bluuebunny/crossref_metadata_2025 huggingface dataset:
THE PUZZLING DIVERGENCE OF RENTS AND USER COSTS, 1980–2004
Authors: Verbrugge Randal
Published: November 2008

This paper demonstrates that, in the context of U.S. housing data, rents and ex ante user costs diverge markedly—in both growth rates and levels—for extended periods of time, a seeming failure of arbitrage and a puzzle from the perspective of standard capital theory. The tremendous volatility of even appropriately‐smoothed ex ante annual user cost measures implies that such measures are unsuitable for inclusion in official price statistics. The divergence holds not only at the aggregate level, but at the metropolitan‐market level as well, and is robust across different house price and rent measures. But transactions costs matter: the large persistent divergences did not imply the presence of unexploited profit opportunities. In particular, even though detached housing is readily moved between owner and renter markets, and the detached‐unit rental market is surprisingly thick, transactions costs would have prevented risk‐neutral investors from earning expected profits by buying a property to rent out for a year, and would have prevented risk‐neutral homeowners from earning expected profits by selling their homes and becoming renters for a year. Finally, computing implied appreciation as a residual yields a house price forecast with huge errors; but either longer‐horizon or no‐real‐capital‐gains forecasts—which turn out to have similar forecast errors—imply a far less divergent user cost measure which might ultimately be useful for official price statistics. Some conjectures are offered.
Geographic color variation ofPhelotrupes auratus(Coleoptera, Geotrupidae) in the Kinki region, central Japan: A quantitative spectrophotometric analysis
Authors: AKAMINE Mayumi , MAEKAWA Kiyoto , KON Masahiro
Published: November 2008

We investigated geographic color variation of the beetlePhelotrupes auratusin the Kinki region of central Japan using a spectrophotometer. The reflectance spectrum of the dorsal surface of the elytron was measured for beetles collected from 23 sites. We focused on λmax(α), the wavelength at the peak (α peak) between 400 and 700 nm (human visual sensitivity range), for analyses of color variation. In populations distributed on the Kii Peninsula, in the southern part of the Kinki region, average λmax(α) values were lower (480–497 nm) than in populations distributed in the area west of Lake Biwa, the western part of the Kinki region (618–633 nm). For populations distributed in the areas south and southeast of Lake Biwa, a geographic cline of λmax(α) was observed approximately along an east–west transect, with average λmax values varying continuously from 624 to 557 nm. The easternmost populations along this cline had almost the same λmax(α) values as the populations distributed west of Lake Biwa. The coefficient of variation for λmax(α) tended to be larger in populations with intermediate averages than those with lower or higher average values.
Forty‐nine new host plant species for Bemisia tabaci (Hemiptera: Aleyrodidae)
Authors: SIMMONS Alvin M. , HARRISON Howard F. , LING Kai‐Shu
Published: November 2008

The sweetpotato whitefly, Bemisia tabaci (Gennadius), is a worldwide pest of numerous agricultural and ornamental crops. In addition to directly feeding on plants, it also acts as a vector of plant viruses of cultivated and uncultivated host plant species. Moreover, host plants can affect the population dynamics of whiteflies. An open‐choice screening experiment was conducted with B‐biotype B. tabaci on a diverse collection of crops, weeds, and other indigenous plant species. Five of the plant species were further evaluated in choice or no‐choice tests in the laboratory. The results reveal 49 new reproductive host plant species for B. tabaci. This includes 11 new genera of host plants (Arenaria, Avena, Carduus, Dichondra, Glechoma, Gnaphalium, Molugo, Panicum, Parthenocissus, Trianthema, and Triticum) for this whitefly. All species that served as hosts were acceptable for feeding, oviposition, and development to the adult stage by B. tabaci. The new hosts include three cultivated crops [oats (Avena sativa L.), proso millet (Panicum miliaceum L.), and winter wheat (Triticum aestivum L.)], weeds and other wild species, including 32 Ipomoea species, which are relatives of sweetpotato [I. batatas (L.) Lam.)]. Yellow nutsedge, Cyperus esculentus L., did not serve as a host for B. tabaci in either open‐choice or no‐choice tests. The results presented herein have implications for whitefly ecology and the numerous viruses that B. tabaci spreads to and among cultivated plants.
A new record, sperm bundle morphology and preliminary data on the breeding type of the ground beetle Jujiroa estriata Sasakawa (Coleoptera: Carabidae: Platynini)
Authors: SASAKAWA Kôji , TOKI Wataru
Published: November 2008

Jujiroa estriata Sasakawa (Coleoptera: Carabidae: Platynini) was recently described based on a single male from a mountain in Kyushu, southwest Japan (type locality: Hagi, Gokanoshô). Here we report collection of the species from a new locality, Mount Osuzuyama. We also describe some reproductive traits based on the materials obtained (one male and four females, collected in late May). The male formed sperm bundles in which the head of each spermatozoon was embedded in a rod‐shaped structure (spermatodesm). Each spermatodesm was elongate (average length 2.44 mm; cf. male body length 10.8 mm), without a conspicuous spiral structure. Three of the females were dissected, and were found to have 11 or 12 mature eggs in their oviducts. This study provides the first description of sperm bundle morphology for a species of the tribe Platynini and preliminary data on the breeding type of Jujiroa Uéno.
First record of Alysia alticola Ashmead (Hymenoptera: Braconidae) in the Neotropical region
Authors: SALVO Adriana , BATTÁN HORENSTEIN Moira
Published: November 2008

Alysia alticola Ashmead, 1890, is recorded for the first time in central Argentina, reared from pig carcasses. This is also the first mention of the genus Alysia Latreille, 1804, in Argentina, which represents the southernmost record in the Neotropical region.
Revisional notes on the genus Toxopoda Macquart (Diptera, Sepsidae) in the Oriental and Australasian regions
Authors: IWASA Mitsuhiro
Published: November 2008

I herein revise the genus Toxopoda Macquart of the Oriental and Australasian regions. A total of 16 species is discussed. Six new species are described: T. cavata sp. nov., T. angulata sp. nov., T. elephantina sp. nov., T. zuskai sp. nov., T. malayana sp. nov., and T. ozerovi sp. nov. The species T. contracta (Walker), T. viduata (Thomson) and T. simplex Iwasa, which can be easily confused with other species, are correctly redescribed and illustrated. Distributional notes and a key to the species of the Oriental and Australasian regions are provided.
Cytotoxin‐Associated Gene‐A – Positive Helicobacter pylori Strains Infection Increases the Risk of Recurrent Atherosclerotic Stroke
Authors: Diomedi Marina , Stanzione Paolo , Sallustio Fabrizio , Leone Giorgia , Renna Antonio , Misaggi Giulia , Fontana Carla , Pasqualetti Patrizio , Pietroiusti Antonio
Published: November 2008

Background: CagA‐positive Helicobacter pylori infection has been found to be associated with a first‐ever atherosclerotic stroke. The aim of this study was to investigate whether these strains represent an independent risk factor for recurrent atherosclerotic stroke.

Materials and Methods: We performed a longitudinal study of patients with a first‐ever large vessels stroke and resulted positive at H. pylori serology. Patients had clinical examination 1 month after the acute event, and were subsequently visited or contacted by telephone up to 3 years at 6‐month intervals. Sera obtained at the time of enrollment were frozen and analyzed for the presence of anti‐CagA antibodies at the end of the study. The primary outcome event was any fatal or nonfatal stroke after the index stroke.

Results: One hundred seventy H. pylori‐positive patients were included (n = 68 CagA positive and n = 102 CagA negative). No significant difference regarding age and other stroke risk factors was detected. According to Kaplan‐Meier survival analysis, CagA‐positive patients showed a significantly higher risk for stroke recurrence than CagA‐negative ones (45.6% vs 17.6%; p < .001). Difference in the rate of recurrent stroke between the two groups persisted after Cox regression analysis taking into account possible confounding factors (hazard ratio = 3.5; 95% CI = 1.9–6.4; p < .001).

Conclusions: Infection with H. pylori CagA‐positive strains increases the risk of recurrent atherosclerotic stroke. Seropositivity determination should be performed in order to identify high‐risk patients requiring a strict clinical surveillance, and the possible beneficial effect of eradication therapy should be evaluated.
Evaluation of Two Triple‐Therapy Regimens with Metronidazole or Clarithromycin for the Eradication of H. pylori Infection in Vietnamese Children: a Randomized, Double‐Blind Clinical Trial
Authors: Nguyen Thi Viet Ha , Bengtsson Carina , Nguyen Gia Khanh , Hoang Thi Thu Ha , Phung Dac Cam , Sörberg Mikael , Granström Marta
Published: November 2008

Background:  Eradication of Helicobacter pylori infection in children in developing countries needs further investigations upon which to base treatment recommendations. The aim of the study was to compare two 2‐week triple therapies in a randomized double‐blind trial.

Materials and Methods:  In order not to exceed recommended dosages, the 238 H. pylori‐infected children, aged 3 to 15 years (mean 8.6), were divided in two weight categories receiving at weights 13–22 kg: lansoprazole 15 mg once‐daily and amoxicillin 500 mg twice‐daily with metronidazole 250 mg twice‐daily or clarithromycin 250 mg once‐daily; at weights 23–45 kg: lansoprazole 15 mg and amoxicillin 750 mg with metronidazole 500 mg or clarithromycin 250 mg, all administered twice daily. H. pylori status was assessed by culture and a monoclonal‐based antigen‐in‐stool test (Premier Platinum HpSA PLUS) and side effects by structured questionnaires.

Results:  The overall per‐protocol eradication (n = 233) was similar in the two treatment regimens, 62.1% for the metronidazole and 54.7% for the clarithomycin‐containing therapy. Eradication rate was higher in children ≥ 23 kg (70.9%) than in children < 23 kg (45.7%). In children ≥ 23 kg (n = 117) that received twice‐daily administration of all drugs, efficacy of the methronidazole and clarithromycin‐containing treatments were 69.5% and 72.4%, respectively.

Conclusions:  The two treatments gave similar eradication rates. Significant differences for both treatments were found by weight, which could be the result of the once‐daily proton pump inhibitor and clarithromycin and/or more antibiotic resistant strains in younger children.
IL‐17 is Involved in Helicobacter pylori‐Induced Gastric Inflammatory Responses in a Mouse Model
Authors: Shiomi Satoshi , Toriie Akihiro , Imamura Shigeyoshi , Konishi Hideyuki , Mitsufuji Shoji , Iwakura Yoichiro , Yamaoka Yoshio , Ota Hiroyoshi , Yamamoto Toshiro , Imanishi Jiro , Kita Masakazu
Published: November 2008

Background:  Helicobacter pylori (H. pylori) is the major cause of chronic active gastritis and peptic ulcer disease. Recent studies have shown that H. pylori produces various cytokines that are related to neutrophil or mononuclear cell accumulation. Interleukin‐17 (IL‐17) is the founding member of an emerging family of inflammatory cytokines whose biological activities remain incompletely defined. In this study, the contributions of IL‐17 to the induction of gastric inflammation and to the protection from H. pylori infection were investigated using IL‐17 gene‐knockout (IL‐17−/–) mice.

Materials and Methods:  IL‐17−/–and wild‐type C57BL/6 mice were challenged with H. pylori CPY2052 (2 × 108 CFU/mL) and the histological and microbiological evaluation were carried out at specified times. IL‐17 and myeloperoxidase (MPO) protein levels in tissues were assayed in duplicate using ELISA kits.

Results:  In wild‐type mice, IL‐17 was undetected at baseline; however, the protein expression of IL‐17 was induced after infection with H. pylori. A severe infiltration of neutrophils appeared in the submucosa and the lamina propria in wild‐type mice. In contrast, the degree of neutrophil infiltration in IL‐17−/– mice was significantly lower than that in wild‐type mice. Although wild‐type mice infected with H. pylori showed drastically higher MPO activity compared with uninfected wild‐type mice, any significant increase in the enzyme activity was not revealed in infected IL‐17−/– mice. The number of H. pylori colonized in the stomach of IL‐17−/– mice was significantly lower than that of wild‐type mice from 1 to 6 months after infection.

Conclusions:  These results suggest that IL‐17 may play an important role in the inflammatory response to the H. pylori infection and ultimately influence the outcome of the H. pylori‐associated disease.
Systemic Immunization with Unadjuvanted Whole Helicobacter pylori Protects Mice Against Heterologous Challenge
Authors: Harbour Stacey N. , Every Alison L. , Edwards Stirling , Sutton Philip
Published: November 2008

Background:  Adjuvant‐free vaccines have many benefits, including decreased cost and toxicity. We examined the protective effect of systemic vaccination with adjuvant‐free formalin‐fixed Helicobacter pylori or bacterial lysate and the ability of this vaccine to induce protection against heterologous challenge.

Materials and Methods:  Mice were vaccinated subcutaneously with H. pylori 11637 lysate or formalin‐fixed bacteria, with or without ISCOMATRIXTM adjuvant, then orally challenged with H. pylori SS1. Serum was taken prior to challenge to examine specific antibody levels induced by the vaccinations, and protection was assessed by colony‐forming assay.

Results:  Vaccination with H. pylori 11637 lysate or formalin‐fixed bacteria delivered systemically induced significantly higher levels of Helicobacter‐specific serum IgG than the control, unvaccinated group and orally vaccinated group. After heterologous challenge with H. pylori SS1, all vaccinated groups had significantly lower levels of colonization compared with unvaccinated, control mice, regardless of the addition of adjuvant or route of delivery. Protection induced by systemic vaccination with whole bacterial preparations, without the addition of adjuvants, was only associated with a mild cellular infiltration into the gastric mucosa, with no evidence of atrophy.

Conclusions:  Subcutaneous vaccination using unadjuvanted formalin‐fixed H. pylori has the potential to be a simple, cost‐effective approach to the development of a Helicobacter vaccine. Importantly, this vaccine was able to induce protection against heterologous challenge, a factor that would be crucial in any human Helicobacter vaccine. Further studies are required to determine mechanisms of protection and to improve protective ability.
Natural Killer Cell Receptor+ T‐Lymphocytes in Normal and Helicobacter pylori‐Infected Human Gastric Mucosa
Authors: O’Keeffe Joan , Gately Carol M. , O'Donoghue Yvonne , Zulquernain Syed A. , Stevens Fiona M. , Moran Anthony P.
Published: November 2008

Background:  Helicobacter pylori infection is associated with development of chronic inflammation and infiltration of immune cells into the gastric mucosa. As unconventional T‐lymphocytes expressing natural killer cell receptors are considered to play central roles in the immune response against infection, a study investigating their frequencies in normal and H. pylori‐infected gastric mucosa was undertaken.

Materials and Methods:  Flow cytometry was used to quantify T‐cells expressing the natural killer cell markers CD161, CD56, and CD94 in freshly isolated lymphocytes from the epithelial and lamina propria layers of gastric mucosa. Thirteen H. pylori‐positive and 24 H. pylori‐negative individuals were studied.

Results:  CD94+ T‐cells were the most abundant (up to 40%) natural killer receptor‐positive T‐cell population in epithelial and lamina propria layers of H. pylori‐negative gastric mucosa. CD161+ T‐cells accounted for about one‐third of all T‐cells in both compartments, but the lowest proportion were of CD56+ T‐cells. Compared with H. pylori‐negative mucosa, in H. pylori‐infected mucosa the numbers of CD161+ T‐cells were significantly greater (p = .04) in the epithelium, whereas the numbers of CD56+ T‐cells were lower (p = .01) in the lamina propria. A minor population (< 2%) of T‐cells in both mucosal layers of H. pylori‐negative subjects were natural killer T‐cells, and whose proportions were not significantly different (p > .05) to those in H. pylori‐infected individuals.

Conclusions:  The predominance, heterogeneity, and distribution of natural killer cell receptor‐positive T‐cells at different locations within the gastric mucosa reflects a potential functional role during H. pylori infection and warrants further investigation.
H. pylori‐Induced Apoptosis in Human Gastric Cancer Cells Mediated via the Release of Apoptosis‐Inducing Factor from Mitochondria
Authors: Ashktorab Hassan , Dashwood Rod H. , Dashwood Mohaiza M. , Zaidi Syed I. , Hewitt Stephen M. , Green William R. , Lee Edward L. , Daremipouran Mohammadreza , Nouraie Mehdi , Malekzadeh Reza , Smoot Duane T.
Published: November 2008

Background and Aim:  Our previous study of Helicobacter pylori‐induced apoptosis showed the involvement of Bcl‐2 family proteins and cytochrome c release from mitochondria. Here, we examine the release of other factors from mitochondria, such as apoptosis‐inducing factor (AIF), and upstream events involving caspase‐8 and Bid.

Methods:  Human gastric adenocarcinoma (AGS) cells were incubated with a cagA‐positive H. pylori strain for 0, 3, 6, and 24 hours and either total protein or cytoplasmic, nuclear, and mitochondrial membrane fractions were collected.

Results:  Proteins were immunoblotted for AIF, Bid, polyadenosine ribose polymerase (PARP), caspase‐8, and β‐catenin. H. pylori activated caspase‐8, caused PARP cleavage, and attenuated mitochondrial membrane potential. A time‐dependent decrease in β‐catenin protein expression was detected in cytoplasmic and nuclear extracts, coupled with a decrease in β‐actin. An increase in the cytoplasmic pool of AIF was seen as early as 3 hours after H. pylori exposure, and a concomitant increase was seen in nuclear AIF levels up to 6 hours. A band corresponding to full‐length Bid was seen in both the cytoplasmic and the nuclear fractions of controls, but not after H. pylori exposure. Active AIF staining was markedly increased in gastric mucosa from infected persons, compared to uninfected controls.

Conclusion:  H. pylori might trigger apoptosis in AGS cells via interaction with death receptors in the plasma membrane, leading to the cleavage of procaspase‐8, release of cytochrome c and AIF from mitochondria, and activation of subsequent downstream apoptotic events, as reported previously for chlorophyllin. This is consistent with AIF activation that was found in the gastric mucosa of humans infected with H. pylori. Hence, the balance between apoptosis and proliferation in these cells may be altered in response to injury caused by H. pylori infection, leading to an increased risk of cancer.
A model of carbon evasion and sedimentation in temperate lakes
Authors: Hanson Paul C. , Pollard Amina I. , Bade Darren L. , Predick Katie , Carpenter Stephen R. , Foley Jonathan A.
Published: November 2008

Lakes process terrigenous carbon. The carbon load processed by lakes may partially offset estimates made for terrestrial net ecosystem exchange (NEE). The balance within lakes between carbon burial and evasion to the atmosphere determines whether lakes are net sinks or net sources of atmospheric carbon. Here we develop a model to study processing of both autochthonous and allochthonous carbon sources in lakes. We run the model over gradients of dissolved organic carbon (DOC) and total phosphorus (TP) concentrations found in the Northern Highlands Lake District of Wisconsin. In our model, lakes processed between 5 and 28 g C m−2  (watershed)  yr−1 derived from the watershed, which approximates one‐tenth of NEE for similar terrestrial systems without lakes. Most lakes were net heterotrophic and had carbon evasion in excess of carbon burial, making them net sources of carbon to the atmosphere. Only lakes low in DOC and moderate to high in TP were net autotrophic and net sinks of carbon from the atmosphere.
Corporate Carbon Performance Indicators
Authors: Hoffmann Volker H. , Busch Timo
Published: November 2008

The dependency on carbon‐based materials and energy sources and the emission of greenhouse gases have been recognized as major problems of the 21st century. Companies are central to the effort to grapple with these issues due to the large material flows they process and their capabilities for technological innovation. It is important, on the one hand, to determine the individual stake companies have in these issues and, on the other, to measure companies' performance. Since the results of studies thus far have been ambiguous, we define four comprehensive and systematic corporate carbon performance indicators: (1) Carbon intensity is physically oriented and represents a company's carbon use in relation to a business metric. (2) Carbon dependency illustrates the change in physical carbon performance within a given time period. (3) Carbon exposure reveals the financial implications of using and emitting carbon. (4) Carbon risk estimates the change in financial implications of carbon usage within a given time period. On the basis of these general definitions, we specify the indicators for a standardized application that can support two important stakeholders in their decision making: policy makers, who can include such information when evaluating current climate policies and formulating future ones, and investors and financial institutions, which can compare companies with respect to their carbon performance and corresponding financial effects.
Mandatory Disclosure and Operational Risk: Evidence from Hedge Fund Registration
Authors: BROWN STEPHEN , GOETZMANN WILLIAM , LIANG BING , SCHWARZ CHRISTOPHER
Published: November 2008

Mandatory disclosure is a regulatory tool intended to allow market participants to assess operational risk. We examine the value of disclosure through the controversial SEC requirement, since overturned, which required major hedge funds to register as investment advisors and file Form ADV disclosures. Leverage and ownership structures suggest that lenders and equity investors were already aware of operational risk. However, operational risk does not mediate flow‐performance relationships. Investors either lack this information or regard it as immaterial. These findings suggest that regulators should account for the endogenous production of information and the marginal benefit of disclosure to different investment clienteles.
The Geography of Block Acquisitions
Authors: KANG JUN‐KOO , KIM JIN‐MO
Published: November 2008

Using a large sample of partial block acquisitions, we examine the importance of geographic proximity in corporate governance and target returns. We find that block acquirers have a strong preference for geographically proximate targets and acquirers that purchase shares in such targets are more likely to engage in post‐acquisition target governance activities than are remote block acquirers. Moreover, the targets of these acquirers realize higher announcement returns and better post‐acquisition operating performance than do targets of other types of acquirers, particularly when they face greater information asymmetries.
How Does Size Affect Mutual Fund Behavior?
Authors: POLLET JOSHUA M. , WILSON MUNGO
Published: November 2008

If actively managed mutual funds suffer from diminishing returns to scale, funds should alter investment behavior as assets under management increase. Although asset growth has little effect on the behavior of the typical fund, we find that large funds and small‐cap funds diversify their portfolios in response to growth. Greater diversification, especially for small‐cap funds, is associated with better performance. Fund family growth is related to the introduction of new funds that hold different stocks from their existing siblings. Funds with many siblings diversify less rapidly as they grow, suggesting that the fund family may influence a fund's portfolio strategy.
Average Returns, B/M, and Share Issues
Authors: FAMA EUGENE F. , FRENCH KENNETH R.
Published: November 2008

The book‐to‐market ratio (B/M) is a noisy measure of expected stock returns because it also varies with expected cashflows. Our hypothesis is that the evolution of B/M, in terms of past changes in book equity and price, contains independent information about expected cashflows that can be used to improve estimates of expected returns. The tests support this hypothesis, with results that are largely but not entirely similar for Microcap stocks (below the 20th NYSE market capitalization percentile) and All but Micro stocks (ABM).
Limited Attention and the Allocation of Effort in Securities Trading
Authors: CORWIN SHANE A. , COUGHENOUR JAY F.
Published: November 2008

While limited attention has been analyzed in a variety of economic and psychological settings, its impact on financial markets is not well understood. In this paper, we examine individual NYSE specialist portfolios and test whether liquidity provision is affected as specialists allocate their attention across stocks. Our results indicate that specialists allocate effort toward their most active stocks during periods of increased activity, resulting in less frequent price improvement and increased transaction costs for their remaining assigned stocks. Thus, the allocation of effort due to limited attention has a significant impact on liquidity provision in securities markets.
The ECG Lead I Paradox in Cardiac Resynchronization Therapy
Authors: VAN GELDER BERRY M. , BRACKE FRANK A.
Published: November 2008

Background: In cardiac resynchronization therapy (CRT), the morphology of the QRS complex plays an important role in the determination of the pacing site and effectiveness of stimulation.

Patients and Methods: Review of the electrocardiograms (ECGs) of 737 patients with a CRT device showed a negative QRS complex in lead I during right ventricular (RV) pacing and a positive QRS complex during left ventricular (LV) pacing in four patients. The RV lead was positioned in the high RV septum and the coronary sinus leads in a posterior or postero‐lateral basal level. Reversed ECG lead or pacemaker lead connection, anodal RV stimulation, and scar tissue‐related depolarization abnormalities were excluded as possible causes.

Conclusion: Pacing from the high RV septum may rarely lead to a negative QRS complex and basal positions of the LV lead to a positive QRS complex in lead I during LV pacing. The lead I paradox becomes obvious when both phenomena, that are not interrelated, are present in the same patient.
Age‐Specific Differences in Women with Implantable Cardioverter Defibrillators: An International Multi Center Study
Authors: VAZQUEZ LAUREN D. , KUHL EMILY A. , SHEA JULIE BISHOP , KIRKNESS ANN , LEMON JIM , WHALLEY DAVID , CONTI JAMIE B. , SEARS SAMUEL F.
Published: November 2008

Background: Common psychological adjustment difficulties have been identified for groups of implantable cardioverter defibrillator patients, such as those who are young (<50 years old), have been shocked, and are female. Specific aspects and concerns, such as fears of death or shock and body image concerns, that increase the chance of distress, have not been examined in different aged female implantable cardioverter defibrillator (ICD) recipients. The aim of the study was to investigate these areas of adjustment across three age groups of women from multiple centers.

Methods: Eighty‐eight female ICD patients were recruited at three medical centers: Shands Hospital at the University of Florida, Brigham and Women's Hospital in Boston, and Royal North Shore Hospital in Sydney, Australia. Women completed individual psychological assessment batteries, measuring the constructs of shock anxiety, death anxiety, and body image concerns. Medical record review was conducted for all patients regarding cardiac illnesses and ICD‐specific data.

Results: Multivariate and univariate analyses of variance revealed that younger women reported significantly higher rates of shock and death anxiety (Pillai's F = 3.053, P = 0.018, η2p= 0.067) and significantly greater body image concerns (Pillai's F = 4.198, P = 0.018, η2p= 0.090) than middle‐ and older‐aged women.

Conclusions: Women under the age of 50 appear to be at greater risk for the development of psychosocial distress associated with shock anxiety, death anxiety, and body image. Clinical‐based strategies and interventions targeting these types of adjustment difficulties in younger women may allow for improved psychosocial and quality of life outcomes.
Analysis during Sinus Rhythm and Ventricular Pacing of Reentry Circuit Isthmus Sites in Right Ventricular Cardiomyopathy
Authors: REITHMANN CHRISTOPHER , ULBRICH MICHAEL , HAHNEFELD ANTON , HUBER ARMIN , MATIS TOMAS , STEINBECK GERHARD
Published: November 2008

Background: The entrainment mapping algorithm is used for ablation of ventricular tachycardia (VT) in right ventricular (RV) cardiomyopathy, but ablation at endocardial isthmus sites has only a moderate success rate. This study was performed to identify additional local electrogram characteristics associated with successful ablation.

Patients and Methods: Using entrainment mapping, 45 reentry circuit isthmus sites were detected in 11 patients with RV cardiomyopathy presenting with 13 monomorphic VTs. Local bipolar electrograms were retrospectively analyzed at reentry circuit isthmus sites during VT, sinus rhythm, and programmed stimulation from the right ventricular apex (RVA), and compared between successful and unsuccessful ablation sites.

Results: Ablation was successful at 10 reentry circuit isthmus sites and unsuccessful at 35 isthmus sites. During VT, a longer endocardial activation time relative to QRS onset, an increased electrogram‐QRS interval as a percentage of VT cycle length, and a longer electrogram duration were found at successful in comparison to unsuccessful ablation sites. The presence of isolated diastolic potentials during sinus rhythm at reentry circuit isthmus sites, consistent with slow conduction or unidirectional conduction block, was associated with successful catheter ablation. Prolongation of the duration of the local multipotential electrogram by >100 ms during programmed RVA pacing at reentry circuit exit sites, indicating functional conduction disorder was also a marker of successful ablation.

Conclusions: The demonstration of multipotential electrogram characteristics indicating fixed or functional conduction block may increase the likelihood of successful VT ablation at exit and central isthmus sites of reentry circuits in RV cardiomyopathy.
Experimental Measures of Ventricular Activation and Synchrony
Authors: SUTHERLAND DAVID R. , NI QUAN , MacLEOD ROB S. , LUX ROBERT L. , PUNSKE BONNIE B.
Published: November 2008

Background:A widened QRS complex as a primary indication for cardiac resynchronization therapy (CRT) for heart failure patients has been reported to be an inconsistent indicator for dyssynchronous ventricular activation. The purpose of this study was to conduct a detailed experimental investigation of total ventricular activation time (TVAT), determine how to measure it accurately, and compare it to the commonly used measure of QRS width. In addition, we investigated a measure of electrical synchrony and determined its relationship to the duration of ventricular activation.

Methods:Unipolar electrograms (EGs) were recorded from the myocardial volume using plunge needle electrodes, from the epicardial surface using “sock” electrode arrays, and from the surface of an electrolytic torso‐shaped tank. EGs were analyzed to determine a root mean square (RMS)‐based measure of ventricular activation and electrical ventricular synchrony.

Results:The RMS‐based technique provided an accurate means of measuring TVAT from unipolar EGs recorded from the heart, the entire tank surface, or the precordial leads. In normal canine hearts, a quantification of ventricular electrical synchrony (VES) for normal ventricular activation showed that the ventricles activate, on average, within 3 ms of each other with the left typically activating first.

Conclusion:Conclusions from this study are: (1) ventricular activation was reflected accurately by the RMS width obtained from direct cardiac measurements and from precordial leads on the tank surface and (2) VES was not strongly correlated with TVAT.
Long‐term Follow‐up of P‐wave Duration and Dispersion in Patients with Mitral Stenosis
Authors: GUNTEKIN UNAL , GUNES YILMAZ , TUNCER MUSTAFA , GUNES AHMET , SAHIN MUSA , SIMSEK HAKKI
Published: November 2008

Background: Patients with mitral stenosis have prolonged P‐wave duration and increased P‐wave dispersion (PWD) that have been associated with increased risk for atrial fibrillation.

Methods: Thirty mild‐to‐moderate mitral stenosis patients were followed for 38.4 ± 10.7 (23–48) months. Baseline and last 12‐lead electrocardiographic and transthoracic echocardiographic measurements were evaluated. Maximum and minimum P‐wave durations (Pmax and Pmin) and PWD were calculated.

Results: Pmax and PWD were significantly higher in patients compared to control group. Left atrial (LA) size, mitral gradient, and pulmonary artery systolic pressure (PASP) were significantly increased and mitral valve area (MVA) was decreased during follow‐up. There were significant increases in Pmax and PWD and significant decrease in Pmin (Pmax: 101.0 ± 12.5 ms vs 105.0 ± 16.5 ms, P = 0.005; Pmin: 59.3 ± 8.5 ms vs 55.0 ± 12.3 ms P = 0.004; PWD: 41.7 ± 5.5 ms vs 50.0 ± 6.2 ms, P < 0.001). Baseline Pmax, Pmin, and PWD were significantly correlated with MVA (Pmax: r =−0.605, P < 0.001, Pmin: r =−0.632, P < 0.001, PWD: r =−0.402, P = 0.0028) and mean mitral gradient (Pmax: r = 0.412, P = 0.024, Pmin: r = 0.632, P = 0.049, PWD: r = 0.378, P = 0.039). In addition to MVA and mean mitral gradient follow‐up P‐wave variables were significantly correlated with LA size (Pmax: r = 0.573, P = 0.001, Pmin: r = 0.636, P = 0.001, PWD: r = 0.265, P = 0.046) and PASP (Pmax: r = 0.462, P = 0.011, Pmin: r = 0.472, P = 0.008 PWD: r = 0.295, P = 0.047).

Conclusions: P‐wave duration and PWD increase progressively in accordance with the progression of mitral stenosis.
Noninvasive Imaging in Cardiac Resynchronization Therapy—Part 2: Follow‐up and Optimization of Settings
Authors: YPENBURG CLAUDIA , VAN DE VEIRE NICO , WESTENBERG JOS J. , BLEEKER GABE B. , MARSAN NINA AJMONE , HENNEMAN MAUREEN M. , VAN DER WALL ERNST E. , SCHALIJ MARTIN J. , ABRAHAM THEODORE P. , BAROLD S. SERGE , BAX JEROEN J.
Published: November 2008

Cardiac resynchronization therapy (CRT) has become a therapeutic option for drug‐refractory heart failure. Several noninvasive imaging techniques play an increasingly important role before and after device implantation. This review highlights the acute and long‐term CRT benefits after implantation as assessed with echocardiography and nuclear imaging. Furthermore, optimization of CRT settings, in particular atrioventricular and interventricular delay, will be discussed using echocardiography and other (device‐based) techniques.
Prospective Study of Cardiac Sarcoid Mimicking Arrhythmogenic Right Ventricular Dysplasia
Authors: VASAIWALA SMIT C. , FINN CYNTHIA , DELPRIORE JEANNE , LEYA FRED , GAGERMEIER JAMES , AKAR JOSEPH G. , SANTUCCI PETER , DAJANI KHALED , BOVA DAVIDE , PICKEN MARIA M. , BASSO CRISTINA , MARCUS FRANK , WILBER DAVID J.
Published: November 2008

Introduction:
Case studies indicate that cardiac sarcoid may mimic the clinical presentation of arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C); however, the incidence and clinical predictors to diagnose cardiac sarcoid in patients who meet International Task Force criteria for ARVD/C are unknown.

Methods and Results:
Patients referred for evaluation of left bundle branch block (LBBB)‐type ventricular arrhythmia and suspected ARVD/C were prospectively evaluated by a standardized protocol including right ventricle (RV) cineangiography‐guided myocardial biopsy. Sixteen patients had definite ARVD/C and four had probable ARVD/C. Three patients were found to have noncaseating granulomas on biopsy consistent with sarcoid. Age, systemic symptoms, findings on chest X‐ray or magnetic resonance imaging (MRI), type of ventricular arrhythmia, RV function, ECG abnormalities, and the presence or duration of late potentials did not discriminate between sarcoid and ARVD/C. Left ventricular dysfunction (ejection fraction <50%) was present in 3/3 patients with cardiac sarcoid, but only 2/17 remaining patients with definite or probable ARVD/C (P = 0.01).

Conclusions:
In this prospective study of consecutive patients with suspected ARVD/C evaluated by a standard protocol including biopsy, the incidence of cardiac sarcoid was surprisingly high (15%). Clinical features, with the exception of left ventricular dysfunction and histological findings, did not discriminate between the two entities.
Predicting Recurrence of Vasovagal Syncope: A Simple Risk Score for the Clinical Routine
Authors: AYDIN MUHAMMET A. , MAAS RENKE , MORTENSEN KAI , STEINIG TOBIAS , KLEMM HANNO , RISIUS TIM , MEINERTZ THOMAS , WILLEMS STEPHAN , MORILLO CARLOS A. , VENTURA RODOLFO
Published: November 2008

Background:
Predictors for recurrence of syncope are lacking in patients with vasovagal syncope. The aim of this study was to identify risk factors for recurrence of syncope and develop a simple prognostic risk score of clinical value.

Methods:
Two hundred seventy‐six patients with a history of vasovagal syncope were prospectively followed for 2 years. Diagnosis of vasovagal syncope was based on clinical history and negative standard work‐up. Inclusion in the study was independent from the result of the head‐up tilt test, which was performed in all cases. Risk factors for syncope recurrence were evaluated by the Cox proportional hazards regression model and implemented in a risk score, which was validated with the log‐rank test and an internal cross‐validation.

Results:
The Cox‐regression analysis identified the number of previous syncopal events, history of bronchial asthma, and female gender as predictors for syncope recurrence (all P < 0.05). In contrast, head‐up tilt test response had no predictive value (P = 0.881). Developing a risk score, study patients were identified as having high (recurrence rate during 2 years of follow‐up: 37.2%), intermediate (24.8%), and low (6.5%) risk for syncope recurrence (receiver operating characteristic [ROC] of score 0.83, P < 0.01; Log‐rank test for event‐free survival, P < 0.005).

Conclusions:
In patients with vasovagal syncope, risk of recurrence can be stratified and is predictable based on a simple risk score.
Relationship Between Catheter Forces, Lesion Characteristics, “Popping,” and Char Formation: Experience with Robotic Navigation System
Authors: DI BIASE LUIGI , NATALE ANDREA , BARRETT CONOR , TAN CARMELA , ELAYI CLAUDE S. , CHING CHI KEONG , WANG PAUL , AL‐AHMAD AMIN , ARRUDA MAURICIO , BURKHARDT J. DAVID , WISNOSKEY BRIAN J. , CHOWDHURY PUNAM , DE MARCO SHARI , ARMAGANIJAN LUCIANA , LITWAK KENNETH N. , SCHWEIKERT ROBERT A. , CUMMINGS JENNIFER E.
Published: November 2008

Introduction:
Popping, char and perforation are complications that can occur following catheter ablation. We measured the amount of grams (g) applied to the endocardium during ablation using a sensor incorporated in the long sheath of a robotic system. We evaluated the relationship between lesion formation, pressure, and the development of complications.

Methods:
Using a robotic navigation system, lesions were placed in the left atrium (LA) at six settings, using a constant duration (40 seconds) and flow rate of either 17 cc/min or 30 cc/min with an open irrigated catheter (OIC). Evidence of complications was noted and lesion location recorded for later analysis at necropsy.

Results:
Lesions using 30 Watts (W) were more likely to be transmural at higher (>40 g) than lower (<30 g) pressures (75% vs 25%, P < 0.001). Significantly higher number of lesions using >40 g of pressure demonstrated “popping” and crater formation as compared with lesions with 20–30 g of pressure (41% vs 15%, P = 0.008). A majority of lesions placed using higher power (45 W) with higher pressures (>40 g) were associated with char and crater formation (66.7%). No lesions using 10 g of pressure were transmural, regardless of the power. Lesions placed with a power setting less than 35 W were more likely to result in “relative” sparing of the endocardial surface than lesions at a power setting higher than 35 W (62% vs 33.3%, P = 0.02) regardless of the pressure.

Conclusions:
When using an OIC, lower power settings (≤35 W) and lower/medium contact pressure were more likely to show a “relative” spared endocardial surface. Overall, contact pressure between 20 g and 30 g and a power setting of 40 W appeared to achieve transmurality by preserving safety.
A Rare Clinical Entity: Ventricular Septal Rupture with Right Ventricular Wall Dissection after Inferior Myocardial Infarction
Authors: Ari Hasan , Tiryakioglu Osman , Ari Selma , Bozat Tahsin , Koca Vedat
Published: November 2008

Right ventricular wall dissection following ventricular septal rupture related to inferior myocardial infarction has been reported in a few cases. In most of the cases, right ventricular wall dissection was diagnosed in postmortem studies. Herein, we present a 68‐year‐old man who had a ventricular septal rupture with right ventricular wall dissection after inferior myocardial infarction. Early recognition of this complication with bedside transthoracic echocardiography and prompt surgical repair are key to achieving survival in these patients.
Platypnea‐Orthodeoxia Syndrome Associated with Patent Foramen Ovale and Aortic Ectasia
Authors: Kusunose Kenya , Yamada Hirotsugu , Todoroki Takashi , Nishio Susumu , Niki Toshiyuki , Yamaguchi Koji , Koshiba Kunihiko , Yagi Shusuke , Iwase Takashi , Soeki Takeshi , Wakatsuki Tetsuzo , Akaike Masashi , Kitagawa Tetsuya , Sata Masataka
Published: November 2008

A 59‐year‐old man was admitted for dyspnea on exertion and edema. The patient did not have any pulmonary diseases that could cause dyspnea. Transesophageal echocardiography on the tilting bed with contrast infusion revealed a right‐to‐left shunt through the patent foramen ovale. Therefore, he was diagosed as platypnea‐orthodeoxia syndrome due to the patent foramen ovale. Surgical closure was done and all of his symptoms had improved.
Patent Foramen Ovale Not So Patent
Authors: López‐Haldón José , López‐Pardo Francisco , Rodríguez‐Puras María J. , Martínez‐Martínez Ángel
Published: November 2008

Transesophageal echocardiography (TEE) with agitated saline contrast is the most sensitive tool for diagnosing patent foramen ovale (PFO), but false positives can result. We report a patient who underwent a TEE during the study of a cryptogenic stroke. Contrast appeared in the left atrium with the Valsalva maneuver. However, the contrast exit site was not identified, and contrast continued to appear with Valsalva once the saline microbubbles had disappeared. Combined with the contrast characteristics, this suggested a spontaneous contrast phenomenon rather than a PFO. This phenomenon must be kept in mind to avoid overdiagnosing PFO.
Severity of personality disorders and suicide attempt
Authors: Blasco‐Fontecilla H. , Baca‐Garcia E. , Dervic K. , Perez‐Rodriguez M. M. , Saiz‐Gonzalez M. D. , Saiz‐Ruiz J. , Oquendo M. A. , De Leon J.
Published: November 2008

Objective:  Severity of personality disorders (PDs) may be more useful in estimating suicide risk than the diagnosis of specific PDs. We hypothesized that suicide attempters with severe PD would present more attempts and attempts of greater severity/lethality.

Method:  Four hundred and forty‐six suicide attempters were assessed. PD diagnosis was made using the International Personality Disorder Questionnaire – Screening Questionnaire. PDs were classified using Tyrer and Johnson’s classification of severity (no PD, simple PD, diffuse PD). Severity/lethality of attempts was measured with the Suicide Intent Scale, Risk‐Rescue Rating Scale and Lethality Rating Scale.

Results:  Attempters with severe (diffuse) PD had more attempts than the other groups. After controlling for age and gender, this difference remained significant only for the younger age group and women. There was no relationship between severity of PDs and severity/lethality of attempts.

Conclusion:  Younger female attempters with severe PD are prone to repeated attempts. However, the severity of PD was not related to the severity/lethality of suicide attempts.
Implant–abutment interface design affects fatigue and fracture strength of implants
Authors: Steinebrunner Lars , Wolfart Stefan , Ludwig Klaus , Kern Matthias
Published: November 2008

Objectives: Failures of implant–abutment connections are relatively frequent clinical problems. The aim of this study was to evaluate the influence of long‐term dynamic loading on the fracture strength of different implant–abutment connections.

Material and methods: Six implant systems were tested: two systems with external connections (Brånemark, Compress) and four systems with internal connections (Frialit‐2, Replace‐Select, Camlog, Screw‐Vent). Fracture strength was tested in two subgroups for each system: one subgroup with (dyn) and the other without prior dynamic loading (contr). Each subgroup consisted of eight specimens with standard implant–abutment combinations for single molar crowns. Dynamic loading was performed in a two‐axis chewing simulator with 1,200,000 load cycles at 120 N.

Results: Median fracture strengths in Newton (N) and 25th and 75th percentiles [in brackets] were: Brånemark: dyn=729 [0;802]/contr=782 [771;811], Frialit‐2: dyn=0 [0;611]/contr=887 [798;941], Replace‐Select: dyn=1439 [1403;1465]/contr=1542 [1466;1623], Camlog: dyn=1482 [1394;1544]/contr=1467 [1394;1598], Screw‐Vent: dyn=0 [0;526]/contr=780 [762;847] and Compress: dyn=818[0;917]/contr=1008 [983;1028]. In some dyn subgroups, failures of the implant–abutment connection occurred already during dynamic loading: three specimens of the Brånemark and Compress groups and six specimens of the Screw‐Vent and the Frialit‐2 groups failed during dynamic loading. Statistically significant differences (P≤0.05) in fracture strength could be found between groups with different connection designs.

Conclusion: Implant systems with long internal tube‐in‐tube connections and cam–slot fixation showed advantages with regard to longevity and fracture strength compared with systems with shorter internal or external connection designs.