bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in 20S subunit composition are largely responsible for altered proteasomal activities in experimental autoimmune encephalomyelitis
Authors: Zheng Jianzheng , Dasgupta Anushka , Bizzozero Oscar A.
Published: February 2012

J. Neurochem. (2012) 121, 486–494.

We recently reported that the proteasomal peptidase activities are altered in the cerebellum of mice with myelin oligodendrocyte glycoprotein (MOG) peptide‐induced experimental autoimmune encephalomyelitis (EAE). To determine whether these fluctuations are caused by proteasome activation/inactivation and/or changes in the levels of individual β subunits, we characterized the proteasome subunit composition by western blotting. The results show that the rise in proteasomal peptidase activity in acute EAE correlates with an augmented expression of inducible β subunits whereas the decline in activity in chronic EAE correlates with a reduction in the amount of standard β subunits. Using pure standard (s) and immuno (i) 20S particles for calibration, we determined that the changes in the levels of catalytic subunits account for all of the fluctuations in peptidase activities in EAE. The i‐20S and s‐20S proteasome were found to degrade carbonylated β‐actin with similar efficiency, suggesting that the amount of protein carbonyls in EAE may be controlled by the activity of both core particles. We also found an increase in proteasome activator 11S regulatory particle and a decrease in inhibitor proteasome inhibitor with molecular mass of 31 kDa levels in acute EAE, reflecting a response to inflammation. Elevated levels of 19S regulatory particle and 11S regulatory particle in chronic EAE, however, may occur in response to diminished proteasomal activity in this phase. These findings are central towards understanding the altered proteasomal physiology in inflammatory demyelinating disorders.
Parental and genetic factors rather than nesting forest patch size affect physiological traits of offspring in an area‐sensitive passerine: an experimental study
Authors: LE TORTOREC ERIC , HELLE SAMULI , SUORSA PETRI , HAKKARAINEN HARRI
Published: February 2012

Our understanding of the effects of habitat loss on individual performance is limited due to a lack of experimental studies that take the potential genetic and parental effects producing phenotypic variation into consideration. To assess the relative role of habitat loss on offspring phenotype while controlling for the confounding effects of genetic and parental variation we performed a partial cross‐fostering experiment using the Eurasian Treecreeper Certhia familiaris. The experiment was carried out by swapping half the nestlings in a brood between small and large nesting forest patches to determine the effect of nesting forest patch size on five nestling traits reflecting morphological size, body condition, physiological stress and inflammation status. There was no effect of nesting forest patch size on the offspring traits examined. Instead, we found evidence of genetic and early parental effects on all traits except inflammation status, as well as parental effects after cross‐fostering for all of the measured offspring traits. Our results suggest that genetic and parental effects should be taken into account when making inferences about species’ responses to habitat loss.
Sensory and demographic characteristics of deafblindness rehabilitation clients in Montréal, Canada
Authors: Wittich Walter , Watanabe Donald H , Gagné Jean‐Pierre
Published: February 2012

Citation information: Wittich W, Watanabe DH & Gagné J‐P. Sensory and demographic characteristics of deafblindness rehabilitation clients in Montréal Canada. Ophthalmic Physiol Opt 2012, 32, 242–251. doi: 10.1111/j.1475‐1313.2012.00897.x

Purpose:  Demographic changes are increasing the number of older adults with combined age‐related vision and hearing loss, while medical advances increase the survival probability of children with congenital dual (or multiple) impairments due to pre‐maturity or rare hereditary diseases. Rehabilitation services for these populations are highly in demand since traditional uni‐sensory rehabilitation approaches using the other sense to compensate are not always utilizable. Very little is currently known about the client population characteristics with dual sensory impairment. The present study provides information about demographic and sensory variables of persons in the Montreal region that were receiving rehabilitation for dual impairment in December 2010. This information can inform researchers, clinicians, educators, as well as administrators about potential research and service delivery priorities.

Method:  A chart review of all client files across the three rehabilitation agencies that offer integrated dual sensory rehabilitation services in Montreal provided data on visual acuity, visual field, hearing detection thresholds, and demographic variables.

Results:  The 209 males and 355 females ranged in age from 4 months to 105 years (M = 71.9, S.D. = 24.6), indicating a prevalence estimate for dual sensory impairment at 15/100 000. Only 5.7% were under 18 years of age, while 69.1% were over the age of 65 years, with 43.1% over the age of 85 years. The diagnostic combination that accounted for 31% of the entire sample was age‐related macular degeneration with presbycusis. Their visual and auditory measures indicated that older adults were likely to fall into moderate to severe levels of impairment on both measures. Individuals with Usher Syndrome comprised 20.9% (n = 118) of the sample.

Conclusion:  The age distribution in this sample of persons with dual sensory impairment indicates that service delivery planning will need to strongly consider the growing presence of older adults as the baby‐boomers approach retirement age. The distribution of their visual and auditory limits indicates that the large majority of this client group has residual vision and hearing that can be maximized in the rehabilitation process in order to restore functional abilities and social participation. Future research in this area should identify the specific priorities in both rehabilitation and research in individuals affected with combined vision and hearing loss.
Using Google Maps to collect spatial responses in a survey environment
Authors: Bearman Nick , Appleton Katy
Published: February 2012

This paper examines the use of Google Maps‐based tools to collect spatial responses from participants during academic research surveys conducted via the internet. Google Maps is regularly used for presenting data to users, but it is less common to ask users to provide their own spatial information as a questionnaire response. Using two recent examples from the University of East Anglia, the article discusses the online survey context and Google Maps’ place within it, issues surrounding the technical implementation of these tools, and processing and use of the collected data. It also considers how this type of methodology can be recorded in a manner compatible with the concept of reproducible research, and concludes with considerations for future researchers wishing to employ similar methods.
Hospital Volume and Mortality of Very Low‐Birthweight Infants in South America
Authors: Wehby George L. , Lopez‐Camelo Jorge , Castilla Eduardo E.
Published: February 2012

Objective

To assess the effects of hospital volume of very low‐birthweight (VLBW) infants on in‐hospital mortality of VLBW and very preterm birth (VPB) infants in South America.

Data Sources/Study Setting

Birth‐registry data for infants born in 1982–2008 at VLBW or very preterm in 66 hospitals in Argentina, Brazil, and Chile.

Design

Regression analyses that adjust for several individual‐level demographic, socioeconomic, and health factors; hospital‐level characteristics; and country‐fixed effects are employed.

Data Collection/Extraction Methods

Physicians interviewed mothers before hospital discharge and abstracted hospital medical records using similar methods at all hospitals.

Principal Findings

Volume has significant nonlinear beneficial effects on VLBW and VPB in‐hospital survival. The largest survival benefits––more than 80 percent decrease in mortality rates––are with volume increases from low to medium or medium‐high levels (from ≤25 to 72 infants annually) with significantly lower incremental benefits thereafter. The cumulative volume effects are maximized at the 121–144 annual VLBW infant range––about 90 percent decrease in mortality rates compared to <25 VLBW infants annually.

Conclusions

Increasing the access of pregnancies at‐risk of VLBW and VPB to medium‐ or high‐volume hospitals up to 144 VLBW infants per year may substantially improve in‐hospital infant survival in the study countries.
Measuring Racial/Ethnic Disparities in Health Care: Methods and Practical Issues
Authors: Cook Benjamin Lê , McGuire Thomas G. , Zaslavsky, Alan M.
Published: February 2012

Objective

To review methods of measuring racial/ethnic health care disparities.

Study Design

Identification and tracking of racial/ethnic disparities in health care will be advanced by application of a consistent definition and reliable empirical methods. We have proposed a definition of racial/ethnic health care disparities based in the Institute of Medicine's (IOM) Unequal Treatment report, which defines disparities as all differences except those due to clinical need and preferences. After briefly summarizing the strengths and critiques of this definition, we review methods that have been used to implement it. We discuss practical issues that arise during implementation and expand these methods to identify sources of disparities. We also situate the focus on methods to measure racial/ethnic health care disparities (an endeavor predominant in the United States) within a larger international literature in health outcomes and health care inequality.

Empirical Application

We compare different methods of implementing the IOM definition on measurement of disparities in any use of mental health care and mental health care expenditures using the 2004–2008 Medical Expenditure Panel Survey.

Conclusion

Disparities analysts should be aware of multiple methods available to measure disparities and their differing assumptions. We prefer a method concordant with the IOM definition.
The gasotransmitter hydrogen sulphide decreases Na+ transport across pulmonary epithelial cells
Authors: Althaus M , Urness KD , Clauss WG , Baines DL , Fronius M
Published: February 2012

BACKGROUND AND PURPOSE The transepithelial absorption of Na+ in the lungs is crucial for the maintenance of the volume and composition of epithelial lining fluid. The regulation of Na+ transport is essential, because hypo‐ or hyperabsorption of Na+ is associated with lung diseases such as pulmonary oedema or cystic fibrosis. This study investigated the effects of the gaseous signalling molecule hydrogen sulphide (H2S) on Na+ absorption across pulmonary epithelial cells.

EXPERIMENTAL APPROACH Ion transport processes were electrophysiologically assessed in Ussing chambers on H441 cells grown on permeable supports at air/liquid interface and on native tracheal preparations of pigs and mice. The effects of H2S were further investigated on Na+ channels expressed in Xenopus oocytes and Na+/K+‐ATPase activity in vitro. Membrane abundance of Na+/K+‐ATPase was determined by surface biotinylation and Western blot. Cellular ATP concentrations were measured colorimetrically, and cytosolic Ca2+ concentrations were measured with Fura‐2.

KEY RESULTS H2S rapidly and reversibly inhibited Na+ transport in all the models employed. H2S had no effect on Na+ channels, whereas it decreased Na+/K+‐ATPase currents. H2S did not affect the membrane abundance of Na+/K+‐ATPase, its metabolic or calcium‐dependent regulation, or its direct activity. However, H2S inhibited basolateral calcium‐dependent K+ channels, which consequently decreased Na+ absorption by H441 monolayers.

CONCLUSIONS AND IMPLICATIONS H2S impairs pulmonary transepithelial Na+ absorption, mainly by inhibiting basolateral Ca2+‐dependent K+ channels. These data suggest that the H2S signalling system might represent a novel pharmacological target for modifying pulmonary transepithelial Na+ transport.
The use of animal models in diabetes research
Authors: King Aileen JF
Published: February 2012

Diabetes is a disease characterized by a relative or absolute lack of insulin, leading to hyperglycaemia. There are two main types of diabetes: type 1 diabetes and type 2 diabetes. Type 1 diabetes is due to an autoimmune destruction of the insulin‐producing pancreatic beta cells, and type 2 diabetes is caused by insulin resistance coupled by a failure of the beta cell to compensate. Animal models for type 1 diabetes range from animals with spontaneously developing autoimmune diabetes to chemical ablation of the pancreatic beta cells. Type 2 diabetes is modelled in both obese and non‐obese animal models with varying degrees of insulin resistance and beta cell failure. This review outlines some of the models currently used in diabetes research. In addition, the use of transgenic and knock‐out mouse models is discussed. Ideally, more than one animal model should be used to represent the diversity seen in human diabetic patients.

LINKED ARTICLES

Animal Models

This paper is the latest in a series of publications on the use of animal models in pharmacology research. Readers might be interested in the previous papers.

Robinson V (2009). Less is more: reducing the reliance on animal models for nausea and vomiting research.

Holmes AM, Rudd JA, Tattersall FD, Aziz Q, Andrews PLR (2009). Opportunities for the replacement of animals in the study of nausea and vomiting.

Giacomotto J and Ségalat L (2010). High‐throughput screening and small animal models, where are we?

McGrath JC, Drummond GB, McLachlan EM, Kilkenny C, Wainwright CL (2010). Guidelines for reporting experiments involving animals: the ARRIVE guidelines.

Kilkenny C, Browne W, Cuthill IC, Emerson M, Altman DG (2010). The ARRIVE guidelines.

Emerson M (2010). Refinement, reduction and replacement approaches to in vivo cardiovascular research.

Berge O‐G (2011). Predictive validity of behavioural animal models for chronic pain.

Vickers SP, Jackson HC and Cheetham SC (2011). The utility of animal models to evaluate novel anti‐obesity agents.

Percie du Sert N, Holmes AM, Wallis R, Andrews PLR (2012). Predicting the emetic liability of novel chemical entities: a comparative study.

The complete series including future publications, as they occur, can be found at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1476‐5381/homepage/animal_models.htm.
From Rio to Rio via Johannesburg: Integrating institutions across governance levels in sustainable development deliberations
Authors: Karlsson‐Vinkhuyzen Sylvia I.
Published: February 2012

Twenty years of international deliberations on sustainable development reaches another peak in 2012 during the United Nations Conference on Sustainable Development, Rio+20. However, with every review of the implementation of the ambitious Agenda 21, it becomes more difficult to reignite the “spirit of Rio” and in this paper I argue that one contributing factor is the inability to find a way to vertically integrate institutions and other actors across governance levels. The paper analyzes this long deliberation process and its normative outcome with respect to its multi‐levelness and approach to vertical integration. It concludes that both the first Earth Summit in Rio 1992 and the World Summit on Sustainable Development expressed high ambitions for dynamic interaction between governance at different levels, both in the deliberation and implementation stages. Yet, the actual number of practical links between levels could have been much higher and the references to vertical linkages in the conference process decreased over time. The preparations for Rio+20 continue this downward trend despite a widespread recognition that the need for coherence and integration were major motivational factors for Rio+20. The prospects for the process to stimulate the forming of coalitions of the willing that could bring closer vertical integration and implement multi‐level governance are thereby limited.
Trivializing sustainability: Environmental governance and rhetorical free‐riders in the Brazilian Amazon
Authors: da Fonseca Igor Ferraz , Bursztyn Marcel , Allen Benjamin S.
Published: February 2012

Interventions focused on sustainability at a local level tend to employ practices according to criteria that are widely accepted in the international development community. These practices constitute an informal “handbook,” establishing general rules for sustainable development to be applied to any situation. In response, local communities endeavor to formally meet these procedural criteria regardless of whether or not the desired end — sustainable development — can be achieved through them. The aim of this study is to demonstrate how the factors that are regarded as necessary for good governance affected the implementation of Agenda 21 programs in three Amazonian municipalities in the state of Mato Grosso, Brazil. We find that, contrary to expectations among international development practitioners, preoccupation with a formal adherence to good governance criteria is associated with the opening of a gap between the discourse of sustainable development and the actual results of the Agenda 21 processes. This paper stresses the need to avoid overtaking the rationale of ends by the discourse concerning means.
Trade‐offs between environmental protection and economic development in China's fisheries policy: A political analysis on the adoption and implementation of the Fisheries Law 2000
Authors: Ferraro Gianluca , Brans Marleen
Published: February 2012

The Rio Declaration of 1992 called for states to integrate environmental protection in their process of development in order to achieve the ultimate goal of sustainable development (Principle 4). The paper investigates to what extent the People's Republic of China (PRC) has integrated environmental protection into her fisheries policy. The environment/development nexus is analysed in relation to the adoption and implementation of the Fisheries Law of 2000. Official documents and, more importantly, interviews conducted in several organizations at multiple levels of governance disclose a complex reality beyond the formal commitment to sustainable fisheries. Diverging interests, goals and strategies can be traced beyond formal policy documents in Beijing, Guangdong and between the Centre and the Province. Inter‐organizational divergences at the central and local levels, as well as between them, hinder the pursuit of environmental protection in the development of China's fisheries sector. The paper highlights the political complexity of pursuing more responsible fisheries in the multi‐actor and multi‐level political‐administrative system of the PRC. Here, as well as in many other developing countries, economic development constitutes the policy priority. Environmental protection often remains not only an ambitious objective but also an unperceived need.
Substitution of tenofovir/emtricitabine for Hepatitis B immune globulin prevents recurrence of Hepatitis B after liver transplantation
Authors: Todd Stravitz R. , Shiffman Mitchell L. , Kimmel Melissa , Puri Puneet , Luketic Velimir A. , Sterling Richard K. , Sanyal Arun J. , Cotterell Adrian H. , Posner Marc P. , Fisher Robert A.
Published: February 2012

Background

Hepatitis B immune globulin (HBIg) with or without nucleos(t)ide analogue (NA) inhibitors has been shown to prevent recurrence of hepatitis B virus (HBV) following orthotopic liver transplantation (OLT). However, the use of HBIg has many disadvantages.

Aims

The present study was performed to determine if converting patients from HBIg±NA to combination NA therapy could prevent recurrence of HBV.

Methods

Twenty‐one recipients without evidence of HBV recurrence on HBIg±NA for ≥6 months were enrolled. Patients received their last injection of HBIg at the time they initiated tenofovir disoproxil fumarate/emtricitabine (TDF/FTC; Truvada®) and were followed up for 31.1 ± 9.0 [range 15–47] months.

Results

After 1 year, 3 patients (14%) had detectable HBsAg, one of whom was non‐compliant. Two of 3 with recurrence cleared HBsAg by last follow‐up on TDF/FTC; the non‐compliant patient became HBV DNA‐undetectable with re‐institution of TDF/FTC. TDF/FTC saved $12,469/year over our standard‐of‐care, monthly intramuscular HBIg/lamivudine. There was no evidence of a general adverse effect of TDF/FTC on renal function. However, 3 patients developed reversible acute renal failure; on renal biopsy, 1 had possible TDF/FTC‐induced acute tubular necrosis.

Conclusions

Substitution of TDF/FTC for HBIg prevented recurrence of HBV DNA in 100% (20/20) of patients who were compliant with the medication and led to substantial cost savings over HBIg‐containing regimens.
Modified Implantation Technique for the Berlin Heart EXCOR Assist Device in Adults
Authors: Bigdeli Amir Khosrow , Michel Sebastian , Kaczmarek Ingo , Juchem Gerd , Ueberfuhr Peter , Schmitz Christoph , Sodian Ralf
Published: February 2012

The Berlin Heart EXCOR ventricular assist device provides pulsatile ventricular assistance. It can be used for univentricular or biventricular support. However, pre‐, intra‐, and postoperative complications (e.g., bleeding, anastomotic insufficiency) are frequent. We present herein a detailed description of our modified implantation technique in order to facilitate further clinical use of the system.
Headache in Carotid Artery Stenting and Angiography
Authors: Gündüz Ayşegül , Göksan Baki , Koçer Naci , Karaali‐Savrun Feray
Published: February 2012

Introduction.— Carotid angioplasty headache and diagnostic criteria are based on scarce data and small series. Here, we aimed to determine presence, frequency, and characteristics of headache after carotid artery stenting and angiography headache and speculate on possible mechanisms of head and neck pain emerging during or after the carotid artery stenting procedure.

Patients and method.— The total of 64 patients who were admitted to our Neuroradiology Division of Radiology Department for primary percutaneous transluminal carotid interna stenting were included in the study. They had symptomatic or asymptomatic carotid artery disease with stenosis more than 70%. All patients were questioned by a neurologist regarding the presence, side, location, quality, severity, duration, and timing of headache after both angiography and stenting procedures.

Results.— Frequency of headache after carotid interna stenting was 39.1%, it commonly arose in a short period after the procedure and relieved in 10 minutes. This type of headache was mild, ipsilateral, frontotemporal in location, pressing in nature, and arose frequently within 10 minutes after the procedure, whereas angiography headache had a frequency of 21.9% and it was ipsilateral, mild, burning‐like headache. Angiography headache also relieved within 10 minutes. Both types of headache were related to severe stenosis.

Discussion.— Our study clearly demonstrates that headache is seen after carotid artery stenting (39.1%) and angiography (21.9%). Although both types of headache have similar characteristics, they differ in that it is mostly pressing in the group of carotid artery stenting and burning in angiography group.
Nitric Oxide Modulation of Low‐Frequency Oscillations in Cortical Vessels in FHM – a NIRS Study
Authors: Schytz Henrik W. , Hansen Jakob M. , Phillip Dorte , Selb Juliette , Boas David A. , Ashina Messoud
Published: February 2012

Background.— The pathophysiological alterations in patients with familial hemiplegic migraine (FHM) are not yet fully known. The headache characteristics in patients with FHM mutations have been examined in a series of glyceryl trinitrate (GTN) provocation studies in FHM patients, but the cortical vascular response to GTN in FHM patients has never been investigated before.

Objective.— To investigate changes in spontaneous low‐frequency oscillations (LFO) of cortical vessels in response to the nitric oxide donor GTN by near‐infrared spectroscopy in FHM patients.

Methods.— Twenty‐three FHM patients without known mutations and 9 healthy controls received a continuous intravenous infusion of GTN 0.5 µg/kg/minute over 20 minutes. Using near‐infrared spectroscopy, we recorded oxygenated hemoglobin (oxyHb) LFO amplitude bilateral at the frontal cortex at baseline and 15 minutes and 40 minutes after start of the GTN infusion.

Results.— GTN changed oxyHb LFO amplitude in FHM patients (P = .002), but not in healthy controls (P = .121). Only in FHM patients with coexisting common migraine types did GTN infusion induced changes in LFO amplitudes (P < .001), where post‐hoc analysis revealed an increase in LFO amplitude 15 minutes (P = .003) and 40 (P = .013) minutes after start of infusion compared with baseline. Interestingly, GTN infusion induced no changes in LFO amplitude in patients with a pure FHM phenotype (P = .695).

Conclusion.— FHM patients with a mixed phenotype (coexisting common type of migraine) showed an increase in oxyHb LFO amplitude during GTN infusion, whereas FHM patients with pure phenotype showed no changes. These data suggest possible differences in frontal cortical nitric oxide vascular sensitivity between FHM patients with a mixed phenotype and patients with pure FHM.
Spatiotemporal neuronal correlates of seizure generation in focal epilepsy
Authors: Bower Mark R. , Stead Matt , Meyer Fredric B. , Marsh W. Richard , Worrell Gregory A.
Published: February 2012

Purpose:  Focal seizures are thought to reflect simultaneous activation of a large population of neurons within a discrete region of pathologic brain. Resective surgery targeting this focus is an effective treatment in carefully selected patients, but not all. Although in vivo recordings of single‐neuron (i.e., “unit”) activity in patients with epilepsy have a long history, no studies have examined long‐term firing rates leading into seizures and the spatial relationship of unit activity with respect to the seizure‐onset zone.

Methods:  Microelectrode arrays recorded action potentials from neurons in mesial temporal structures (often including contralateral mesial temporal structures) in seven patients with mesial temporal lobe epilepsy.

Key Findings:  Only 7.6% of microelectrode recordings showed increased firing rates before seizure onset and only 32.4% of microelectrodes showed any seizure‐related activity changes. Surprisingly, firing rates on the majority of microelectrodes (67.6%) did not change throughout the seizure, including some microelectrodes located within the seizure‐onset zone. Furthermore, changes in firing rate before and at seizure onset were observed on microelectrodes located outside the seizure‐onset zone and even in contralateral mesial temporal lobe. These early changes varied from seizure to seizure, demonstrating the heterogeneity of ensemble activity underlying the generation of focal seizures. Increased neuronal synchrony was primarily observed only following seizure onset.

Significance:  These results suggest that cellular correlates of seizure initiation and sustained ictal discharge in mesial temporal lobe epilepsy involve a small subset of the neurons within and outside the seizure‐onset zone. These results further suggest that the “epileptic ensemble or network” responsible for seizure generation are more complex and heterogeneous than previously thought and that future studies may find mechanistic insights and therapeutic treatments outside the clinical seizure‐onset zone.
All‐Cause 1‐, 5‐, and 10‐Year Mortality in Elderly People According to Activities of Daily Living Stage
Authors: Stineman Margaret G. , Xie Dawei , Pan Qiang , Kurichi Jibby E. , Zhang Zi , Saliba Debra , Henry‐Sánchez John T. , Streim Joel
Published: February 2012

Objectives

To examine the independent association between five stages of activities of daily living (ADLs) and mortality after accounting for known diagnostic and sociodemographic risk factors.

Design

For five stages of ADLs (0 to IV), determined according to the severity and pattern of ADL limitations, unadjusted life expectancies and adjusted associations with mortality were estimated using a Cox proportional hazards regression model.

Setting

Community.

Participants

Nine thousand four hundred forty‐seven participants aged 70 and older from the second Longitudinal Study of Aging.

Measurements

One‐, 5‐, and 10‐year survival and time to death.

Results

Median life expectancy was 10.6 years for participants with no ADL limitations and 6.5, 5.1, 3.8, and 1.6 years for those at ADL stages I, II, III, and IV, respectively. The sociodemographic‐ and diagnostic‐adjusted hazard of death at 1 year was five times as great at stage IV as at stage 0 (hazard ratio = 5.6, 95% confidence interval = 3.8–8.3). The associations between ADL stage and mortality declined over time but remained statistically significant at 5 and 10 years.

Conclusion

ADL stage continued to explain mortality risk after adjusting for known risk factors including advanced age, stroke, and cancer. ADL stages might aid clinical care planning and policy as a powerful prognostic indicator particularly of short‐term mortality, improving on current ADL measures by profiling activity limitations of relevance to determining community support needs.
A prospective trial assessing the safety and efficacy of collecting up to 840 mL of plasma in conjunction with saline infusion during plasmapheresis
Authors: Buzza Mark , Marks Denese C. , Capper Hugh , Cassin Elisa , Badcock Caro‐Anne , Reid Samantha , Kwok Matthew , Yang Hung , Lee June , Corrigan Carolyn , Hartkopf‐Theis Tanja , Keller Anthony
Published: February 2012

BACKGROUND: The demand for plasma for manufacturing intravenous immunoglobulin and other plasma derivatives is increasing. A prospective study was conducted to determine whether up to 840 mL of plasma could be safely and effectively collected in conjunction with saline infusion during plasmapheresis.

STUDY DESIGN AND METHODS: Ninety‐one plasma donors were enrolled in a modified 3 × 3 crossover study to assess the equivalence of three plasma collection methods: 750 mL of plasma with no saline (control, Method 1), 840 mL of plasma with a 250‐mL saline infusion during and at the end of the donation (Method 2), and 800 mL of plasma with a 500‐mL saline infusion at the end of the donation (Method 3). The primary efficacy endpoint was the total protein concentration of the collected plasma. Secondary efficacy endpoints were immunoglobulin (Ig)G and Factor (F)VIII plasma concentration and donors' acceptance of the new procedures. Safety was determined from the adverse event (AE) rate.

RESULTS: The total protein, IgG, and FVIII concentrations in plasma collected under Methods 2 and 3 were significantly lower than those in plasma collected under Method 1 (p < 0.0001). These variables were also significantly lower in plasma collected under Method 2 compared to Method 3. During the study, 75 AEs were recorded, 73 of which were mild to moderate. Significantly more donors (31%) preferred Method 2 compared to Method 3 (p = 0.006).

CONCLUSIONS: Saline infusion during plasmapheresis led to hemodilution of plasma proteins. However, the benefits to donor safety and satisfaction are compelling reasons to implement saline infusion during plasmapheresis.
Incomplete pretransfusion testing leads to surgical delays
Authors: McWilliams Brian , Yazer Mark H. , Cramer James , Triulzi Darrell J. , Waters Jonathan H.
Published: February 2012

BACKGROUND: The Joint Commission has highlighted the importance of having appropriate and complete pretransfusion testing before surgery begins. The maximum surgical blood ordering schedule (MSBOS) indicates which patients require preoperative transfusion testing. We determined the number of times surgical delays were caused due to the lack of completed pretransfusion testing.

STUDY DESIGN AND METHODS: All transfusion events reported through the common medical event reporting system of eight networked hospitals over a 12‐month period were evaluated to determine how often patients experienced surgical delays due to not having complete pretransfusion testing.

RESULTS: During this 12‐month period 12 patients were identified who were either in or en route to the operating room with incomplete pretransfusion testing leading to a delay in providing crossmatched red blood cells (RBCs). In 6 of 12 cases a new antibody was discovered, which required extra time for the provision of crossmatched RBCs, while in 4 of 12 patients the samples were not sent or were lost on the way to the blood bank. In the remaining two patients other parts of the pretransfusion testing process were not followed according to hospital policy. The median surgery start time delay was approximately 12 hours (range, 1‐168 hr) in 11 of 12 cases. One patient's case was not aborted when it was discovered that crossmatched RBCs were not immediately available due to newly detected alloantibodies.

CONCLUSIONS: We identified three mechanisms by which delays in completing pretransfusion testing in surgical patients occurred. Adherence to the MSBOS and sample collection policies should reduce delays.
What Wins Votes: Why Some Politicians Opt Out of Clientelism
Authors: Weitz‐Shapiro Rebecca
Published: February 2012

In a context where clientelism is widespread, why do some politicians choose not to condition the delivery of goods and services to citizens on individual political behavior? I argue that the answer to this question lies in the heretofore unexamined electoral costs of clientelism: clientelism decreases support from nonpoor constituents even while it generates votes from among the poor. Taking into account these costs and other factors that shape politician incentives, I posit that the interaction between political competition and poverty will explain variation in clientelism. I test this claim using an original measure of clientelism that assesses mayoral involvement in social policy implementation in Argentine municipalities. The results of statistical analysis suggest that high levels of political competition are compatible with clientelism when poverty is also high. Only when high competition is coupled with low rates of poverty does clientelism decline.
Government Has No “Religious Agency”: James Madison's Fundamental Principle of Religious Liberty
Authors: Sikkenga Jeffrey
Published: February 2012

Religious liberty has reemerged as a problem in liberal democracy. For guidance we can turn to James Madison. Unfortunately, his fundamental principle of religious liberty has been misunderstood. Madison believed that power over religious conscience always remains with the individual, which means that government never has a power to attempt to cause or prohibit religious opinions or profession and only has the power to prohibit religious practices that are “adverse to the rights of other citizens, or to the permanent and aggregate interests of the community.” Madison's fundamental principle of religious liberty is therefore that government has no “religious agency.” In matters of religious establishment, “no agency” means that government lacks even the power to cognize religious opinions or practices. But in matters of free exercise, “no agency” means that government can accommodate citizens’ religious consciences, even if that accommodation requires cognizing their religious opinions. An important but widely overlooked example of Madison's complex but principled approach to religious liberty is his 1790 proposal for a statutory exemption from federal militia service for religious objectors.
A Service Provider's Elicitation of Its Customers’ Demand Distributions by a Price Mechanism
Authors: Dobson Gregory , Lederer Phillip J. , Robinson Lawrence W.
Published: February 2012

In a service environment a service provider needs to determine the amount and kinds of capacity to meet customers’ needs over many periods. To make good decisions, she needs to know the probability distribution of her customers’ demand in each period. We study a situation in which customers’ demand for a given service is random in each period, but inelastic, or modeled well by this assumption, and cannot be delayed to the next period. This article presents a mechanism that allows a service provider to learn the distribution of a customer's demand by offering him a set of contracts through which he can partially prepay for future service for a reduced cost for units of service based on anticipated needs. We describe the form of a set of contracts that will cause the customer to reveal his demand distribution as he minimizes his expected costs. To justify the effort of organizing and offering contracts, we present an application that demonstrates the cost savings to the service provider with better capacity planning using the truthfully elicited distribution.
Use of the Mechanical Dilator Sheath for Removal of Endocardial Leads: A Single Center Experience
Authors: AKSU TOLGA , GURAY UMIT , SEN TANER , DURUKAN MINE , GURAY YESIM , DEMIRKAN BURCU , KISACIK HALIL
Published: February 2012

Background:

Due to an increasing number of cardiac device implantations, the number of leads that need to be extracted because of infection or lead failure is consistently rising. We present our experience in percutaneous lead removal in a single tertiary center.

Methods:

From December 2009 to August 2010, 12 patients underwent percutaneous lead extraction procedure by the Evolution™ mechanical dilator sheath (Cook Medical Inc., Bloomington, IN, USA) system after failure of manual traction and a locking stylet.

Results:

Ages of the patients ranged between 7 and 86 years (mean age was 58 ± 12 years). Mean implantation time was 73 months (range between 12 and 244 months). Ten patients had one lead; only two patients had two leads. Indications for lead removal were: lead endocarditis in five patients, local (pocket) infection in four patients, and lead failure in three patients. All leads were successfully removed by using the device, except one lead which was one of the two leads in a patient with dual chamber pacemaker implanted 10 years ago. In three patients, same venous accesses (sheath of extraction system) were used to implant a new lead after removal of damaged leads without a new venous puncture. In only one patient, significant hematoma was found after the intervention and treated conservatively. No other significant complications were encountered in any patients.

Conclusions:

Damaged or infected leads can safely and relatively easily be extracted by using this new percutaneous extraction technique.
(PACE 2012; 1–5)
Inappropriate Implantable Cardioverter‐Defibrillator Magnet‐Mode Switch Induced by a Laptop Computer
Authors: TIIKKAJA MARIA , ARO AAPO , ALANKO TOMMI , LINDHOLM HARRI , HIETANEN MAILA
Published: February 2012

An implantable cardioverter‐defibrillator (ICD) experienced electromagnetic interference from a laptop computer's hard disk. The patient with the ICD was using his laptop computer at home while lying on his bed. The laptop was positioned on his chest, when he heard a beeping sound from the ICD, indicating magnet mode conversion. This situation was replicated in a controlled environment, and the conversion was found to be due to the static magnetic field produced by the laptop's hard disk. The ICD's conversion to magnet mode can be dangerous because it ends all tachyarrhythmia detections and therapies. (PACE 2012; 35:e177–e178)
Circadian and Seasonal Variations of Ventricular Tachyarrhythmias in Patients with Early Repolarization Syndrome and Brugada Syndrome: Analysis of Patients with Implantable Cardioverter Defibrillator
Authors: KIM SUNG‐HWAN , NAM GI‐BYOUNG , BAEK SEUNGHEE , OH CHOI HYUNG , HUN KIM KI , CHOI KEE‐JOON , JOUNG BOYOUNG , PAK HUI‐NAM , LEE MOON‐HYOUNG , SOON KIM SUNG , PARK SEUNG‐JUNG , KEUN ON YOUNG , SOO KIM JUNE , OH IL‐YOUNG , CHOI EUE‐KEUN , OH SEIL , CHOI YUN‐SHIK , IL CHOI JONG , WEON PARK SANG , KIM YOUNG‐HOON , YOUNG LEE MAN , EUY LIM HONG , LEE YOUNG‐SOO , CHO YONGKEUN , KIM JUN , LEE DONG‐IL , KYOUNG CHO DAE , KIM YOU‐HO
Published: February 2012

Circadian and Seasonal Variation in Early Repolarization Syndrome. 

Introduction: The circadian and seasonal patterns of ventricular tachyarrhythmia (VTA) in patients with early repolarization syndrome (ERS) have not been determined. We compared the timing of VTAs in patients with ERS and Brugada syndrome (BS).

Methods and Results: We enrolled patients with ERS (n = 14) and BS (n = 53) who underwent implantable cardioverter defibrillator (ICD) implantation. The timing of VTAs, including cardiac arrest and appropriate shocks, was determined. During follow up of 6.4  ±  3.6 years in the ERS group and 5.0  ±  3.3 years in the BS group, 5 of 14 (36%) ERS and 10 of 53 (19%) BS patients experienced appropriate shocks (P = 0.37). Cardiac arrest showed a trend of nocturnal distribution peaking from midnight to early morning (P = 0.14 in ERS, P = 0.16 in BS). Circadian distribution of appropriate shocks showed a significant nocturnal peak in patients with ERS (P  <  0.0001) but a trend toward a nocturnal peak in patients with BS (P = 0.08). There were no seasonal differences in cardiac arrest in patients with ERS and BS. However, patients with ERS showed a seasonal peak in appropriate shocks from spring to summer (P  <  0.0001). There was no significant seasonal peak in patients with BS. The timing of VTAs (cardiac arrest plus appropriate shock) showed significant nocturnal distributions in patients with ERS and BS (P  <  0.01, respectively). A significant clustering of VTAs was noted from spring to summer (P  <  0.01) in patients with ERS, but not in patients with BS (P = 0.42).

Conclusions: Incidence of VTAs showed marked circadian variations with night‐time peaks in patients with ERS and BS. (J Cardiovasc Electrophysiol, Vol. 23, pp. 757‐763, July 2012)
Percutaneous Left Axillary Artery Approach for Impella 2.5 Liter Circulatory Support for Patients with Severe Aortoiliac Arterial Disease Undergoing High‐Risk Percutaneous Coronary Intervention
Authors: LOTUN KAPILDEO , SHETTY RANJITH , PATEL MANISHKUMAR , ARAIN SALMAN A.
Published: February 2012

The use of the Impella 2.5 liter (L) device for hemodynamic support has been well described. The typical access site for the Impella 2.5 L device is the femoral artery. The use of the axillary and subclavian artery has been described via surgical cut down for the Impella 5 L device when femoral artery access is not possible. In patients with severe aortoiliac disease and difficult anatomy the femoral artery access for the Impella 2.5 L device is not feasible. We describe the successful percutaneous use of the Impella 2.5 L device for hemodynamic support via the left axillary artery in 2 patients undergoing high‐risk PCI with concomitant severe aortoiliac disease.

(J Interven Cardiol 2012;25:210–213)
Preparation of Platelike NaNbO3 Particles by Single‐Step Molten Salt Synthesis
Authors: Kikuchihara Anna , Sakurai Fumito , Kimura Toshio
Published: February 2012

This article reports single‐step molten salt synthesis to prepare single‐crystal, platelike NaNbO3 particles without the Bi2O3 byproduct. In the previous method of two‐step molten salt synthesis, platelike Bi2.5Na3.5Nb5O18 particles have been prepared by heating a mixture of Bi2O3,Na2CO3, and Nb2O5 in molten NaCl; the particles are then converted to platelike NaNbO3 particles by reaction with Na2CO3 in molten NaCl. The obtained NaNbO3 particles are polycrystalline, and Bi2O3 particles form as a byproduct. In the present method, single‐crystal, platelike NaNbO3 particles without the Bi2O3 byproduct are obtained by heating mixtures of Bi2O3, Na2CO3, and Nb2O5 with molar ratios of 5:7:10 (the composition of Bi2.5Na3.5Nb5O18) and 5:5:8 (the composition of Bi2.5Na2.5Nb4O15) in molten NaCl at 1225°C for 12 h. During heating, platelike Aurivillius (Bi2.5Na3.5Nb5O18 and Bi2.5Na2.5Nb4O15) particles are formed first and these then react with NaCl to form platelike NaNbO3 particles, BiCl3, and Na2O. BiCl3 evaporates from the system and Na2O is washed out after heating. Thus, single‐phase NaNbO3 is obtained. Sluggish conversion from the Aurivillius phases to NaNbO3 is responsible for the formation of single‐crystal particles.
Effect of hypoxia on integrin‐mediated adhesion of endothelial progenitor cells
Authors: Kaiser Ralf , Friedrich Denise , Chavakis Emmanouil , Böhm Michael , Friedrich Erik B.
Published: February 2012

Homing of endothelial progenitor cells (EPCs) is crucial for neoangiogenesis, which might be negatively affected by hypoxia. We investigated the influence of hypoxia on fibronectin binding integrins for migration and cell‐matrix‐adhesion. AMP‐activated kinase (AMPK) and integrin‐linked kinase (ILK) were examined as possible effectors of hypoxia.Human EPCs were expanded on fibronectin (FN) and integrin expression was profiled by flow cytometry. Cell‐matrix‐adhesion‐ and migration‐assays on FN were performed to examine the influence of hypoxia and AMPK‐activation. Regulation of AMPK and ILK was shown by Western blot analysis. We demonstrate the presence of integrin β1, β2 and α5 on EPCs. Adhesion to FN is reduced by blocking β1 and α5 (49% and 2% of control, P < 0.05) whereas α4‐blockade has no effect. Corresponding effects were shown for migration. Hypoxia and AMPK‐activation decrease adhesion on FN. Although total AMPK‐expression remains unchanged, phospho‐AMPK increases eightfold.The EPCs require α5 for adhesion on FN. Hypoxia and AMPK‐activation decrease adhesion. As α5 is the major adhesive factor for EPCs on FN, this suggests a link between AMPK and α5‐integrins. We found novel evidence for a connection between hypoxia, AMPK‐activity and integrin activity. This might affect the fate of EPCs in ischaemic tissue.
Pharmacokinetics of 250 μg anti‐D IgG in the third trimester of pregnancy: An observational study
Authors: TIBLAD ELEONOR , WIKMAN AGNETA , RANE ANDERS , JANSSON YVONNE , WESTGREN MAGNUS
Published: February 2012

Objective. We present a pharmacokinetic study evaluating a single intramuscular dose of 250 μg anti‐D immunoglobulin in the third trimester of pregnancy. The aim of the study was to determine the kinetic profile and duration of detectable levels of anti‐D. Design. Prospective observational study. Setting. Antenatal outpatient clinic. Population. Healthy Rhesus D (RhD)‐negative pregnant women with an RHD‐positive fetus. Methods. Serial plasma anti‐D quantitations following antenatal administration of anti‐D immunoglobulin were performed using flow cytometry. Kinetic profiles for anti‐D levels were generated from the concentration values at predetermined sampling time points. The half‐lives were calculated by linear regression analysis. Main outcome measures. Time vs. concentration profile, half‐life and anti‐D concentration ≥1 ng/mL close to term. Results. The maximal plasma concentration of anti‐D was usually seen at 3–10 days postinjection, with a median value of 25 ng/mL. The half‐life varied between individuals, with a median of 23 days. We found detectable levels of anti‐D IgG within two weeks of parturition in 11 of 12 women. Conclusions. The preparation of anti‐D immunoglobulin used in the present study, if administrated in pregnancy week 28–30, is associated with detectable levels of anti‐D in most women at the time of delivery. Although the half‐time is 23 days, it is uncertain whether all mothers have adequate anti‐D concentrations at term. Alternative strategies may be evaluated in the future, with repeated administration of antenatal prophylaxis at term rather than conventional postpartum administration of anti‐D.