bluuebunny/crossref_metadata_2025 huggingface dataset:
Stability of Complex Fractionated Atrial Electrograms: A Systematic Review
Authors: LAU DENNIS H. , MAESEN BART , ZEEMERING STEF , VERHEULE SANDER , CRIJNS HARRY J. , SCHOTTEN ULRICH
Published: May 2012

Stability of CFAE. Introduction: The efficacy of complex fractionated atrial electrograms (CFAE) ablation as additional substrate modification in atrial fibrillation (AF) patients has been shown to be highly variable. Recently, the validity of sequential CFAE mapping has been challenged by concerns regarding temporal stability of CFAE. Existing studies on CFAE stability are small with very different CFAE definitions. Here, we undertook a systematic literature review to address these controversial findings.

Methods and Results: A systematic search of the scientific literature was performed through to September 1, 2011. From a total of 162 manuscripts, 7 were identified to contain assessment of the temporal stability of CFAE in human AF. These studies included a total of 96 (80 persistent/16 paroxysmal AF) patients (79% male, mean 58 years old). Varying CFAE mapping techniques or definitions were utilized. CFAE stability averaged 81% between 2 high‐density sequential fractionation maps over an average time interval of 19 minutes. However, CFAE stability only averaged at 75% from shorter term continuous recordings (mean 15 comparisons within 75 seconds). Although the variability in CFAE cycle length was small (12–15 ms), coefficients of variation in continuous electrical activity were high (up to 300%). The overall spatial distribution of CFAE was found to be stable. Nevertheless, sequential mapping may not capture all CFAE sites given their dynamic characteristics.

Conclusion: CFAE are temporally variable in keeping with the diverse mechanisms underlying their existence. The dynamic nature of CFAE will continue to pose a challenge for electrophysiologists in search of critical sites requiring ablation to combat AF. (J Cardiovasc Electrophysiol, Vol. 23, pp. 980‐987, September 2012)
Voltage‐Guided Ablation Technique for Cavotricuspid Isthmus‐Dependent Atrial Flutter: Refining the Continuous Line
Authors: JACOBSEN PETER K. , KLEIN GEORGE J. , GULA LORNE J. , KRAHN ANDREW D. , YEE RAYMOND , LEONG‐SIT PETER , MECHULAN ALEXIS , SKANES ALLAN C.
Published: May 2012

Voltage‐Guided Ablation Technique for Cavotricuspid Isthmus‐Dependent Atrial Flutter. 

Ablation of the cavotricuspid isthmus has become first‐line therapy for “isthmus‐dependent” atrial flutter. The goal of ablation is to produce bidirectional cavotricuspid isthmus block. Traditionally, this has been obtained by creation of a complete ablation line across the isthmus from the ventricular end to the inferior vena cava. This article describes an alternative method used in our laboratory. There is substantial evidence that conduction across the isthmus occurs preferentially over discrete separate bundles of tissue. Consequently, voltage‐guided ablation targeting only these bundles with large amplitude atrial electrograms results in a highly efficient alternate method for the interruption of conduction across the cavotricuspid isthmus. Understanding the bundle structure of conduction over the isthmus facilitates more flexible approaches to its ablation and targeting maximum voltages in our hands has resulted in reduction of ablation time and fewer recurrences. (J Cardiovasc Electrophysiol, Vol. 23, pp. 672–676, June 2012)
Improved Estimation of the Noncentrality Parameter Distribution from a Large Number oft‐Statistics, with Applications to False Discovery Rate Estimation in Microarray Data Analysis
Authors: Qu Long , Nettleton Dan , Dekkers Jack C. M.
Published: May 2012

SummaryGiven a large number oft‐statistics, we consider the problem of approximating the distribution of noncentrality parameters (NCPs) by a continuous density. This problem is closely related to the control of false discovery rates (FDR) in massive hypothesis testing applications, e.g., microarray gene expression analysis. Our methodology is similar to, but improves upon, the existing approach by Ruppert, Nettleton, and Hwang (2007, Biometrics, 63, 483–495). We provide parametric, nonparametric, and semiparametric estimators for the distribution of NCPs, as well as estimates of the FDR and local FDR. In the parametric situation, we assume that the NCPs follow a distribution that leads to an analytically available marginal distribution for the test statistics. In the nonparametric situation, we use convex combinations of basis density functions to estimate the density of the NCPs. A sequential quadratic programming procedure is developed to maximize the penalized likelihood. The smoothing parameter is selected with the approximate network information criterion. A semiparametric estimator is also developed to combine both parametric and nonparametric fits. Simulations show that, under a variety of situations, our density estimates are closer to the underlying truth and our FDR estimates are improved compared with alternative methods. Data‐based simulations and the analyses of two microarray datasets are used to evaluate the performance in realistic situations.
Electrode‐Limited Dielectric Breakdown of Alkali Free Glass
Authors: Murata Takashi , Dash Priyanka , Furman Eugene , Pantano Carlo , Lanagan Michael
Published: May 2012

The dielectric breakdown statistics of alkali‐free glass was determined for various thicknesses with electrodes having controlled morphology and continuity. The characteristic electrical breakdown field strength increased from 400 to 1100 MV/m as the glass substrate thickness decreased from 58 to 5 μm, respectively. Surface roughness RMS values of as‐drawn and etched glass substrates were in the 0.9–1.8 nm range, which is small in comparison to the glass substrate thickness. The glass etching, itself did not have significant effect on the dielectric breakdown strength. The dielectric breakdown strength was also independent of the sputtered‐deposited electrode composition (Au, Pt); however, electrode thickness played an important role in controlling the breakdown process. The Au electrode morphology transitioned from a continuous sheet for thicker electrodes to discrete nano‐scale islands for very thin electrodes (<2 nm thick). The thin electrode morphology provides a unique opportunity to explore the intrinsic properties and high dielectric breakdown strength regime (1100 MV/m) in glasses with Weibull modulus values approaching 100.
Synthesis of Lithium Metasilicate Powders at Low Temperature via Mechanical Milling
Authors: Yang Aixia , Wang Huijun , Li Wei , Shi Jianlin
Published: May 2012

The Li2SiO3 powder has been successfully synthesized at low temperature via mechanical milling process. By using LiOH·H2O and tetraethyl orthosilicate (TEOS) as raw materials, Li2SiO3 powder with grain size of about 100 nm could be obtained at room temperature (~20°C) after mechanical milling for 120 h. This nano Li2SiO3 powder shows excellent thermal stability that no decomposing reaction or phase change would happen even after calcined at 900°C for 4 h. Experiments show that high concentration of the raw materials is helpful to the forming of Li2SiO3 phase. When the concentration of the raw materials is too low, no Li2SiO3 phase could be obtained. The investigation also shows that small content of B2O3 could accelerate the densifying speed of Li2SiO3 ceramics and decrease the thermal stability of Li2SiO3 phase.
Challenges in International Medicine: Ethical Dilemmas, Unanticipated Consequences, and Accepting Limitations
Authors: Iserson Kenneth V. , Biros Michelle H. , James Holliman C.
Published: May 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:683–692 © 2012 by the Society for Academic Emergency Medicine

While personal and organizational challenges occur in every area of health care, practitioners of international medicine face unique problems and dilemmas that are rarely discussed in training programs. Health professions schools, residency and fellowship programs, nongovernmental organizations (NGOs), and government programs have a responsibility to make those new to international medicine aware of the special circumstances that they may face and to provide methods for understanding and dealing with these circumstances.

Standard “domestic” approaches to such challenges may not work in international medicine, even though these challenges may appear to be similar to those faced in other clinical settings. How should organizations ensure that well‐meaning health intervention efforts do not cause adverse unintended sequelae? How should an individual balance respect for cultural uniqueness and local mores that may profoundly differ from his or her own beliefs, with the need to remain a moral agent true to one’s self? When is acceptance the appropriate response to situations in which limitations of resources seem to preclude any good solution?

Using a case‐based approach, the authors discuss issues related to the four major international medicine domains: clinical practice (postdisaster response, resource limitations, standards of care), medical systems and systems development (prehospital care, wartime casualties, sustainable change, cultural awareness), teaching (instruction and local resources, professional preparation), and research (questionable funded studies, clinical trials, observational studies). It is hoped that this overview may help prepare those involved with international medicine for the challenges and dilemmas they may face and help frame their responses to these situations.
Prevalence and risk factors for peri‐implant disease in Belgian adults
Authors: Marrone Alexandra , Lasserre Jérôme , Bercy Pierre , Brecx Michel C.
Published: May 2012

Objectives

This study aimed to evaluate in a Belgian population the frequence of mucositis and peri‐implantitis in patients with implants of at least 5 years of function. Another outcome was to access implants/patients characteristics as possible risk indicators for peri‐implantitis.

Material and methods

One hundred and three patients (38 males/65 females) with a total of 266 implants were examined. Implants had been inserted in university hospitals as well as in private clinics and the mean time of implants in function was 8.5 years (±3.2). The average patients' age within the population was 62 years (±13.4). General health informations were recorded as well as habits regarding smoking, maintenance visits and oral hygiene. Full mouth clinical parameters (PlI, BoP, PPD) were assessed and radiographs taken to determine the periodontal status and implants diagnosis.

Results

Prevalences of mucositis and peri‐implantitis at the patient's level were respectively 31% and 37%. They were 38% and 23% at the implant's level. Subjects older than 65 years (OR = 1.39) and those with active periodontitis (OR = 1.98) were prone to peri‐implantitis. The association was stronger for hepatitis (OR = 2.92) and totally edentulous patients (OR = 5.56). Finally, at the implant's level, a significant correlation was found in the multi‐level analyses between rough surfaces, overdentures and peri‐implantitis.

Conclusion

After 8.5 years an important proportion (±60%) of implants presented biological complications. Furthermore, a positive correlation was showed between age, periodontitis, absence of teeth, rough surfaces and peri‐implantitis. Consequently, patients with such characteristics should be informed before implant placement and frequently re‐called after for maintenance visits.
The role of pericranium grafts in the reduction of postoperative dehiscences and bone resorption after reconstruction of severely deficient edentulous ridges with autogenous onlay bone grafts
Authors: Chiapasco Matteo , Autelitano Luca , Rabbiosi Dimitri , Zaniboni Marco
Published: May 2012

Purpose

To compare: (i) the incidence of soft tissue dehiscences; (ii) bone resorption before and after implant placement; and (iii) the survival and success rates of implants placed in two groups of patients with severe bone defects of the jaws reconstructed with autogenous onlay bone grafts alone (control group) or in association with autogenous pericranium coverage (study group).

Material and methods

Forty‐four patients affected by severe atrophy of the alveolar ridges underwent bone reconstruction with vertical/tridimensional autogenous onlay grafts harvested from the calvarium or the mandibular ramus. In 23 patients (study group), grafts were covered with autogenous pericranium before suturing, while in 21 patients (control group) no coverage of the grafts before suturing was performed. After a 4–7 month waiting period, 199 implants were placed (105 in the study group, 94 in the control group) and 3–4 months afterward prosthetic rehabilitation was carried out. The mean follow‐up after the start of prosthetic loading was 23.9 months (range: 12–48 months).

Results

The incidence of soft tissue dehiscences was 5,7% in the study group and 16% in the control group. The mean graft resorption before implant placement was 0.12 mm (SD ± 0.32) in the study group and 0.98 mm (SD ± 2.79) in the control group. The mean peri‐implant bone resorption at the end of the follow‐up period was 0.21 mm (SD ± 0.48) in the study group and 0.43 mm (SD ± 0.83) in the control group. The survival rate of implants was 99.1% in the study group and 100% in the control group, while success rate was 96.2% in the study group and 93.6% in the control group.

Conclusions

The use of pericranium as an autogenous membrane for the coverage of onlay bone grafts seems to reduce the risk of soft tissue dehiscences after the reconstruction of atrophic edentulous ridges to reduce peri‐implant bone resorption over time, while it seems to have no significant effect in reducing bone resorption in the reconstructed areas before implant placement.
A comparison of perceived and actual dental needs of a select group of children in Texas
Authors: Friedman Lawrence A. , Mackler Irene Goding , Hoggard Gloria J. , French Christine I.
Published: May 2012

Abstract— Dental caries (DMFS) evaluations were made for 150 children in Grades 2 to 7. Three months later, a trained interviewer questioned 120 children from 100 families to determine attitudes toward oral hygiene and dental health on the part of (a) the child, (b) the parent, along with (c) the child's perception of the parent's attitude, and (d) the parent's perception of the child's attitude. Evaluation of the perceived attitudes toward oral hygiene revealed a statistically significant correlation between the child's attitude and the degree of dental health as well as between the attitudes of child and parent. Conclusions were: (1) parents were not accurate in their perception of the dental health habits of their children, (2) children were not performing acceptable routine oral hygiene procedures, (3) children accurately perceived the attitudes of their parents toward dental health, and (4) children's actual dental health behavior as manifested by dental health status was related to the attitudes of their parents.
Comparisons of caries prevalence of children with different daily toothbrushing frequencies
Authors: Leske Gary S. , Ripa Louis W. , Barenie James T.
Published: May 2012

Abstract— Clinical caries examinations, supplemented by bite‐wing radiographs, were conducted on 290 schoolchildren. The children ranged from 12 to 15 years of age and were residents of a fluoride‐deficient community in New York State. The children were divided into two groups based upon their stated daily toothbrushing frequency, namely, those brushing once or less/day and those brushing twice or more/day. Mean DMFS and DMFT scores were recorded for children in both brushing categories. A trend was noted that more frequent brushing was associated with less caries activity. For females and males‐females combined the differences in mean DMFS and DMFT scores between those children brushing two times a day or more were significantly different (P < .01) from the group brushing once a day or less. The caries scores for males in these two brushing groups were marginally significant (P < .05). Ninety percent of the children used fluoride‐containing dentifrices. The inverse relationship between brushing frequency and caries activity may be related to the more frequent fluoride contact when the children brush.
The absence of Brm exacerbates photocarcinogenesis
Authors: Halliday Gary M. , Zhou Yue , Sou Paul W. , Huang Xiao X. J. , Rana Sabita , Bugeja Matthew J. , Painter Nicole , Scolyer Richard A. , Muchardt Christian , Di Girolamo Nick , Guy Lyons J.
Published: May 2012

Brm is an ATPase subunit of the SWI/SNF chromatin–remodelling complex. Previously, we identified a novel hotspot mutation in Brm in human skin cancer, which is caused by exposure to ultraviolet radiation (UVR). As SWI/SNF is involved in DNA repair, we investigated whether Brm−/− mice had enhanced photocarcinogenesis. P53+/− and Brm−/−p53+/− mice were also examined as the p53 tumor suppressor gene is mutated early during human skin carcinogenesis. Mice were exposed to a low‐dose irradiation protocol that caused few skin tumors in wild‐type mice. Brm−/− mice with both p53 alleles intact had an increased incidence of skin and ocular tumors compared to Brm+/+p53+/+ controls. Brm loss in p53+/− mice did not further enhance skin or ocular cancer incidence beyond the increased photocarcinogenesis in p53+/− mice. However, the skin tumors that arose early in Brm−/− p53+/− mice had a higher growth rate. Brm−/− did not prevent UVR‐induced apoptotic sunburn cell formation, which is a protective response. Unexpectedly, Brm−/− inhibited UVR‐induced immunosuppression, which would be predicted to reduce rather than enhance photocarcinogenesis. In conclusion, the absence of Brm increased skin and ocular photocarcinogenesis. Even when one allele of p53 is lost, Brm has additional tumor suppressing capability.
Contrasting patterns of trait‐based community assembly in lianas and trees from temperate Australia
Authors: Gallagher Rachael V. , Leishman Michelle R.
Published: May 2012

Trait variation in plant communities is thought to be constrained by two opposing community assembly processes operating at discrete spatial scales: habitat filtering and limiting similarity between coexisting species. Filtering processes cause convergence in ecological strategy as species are excluded from unsuitable sites, whilst limiting similarity leads to the divergence of trait values between co‐occurring species in order to alleviate competition for finite resources. Levels of alpha (within‐site) and beta (among‐site) trait variation can be indicative of the strength of these community assembly processes. We used trait‐gradient analysis to explicitly compare evidence of community assembly patterns in lianas (woody vines) and trees. These two growth forms exhibit striking differences in carbon capture and regeneration strategies, yet trait‐based mechanisms that maintain their coexistence remain understudied. Using data for four functional traits – leaf mass per area, leaf nitrogen content (Nmass), leaf area and seed mass – we partitioned interspecific trait variation in lianas and trees into alpha and beta components. Our three key findings were: 1) lianas and trees exhibit divergent patterns of trait‐based habitat filtering, due to differences in the relationship between leaf size and the other three traits examined (LMA, Nmass and seed mass), 2) on average, liana species possess smaller seeds, lower LMA and higher Nmass than do trees, but there was no clear difference in leaf area between the two growth forms, and 3) soil fertility was correlated with trait variation (leaf area, seed mass) at the site‐level in trees, but not in lianas. These results provide evidence that dominant growth forms can be filtered into the same habitat on the basis of different combinations of traits. Our findings have important implications for community assembly and co‐existence theory and for more pragmatic matters such as using trait‐based principles to inform community restoration.
Expression and localization of aquaporin‐1 in temporomandibular joint disc with internal derangement
Authors: Loreto Carla , Galanti Concetta , Almeida Luis Eduardo , Leonardi Rosalia , Pannone Giuseppe , Musumeci Giuseppe , Carnazza Maria Luisa , Caltabiano Rosario
Published: May 2012

J Oral Pathol Med (2012) 41: 642–647

Background:  Internal derangement is the most frequent arthropathy affecting the temporomandibular joint, where its commonest form is anterior disc displacement with or without reduction. Despite the frequency of the disorder, the biochemical features of displaced discs are still unclear.

Methods:  We investigated the expression pattern and localization of aquaporin‐1, an important channel protein involved in plasma membrane water permeability, in patients with anterior disc displacement (both with and without reduction), with a view to assessing the characteristics of local tissue responses to the microenvironmental changes induced by abnormal mechanical loading of the displaced disc. Protein expression was studied by immunohistochemistry in different areas of discs from 18 patients with anterior disc displacement with or without reduction and in four normal controls.

Results:  A greater proportion of cells immunopositive for aquaporin‐1 were detected in diseased than in normal discs. Whereas protein expression was substantially similar in the different areas of normal discs, a significantly larger number of immunopositive cells were detected in the posterior band of displaced discs without reduction and in the anterior and intermediate bands of those with reduction.

Conclusions:  These findings suggest that aquaporin‐1 is expressed and upregulated in temporomandibular joint with anterior disc displacement (both with and without reduction).
Comparison of the efficacy of ALA‐PDT using an excimer‐dye laser (630 nm) and a metal‐halide lamp (600 to 740 nm) for treatment of Bowen's disease
Authors: Mizutani Kentaro , Akita Yoichi , Yanagishita Takeshi , Kimura Makoto , Tanaka Tohru , Kinoshita Yumi , Nakano Aki , Tamada Yasuhiko , Matsumoto Yoshinari , Watanabe Daisuke
Published: May 2012

Background/Purpose

Topical 5‐aminolevulinic acid‐based photodynamic therapy (ALA‐PDT) is an effective treatment for Bowen's disease (BD). In order to compare the efficacy of two different light sources, using either an excimer‐dye laser (EDL) (630 nm) or a metal‐halide lamp (MHL) (600 to 740 nm) a protocol for topical ALA‐PDT for treatment of BD of the extremities was established, and responses during 12 months follow‐up were assessed.

Methods

From 25 patients a total of 26 lesions that had been histopathologically diagnosed as BD from 2005 to 2010 in the Department of Dermatology at the Aichi Medical University Hospital were randomly selected. The light source used for the topical ALA‐PDT was EDL in 17 lesions and MHL in 9 lesions. The photosensitizing protoporphyrin IX that is produced within BD lesions 4 h after application of 20% ALA cream was mostly consumed after exposure to 100 J/cm2 irradiation using 630 nm EDL. Each lesion was irradiated once a week for 3 weeks, for a total dosage of 300 J/cm2 (100 mW/cm2). Patients were followed up clinically every 3 months for 12 months, and at 1 month after the final treatment lesions were evaluated histopathologically.

Results

Histologically, the complete response (CR) rate at 1‐month follow‐up was 82% (14/17 lesions) in the EDL treatment group and 100% (9/9 lesions) in the MHL treatment group (P > 0.05). The recurrence rate at 12 months after PDT was 46% (6/13 lesions, one patient lost to follow‐up) in the EDL group and 0% in the MHL group (P < 0.05) (χ2 test with Fisher's exact test). The average period before recurrence after EDL treatment was 6.5 months.

Conclusion

A novel protocol for topical ALA‐PDT in Japanese in Asian patients with BD was developed and implemented. The protocol improved the CR rate compared with previous studies. Moreover, the present results indicate that the efficacy of topical ALA‐PDT using MHL was superior to that using EDL for BD patients.
Melatonin promotes seminal root elongation and root growth in transgenic rice after germination
Authors: Park Sangkyu , Back Kyoungwhan
Published: May 2012

Abstract:  The effect of melatonin on root growth after germination was examined in transgenic rice seedlings expressing sheep serotonin N‐acetyltransferase (NAT). Enhanced melatonin levels were found in T3 homozygous seedlings because of the ectopic overexpression of sheep NAT, which is believed to be the rate‐limiting enzyme in melatonin biosynthesis in animals. Compared with wild‐type rice seeds, the transgenic rice seeds showed enhanced seminal root growth and an analogous number of adventitious roots 4 and 10 days after seeding on half‐strength Murashige and Skoog medium. The enhanced initial seminal root growth in the transgenic seedlings matched their increased root biomass well. We also found that treatment with 0.5 and 1 μm melatonin promoted seminal root growth of the wild type under continuous light. These results indicate that melatonin plays an important role in regulating both seminal root length and root growth after germination in monocotyledonous rice plants. This is the first report on the effects of melatonin on root growth in gain‐of‐function mutant plants that produce high levels of melatonin.
The BLOS1‐Interacting Protein KXD1 is Involved in the Biogenesis of Lysosome‐Related Organelles
Authors: Yang Qing , He Xin , Yang Lin , Zhou Zhiyong , Cullinane Andrew R. , Wei Aihua , Zhang Zhe , Hao Zhenhua , Zhang Aili , He Min , Feng Yaqin , Gao Xiang , Gahl William A. , Huizing Marjan , Li Wei
Published: May 2012

Biogenesis of lysosome‐related organelles (LROs) complex‐1 (BLOC‐1) is an eight‐subunit complex involved in lysosomal trafficking. Interacting proteins of these subunits expand the understanding of its biological functions. With the implementation of the naïve Bayesian analysis, we found that a human uncharacterized 20 kDa coiled‐coil KxDL protein, KXD1, is a BLOS1‐interacting protein. In vitro binding assays confirmed the interaction between BLOS1 and KXD1. The mouse KXD1 homolog was widely expressed and absent in Kxd1 knockout (KO) mice. BLOS1 was apparently reduced in Kxd1‐KO mice. Mild defects in the melanosomes of the retinal pigment epithelia and in the platelet dense granules of the Kxd1‐KO mouse were observed, mimicking a mouse model of mild Hermansky–Pudlak syndrome that affects the biogenesis of LROs.
Immunohistochemical localization of CD1a and S100 in gingival tissues of healthy and chronic periodontitis subjects
Authors: Anjana R , Joseph LD , Suresh R
Published: May 2012

Oral Diseases (2012) 18, 778–785

Objective:  The aim of this study was to evaluate the presence and distribution of CD1a and S100 protein markers in states of gingival health and chronic periodontitis in human subjects.

Materials and Methods:  Gingival tissue samples were derived from 10 healthy and 10 chronic periodontitis‐affected human subjects. The presence and distribution of CD1a and S100 protein was assessed using immunohistochemistry, and the cell types involved in their expression was determined.

Results:  The presence and distribution of CD1a was confined only to the gingival epithelium, whereas S100 was seen in the epithelium and connective tissue. However, increased expression of both CD1a and S100 protein was seen in periodontitis‐affected gingival tissues compared with healthy gingiva. Immunohistochemistry demonstrated that CD1a‐ and S100‐positive cells in the epithelium are Langerhans cells (LCs) and S100 positive cells in the connective tissue are dendritic cells (DCs).

Conclusion:  Our findings suggest the transition of CD1a‐positive LCs to S100‐positive DCs from epithelium to connective tissue in response to an antigenic challenge. Demonstration of increased number of S100‐positive DCs in the gingival connective tissue in chronic periodontitis possibly suggests their involvement in bone resorption in addition to their antigen presentation property.
Frequency of lower respiratory tract infections in relation to adaptive immunity in children with Down syndrome compared to their healthy siblings
Authors: Broers Chantal JM , Gemke Reinoud JBJ , Weijerman Michel E , Kuik Dirk‐J , van Hoogstraten Ingrid MW , van Furth A Marceline
Published: May 2012

Aim:  Children with Down syndrome (DS) experience respiratory tract infections (RTIs) more frequently than healthy children. We investigated whether this is related to different immunological characteristics associated with DS.

Methods:  The study group consisted of 22 children with DS and 22 of their healthy, age‐range matched siblings. Data were collected on infections and hospitalizations because of lower RTIs. Immunoglobulin and IgG subclass levels in blood, as well as lymphocyte and T cell (subset) counts, were determined.

Results:  The children with DS had a significantly higher frequency of lower RTIs and related hospitalization than their siblings. We also found significantly reduced IgG2 levels as well as significantly lower counts of total lymphocytes, CD4+ T lymphocytes, CD4+ invariant natural killer (iNKT) cells and regulatory T cells in the DS group.

Conclusion:  In children with DS, reduced levels of IgG2, total lymphocytes, T lymphocytes, iNKT cells and regulatory T cells might contribute to their higher susceptibility to lower RTIs.
CONTRAST AGENT Gd‐EOB‐DTPA (EOB·Primovist®) FOR LOW‐FIELD MAGNETIC RESONANCE IMAGING OF CANINE FOCAL LIVER LESIONS
Authors: Yonetomi Daisuke , Kadosawa Tsuyoshi , Miyoshi Kenjirou , Nakao Yukie , Homma Emi , Hanazono Kiwamu , Yamada Eriko , Nakamura Kozo , Ijiri Atsuki , Minegishi Noriyuki , Maetani Shigeki , Hirayama Kazuko , Taniyama Hiroyuki , Nakade Tetsuya
Published: May 2012

Contrast‐enhanced magnetic resonance (MR) imaging with a new liver‐specific contrast agent gadolinium‐ethoxybenzyl‐diethylenetriamine penta‐acetic acid (Gd‐EOB‐DTPA; EOB·Primovist®) was studied in 14 normal beagles and 9 dogs with focal liver lesions. Gd‐EOB‐DTPA accumulates in normally functioning hepatocytes 20 min after injection. As with Gd‐DTPA, it is also possible to perform a dynamic multiphasic examination of the liver with Gd‐EOB‐DTPA, including an arterial phase and a portal venous phase. First, a reliable protocol was developed and the appropriate timings for the dynamic study and the parenchymal phase in normal dogs using Gd‐EOB‐DTPA were determined. Second, the patterns of these images were evaluated in patient dogs with hepatic masses. The optimal time of arterial imaging was from 15 s after injection, and the optimal time for portal venous imaging was from 40 s after injection. Meanwhile, the optimal time to observe changes during the hepatobiliary phase was from 20 min after injection. In patient dogs, 11 lesions were diagnosed as malignant tumors; all were hypointense to the surrounding normal liver parenchyma during the hepatobiliary phase. Even with a low‐field MR imaging unit, the sequences afforded images adequate to visualize the liver parenchyma and to detect tumors within an appropriate scan time. Contrast‐enhanced MR imaging with Gd‐EOB‐DTPA provides good demarcation on low‐field MR imaging for diagnosing canine focal liver lesions.
COXOFEMORAL JOINT RADIOGRAPHY IN STANDING CATTLE
Authors: Wenzinger Beatrice , Hagen Regine , Schmid Tanja , Nuss Karl
Published: May 2012

The objective of this study was to establish a technique for radiographic examination of the coxofemoral joint and adjacent bony structures in standing cattle. Left (or right) 30° dorsal–right (or left) ventral radiographic views of the coxofemoral joint region of standing cattle (n = 10) with hind limb lameness were evaluated retrospectively. In addition, an experimental study of oblique laterolateral views of the coxofemoral joint region of a bovine skeleton at angles of 15–45° was carried out to determine the optimal position for visualization of the hip region. In the 10 clinical patients, the bodies of the ilium and ischium, the acetabulum and proximal third of the femur could be assessed. Six of these cattle had fractures of the body of the ilium and body of the ischium, five with and one without involvement of the acetabulum, two had craniodorsal and one caudoventral luxation of the femur and one had a femoral neck fracture. The described laterodorsal–lateroventral radiographs of the hip region in standing cattle were suitable for assessing the coxofemoral joint, the proximal aspect of the femur and parts of the ischium, ilium and pubis. After testing the optimal angle on the skeleton, it was seen that distortion and superimposition were minimized by positioning the X‐ray beam at an angle of 25° to the horizontal plane. It can be concluded that the described technique improves the evaluation of injuries of the coxofemoral region in cattle. With the appropriate angle, the technique can also be applied in recumbent cattle.
PRESSURE–VOLUME INDEX‐BASED VOLUME CALCULATION OF CONTRAST MEDIUM FOR ATLANTO‐OCCIPITAL MYELOGRAPHY IN DOGS
Authors: Arany‐Tóth Attila , Csébi Péter , Reiczigel Jenő , Németh Tibor
Published: May 2012

Subarachnoid pressure recordings were made during atlanto‐occipital myelography in 45 dogs with clinical signs of spinal disease. Iohexol was injected at a dosage of 0.3 ml/kg body weight and simultaneous pressure values were recorded in the cerebellomedullary cistern. The mean subarachnoid pressure was 9 ± 3 mmHg before and 70 ± 32 mmHg at the end of administration. From the pressure change induced by the volume load, the pressure–volume index (PVI) of the subarachnoid space was calculated and found to be in close correlation with body weight and the crown‐rump length (r= 0.94 and 0.87). Using the estimatedPVIvalues, the appropriate volume of contrast medium can be calculated for an animal according to body weight. Dogs of a large body size require relatively less contrast medium than small‐sized dogs (range 0.17–0.35 ml/kg). This calculated volume is unlikely to increase the subarachnoid pressure above 40 mmHg as a specific pressure limit. Using these data, simplified recommendations for the choice of contrast medium volumes have been generated.
TRANS‐VICTORIANS: Poetics, Translation, English
Authors: Martin Meredith
Published: May 2012

This essay discusses recent movements in poetics that highlight the circulation and mediation of poems and poetic discourse across the Atlantic, the translation and adaptation of poetry from other languages, and the influence of comparative linguistics on concepts of English poetry. Nineteenth‐century poets in England and America invented genres, histories, and traditions that became cemented by 20th century reading practices. If 19th‐century poetry is a space of possibility and questioning, we might rethink the upheavals of Anglo‐American modernism as well as rethink our narrow critical focus on the Anglophone world.
Shakespeare and Friendship: An Intersection of Interest
Authors: Garrison John
Published: May 2012

This essay examines the role of friendship in Shakespeare’s work. Friendship was a highly valued social relation in early modern England and constituted an important theme for humanist writers attempting to revive the virtues associated with classical antiquity. Recent scholarship has demonstrated how the terms of friendship helped legitimate and define social ties ranging from those between literary collaborators to those between political allies. Shakespeare’s work frequently depicts friendship’s complex relationship to rivalry and to marriage, as well as how same‐sex relations offered a means to navigate group environs including the martial encampment, the marketplace, and the court. These depictions at times come into conflict with a major Renaissance humanist concept of friendship as a relationship characterized by parity and lack of self‐interest. This essay focuses on recent critical approaches that have opened new lines of inquiry into the role of friendship in Shakespeare’s plays and poetry, especially with regards to how his work may attempt to reconcile friendship ideals with the increasing opportunities for advancement in England’s expanding economy and increasingly diverse social sphere.
Pathological response and prognosis of stage III non‐small cell lung cancer patients treated with induction chemoradiation
Authors: ISOBE Kazutoshi , HATA Yoshinobu , SAKAGUCHI Shinji , SATO Fumitomo , TAKAHASHI Shoji , SATO Keita , SANO Go , SUGINO Keishi , SAKAMOTO Susumu , TAKAI Yujiro , MITSUDA Aki , TERAHARA Atsuro , SHIBUYA Kazutoshi , TAKAGI Keigo , HOMMA Sakae
Published: May 2012

Aim:  The aim of this study was to clarify the relationship between pathological effects and the prognosis of patients with stage III non‐small cell lung cancer (NSCLC) treated with induction chemoradiation.

Methods:  Patients who were untreated and potentially resectable with stage III NSCLC were enrolled. They received carboplatin and docetaxel with concurrent radiotherapy (5 × 2 Gy/week with a total dose of 40 Gy) followed by surgery. We assessed the relationship between the pathological effect (Ef) (Ef 1: slight pathological response, Ef 2: moderate pathological response, Ef 3: complete pathological response) and prognosis.

Results:  In all, 30 patients with stage III NSCLC (24 men and 6 women, mean age 60.7 years, 17 with adenocarcinomas and 13 with squamous cell carcinomas, 21 with clinical stage IIIA and nine with stage IIIB) participated in the trial and underwent induction chemoradiation. A total of 27 patients (90%) with complete response, partial response and stable disease had surgical resection. The pathological effect was Ef 1 and Ef 2 in 10 patients each, and Ef 3 in seven patients. Median survival was 10.9 months in patients with Ef 1 and 49.6 months in patients with Ef 2. Six out of seven Ef 3 patients are alive at the time of writing with a mean survival of 77.1 months (14–104 months). There was a significant difference in overall survival based on pathological effect rating (P = 0.0036).

Conclusion:  The Ef rating was well correlated with prognosis after induction chemoradiation.
Cuticle and muscle variation underlying phenotypic plasticity in barnacle feeding leg and penis form
Authors: Neufeld Christopher J. , Rankine Cassidy
Published: May 2012

Many aspects of barnacle body form are known to be developmentally plastic. Perhaps the most striking examples of such plasticity occur in their feeding legs and unusually long penises, the sizes and shapes of which can change dramatically and adaptively with changes in conspecific density and local water flow conditions. However, whether variation in overall appendage form is mirrored by structural responses in cuticle and muscle is not known. In order to determine how structural variation underlies phenotypic plasticity in barnacle appendages, we examined barnacles occurring at low and high population densities from one wave‐protected and one wave‐exposed site. We used histological sectioning and fluorescence microscopy of feeding legs and penises to compare cuticle thickness, muscle thickness, and muscle organization, and artificial penis inflation to compare penis extensibility. We observed striking differences in cuticle thickness, muscle thickness, and muscle organization between sites that differed in water velocity, but we found no clear differences associated with variation in conspecific density. Penis extensibility also did not differ consistently between sites. These results are consistent with an adaptive explanation for much of the remarkable and complex variation in barnacle feeding leg and penis morphology among sites that differ in water velocity.
Core competencies required for the cardiac surgical nurse practitioner
Authors: Foster Sara Schewel
Published: May 2012

Purpose: To propose a set of core competencies for the cardiac surgery nurse practitioner (CSNP).

Data sources: Research, review articles, standards of practice, hospital practice guidelines.

Conclusion: Although there have been preliminary studies that demonstrate the effectiveness and cost savings associated with the use of a CSNP, specific competencies have yet to be defined. The CSNP provides direct patient care and functions simultaneously as part of an interdisciplinary team. The CSNP cares for the patient from preadmission until postdischarge. The CSNP facilitates the transfer of information along the transitions of care that is vital to positive patient outcomes.

Implications for practice: Changes in health care have forced providers to find ways to decrease the cost of services while maintaining high‐quality, efficient care for their patients. In addition, there is a rising acuity of the patient population admitted for cardiac surgery. The continued development of the role of the CSNP and evidence that supports the cost savings and improved patient outcomes that result from the use of CSNPs will encourage more and more cardiac surgery programs to use CSNPs along the continuum of care.
Primary care management of tuberous sclerosis complex in children
Authors: Manohara Deepa
Published: May 2012

Purpose: To provide primary care providers with a general overview of the genetic disorder tuberous sclerosis complex (TSC). By understanding the disease mechanism for this genetic condition, providers can effectively care for TSC patients and properly educate families who are affected by TSC. The article also describes the multi‐system clinical presentation of the disease to assist primary care providers with an early diagnosis.

Data Resources: Research articles and evidence‐based guidelines found through MEDLINE and the World Wide Web.

Conclusions: Using various diagnostic tools and treatment options, providers can offer the multidisciplinary approach needed to manage this disease appropriately. New treatment options, such as rapamycin, may be the future drug of choice in treating TSC.

Implications for practice: By following evidence‐based clinical practice guidelines, providers can hope to reduce TSC‐related morbidity and mortality.
Overview of: “The Impact of Drug Market Pulling Levers Policing on Neighborhood Violence: An Evaluation of the High Point Drug Market Intervention”
Authors: Corsaro Nicholas , Hunt Eleazer D. , Hipple Natalie Kroovand , McGarrell Edmund F.
Published: May 2012

Research Summary  Pulling levers policing draws upon the focused deterrence framework, which has shown considerable promise when directed at youth, gun, and gang offenders. However, much less is known about the viability of pulling levers when applied to different contexts as well as to diverse groups of offenders. We examine the High Point (North Carolina) Drug Market Intervention (DMI), the first site to use pulling levers as a place‐based policing approach to disrupt a series of open‐air drug markets across the city. Eleven years of longitudinal data are analyzed by using difference‐in‐difference panel regression analyses combined with finite mixture estimation as a means to test for divergence in violent crime patterns. Several key, although inconsistent, findings are presented. First, we found a statistically significant reduction in violent offenses in specific high‐crime places (i.e., high‐trajectory census blocks) located across the different targeted neighborhoods compared with the remainder of High Point, and relative to comparable nontargeted areas. Second, the citywide violent crime rate actually increased after a series of interventions unfolded, which may suggest limitations with the approach. Finally, trend analyses indicated the strategy had different levels of violent crime impact throughout unique geographic contexts.

Policy Implications  Rather than arresting every offender identified as having participated in illicit drug trafficking across various geographic contexts within the city, officials in High Point decided to invite low‐risk drug offenders to community notification sessions in order to change their perceived risk of punishment as well as to mobilize community members across the different targeted neighborhoods. The suggestive evidence of potential, although limited, violent crime impact illustrates that this type of policing strategy may hold considerable promise. This interpretation gains credence when considered with prior evaluations of the DMI approach that illustrated the potential for reducing drug‐related crime and in light of reports of improved police–community relations. The inconsistent findings across all locations and the overall city increase in violent crime toward the end of the study period, however, raise several concerns when interpreting study results. Additionally, our findings suggest that further replications should include systematic problem‐identification, process measures, and more precise research designs.
A Strategy for Selective O6‐Alkylguanine‐DNA Alkyltransferase Depletion Under Hypoxic Conditions
Authors: Penketh Philip G. , Shyam Krishnamurthy , Baumann Raymond P. , Ishiguro Kimiko , Patridge Eric V. , Zhu Rui , Sartorelli Alan C.
Published: May 2012

Cellular resistance to chemotherapeutics that alkylate the O‐6 position of guanine residues in DNA correlates with their O6‐alkylguanine‐DNA alkyltransferase activity. In normal cells high [O6‐alkylguanine‐DNA alkyltransferase] is beneficial, sparing the host from toxicity, whereas in tumor cells high [O6‐alkylguanine‐DNA alkyltransferase] prevents chemotherapeutic response. Therefore, it is necessary to selectively inactivate O6‐alkylguanine‐DNA alkyltransferase in tumors. The oxygen‐deficient compartment unique to solid tumors is conducive to reduction, and could be utilized to provide this selectivity. Therefore, we synthesized 2‐nitro‐6‐benzyloxypurine, an analog of O6‐benzylguanine in which the essential 2‐amino group is replaced by a nitro moiety, and 2‐nitro‐6‐benzyloxypurine is >2000‐fold weaker than O6‐benzylguanine as an O6‐alkylguanine‐DNA alkyltransferase inhibitor. We demonstrate oxygen concentration sensitive net reduction of 2‐nitro‐6‐benzyloxypurine by cytochrome P450 reductase, xanthine oxidase, and EMT6, DU145, and HL‐60 cells to yield O6‐benzylguanine. We show that 2‐nitro‐6‐benzyloxypurine treatment depletes O6‐alkylguanine‐DNA alkyltransferase in intact cells under oxygen‐deficient conditions and selectively sensitizes cells to laromustine (an agent that chloroethylates the O‐6 position of guanine) under oxygen‐deficient but not normoxic conditions. 2‐Nitro‐6‐benzyloxypurine represents a proof of concept lead compound; however, its facile reduction (E1/2– 177 mV versus Ag/AgCl) may result in excessive oxidative stress and/or the generation of O6‐alkylguanine‐DNA alkyltransferase inhibitors in normoxic regions in vivo.
Synthesis and In Vitro Antibacterial Activity of Novel 3‐Azabicyclo[3.3.0]octanyl Oxazolidinones
Authors: Bhattarai Deepak , Lee Sun H. , Seo Seon H. , Nam Ghilsoo , Kang Soon B. , Pae Ae N. , Kim Eunice E. , Oh Taegwon , Cho Sang‐Nae , Keum Gyochang
Published: May 2012

We synthesized a series of oxazolidinone‐type antibacterials in which morpholine C‐ring of linezolid has been modified by substituted 3‐azabicyclo[3.3.0]octanyl rings. Acetamide or 1,2,3‐triazole heterocycle was used as C‐5 side chain of oxazolidinone. The resulting series of compounds was then screened in vitro against panel of susceptible and resistant Gram‐positive, Gram‐negative bacteria, and Mycobacterium tuberculosis (Mtb). Several analogs in this series exhibited potent in vitro antibacterial activity comparable or superior to linezolid against the tested bacteria. Compounds 10a, 10b, 11a, and 15a displayed highly potent activity against M. tuberculosis. Selected compound 10b showed good human microsomal stability and CYP‐profile, and showed low activity against hERG channel.