIX (60 patients, 6.6%), receiving an active‐fixation screw‐in J‐shaped atrial lead.

Procedural and short‐term complication rates were analyzed up to 3 months postimplantation.

Results: One complication occurred in each group (S‐FIX 0.6% vs J‐PASS 0.1% vs J‐FIX 1.6%, P = 0.3, 0.1, and 0.4, respectively, for each comparison). The rate of atrial lead dislodgement was higher in Group J‐PASS than in S‐FIX but not J‐FIX (Group S‐FIX 0 vs Group J‐PASS 16 vs Group J‐FIX 1 dislodgements; P = 0.04 and 0.7, respectively).

Conclusion: Straight screw‐in atrial leads, “J‐post shaped” in the right appendage, offer better stability than passive‐fixation J‐shaped leads and display a similarly acceptable safety profile compared with both the J‐shaped systems. (PACE 2011; 34:325–330)
Interatrial Conduction Correlates with Optimal Atrioventricular Timing in Cardiac Resynchronization Therapy Devices
Authors: LEVIN VADIM , RAZAVI MEHDI , COLL ROBERT , COLES Jr JAMES A. , SAMBELASHVILI ALEKSANDRE
Published: January 2011

Background: Echocardiographic optimization of the atrioventricular delay (AV) may result in improvement in cardiac resynchronization therapy (CRT) outcome. Optimal AV has been shown to correlate with interatrial conduction time (IACT) during right atrial pacing. This study aimed to prospectively validate the correlation at different paced heart rates and examine it during sinus rhythm (Sinus).

Methods: An electrophysiology catheter was placed in the coronary sinus (CS) during CRT implant (n = 33). IACT was measured during Sinus and atrial pacing at 5 beats per minute (bpm) and 20 bpm above the sinus rate as the interval from atrial sensing or pacing to the beginning of the left atrial activation in the CS electrogram. P‐wave duration (PWd) was measured from 12‐lead surface electrocardiogram, and the interval from the right atrial to intrinsic right ventricular activation (RA‐RV) was measured from device electrograms. Within 3 weeks after the implant patients underwent echocardiographic optimization of the sensed and paced AVs by the mitral inflow method.

Results: Optimal sensed and paced AVs were 129 ± 19 ms and 175 ± 24 ms, respectively, and correlated with IACT during Sinus (R = 0.76, P < 0.0001) and atrial pacing (R = 0.75, P < 0.0001), respectively. They also moderately correlated with PWd (R = 0.60, P = 0.0003 during Sinus and R = 0.66, P < 0.0001 during atrial pacing) and RA‐RV interval (R = 0.47, P = 0.009 during Sinus and R = 0.66, P < 0.0001 during atrial pacing). The electrical intervals were prolonged by the increased atrial pacing rate.

Conclusion: IACT is a critical determinant of the optimal AV for CRT programming. Heart rate‐dependent AV shortening may not be appropriate for CRT patients during atrial pacing. (PACE 2011; 34:443–449)
Muscle Noise Effects on Atrial Evoked Response Sensing: Implications on Atrial Auto‐Threshold and Auto‐Capture Determination
Authors: TSE HUNG‐FAT , SAHA SUNIPA , GARG ANKUR , BOHN DEREK , LEE YIM LING , LAU CHU‐PAK
Published: January 2011

Background: Automatic pacing capture verification algorithms that are based on detection of local evoked response signals are susceptible to interference from myopotential noise. This is especially true in the atrium where the lower signal amplitude and signal‐to‐noise ratio make pacing capture verification more challenging. The aim of this study is to evaluate the impact of myopotential noise induced by various maneuvers on the atrial evoked response (AER) signal.

Methods: Data were collected from 18 patients (7 M/11 F, 77.6 ± 8.8 years), implanted with a dual chamber rate response (DDDR) pacemaker and acute and chronic right atrial leads and right ventricular leads, at three regular follow‐up visits scheduled at 1, 3, and 6 months after pacemaker implantation or replacement procedures. During each study visit, manual atrial pacing threshold tests during unipolar pacing in the DDD mode were conducted with two evoked response sensing configurations (RARing→ Ind and RARing→ VTip) while patients performed six different maneuvers. Noise estimates were calculated for each maneuver.

Results: The greatest noise estimates in both sensing configurations were measured during the hand‐pressing exercise (0.649 ± 0.342 mV in the RARing→ Ind vector, 0.309 ± 0.223 mV in the RARing→ VTip vector). No significant differences in overall noise estimates were observed between the follow‐up visits. Of the beats that exhibited noise estimates greater than a sensing floor of 0.3 mV, up to 22% of cardiac beats had a signal‐to‐noise ratio less than 2 in the RARing→ Ind configuration.

Conclusions: Results indicate that myopotential noise generated by performing maneuvers has a demonstrable impact on AER sensing. Therefore, noise mitigation processes are necessary in atrial automatic pacing capture verification algorithms based on evoked response signals to identify and appropriately manage noise. (PACE 2011; 34:460–466)
Neurocardiogenic Syncope Coexisting with Postural Orthostatic Tachycardia Syndrome in Patients Suffering from Orthostatic Intolerance: A Combined form of Autonomic Dysfunction
Authors: KANJWAL KHALIL , SHEIKH MUJEEB , KARABIN BEVERLY , KANJWAL YOUSUF , GRUBB BLAIR P.
Published: January 2011

Introduction: There is anecdotal evidence that one or more forms of orthostatic intolerance (OI) subgroups may coexist in the same patients. However, there is a paucity of published data on the clinical features and management of patients who suffer from coexisting features of postural tachycardia syndrome (POTS) and neurocardiogenic syncope (NCS). We herein present our experience of 18 patients who we found displayed evidence of coexisting NCS and POTS.

Methods: We reviewed charts of 300 POTS patients seen at the University of Toledo Syncope and Autonomic Disorders Center from 2003 to 2010 and found 18 patients eligible for inclusion in this study. Patients were included in this study if they reported clinical symptoms consistent with both POTS and NCS and then demonstrated a typical POTS pattern (a rise in heart rate without change in blood pressure [BP]) on head up tilt table (HUTT) within the first 10 minutes of upright posture followed by a neurocardiogenic pattern (a sudden fall in heart rate and/or fall in blood pressure) reproducing symptoms that were similar to the patients spontaneous episodes.

Results: We found 18 patients, mean age (30 ± 12), with 15 (84%) women and three (16%) men, who met the inclusion criterion for this study. Each of these 18 patients demonstrated a typical POTS pattern within the first 10 minutes on initial physical exam and on a HUTT. Continued tilting beyond 10 minutes resulted in a sudden decline in heart rate (which in some patients manifested as an asystole that lasted anywhere between 10 and 32 seconds [mean of 18 seconds]) and/or a fall in BP in each of these patients demonstrating a pattern consistent with neurocardiogenic subtype of OI. The mean time to the NCS pattern of a fall in BP and heart was 15 minutes with a range of 13–20 minutes. This group of patients was highly symptomatic and reported frequent clinical symptoms that were suggestive of OI. Recurrent presyncope, syncope, orthostatic palpitations, exercise intolerance, and fatigue were the principal symptoms reported.

Conclusion: NCS may coexist with POTS in a subgroup of patients suffering from OI. (PACE 2011; 34:549–554)
The Impact of the Right Ventricular Lead Position on Response to Cardiac Resynchronization Therapy
Authors: KHAN FAKHAR Z. , SALAHSHOURI PEGAH , DUEHMKE RUDY , READ PHILIP A. , PUGH PETER J. , ELSIK MAROS , BEGLEY DAVID , FYNN SIMON P. , DUTKA DAVID P. , VIRDEE MUNMOHAN S.
Published: January 2011

Introduction: Left ventricular (LV) lead placement to the latest contracting area (concordant LV lead) is associated with better response to cardiac resynchronization therapy (CRT) compared to a discordant LV lead. However, the effect of the right ventricular (RV) lead site on CRT response is unclear. We investigated the relationship of the RV and LV lead positions on CRT response.

Methods: In 131 CRT patients, the LV lead was positioned preferentially in a lateral or posterolateral vein and the RV lead to either the RV septum (RVS, n = 55) or RV apex (RVA, n = 76). The latest site of contraction was determined with two‐dimensional speckle tracking radial strain imaging and patients had a concordant LV lead position if pacing the latest segment, and discordant if not. Response was defined as ≥15% reduction in LV end systolic volume (LVESV) at 6‐month follow‐up.

Results: There were no significant differences in mean reduction of LVESV at follow‐up (RVS vs RVA: −23.3 ± 16% vs 22.1 ± 18%, P = 0.70) or rate of responders (58.2% vs 57.9%, P = 0.97) between the two groups. In patients with a concordant LV lead (n = 71), the response rate was significantly higher than those with a discordant lead (76.1% vs 36.7%, P < 0.001). There were no differences in outcomes in patients with a concordant or discordant LV lead according to the RV lead location.

Conclusion: The extent of LV reverse remodeling following CRT is not related to the RV lead position, but is significantly higher in patients with a concordant LV lead. (PACE 2011; 34:467–474)
Suppression of Storms of Ventricular Tachycardia by Epicardial Ablation of Isolated Delayed Potential in Noncompaction Cardiomyopathy
Authors: CHINUSHI MASAOMI , IIJIMA KENICHI , FURUSHIMA HIROSHI , IZUMI DAISUKE , SATO AKINORI , YAGIHARA NOBUE , HASEGAWA KANAE , WATANABE HIROSHI , SOEJIMA KYOKO , AIZAWA YOSHIFUSA
Published: January 2011

A 65‐year‐old recipient of an implantable cardioverter defibrillator suffering from ventricular noncompaction developed storms of ventricular tachycardia (VT). Epicardial voltage mapping revealed the presence of a large low‐voltage area in the left ventricular apical and inferoposterior wall, and isolated delayed potential was recorded over 1.5 cm in the posterior border between low and normal myocardial voltage. Pacemapping at the delayed potential recording site produced two different QRS depending on pacing output strength, and these two QRS morphologies were similar to clinically documented VTs. During one of the VTs, a mid‐diastolic potential was recorded from the site with the delayed potential, and rapid pacing produced concealed entrainment. After epicardial radiofrequency ablation of the isolated delayed potential, VTs were noninducible and the VT storm was suppressed.
Ventricular Tachyarrhythmias in Patients Receiving an Implantable Cardioverter‐Defibrillator for Primary versus Secondary Prophylaxis Indications
Authors: MANUCHEHRY AMIN , AGUSALA KARTIK , MONTEVECCHI MAURO , KADISH ALAN , PASSMAN ROD
Published: January 2011

Introduction: Data on the mechanisms of sudden cardiac death are limited and may be biased by delays in rhythm recording and selection bias in survivors. As a result, the relative contributions of monomorphic ventricular tachycardia (VT) (cycle length [CL] > 260 ms), monomorphic fast VT (FVT) (CL ≤ 260 ms), and polymorphic VT (PMVT)/ventricular fibrillation (VF) have not been well characterized nor compared in patients with and without prior arrhythmic events.

Methods: A retrospective cohort study of implantable cardioverter‐defibrillator (ICD) recipients with primary or secondary implant indications was used to evaluate intracardiac electrograms (EGMs) for the first spontaneous VT/VF resulting in appropriate ICD therapy. EGMs were categorized into VT, FVT, and PMVT/VF based on CL and morphologic criteria.

Results: Of 616 implants, 145 patients (58 [40%] primary indications) received appropriate ICD therapy for VT/VF over mean follow‐up of 3.8 ± 3.2 years. Primary implants had more diabetes (28% vs 12%; P = 0.02) and less antiarrhythmic use (15% vs 33%; P = 0.02). In those patients with spontaneous arrhythmia, PMVT/VF occurred in 20.7% of primary versus 21.8% of secondary implants, FVT in 19.0% versus 21.8%, and VT in 60.3% versus 56.4%, respectively (P = 0.88). Spontaneous VT CL was similar regardless of implant indication (284 ± 56 [primary] vs 286 ± 67 ms [secondary]; P = 0.92).

Conclusions: Monomorphic VT is the most common cause of appropriate ICD therapy regardless of implant indication. These results provide insight into the mechanisms of sudden cardiac death and have implications for the use of interventions designed to limit ICD shocks. (PACE 2011; 34:571–576)
Implantable Intravascular Defibrillator: Evaluation of Defibrillation Waveforms with Inferior Vena Cava Electrode System
Authors: SANDERS WILLIAM E. , MALKIN ROBERT A. , RICHEY MARK W. , MASSON STEPHEN C. , RANSBURY TERRANCE J. , URTZ MARK W. , IDEKER RAYMOND E.
Published: January 2011

Background: A percutaneously placed, totally intravascular defibrillator has been developed that shocks via a right ventricular (RV) single‐coil and titanium electrodes in the superior vena cava (SVC) and the inferior vena cava (IVC). This study evaluated the defibrillation threshold (DFT) with this electrode configuration to determine the effect of different biphasic waveform tilts and second‐phase durations as well as the contribution of the IVC electrode.

Methods: Eight Bluetick hounds (wt = 30–40 kg) were anesthetized and the RV coil (first‐phase anode) was placed in the RV apex. The intravascular defibrillator (PICD®, Model no. IIDM‐G, InnerPulse Inc., Research Triangle Park, NC, USA) was positioned such that the titanium electrodes were in the SVC and IVC
. Ventricular fibrillation was electrically induced and a Bayesian up‐down technique was employed to determine DFT with two configurations: RV to SVC + IVC and RV to SVC. Three waveform tilts (65%, 50%, and 42%) and two second‐phase durations (equal to the first phase [balanced] and truncated at 3 ms [unbalanced]) were randomly tested. The source capacitance of the defibrillator was 120 μF for all waveforms.

Results: DFT with the IVC electrode was significantly lower than without the IVC electrode for all waveforms tested (527 ± 9.3 V [standard error], 14.5 J vs 591 ± 7.4 V, 18.5 J, P < 0.001). Neither waveform tilt nor second‐phase duration significantly changed the DFT.

Conclusion: In canines, a totally intravascular implantable defibrillator with electrodes in the RV apex, SVC, and IVC had a DFT similar to that of standard nonthoracotomy lead systems. No significant effect was noted with changes in tilt or with balanced or unbalanced waveforms. (PACE 2011; 34:577–583)
Seeking Confirmation Is Rational for Deterministic Hypotheses
Authors: Austerweil Joseph L. , Griffiths Thomas L.
Published: January 2011

The tendency to test outcomes that are predicted by our current theory (the confirmation bias) is one of the best‐known biases of human decision making. We prove that the confirmation bias is an optimal strategy for testing hypotheses when those hypotheses are deterministic, each making a single prediction about the next event in a sequence. Our proof applies for two normative standards commonly used for evaluating hypothesis testing: maximizing expected information gain and maximizing the probability of falsifying the current hypothesis. This analysis rests on two assumptions: (a) that people predict the next event in a sequence in a way that is consistent with Bayesian inference; and (b) when testing hypotheses, people test the hypothesis to which they assign highest posterior probability. We present four behavioral experiments that support these assumptions, showing that a simple Bayesian model can capture people's predictions about numerical sequences (Experiments 1 and 2), and that we can alter the hypotheses that people choose to test by manipulating the prior probability of those hypotheses (Experiments 3 and 4).
Dose-related effects of venlafaxine on pCREB and brain-derived neurotrophic factor (BDNF) in the hippocampus of the rat by chronic unpredictable stress
Authors: Li Jing-Jing , Yuan Yong-Gui , Hou Gang , Zhang Xiang-Rong
Published: January 2011

Background: The molecular pathogenesis of depression and psychopharmacology of antidepressants remain elusive. Recent hypotheses suggest that changes in neurogenesis and plasticity may underlie the aetiology of depression. The hippocampus is affected by depression and shows neuronal remodelling during adulthood.

Objective: The present study on the adult rat hippocampus, was to evaluate the dose-related effects of chronic venlafaxine on the expression of brain-derived neurotrophic factor (BDNF) and phosphorylated cyclic-AMP response element binding protein (pCREB).

Methods: Sprague-Dawley rats were exposed to a variety of chronic unpredictable stressors (CUSs) to establish a depression model. Rats were treated for either 14 or 28 days with venlafaxine (5 and 10 mg/kg, respectively). The hippocampal expression of pCREB and BDNF mRNA and protein was assessed by using immunohistochemistry, western blotting and reverse transcription polymerase chain reaction (RT-PCR).

Results: Rats subjected to CUS procedure consumed less sucrose solution compared with non-stressed rats. The CUS influenced exploratory activity resulting in a reduction of the motility counts. Chronic low dose (5 mg/kg, 14 and 28 days), but not high dose (10 mg/kg, 14 and 28 days) of venlafaxine treatment increased the expression of pCREB and BDNF mRNA and protein in the CUS rat hippocampus.

Conclusion: Neuronal plasticity-associated proteins such as pCREB and BDNF play an important role both in stress-related depression and in antidepressant effect.
EVALUATION FOR ANTIBACTERIAL EFFECTS OF VOLATILE FLAVORS FROM CHRYSANTHEMUM INDICUM AGAINST FOOD‐BORNE PATHOGENS AND FOOD SPOILAGE BACTERIA
Authors: LEE J.H. , JANG M. , SEO J. , KIM G.H.
Published: January 2011

The antimicrobial activities of C. indicum‐essential oil and its components (thujone, chrysanthemyl alcohol, camphor, and γ‐terpinene) were examined with ten food‐borne pathogens. C. indicum‐essential oil showed the potent inhibition of growth for Listeria monocytogenes, Staphylococcus aureus, Aeromonas hydrophila, Salmonella choleraesuis, Shigella sonnei and Vibrio parahaemolyticus. MIC values for C. indicum‐essential oil were found to be the range of 1.25–10 µg/mL, and C. indicum‐essential oil inhibited very effectively the growth of B. cereus, S. aureus, A. hydrophilia, S. choleraesuis, S. enterica, S. sonnei, V. parahaemolyticus and V. vulnificus. MBC values of C. indicum‐essential oil was declined as the following order; A. hydrophilia < B. cereus, B. subtilis, V. parahaemolyticus < S. aureus, S. sonnei, V. vulnificus. A time‐killing curve exhibited a similar pattern against all tested foodborne pathogens. The exposure time of C. indicum‐essential oil for 50% bactericidal effect was in the range of 5.6–9.2 h. Antibacterial activities lasted throughout 24 h incubation. From the results for antibacterial activity of C. indicum‐essential oil against food spoilage bacteria and foodborne pathogens, it is anticipated that C. indicum‐essential oil has a great potential as food preservative.

PRACTICAL APPLICATIONS

Recently, the concerns for chemical food preservatives have been raised to customers, food companies, and whole food industry in a world. For this reason, many investigators have been tried to explore and develop the safe and natural food preservative. Some plant materials, especially essential oils, are used as natural antimicrobials in food systems traditionally. Investigating and providing the scientific evidence for antibacterial activity of essential oil will help suggest the alternatives for natural food preservative.
Is the Devil in the Data? A Literature Review of Piracy Around the World
Authors: Kariithi Nixon K.
Published: January 2011

This article examines the scholarly literature pertaining to music, film and software piracy around the world, with special attention to data sources, research scope and general findings. The article finds that the conspicuous absence of methodologies utilizing critical theory in this broad literature has constricted the world view of piracy, resulting in monolithic explanations of the causes and correlates of piracy. It further identifies systematic biases relating to the unjustified use of data published by the industry watchdog Business Software Alliance (BSA).
Pharmaceutical Innovation, Fair Following and the Constrained Value of TRIPS Flexibilities
Authors: Tetteh Ebenezer K.
Published: January 2011

The Trade‐Related Intellectual Property Rights (TRIPS) regime agreed by member nations of the World Trade Organization (WTO) provides public‐health‐protecting flexibilities to mitigate the negative externalities of diminished medicines access from cross‐country harmonization of patent protection. This article analyses the expected benefits from invoking TRIPS flexibilities taking into account the real social costs and constraints of doing so. It highlights the concept of fair following and discusses why the optimal public policy leans towards free‐riding by low‐income countries only. It compares the welfare effects of alternative models of fair following: selective use of TRIPS flexibilities and the bilateral dependence solution. Faced with externally imposed political and macroeconomic constraints, the article argues why the bilateral dependence solution offers an alternative means of creating a high‐volume low‐price purchasing process that is expected to improve access to both on‐patent and off‐patent medicines. It notes that there is no easy, costless set of policy choices for low‐income nations to follow. Even a policy choice of accepting bilateral trade deals (and using the bilateral dependence solution as a safety valve) may damage social identity trust (with fellow low‐income nations) and collective bargaining leverage; and unravel the aggregation of “implementation experiences” needed for reforming the TRIPS regime.
Health Education in Patients with a Recent Stroke or Transient Ischaemic Attack: A Comprehensive Review
Authors: Maasland Lisette , Brouwer-Goossensen Dorien , den Hertog Heleen M. , Koudstaal Peter J. , Dippel Diederik W.J.
Published: January 2011

Health education aims at the acquisition of skills and attitudes to modify behaviour that influences health, leads to a modification of risk factors and ultimately to a decrease in disability and case fatality from stroke. Health education is an underdeveloped but important aspect of stroke care. Health education could promote compliance and healthy behaviour, improve patients' understanding of their health status and treatment options and facilitate communication. We reviewed the effect of health education in stroke and transient ischaemic attack patients, aiming at feasibility, effectiveness at the level of knowledge, attitude and skills, health behaviour changes and stroke outcome. We also describe the current status of health education for patients with recent coronary artery disease and public health education in stroke. Basic knowledge of stroke and transient ischaemic attack patients of their disease and associated risk factors is not sufficient. This is also observed in patients with coronary artery disease and in the general population. A beneficial effect of health education in stroke and transient ischaemic attack patients on health behaviour, risk reduction or stroke outcome has not been proven. Trials in patients with coronary artery disease, however, have shown that health education could result in a change of lifestyle. No specific method is superior, although the individualised, repetitive and active methods appear more successful. More intervention studies of health education in stroke and transient ischaemic attack patients are needed. Future trials should be large, have a long follow-up, should use an intensive and repetitive approach and involve patients' relatives to induce and maintain a healthy lifestyle.