bluuebunny/crossref_metadata_2025 huggingface dataset:
Depressive Symptoms in Alzheimer's Disease: Natural Course and Temporal Relation to Function and Cognitive Status
Authors: Holtzer Roee , Scarmeas Nikolaos , Wegesin Domonick J. , Albert Marilyn , Brandt Jason , Dubois Bruno , Hadjigeorgiou George M. , Stern Yaakov
Published: November 2005

Objectives: To examine the natural course of depressive symptoms in patients with probable Alzheimer's disease (AD), specifically, the temporal relationship between depressive symptoms, function, and cognitive status.

Design: Multicenter cohort study with follow‐up of up to 14 years.

Setting: Patients from the two Multicenter Study of Predictors of Disease Course in Alzheimer's Disease (Predictors Study) cohorts were recruited at five sites in the United States and Europe.

Participants: Patients diagnosed with probable AD (n=536) enrolled in a longitudinal study (Predictors Study).

Measurements: Depressive symptoms were evaluated at 6‐month intervals using the Columbia Scale for Psychopathology in Alzheimer's Disease. The Modified Mini‐Mental State (3MS) and Blessed Dementia Rating Scale (BDRS) were used to assess cognitive status and functional activity, respectively.

Results: The prevalence of depressive symptoms was stable over the first 3 years of follow‐up, at approximately 40%. There was a significant drop to 28% and 24% in the fourth and fifth years of follow‐up, respectively. Time‐dependent Cox analysis revealed that functional activity (BDRS) but not cognitive status (3MS) was a significant predictor of the first episode of depressive symptoms during follow‐up. Generalized estimating equation analyses showed that AD duration and functional activity but not cognitive status were significantly related to depressive symptoms over the entire follow‐up period.

Conclusion: Depressive symptoms are common in AD, but their prevalence decreases over time. Examination of the temporal relationship between depressive symptoms and risk factors suggests that decline in function but not in cognition precedes the first episode of depressive symptoms in patients with probable AD.
Antimuscarinic Drugs for Overactive Bladder and Their Potential Effects on Cognitive Function in Older Patients
Authors: Kay Gary G. , Abou‐Donia Mohamed B. , Messer William S. , Murphy Declan G. , Tsao Jack W. , Ouslander Joseph G.
Published: November 2005

Antimuscarinic agents are the predominant pharmacological treatment for patients with overactive bladder (OAB). These drugs are thought to act primarily through antagonism at muscarinic M3 receptors located at neuromuscular junctions in the human bladder detrusor muscle. Several of these drugs have been shown to be efficacious in ameliorating the symptoms of OAB in older patients, but most currently available agents lack selectivity for the M3 receptor subtype, and interaction with other muscarinic receptor subtypes throughout the body may adversely affect a variety of physiological functions and result in unwanted side effects, including cognitive dysfunction. With the recent availability of antimuscarinic agents that show increased selectivity for M3 receptors relative to other muscarinic subtypes, an invitational expert panel meeting was convened to review not only the mechanisms by which antimuscarinic agents could affect cognitive function, but also the published literature on cognitive adverse events. A review of the literature shows that the cholinergic system in the central nervous system (CNS) exerts a major influence on cognitive processes, in particular memory via M1 cholinergic receptors. In addition, recent evidence suggests a role for M2 receptors in mediating cognitive function. Thus, cognitive dysfunction (including memory loss) during treatment with nonselective antimuscarinic agents for OAB is of growing concern, particularly in older patients and those with mild cognitive impairment or dementia. Increased blood–brain barrier permeability, which can occur with advanced age and certain comorbidities, may also facilitate CNS access of antimuscarinic agents (regardless of their physiochemical properties) and add to antimuscarinic burden. On the basis of available evidence, antimuscarinic agents with selectivity for M3 over M1 and M2 receptors, limited CNS penetration, or both may therefore offer a favorable balance of efficacy in treating OAB together with a reduced risk of adverse cognitive events in the older population.
Granulocyte–colony‐stimulating factor–mobilized prophylactic granulocyte transfusions given after allogeneic peripheral blood progenitor cell transplantation result in a modest reduction of febrile days and intravenous antibiotic usage
Authors: Oza Aarti , Hallemeier Chris , Goodnough Lawrence , Khoury Hanna , Shenoy Shalini , Devine Steven , Augustin Kristan , Vij Ravi , Trinkaus Kathryn , DiPersio John F. , Adkins Douglas
Published: November 2005

BACKGROUND:  It was hypothesized that transfusion of two granulocyte–colony‐stimulating factor (G‐CSF)‐mobilized prophylactic granulocyte components into allogeneic peripheral blood progenitor cell (PBPC) transplant patients during the regimen‐related neutropenic interval would result in clinical benefit.

STUDY DESIGN AND METHODS:  HLA‐matched sibling PBPC donors (n = 151) were biologically randomized based on ABO mismatch to donate granulocyte components (Cohort G) or not donate granulocytes (control group, Cohort C). ABO‐matched donors who did not meet other study‐specific criteria were reassigned to Cohort C.

RESULTS:  Feasibility, defined as the proportion of ABO‐matched donors who underwent granulocyte collections, was 42 percent (53 of 125). The percentage of patients who developed fever during the initial hospitalization was greater in Cohort C versus Cohort G (82.7% vs. 64.2%; p = 0.03). In the interval from when granulocyte transfusions were initially given in Cohort G (Day +3 or Day +5) until neutrophil engraftment, the number of febrile days was less in Cohort G versus Cohort C (median, 0 vs. 1; Mann‐Whitney p = 0.003). The median number of days of intravenous antibiotics given during the initial hospitalization was less in Cohort G versus Cohort C (9 vs. 11; Mann‐Whitney p = 0.03), a difference accounted for in the interval from Day +3 or Day +5 to neutrophil recovery. There was no significant difference in length of the initial hospital stay, acute graft‐versus‐host disease rates, or 100‐day survival between the two cohorts.

CONCLUSION:  This prospective study demonstrates a modest, but significant, benefit of G‐CSF–mobilized HLA‐matched prophylactic granulocyte transfusions in neutropenic allogeneic PBPC recipients.
Basics of flow cytometry–based sterility testing of platelet concentrates
Authors: Mohr Harald , Lambrecht Bernd , Bayer Anette , Spengler Hans‐Peter , Nicol Sven‐Boris , Montag Thomas , Müller Thomas H.
Published: November 2005

BACKGROUND:  Flow cytometry (FACS) is a common technique in blood banking. It is used, for example, for the enumeration of residual white blood cells in plasma and in cellular blood products. It was investigated whether it can also be applied for sterility testing of buffy coat–derived platelet concentrates (PCs).

STUDY DESIGN AND METHODS:  Plasma‐reduced PCs were spiked with bacteria and stored at 20 to 24 or 37°C for various times. The following 10 species were used: Bacillus cereus, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Propionibacterium acnes, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, Serratia marcescens, and Yersinia enterocolitica. Bacterial DNA was stained with thiazole orange. After the platelets were lysed, bacteria were enumerated by FACS.

RESULTS:  All bacteria species used were detectable by FACS. The lower detection limit was approximately 100 bacteria per µL, that is, 105 per mL. In general, the titers measured were 1.2‐ to 3‐fold higher than those determined by colony forming assay. In one case (K. pneumoniae) in which the dot plot of the bacteria cloud overlapped with that of bacteria debris, they were consistently lower. When PC samples were inoculated with approximately 1 colony‐forming unit per mL of bacteria and kept at 37°C, most species were detected within 21 hours or less. Exceptions were E. cloacae and P. acnes, which were detected after 24 to 40 and 64 hours, respectively. At 20 to 24°C, the detection times were strongly prolonged.

CONCLUSION:  Sterility testing of PCs by FACS is a feasible approach. The present data suggest incubating PC samples for 20 to 24 hours at 37°C before testing. For slow‐growing bacteria, the incubation period must be prolonged by 1 to 2 days.
Quality control of blood irradiation: determination T cells radiosensitivity to cobalt‐60 gamma rays
Authors: Góes E.G. , Borges J.C. , Covas D.T. , Orellana M.D. , Palma P.V.B. , Morais F.R. , Pelá C.A.
Published: November 2005

BACKGROUND:  To identify the most appropriate dose for the prevention of transfusion‐associated graft‐versus‐host disease, the radiosensitivity of T cells has been determined in blood bags irradiated with X‐rays produced by a linear accelerator and gamma rays derived from the cesium‐137 source of a specific irradiator. In this study, the influence of doses ranging from 500 to 2500 cGy was investigated on T cells isolated from red blood cell (RBC) units preserved with ADSOL and irradiated with a cobalt teletherapy unit.

STUDY DESIGN AND METHODS:  A thermal device consisting of acrylic and foam was constructed to store the blood bags during irradiation. Blood temperature was monitored with an automated data acquisition system. Dose distribution in the blood bags was analyzed based on isodose curves obtained with a polystyrene phantom constructed for this purpose. The influence of cobalt‐60 gamma radiation on T cells was determined by limiting‐dilution analysis, which measures clonable T cells. T‐cell content of the mononuclear cell population plated was assessed by flow cytometry with a monoclonal antibody specific for CD3.

RESULTS:  Blood temperature ranged from 2 to 4.5°C during irradiation. Dosimetry performed on the phantom showed a homogenous dose distribution when the phantom was irradiated with a parallel‐opposite field. A radiation dose of 1500 cGy led to the inactivation of T cells by 4 log, but T‐cell growth was observed in all experiments. At 2500 cGy, no T‐cell growth was detected in any of the experiments and a greater than 5 log reduction in functional T cells was noted.

CONCLUSION:  The results showed that a dose of 2500 cGy completely inactivates T cells in RBC units irradiated with cobalt‐60 source.
Maturation state of dendritic cells during the extracorporeal photopheresis and its relevance for the treatment of chronic graft‐versus‐host disease
Authors: Spisek Radek , Gasova Zdena , Bartunkova Jirina
Published: November 2005

BACKGROUND:  Chronic graft‐versus‐host disease (cGVHD) represents a major cause of morbidity and mortality after allogeneic bone marrow transplantation (BMT). Extracorporeal photochemotherapy (ECP), a technique used in the treatment of cutaneous T‐cell lymphoma, has also shown clinical efficacy in the treatment of refractory cGVHD.

STUDY DESIGN AND METHODS:  In this study, the dynamics of dendritic cell (DC) activation were investigated during the process of photopheresis in patients treated for refractory cGVHD.

RESULTS:  It is reported that myeloid DCs can be isolated from the photopheretic products before retransfusion to the patient. It is shown that DCs in ECP product are in the immature state with respect to the phenotypic and functional characteristics. In contrast to the in vitro–generated monocyte‐derived DCs and DCs not treated by 8‐methoxypsoralen and UVA, they produce significant amounts of interleukin‐10 (IL‐10). They efficiently capture apoptotic lymphocytes and do not induce proliferation of T lymphocytes. They preserve the capacity to be activated by polyriboinosinic polyribocytidylic acid and lipopolysaccharide, however. ECP also induces rapid and massive apoptosis of alloreactive lymphocytes. A model of the potential implication of IL‐10‐producing DCs in the down regulation of harmful alloreactive immune reaction is presented.

CONCLUSION:  It is believed that this study provides a novel insight into the mechanisms of action of ECP in the control of cGVHD.
A clinical‐scale expansion of mobilized CD34+ hematopoietic stem and progenitor cells by use of a new serum‐free medium
Authors: Ivanovic Zoran , Duchez Pascale , Dazey Bernard , Hermitte Francis , Lamrissi‐Garcia Isabelle , Mazurier Frédéric , Praloran Vincent , Reiffers Josy , Vezon Gérard , Boiron Jean‐Michel
Published: November 2005

BACKGROUND:  The autologous transplantation of CD34+ cells expanded ex vivo in serum‐free conditions dramatically reduces postmyeloablative neutropenia in myeloma patients. In our cell therapy unit, cells for this clinical assay have been expanded under GMP with serum‐free Irvine Scientific (IS) medium with stem cell factor (SCF), granulocyte–colony‐stimulating factor (G‐CSF), and megakaryocyte growth and development factor (MGDF; 100 ng/mL, respectively). Because this clinical‐grade IS medium is no longer available, a new serum‐free medium, Maco Biotech HP01 (Macopharma), was evaluated.

STUDY DESIGN AND METHODS:  Purified CD34+ cells (Isolex 300i, Baxter) from mobilized peripheral blood samples of myeloma patients were thawed, washed, and cultured, as for previous clinical assays. Twenty million CD34+ cells were resuspended per 1 L of SCF‐, G‐CSF‐, and MGDF‐supplemented medium (HP01 or IS), introduced into 3‐L culture bags (AFC), and cultured for 10 days in 5 percent CO2, at 37°C, and at 100 percent humidity.

RESULTS:  A higher amplification of total nucleated cells (NCs) and colony‐forming cells (CFCs) was obtained with HP01 medium than with IS medium (42 ± 16.6‐fold vs. 20.5 ± 5.9‐fold for NCs and 26.7 ± 7.4‐fold vs. 15.5 ± 2.5‐fold for CFCs, respectively), whereas an increase in CD34+ cells (3.5 ± 1.2‐fold for HP01 vs. 2.7 ± 1.5‐fold for IS) was not significant. IS medium partially maintained SCID‐repopulating cells (SRC), whereas the culture in HP01 medium fully maintained the stem cell activity for 10 days. A higher frequency of CD41+ cells after expansion in HP01 than in IS medium was also observed.

CONCLUSION:  Maco Biotech HP01 medium is suitable for clinical‐scale expansion of CD34+ cells with the SCF, G‐CSF, and MGDF cytokine cocktail, permitting an intensive amplification of CFCs and maintenance of SRCs.
Sex‐dependent up regulation of CD177‐specific mRNA expression in cord blood due to different stimuli
Authors: Wolff Jens‐Christian , Goehring Katrin , Heckmann Matthias , Bux Juergen
Published: November 2005

BACKGROUND:  The neutrophil‐specific CD177 molecule (NB1 glycoprotein/HNA‐2a) has gained clinical interest because of its involvement in severe antibody‐dependent diseases like transfusion‐related acute lung injury and neonatal alloimmune neutropenia. Up regulation of CD177 in response to different stimuli (granulocyte–colony‐stimulating factor, N‐formyl‐Met‐Leu‐Phe, bacterial infections) has been described in adults.

STUDY DESIGN AND METHODS:  The regulation of CD177 expression was evaluated on mRNA and glycoprotein levels from cord blood neutrophils of 56 neonates, 38 of them with complications during pregnancy or delivery. Real‐time polymerase chain reaction and flow cytometry were used for quantification.

RESULTS:  White blood cells from neonates of both sexes showed significantly elevated glycoprotein and mRNA levels compared to adults. In addition, there was a significant mRNA up regulation in female newborns predominantly occurring in cases with pathologic cardiotocogram, premature rupture of the amniotic membrane, and health disorders of the mother.

CONCLUSION:  These findings show a significantly increased CD177 expression in neutrophils from newborns compared to adults, which suggests the existence of additional factors being able to stimulate CD177 expression.
Whole‐blood leukodepletion filters as a source of CD34+ progenitors potentially usable in cell therapy
Authors: Ivanovic Zoran , Duchez Pascale , Morgan Doris A. , Hermitte Francis , Lafarge Xavier , Chevaleyre Jean , Praloran Vincent , Dazey Bernard , Vezon Gérard , Boiron Jean‐Michel
Published: November 2005

BACKGROUND:  Used leukodepletion filters (LDFs), containing billions of white blood cells (WBCs), are discarded. Because the steady‐state blood contains low quantities of stem and progenitor cells that are retained in LDFs, the viability and the functional properties of mononuclear cells (MNCs) and CD34+ cells recovered from LDFs were investigated.

STUDY DESIGN AND METHODS:  WBCs were recovered from LDFs by use of a closed system. MNCs and CD34+ cells were isolated from freshly LDF‐recovered WBCs or after their overnight incubation. The CD34+ cells were enumerated, as well as the number of colony‐forming unit (CFU)–granulocyte‐macrophage, burst‐forming unit–erythroid, and CFU‐Mixed. The expansion in clinical‐scale volume cultures (serum‐free medium plus stem cell factor, granulocyte–colony‐stimulating factor, and megakaryocyte growth and development factor) was performed starting from MNCs, freshly isolated CD34+ cells, and CD34+ cells isolated after overnight incubation of WBCs. The erythroid, megakaryocytic, eosinophilic, and monocyte‐myelocytic lineage differentiation of LDF‐recovered CD34+ cells was challenged in liquid cultures by adding relevant cytokines.

RESULTS:  Nearly 450 × 103 viable CD34+ cells were recovered per LDF. These cells exhibit unimpaired colony‐forming ability. It is possible to expand these cells ex vivo, but their response to cytokines is different compared to mobilized peripheral blood and cord blood CD34+ cells. Thus, further work is necessary to optimize their ex vivo expansion. These cells give rise to the mature cells and precursors of erythroid, megakaryocytic, eosinophilic, and monomyelocytic lineage in liquid cultures.

CONCLUSION:  MNCs and CD34+ cells recovered from the LDFs exhibit unimpaired functional capacities. Recent development of ex vivo technologies for expansion, retrodifferentiation, and differentiation reinforces the value in cell therapy of these LDG‐recovered peripheral blood progenitor cells that are routinely discarded.
Rhythm Abnormalities in Children with Isolated Ventricular Noncompaction
Authors: ÇELIKER ALPAY , ÖZKUTLU SÜHEYLA , DILBER EMBIYA , KARAGÖZ TEVFIK
Published: November 2005

Background: Isolated ventricular noncompaction (IVNC) is a serious cardiomyopathy with a generally poor prognosis. It is characterized by the presence of prominent ventricular myocardial trabeculations and deep intertrabecular recesses, in the absence of other structural heart defects. This cardiomyopathy is usually associated with ventricular dysfunction, thromboembolic events, and rhythm problems.

Methods and Results: This article describes 11 children who have rhythm abnormalities associated with IVNC. On admission, eight children had complaints including palpitation, syncope, heart failure, and bradycardia. Ventricular arrhythmias were diagnosed in four children, sinus node and atrioventricular conductance disturbances in six children, and Wolff‐Parkinson‐White syndrome and associated tachycardia in one child. Three children with ventricular arrhythmias received an automatic implantable cardioverter defibrillator (ICD). Three patients died of cardiac problems during the follow‐up period.

Conclusion: Since many of rhythm abnormalities, including life‐threatening ventricular arrhythmias, may be seen in patients with IVNC, children with IVNC should be screened for arrhythmias. An ICD may be the best treatment for some of these patients.
Long‐Term Outcomes of a Telephone Intervention After an ICD
Authors: DOUGHERTY CYNTHIA M. , THOMPSON ELAINE ADAMS , LEWIS FRANCES MARCUS
Published: November 2005

Background: The purpose of this study was to determine the long‐term benefits of participating in a structured, 8‐week educational telephone intervention delivered by expert cardiovascular nurses post‐ICD. The intervention was aimed to (1) increase physical functioning, (2) increase psychological adjustment, (3) improve self‐efficacy in managing the challenges of ICD recovery, and (4) lower levels of health care utilization over usual care in the first 12 months post‐ICD. This article reports on the 6‐ and 12‐month outcomes of the nursing intervention trial.

Methods and Results: A two‐group (N = 168) randomized control group design was used to evaluate intervention efficacy with persons receiving an ICD for the secondary prevention of sudden cardiac arrest. Measures were obtained at baseline, 6 and 12 months post hospitalization. Outcomes included (1) physical functioning (Patient Concerns Assessment [PCA], Short Form Health Survey [SF‐12], ICD shocks), (2) psychological adjustment (State‐Trait Anxiety Inventory [STAI], Centers for Epidemiologic Studies–Depression [CES‐D], fear of dying), (3) self‐efficacy (Sudden Cardiac Arrest–Self‐Efficacy [SCA‐SE], Sudden Cardiac Arrest–Behavior [SCA‐B], Sudden Cardiac Arrest–Knowledge [SCA‐K]), and (4) health care utilization (emergency room [ER] visits, outpatient visits, hospitalizations). Using repeated measures ANOVA, the 6‐ and 12‐month benefits of the intervention over usual care were in reductions in physical concerns (P = 0.006), anxiety (P = 0.04), and fear of dying (P = 0.01), with enhanced self‐confidence (P = 0.04) and knowledge (P = 0.001) to manage ICD recovery. There were no statistically significant differences between the groups on total outpatient visits, hospitalizations, or ER visits over 12 months.

Conclusion: A structured 8‐week post‐hospital telephone nursing intervention after an ICD had sustained 12‐month improvements on patient concerns, anxiety, fear of dying, self‐efficacy, and knowledge. Results may not apply to individuals with congestive heart failure who receive an ICD for primary prevention of sudden cardiac arrest.
Heart Rate Variability Is a Useful Parameter for Evaluation of Anticholinergic Effect Associated with Inducibility of Atrial Fibrillation
Authors: SUGIURA HIROTAKA , CHINUSHI MASAOMI , KOMURA SATORU , HIRONO TAKASHI , AIZAWA YOSHIFUSA
Published: November 2005

Background: Disopyramide is thought to have an advantageous effect for atrial fibrillation (AF) associated with vagal activity because of its anticholinergic effect.

Method: We used a canine vagal nerve stimulation (VNS) model. The monophasic action potential (MAP) duration at 90% repolarization (MAP90), the intraatrial conduction time, the induciblity of AF by electrical stimulation, and the amplitude of high‐frequency component (HF‐amp) of the heart rate variability (HRV) were evaluated before and after the administration of disopyramide (1 mg/kg) (group D, n = 8) or pilsicainide (1 mg/kg) (group P, n = 5).

Results: In group D, HF‐amp decreased in the baseline condition from 1.1 ± 0.6 to 0.6 ± 0.4 ms and the degree of VNS‐induced augmentation of HF‐amp was attenuated from +492% to +127%. VNS‐induced shortening of MAP90 was also attenuated in the right atrium (from −30 ± 15% to −10 ± 6%) and in the left atrium (from −15 ± 9% to −6 ± 6%). In group P, little effect was shown in these parameters. The vagotonic AF became noninducible in all eight experiments in group D, while in only one of five in group P.

Conclusion: The beneficial effect of disopyramide for vagotonic AF is based on the decrease of basal vagal tone and attenuation of the effect of vagal stimulation in the atrial myocardium. HRV is a useful parameter for evaluation of the effect of antiarrhythmic drugs on the autonomic nerve system, and the evaluation of variability may be useful for testing drug efficacy for arrhythmias.
Unsuccessful AV Nodal Ablation in Atrial Fibrillation: An Alternative Method to Achieve Complete Heart Block
Authors: SUNTHORN H. , HASIJA P. , BURRI H. , SHAH D.
Published: November 2005

We report the case of an elderly patient who presented with poorly tolerated episodes of atrial arrhythmia refractory to medical treatment. AV node ablation was identified as the only alternative expected to be efficacious for symptom relief. However, this usually simple intervention failed. The goal of creating a complete AV block was finally achieved through ablation of the anterior fascicle of the His bundle, which represented the only pathway for residual conduction in this patient.
Successful Radiofrequency Ablation of Ventricular Premature Contractions Within the Coronary Sinus
Authors: YAMAUCHI YASUTERU , AONUMA KAZUTAKA , SEKIGUCHI YUKIO , OBAYASHI TOHRU , KUMAGAI KOJI , ISOBE MITSUAKI
Published: November 2005

This case report describes frequent ventricular premature contractions (VPCs) originating from an epicardial site of the basal posteroseptal ventricle. Detailed pace‐mapping using a high output pacing stimulator was utilized to successfully ablate VPCs within the coronary sinus.
Prolonged Paced QRS Duration as a Predictor for Congestive Heart Failure in Patients with Right Ventricular Apical Pacing
Authors: MIYOSHI FUMITO , KOBAYASHI YOUICHI , ITOU HIROYUKI , ONUKI TATSUYA , MATSUYAMA TAKAAKI , WATANABE NORIKAZU , LIU CHUNGCHANG , KAWAMURA MITSUHARU , ASANO TAKU , MIYATA AKIRA , NAKAGAWA HARUYUKI , TANNO KAORU , BABA TAKAO , KATAGIRI TAKASHI
Published: November 2005

Background: The recent studies showed that right ventricular (RV) pacing was associated with worsening of heart failure. The aim of this study is to clarify the clinical significance of paced QRS duration during RV pacing to predict congestive heart failure (CHF) patients.

Methods and Results: This study enrolled in 92 patients with atrioventricular block who underwent initial pacemaker implantation. The paced QRS duration was automatically obtained by electrocardiography immediately after pacemaker implantation and then by routine attendance at a pacemaker clinic every 3 months. The paced QRS duration was positively correlated with left ventricular end‐diastolic dimension (P < 0.05) and left ventricular end‐systolic dimension (P < 0.05), and tended to negatively correlate with left ventricular ejection fraction (P = 0.0507). The paced QRS duration immediately after pacemaker implantation was 170.4 ± 18.9 ms. During a mean follow‐up period of 53 ± 16 months, 16 patients developed CHF. We selected as a cut‐off value the nearest whole number (190 ms) that was one standard deviation greater than the mean, and divided into two groups according to baseline paced QRS duration. Patients with a paced QRS duration of <190 ms comprised group A (n = 77, nine of which developed CHF) and the remainder comprised group B (n = 15, seven of which developed CHF). Prolonged paced QRS duration (≥190 ms) was associated with a significant increase in the overall morbidity of CHF (P < 0.05). Additionally, paced QRS duration significantly prolonged during the follow‐up period among group A patients with CHF (P < 0.05), but did not change among patients without CHF.

Conclusion: We concluded that paced QRS duration can be a useful indicator of impaired left ventricular function in patients with RV pacing. Even in patients whose paced QRS duration is relatively shorter, progressive prolongation of paced QRS duration can predict the development of CHF.
Persistent Left Superior Vena Cava‐Inferior Vena Caval Communication Complicating Implantation of an Implantable Cardioverter Defibrillator
Authors: GOYAL SANJEEV , ROSENTHAL LAWRENCE
Published: November 2005

A persistent left superior vena cava has been observed in 0.3% of the general population on autopsy. Its presence can complicate left‐sided device implantation. Commonly, a LSVC connects to the right atrium via the coronary sinus. A LSVC‐accessory hemiazygous‐hemiazygous‐inferior vena caval communication has not been described previously. The presence of such a congenital venous anomaly will prohibit a left‐sided device implant.
Abnormal Heart Rate Turbulence Predicts the Initiation of Ventricular Arrhythmias
Authors: IWASA ATSUSHI , HWA MICHAEL , HASSANKHANI ALBORZ , LIU TAYLOR , NARAYAN SANJIV M.
Published: November 2005

Background: Abnormal heart rate turbulence (HRT) reflects autonomic derangements predicting all‐cause mortality, yet has not been shown to predict ventricular arrhythmias in at‐risk patients. We hypothesized that HRT at programmed ventricular stimulation (PVS) would predict arrhythmia initiation in patients with left ventricular dysfunction.

Methods: We studied 27 patients with coronary disease, left ventricular ejection fraction (LVEF) 26.7 ± 9.1%, and plasma B‐type natriuretic peptide (BNP) 461 ± 561 pg/mL. Prior to arrhythmia induction at PVS, we measured sinus cycles after spontaneous or paced premature ventricular contractions (PVCs) for turbulence onset (TO; % cycle length change following PVC) and slope (TS; greatest slope of return to baseline cycle). T‐wave alternans (TWA) was also measured during atrial pacing.

Results: At PVS, abnormal TO (≥0%) predicted inducible ventricular tachycardia (VT; n = 10 patients; P < 0.05). TO was greater in inducible than in noninducible patients (2.3 ± 3.1% vs –0.02 ± 2.8%, P < 0.05) and correlated with LVEF (P < 0.05) but not with BNP. TS did not differ between groups. Conversely, ambulatory HRT differed significantly from HRT at PVS (TO –0.55 ± 1.08% vs 0.85 ± 3.02%, P < 0.05; TS 2.63 ± 2.09 ms/RR vs 8.70 ± 6.56 ms/RR, P < 0.01), and did not predict inducible VT but trended (P = 0.05) to predict sustained VT on 739 ± 179 days follow‐up. TWA predicted inducible (P < 0.05) and spontaneous (P = 0.0001) VT but did not co‐migrate with HRT.

Conclusions: Abnormal HRT measured at PVS predicted the induction of sustained ventricular arrhythmias in patients with ischemic cardiomyopathy. However, HRT at PVS did not correlate with ambulatory HRT, nor with TWA, both of which predicted spontaneous ventricular arrhythmias. Thus, HRT may reflect the influence of autonomic milieu on arrhythmic susceptibility and is likely complementary to traditional arrhythmic indices.
Absence of Device‐Device Interaction (DDI) in a Patient with Cardiac and Diaphragmatic Pacemakers for Congenital Central Hypoventilation Syndrome
Authors: MOVAHED MOHAMMAD‐REZA , JALILI MEHRDAD , KICIMAN NAFIZ
Published: November 2005

Autonomic control of ventilation is impaired in patients with Ondine's curse or congenital central hypoventilation syndrome (CCHS), but voluntary control remains intact. Bradyarrhythmias can be life threatening. In a patient with CCHS and long sinus pause requiring cardiac pacemaker insertion, a diaphragmatic pacemaker inserted in early childhood caused diaphragmatic pacer spikes observed during the interrogation of the cardiac pacemaker. Diaphragmatic pacing did not interfere with the cardiac pacemaker function.
Cardiovascular Abnormalities and Arrhythmias in Patients with Ondine's Curse (Congenital Central Hypoventilation) Syndrome
Authors: MOVAHED MOHAMMAD‐REZA , JALILI MEHRDAD , KICIMAN NAFIZ
Published: November 2005

Patients with congenital central hypoventilation syndrome (CCHS) (Ondine's curse syndrome) have impaired autonomic control of ventilation with intact voluntary control of respiration. Autonomic dysfunction and cardiac abnormalities are common in CCHS. Bradyarrhythmias are life‐threatening and often require pacemaker insertion. We presented a case of a patient with CCHS suffering from long sinus pauses requiring cardiac pacemaker insertion. Patients with CCHS are at risk for pulmonary hypertension and cor pulmonale secondary to chronic hypoxia. Diaphragmatic pacing has been beneficial in some patients with CCHS. In this article, we review concomitant cardiac abnormalities and the occurrence of bradyarrhythmias in patients with CCHS.
Apropos “Tachycardia Begets Tachycardia”
Authors: RICHTER SERGIO , ISRAEL CARSTEN W. , HOHNLOSER STEFAN H.
Published: November 2005

It has been shown that a tachycardia can facilitate the induction of the same (“atrial fibrillation begets atrial fibrillation”) or a different tachycardia. This may also apply for pacemaker‐mediated tachycardia as the present case documents.
Community Social Organization: A Conceptual Linchpin in Examining Families in the Context of Communities*
Authors: Mancini Jay A. , Bowen Gary L. , Martin James A.
Published: November 2005

Abstract:The concept of social organization provides an important framework for understanding families in the context of communities and focuses our attention on norms, networks, and associated processes that typify community life. We discuss the significance of community for understanding family outcomes, discuss challenges in defining community context, define social organization and feature several of its associated components and their linkages, and assess research designs that inform the study of social organization. We conclude by suggesting implications for theory (elaborating social organization community processes), research (incorporating designs and measures that reflect collective processes), and practice (maximizing effects generated by informal and formal networks in communities).
The Effects of Community Demands, Resources, and Strategies on the Nature and Consequences of the Work‐Family Interface: An Agenda for Future Research
Authors: Voydanoff Patricia
Published: November 2005

Abstract: This article presents a broad conceptual framework that suggests ways in which community demands, resources, and strategies influence relationships between work demands, resources, and family well‐being. Within‐domain and boundary‐spanning community demands and resources are proposed to combine with work demands and resources in relation to work‐family conflict and facilitation. Boundary‐spanning community strategies are expected to mediate and moderate relationships between work‐family conflict and facilitation and family well‐being. The paper closes with an agenda for future research and a strategy for policy and practice.
Neighborhood and Gender Effects on Family Processes: Results From the Moving to Opportunity Program*
Authors: Leventhal Tama , Brooks‐Gunn Jeanne
Published: November 2005

Abstract: Data from the New York City Moving to Opportunity 3‐year follow‐up were used to examine neighborhood and gender effects on adolescents’ family processes. Low‐income, minority families in public housing in high‐poverty neighborhoods were assigned randomly to (a) move to private housing in low‐poverty neighborhoods only, (b) move to private housing in neighborhoods of their choice, or (c) stay in place. Family processes, assessed by parent reports and interviewer observations, were compared for those who relocated and those who stayed in place. Parents in the low‐poverty group were observed to be harsher toward their daughters than parents in the high‐poverty group. In adolescence, residential relocation may be difficult for mother‐daughter relations and require additional services to ease the transition.
Democratic Community Initiatives: The Case of Overscheduled Children
Authors: Anderson Jared R. , Doherty William J.
Published: November 2005

Abstract: We describe a democratic citizen model of community organizing for mobilizing and partnering with families, using the overscheduling of children as a case example. We provide an overview of the growing body of research on this aspect of family time, describe the difference between a citizen model and program models for working with families, give two examples of community initiatives initiated by family professionals, describe next steps for evaluating this community organizing model, and offer implications for family professionals.
Families and Communities: An Annotated Bibliography
Authors: Brossoie Nancy , Graham Bonnie , Lee Soyoung
Published: November 2005

Abstract: Connections between families and communities are dynamic and contextual, and their influences are reciprocal. We present a resource guide for family social scientists who are focusing on the nexus of families and communities by highlighting recent theoretical, methodological, and empirical contributions.
Contextual Factors Influencing Research Use in Nursing
Authors: French Beverley
Published: November 2005

Background: Contextual factors are perceived to be significant barriers to research‐utilisation‐related activity, but little is known about how context impacts on specific research‐based decisions, or how the individual interacts with the organisation in the requirement for research‐based change.

Aim: This study describes the impact of contextual factors on the practical reasoning of nurse specialists in the construction of policy for practice.

Methods: Three groups of clinical nurse specialists were observed during a series of meetings convened to construct evidence‐based guidelines for nursing practice. Transcripts of the meetings were analysed to identify and categorise the physical, social, political, and economic influences on 31 nursing issues.

Findings: Multiple contextual factors influenced each decision made, with decisions about nursing practice bounded by setting and system considerations, relationships with others in the care team, and resource constraints. Practitioners were involved in weighing up alternative scenarios, contexts, and contingencies for each decision, requiring strategies to adapt and reconstruct the nature of care, to influence others, and to affect organisational decision‐making processes.

Discussion: The practical accomplishment of evidence‐based practice required diverse skills: translating between evidence and practice; mediating the values, preferences, and working practices of multiple stakeholders; negotiating organisational complexity and the management of boundaries; and coordinating inter‐organisational and inter‐agency working. Nurse specialists in this study had a significant role in instigating, fuelling, and coordinating policy review, predominantly by communication across professional and organisational boundaries.

Implications/Conclusions: Clinical specialists acting as organisational boundary spanners require skills in the informal cultural work of organising, facilitating, and maintaining links across professional, team, and organisational boundaries. If their role in the negotiation of evidence‐based practice patterns across professional and organisational boundaries is to be successful, wider skills than information management need to be recognised and their development and enactment supported.

Worldviews on Evidence‐Based Nursing 2005; 2(4):172‐183
Application of chemical and biological agents for the management of frosty pod rot (Moniliophthora roreri) in Costa Rican cocoa (Theobroma cacao)
Authors: Bateman R.P. , Hidalgo E. , García J. , Arroyo C. , Ten Hoopen G.M. , Adonijah V. , Krauss U.
Published: November 2005

This article describes two field trials carried out at La Lola, Costa Rica, to assess control measures against frosty pod rot of cocoa (Theobroma cacao) caused by Moniliophthora (Crinipellis) roreri. In the first, factorial, trial the control agents were applied using motorised mistblowers (MMs) and hydraulic sprayers fitted with a narrow angle cone nozzle. There was an interaction between agents and application methods; together with previous application data for the most active fungicide (copper hydroxide), these trials indicate that best yields are achieved with sprays that maximise deposits on pods. We describe the droplet size spectra produced by a Stihl SR400 MM under a range of conditions because this has become the standard method of fungicide application in this series of trials at La Lola. The factor that had the largest effect on droplet size spectrum was the presence or the absence of a detachable baffle plate in front of the air‐shear nozzle. In both trials described here, MMs were fitted with baffle plates, a formulation pump and restrictor transmitting 550 mL min−1 to deliver an estimated equivalent of 190 L ha−1. Copper hydroxide as prophylactic applications at 1500 g a.i. ha−1 have, to date, shown the most consistent (but incomplete) improvement in healthy pod yield. Use of copper fungicides may be cost effective when farm‐gate cocoa prices exceed approximately $1.25 kg−1. In these trials, isolates of the hyperparasitic fungi Clonostachys byssicola and Trichoderma asperellum and two off‐patent triazole fungicides (bitertanol and triadimenol) made no significant improvement to healthy yields. The systemic oxathiin fungicide flutolanil, at a dosage of 300 g a.i. ha−1, appears to protect pods substantially at early stages but gives proportionately less control of M. roreri than copper at later stages of pod development.
CHANGES IN CELL WALL NEUTRAL SUGAR COMPOSITION AND ETHYLENE EVOLUTION AS POTENTIAL INDICATORS OF WOOLLINESS IN COLD‐STORED NECTARINE FRUIT
Authors: MANGANARIS GEORGE ATHANASIOS , VASILAKAKIS MILTIADIS , DIAMANTIDIS GRIGORIOS , MIGNANI ILARIA
Published: November 2005

Changes in cell wall composition during ripening of nectarine fruit (Prunus persica var nectarina, Ait. Max, cv. “Caldesi 2000”) after harvest or after cold storage were investigated. Cell wall materials were prepared from nectarine fruits after harvest, after 2, 4 and 6 weeks of cold storage (0C) and after additional ripening at room temperature (20C) for 1 and 5 days, respectively. The materials were analyzed for neutral sugars and cellulose content. Incidence of chilling injury (CI) symptoms, expressed as woolliness and gaseous emissions of CO2 and ethylene evolution, were also monitored. A significant decrease in arabinose and galactose contents as the woolliness symptoms became more intense was observed. After 6 weeks of cold storage and an additional 5 days at room temperature, arabinose and galactose contents decreased up to 63 and 34%, respectively. In addition, as the cold storage period increased, a linear decrease of total neutral sugars (r = 0.9832, P < 0.01) and arabinose content (r = 0.9903, P < 0.01) after 5 days of ripening at room temperature was recorded. Furthermore, reduced ethylene production after 6‐week cold storage was accompanied by intense woolliness symptoms. Inversely, respiration rate and cellulose content did not show any consistent trend during nectarine ripening after harvest or after removal from cold storage, and therefore cannot be used as indicators of CI symptoms.
PRODUCTION OF LIQUID AND WHITE SOLID  PEKMEZ IN TURKEY
Authors: BATU ALI
Published: November 2005

The research was carried out to evaluate gelling and bleaching agents for white solid pekmez production. Grape juice with 26% total soluble solids as °Brix was used for the production of pekmez. Acidity was reduced with the application of sterile white soil containing 70.4% CaCO3, followed by tannin–gelatin clarification and filtration. The grape juice was concentrated to 76% total soluble solids by vacuum. Gelling treatments were designed to produce a solid pekmez by adding high or low methoxyl pectins or carboxymethylcellulose (CMC). It was found that sufficient gelling could be achieved using less than 0.5% CMC and 1% for either pectin. Also, a desirable white color was obtained with 1.5% soapwort juice and 3% egg white with the combination of 1% pectins.
DEFINITION OF INTERNAL MORPHOLOGY AND STRUCTURAL CHANGES DUE TO DEHYDRATION OF RADISH (RAPHANUS SATIVUS L. CV. SUPRELLA) USING MAGNETIC RESONANCE IMAGING SPECTROSCOPY
Authors: SALERNO ANNA , PIERANDREI FERNANDO , REA ELVIRA , SEQUI PAOLO , VALENTINI MASSIMILIANO
Published: November 2005

Magnetic resonance imaging (MRI) spectroscopy is a promising nondestructive analytical technique in food science. It offers the unique opportunity of studying vegetables, fruits and other foods in general, in their wholeness without any preparative manipulation of the sample. The aim of this study was to investigate the internal structure of radish and to monitor the variations induced by postharvest storage at low relative humidity. The MRI allowed for a clear definition of the internal structure of radishes with distinct visibility of xylematic and phloematic vessels distributed in a radial way. A decrease in water content, which results in the breakdown of tissues and the formation of large cavities with the detachment of the external cortex, is the main consequence of a few days' storage in low relative humidity. Both of these are factors that drastically decrease the quality of the radish's fleshy root. The MRI images give a novel insight into the internal organization of the hypocotyl, and this offers opportunities for further studies with regard to the structural differences related to the cultivars as well as the cultivation system.
MEAT SPAGHETTI TENSILE STRENGTH AND EXTENSIBILITY AS INDICATORS OF THE MANUFACTURING QUALITY OF THAWED BEEF
Authors: FAROUK M.M. , ZHANG S.X. , WALLER J.
Published: November 2005

The functional attributes of thawed whole, diced or minced high‐ (6.10–6.79) and normal‐ (5.40–5.79) pH longissimus dorsi muscles of a line of bulls were determined, and the meat was used to prepare sausage and meat spaghetti batters. The torsion stress and strain to failure of cooked sausages and the tensile strength and extensibility of the cooked meat spaghetti were determined. The results of bivariate regression indicate that meat spaghetti tensile strength and extensibility had a significant (P < 0.01) correlation to pH, sarcoplasmic protein solubility, water‐holding capacity, cooked batter torsion stress, strain, yield and emulsion stability. Regression analysis of batter torsion stress on meat spaghetti tensile strength and extensibility indicated that torsion stress could be predicted by tensile strength only, with extensibility not adding any further predictive ability. On the other hand, torsion strain could be predicted by extensibility only, with tensile strength not providing any extra predictive ability. The reverse of both of these regressions was not true. Torsion stress =–14.296 + 0.2935 * tensile strength (r2 = 0.92) and torsion strain = 0.452 + 0.0936 * extensibility (r2 = 0.90). Within the parameters of the present study, meat spaghetti tensile strength and extensibility could be used to determine the manufacturing quality of frozen beef.
QUALITY EVALUATION OF COMMERCIAL FRANKFURTER BY DETERIORATION INDEX METHOD
Authors: SABBAG NORA G. , ARÍNGOLI E. ELENA , SANTIAGO LILIANA G. , COSTA SILVIA C. , GONZÁLEZ ROLANDO J.
Published: November 2005

The objectives of this study were to evaluate sensory properties during the storage at two different temperatures, to develop and evaluate a Deterioration Index Method (DIM) and to compare it with microbial counts and physicochemical measurements in order to obtain the correlation with the Deterioration Index (DI). The frankfurters were stored at 10 and 15C for 30 days, and the changes during storage were sensorially evaluated by using Quantitative Descriptive Analysis, DIM, microbiological analysis, acidity and purge loss. A linear relationship with high correlation was obtained between the average DI of each storage day for the two samples and storage temperatures. The correlation coefficients between physicochemical parameters and deterioration indixes were high for both samples and temperatures.
SHELF LIFE OF HHP‐PROCESSED PEACH PUREE WITH ANTIBROWNING AGENTS
Authors: GUERRERO‐BELTRÁN JOSÉ A. , SWANSON BARRY G. , BARBOSA‐CÁNOVAS GUSTAVO V.
Published: November 2005

Natural peach puree and peach puree containing 500 ppm of ascorbic acid (AA) or cysteine (250 ppm) were treated at high pressure (517 MPa/5 min). High hydrostatic processing (HHP)‐processed and control purees were stored at 3, 21 and 35 ± 1C for 30 days. Total count, yeast/molds, color and polyphenoloxidase (PPO) activity were analyzed regularly. PPO activity was reduced to 12.1, 26.4 and 5.5% in both the natural puree and puree containing AA and cysteine after applying HHP. PPO activity of the non‐HHP‐processed puree containing cysteine was different from the other purees, as well as the PPO activity of HHP‐processed purees. Non‐HHP‐processed natural puree (yellow color) and purees containing AA (yellow color) and cysteine (orange color) maintained their colors individually for 9 days. HHP‐processed purees maintained their yellow (natural puree and puree with AA) and orange colors (puree containing cysteine) for 21 to 24 and 30 days, respectively. Less than 10 cfu/g were counted in HHP‐processed purees stored at 3C.