bluuebunny/crossref_metadata_2025 huggingface dataset:
A joint analysis of metabolomics and genetics of breast cancer
Authors: Tang Xiaohu , Lin Chao-Chieh , Spasojevic Ivan , Iversen Edwin S , Chi Jen-Tsan , Marks Jeffrey R
Published: August 2014

Introduction

Remodeling of cellular metabolism appears to be a consequence and possibly a cause of oncogenic transformation in human cancers. Specific aspects of altered tumor metabolism may be amenable to therapeutic intervention and could be coordinated with other targeted therapies. In breast cancer, the genetic landscape has been defined most comprehensively in efforts such as The Cancer Genome Atlas (TCGA). However, little is known about how alterations of tumor metabolism correlate with this landscape.

Methods

In total 25 cancers (23 fully analyzed by TCGA) and 5 normal breast specimens were analyzed by gas chromatography/mass spectrometry and liquid chromatography/mass spectrometry, quantitating 399 identifiable metabolites.

Results

We found strong differences correlated with hormone receptor status with 18% of the metabolites elevated in estrogen receptor negative (ER-) cancers compared to estrogen receptor positive (ER+) including many glycolytic and glycogenolytic intermediates consistent with increased Warburg effects. Glutathione (GSH) pathway components were also elevated in ER- tumors consistent with an increased requirement for handling higher levels of oxidative stress. Additionally, ER- tumors had high levels of the oncometabolite 2-hydroxyglutarate (2-HG) and the immunomodulatory tryptophan metabolite kynurenine. Kynurenine levels were correlated with the expression of tryptophan-degrading enzyme (IDO1). However, high levels of 2-HG were not associated with somatic mutations or expression levels of IDH1 or IDH2. BRCA1 mRNA levels were positively associated with coenzyme A, acetyl coenzyme A, and GSH and negatively associated with multiple lipid species, supporting the regulation of ACC1 and NRF2 by BRCA1. Different driver mutations were associated with distinct patterns of specific metabolites, such as lower levels of several lipid-glycerophosphocholines in tumors with mutated TP53. A strong metabolomic signature associated with proliferation rate was also observed; the metabolites in this signature overlap broadly with metabolites that define ER status as receptor status and proliferation rate were correlated.

Conclusions

The addition of metabolomic profiles to the public domain TCGA dataset provides an important new tool for discovery and hypothesis testing of the genetic regulation of tumor metabolism. Particular sets of metabolites may reveal insights into the metabolic dysregulation that underlie the heterogeneity of breast cancer.
Non-exhaustive DNA methylation-mediated transposon silencing in the black truffle genome, a complex fungal genome with massive repeat element content
Authors: Montanini Barbara , Chen Pao-Yang , Morselli Marco , Jaroszewicz Artur , Lopez David , Martin Francis , Ottonello Simone , Pellegrini Matteo
Published: August 2014

Background

We investigated how an extremely transposon element (TE)-rich organism such as the plant-symbiotic ascomycete truffle Tuber melanosporum exploits DNA methylation to cope with the more than 45,000 repeated elements that populate its genome.

Results

Whole-genome bisulfite sequencing performed on different developmental stages reveals a high fraction of methylated cytosines with a strong preference for CpG sites. The methylation pattern is highly similar among samples and selectively targets TEs rather than genes. A marked trend toward hypomethylation is observed for TEs located within a 1 kb distance from expressed genes, rather than segregated in TE-rich regions of the genome. Approximately 300 hypomethylated or unmethylated TEs are transcriptionally active, with higher expression levels in free-living mycelium compared to fruitbody. Indeed, multiple TE-enriched, copy number variant regions bearing a significant fraction of hypomethylated and expressed TEs are found almost exclusively in free-living mycelium. A reduction of DNA methylation, restricted to non-CpG sites and accompanied by an increase in TE expression, is observed upon treatment of free-living mycelia with 5-azacytidine.

Conclusions

Evidence derived from analysis of the T. melanosporum methylome indicates that a non-exhaustive, partly reversible, methylation process operates in truffles. This allows for the existence of hypomethylated, transcriptionally active TEs that are associated with copy number variant regions of the genome. Non-exhaustive TE methylation may reflect a role of active TEs in promoting genome plasticity and the ability to adapt to sudden environmental changes.
Attribute expression of fault-controlled karst — Fort Worth Basin, Texas: A tutorial
Authors: Qi Jie , Zhang Bo , Zhou Huailai , Marfurt Kurt
Published: August 2014

Much of seismic interpretation is based on pattern recognition, such that experienced interpreters are able to extract subtle geologic features that a new interpreter may easily overlook. Seismic pattern recognition is based on the identification of changes in (1) amplitude, (2) phase, (3) frequency, (4) dip, (5) continuity, and (6) reflector configuration. Seismic attributes, which providing quantitative measures that can be subsequently used in risk analysis and data mining, partially automate the pattern recognition problem by extracting key statistical, geometric, or kinematic components of the 3D seismic volume. Early attribute analysis began with recognition of bright spots and quickly moved into the mapping of folds, faults, and channels. Although a novice interpreter may quickly recognize faults and channels on attribute time slices, karst terrains provide more complex patterns. We sought to instruct the attribute expression of a karst terrain in the western part of the Fort Worth Basin, Texas, United States of America. Karst provides a specific expression on almost every attribute. Specifically, karst in the Fort Worth Basin Ellenburger Group exhibits strong dip, negative curvature, low coherence, and a shift to lower frequencies. Geomorphologically, the inferred karst geometries seen in our study areas indicate strong structural control, whereby large-scale karst collapse is associated with faults and where karst lineaments are aligned perpendicularly to faults associated with reflector rotation anomalies.
Photofunctional Lanthanoid Complexes, Coordination Polymers, and Nanocrystals for Future Photonic Applications
Authors: Hasegawa Yasuchika
Published: August 2014

In this account, lanthanoid complexes, coordination polymers, and nanocrystals with photofunctional properties are introduced. To maintain the effective emission of Nd(III), Sm(III), Eu(III), Tb(III), and Yb(III) ions in organic media, the coordination sphere of the lanthanoid ions should consist of strong, bulky, and asymmetric ligands with low vibrational frequencies, that is, there are three criteria for luminescence: 1) suppression of vibrational relaxation, 2) prevention of nonradiative cross relaxation at diffusional collision, and 3) introduction of asymmetric coordination geometry for enhancing electric dipole transition. Lanthanoid coordination compounds with characteristic photosensitizing properties, photochromic properties, circularly polarized luminescence (CPL), metal ion sensing properties, solvent sensing properties, energy-conversion properties, thermostable properties, triboluminescent properties, and thermosensing properties are also described for the development of photofunctional materials. In the second half, the synthesis, photophysical magnetic, and magneto-optical properties of lanthanoid nanocrystals, EuO, EuS, and EuSe, are reported. In particular, the remarkable photophysical properties of nanoaggregates composed of EuS nanocrystals are presented. Photofunctional lanthanoid(III) complexes, coordination polymers, and nanocrystals are expected to open up a frontier field of materials science.
Hyperbranched Cyclotriphosphazene Polymer-grafted Graphene with Amphipathicity
Authors: Liu Chao , Yan Hongxia , Feng Shuyao , Li Tingting , Zhang Mengmeng
Published: August 2014

Grafting of hyperbranched cyclotriphosphazene polymer (HBP) onto reduced graphene oxide (HBP-RGO) surface was achieved by the repeated reactions between the chlorine groups of hexachlorocyclotriphosphazene and the amino groups of hexamethylenediamine. FTIR and XPS analyses showed that hyperbranched cyclophosphazene-grafted graphene had been successfully prepared. AFM results showed that HBP-RGO had a dendritic structure as designed. TGA analysis indicated that HBP-RGO had good thermal stability. The dispersion showed that HBP-RGO is amphiphilic.
A Rubber Elastic Low-molecular-weight Organogel
Authors: Shirakawa Michihiro , Fujita Norifumi , Takada Akihiko , Shinkai Seiji
Published: August 2014

A low-molecular-weight gel prepared from a Cu complex of a protoporphyrin IX derivative exhibits an unusual elastic behavior as revealed by rheological studies. It possesses rubber elasticity despite the formation of LMOG by noncovalent molecular stacking. This is due to the feature of the present system that the gel fibers behave similarly to covalent polymers without bundling.
Synthesis of Aqueous-stable and Water-soluble Mononuclear Nonheme MnV–Oxo Complexes Using H2O2 as an Oxidant
Authors: Yatabe Takeshi , Kikunaga Takahiro , Matsumoto Takahiro , Nakai Hidetaka , Yoon Ki-Seok , Ogo Seiji
Published: August 2014

We report the synthesis of mononuclear nonheme manganese(V)–oxo complexes in aqueous acetonitrile solution from the reaction of manganese(III) complexes using hydrogen peroxide as an oxidant for the first time. A crystal structure of chloro derivative of manganese(V)–oxo complex and its reactivity toward 3,5-di-tert-butyl-catechol are also reported.
The second touch hypothesis: T cell activation, homing and polarization
Authors: Ley Klaus
Published: August 2014

The second touch hypothesis states that T cell activation, proliferation, induction of homing receptors and polarization are distinguishable and, at least in part, sequential. The second touch hypothesis maintains that full T cell polarization requires T cell interaction with antigen-presenting cells (DCs, macrophages, B cells and certain activated stromal cells) in the non-lymphoid tissue where the antigen resides. Upon initial antigen encounter in peripheral lymph nodes (PLN), T cells become activated, proliferate and express homing receptors that enable them to recirculate to the (inflamed) tissue that contains the antigen. Differentiation into the T helper lineages Th1, Th2, Th17 and induced regulatory T cells (iTreg) requires additional antigen presentation by tissue macrophages and other antigen presenting cells (APCs) in the inflamed tissue. Here, I present a conceptual framework for the importance of peripheral (non-lymphoid) antigen presentation to antigen-experienced T cells.
Joint Pricing and Production Decisions in an Assemble-to-Order System
Authors: Oh Sechan , Sourirajan Karthik , Ettl Markus
Published: August 2014

This paper studies coordinated pricing and production decisions in an assemble-to-order system. We first show that unlike in make-to-stock systems, a state-dependent base-stock list-price policy is optimal. The optimal state-dependent base-stock levels and list prices may increase or decrease as demand backlogs increase, whereas demand backlogs always improve the optimal expected profit. Because the problem easily becomes intractable under general system settings, we next develop a simple heuristic policy. The heuristic policy decouples inventory replenishment, pricing, and component allocation decisions in a coordinated way. We provide a sufficient condition that ensures the optimality of the heuristic policy, and present a numerical study to demonstrate its performance when the condition is not met. The numerical study also shows how the performance of the heuristic policy is affected by various market and operational conditions, and by the structure of the assemble-to-order system. By focusing on the simple W-model, we show how the heuristic pricing decisions are made in response to changes in inventory levels and various cost parameters.
Improvements in the surgical management of bitches with urinary incontinence
Authors: White Richard AS
Published: August 2014

The combination of urethropexy and colposuspension for the management of urinary incontinence associated with urethral sphincter mechanism in bitches has recently been described. The success rate for this procedure (70%) is considerably more favourable than has been reported for either individual technique, and is associated with a low rate of complications.
Emetics in the management of poisoning
Authors: Bates Nicola , Edwards Nick
Published: August 2014

Emetics are used in an effort to reduce absorption of a poison. Apomorphine in dogs and xylazine in cats appear relatively safe and efficacious (they produce vomiting). Emetics are no longer used in the management of poisoning in humans as there is no evidence that the emetic previously used improves the outcome of poisoned patients. There is no evidence that emesis improves the clinical outcome in poisoned animals, either. This means that for now, emesis will continue to be induced in potentially poisoned animals. It should be done safely (after assessment of the clinical condition of the animal, dose and agent involved and time since ingestion) and should not be routine.
Wonderful woodwork
Authors: Ashworth Sally
Published: August 2014

Working with wood is a pleasure for most children, but beyond the fun, serious learning is taking place, from mathematics to critical thinking, from motor control to numeracy and literacy skills.
The characteristic changes of betung bamboo (Dendrocalamus asper) pretreated by fungal pretreatment
Authors: Fatriasari Widya , Syafii Wasrin , J Wistara Nyoman , Syamsu Khaswar , Prasetya Bambang
Published: August 2014

The fungal pretreatment effect on chemical structural and morphological changes of Betung Bamboo was evaluated based on its biomass components after being cultivated by white rot fungi, Trametes versicolor. Betung bamboo powder (15 g) was exposed to liquid inoculum of white rot fungi and incubated at 270C for 15, 30 and 45 days. The treated samples were then characterized by FT-IR spectroscopy, X-Ray diffraction and SEM-EDS analyses. Cultivation for 30 days with 5 and 10% loadings retained greater selectivity compared to that of the other treatments. FTIR spectra demonstrated that the fungus affected the decreasing of functional group quantities without changing the functional groups. The decrease in intensity at wave number of 1246 cm-1 (guaiacyl of lignin) was greater than that at wave number of 1328 cm-1 (deformation combination of syringyl and xylan) after fungal treatment. X-ray analysis showed the pretreated samples had a higher crystallinity than the untreated ones which might be due to the cleavage of amorphous fractions of cellulose. The pretreated samples have more fragile than the untreated ones confirmed by SEM. Crystalline allomorph calculated by XRD analysis showed that fungus pretreatment for 30 days has transformed triclinic structure of cellulose to monoclinic structure.
Tin (II) Chloride Catalyzed Esterification of High FFA Jatropha Oil: Experimental and Kinetics Study
Authors: Kusumaningtyas Ratna Dewi , Handayani Prima Astuti , Rochmadi Rochmadi , Purwono Suryo , Budiman Arief
Published: August 2014

Biodiesel is one of the promising energy source alternatives to fossil fuel. To produce biodiesel in a more economical way, the employment of the low-cost feed stocks, such as non-edible oils with high free fatty acid (FFA), is necessary. Accordingly, the esterification reaction of FFA in vegetable oils plays an important role in the biodiesel production. In this work, esterification of FFA contained in Crude Jatropha Oil (CJO) in the presence of tin (II) chloride catalyst in a batch reactor has been carried out. The esterification reaction was conducted using methanol at the temperature of 40-60 °C for 4 hours. The effect of molar ratio of methanol to oil was studied in the range 15:1 to 120:1. The influence of catalyst loading was investigated in the range of 2.5 to 15% w/w oil. The optimum reaction conversion was obtained at 60 °C with the catalyst loading of 10% w/w oil and molar ratio of methanol to oil of 120:1. A pseudo-homogeneous reversible second order kinetic model for describing the esterification of FFA contained in CJO with methanol over tin (II) chloride catalyst was developed based on the experimental data. The kinetic model can fit the data very well.
On B(m)${B^{(m)}}$-difference sequence spaces using generalized means and compact operators
Authors: Maji Amit , Srivastava Parmeshwary Dayal
Published: August 2014

In this paper,
sequence spaces

X
(
r
,
s
,
t
;

B

(
m
)

)

$X(r, s, t;B^{(m)})$

for

X
∈
{

l
∞

,
c
,

c
0

}

$X\in \lbrace l_\infty , c, c_0\rbrace $

are introduced by combining the generalized means and the m-th order
generalized difference operator

B

(
m
)

(
u
,
v
)

$B^{(m)}(u, v)$

. It is shown that these spaces are complete normed linear spaces and the spaces

c
0

(
r
,
s
,
t
;

B

(
m
)

)

$c_0(r, s, t; B^{(m)})$

,

c
(
r
,
s
,
t
;

B

(
m
)

)

$c(r, s, t;B^{(m)})$

have Schauder bases. Furthermore, the α-, β-, γ-duals of these spaces are computed. The necessary and sufficient conditions for some matrix transformations from

X
(
r
,
s
,
t
;

B

(
m
)

)

$X(r, s, t;B^{(m)})$

to Y, where

X
,
Y
∈
{

l
∞

,
c
,

c
0

}

$X, Y \in \lbrace l_\infty , c, c_0\rbrace $

, are also obtained. Finally, some classes of compact operators on the spaces

X
(
r
,
s
,
t
;

B

(
m
)

)

$X(r, s, t;B^{(m)})$

for

X
∈
{

l
∞

,
c
,

c
0

}

$X\in \lbrace l_\infty , c, c_0\rbrace $

are characterized by using the Hausdorff measure of noncompactness.
Alternative proofs of a formula for Bernoulli numbers in terms of Stirling numbers
Authors: Qi Feng , Guo Bai-Ni
Published: August 2014

This is a corrected version of http://dx.doi.org/10.1515/anly-2012-1238.
the paper,
the authors provide four alternative proofs of an explicit formula for computing Bernoulli numbers in terms of Stirling numbers of the second kind.
Towards a dialogic syntax
Authors: Du Bois John W.
Published: August 2014

This paper argues for the need to recognize a new order of syntactic phenomena, and for a theory of syntax capable of addressing it. Dialogic syntax encompasses the linguistic, cognitive, and interactional processes involved when speakers selectively reproduce aspects of prior utterances, and when recipients recognize the resulting parallelisms and draw inferences from them. Its most visible reflex occurs when one speaker constructs an utterance based on the immediately co-present utterance of a dialogic partner. Words, structures, and other linguistic resources invoked by the first speaker are selectively reproduced by the second. The alignment of utterances yields a pairing of patterns at varying levels of abstraction, ranging from identity of words and affixes, to parallelism of syntactic structures, to equivalence of grammatical categories and abstract features of form, meaning, and function. This mapping generates dialogic resonance, defined as the catalytic activation of affinities across utterances. The key unit of analysis is the diagraph, recognized as a higher-order, supra-sentential syntactic structure that emerges from the structural coupling of two or more utterances. Dialogic syntax goes beyond traditional linear syntax to recognize as integral to the task of syntactic analysis a new kind of structural relation that arises between otherwise independent sentences.
Normal criteria of meromorphic functions and shared functions
Authors: Wu Chun
Published: August 2014

In this paper, we investigate the normal families of meromorphic functions
concerning shared analytic functions and prove some normal
criteria that generalize or extend some results obtained by J. Ding et al. [Abstr. Appl. Anal. (2012), Art. ID 582854],
[Bull. Malays. Math. Sci. Soc. (2) 35 (2012), 449–457].
Stitching proteins into membranes, not sew simple
Authors: Whitley Paul , Mingarro Ismael
Published: August 2014

Most integral membrane proteins located within the endomembrane system of eukaryotic cells are first assembled co-translationally into the endoplasmic reticulum (ER) before being sorted and trafficked to other organelles. The assembly of membrane proteins is mediated by the ER translocon, which allows passage of lumenal domains through and lateral integration of transmembrane (TM) domains into the ER membrane. It may be convenient to imagine multi-TM domain containing membrane proteins being assembled by inserting their first TM domain in the correct orientation, with subsequent TM domains inserting with alternating orientations. However a simple threading model of assembly, with sequential insertion of one TM domain into the membrane after another, does not universally stand up to scrutiny. In this article we review some of the literature illustrating the complexities of membrane protein assembly. We also present our own thoughts on aspects that we feel are poorly understood. In short we hope to convince the readers that threading of membrane proteins into membranes is ‘not sew simple’ and a topic that requires further investigation.
What vibrations tell us about GTPases
Authors: Kötting Carsten , Gerwert Klaus
Published: August 2014

In this review, we discuss how time-resolved Fourier transform infrared (FTIR) spectroscopy is used to understand how GTP hydrolysis is catalyzed by small GTPases and their cognate GTPase-activating proteins (GAPs). By interaction with small GTPases, GAPs regulate important signal transduction pathways and transport mechanisms in cells. The GTPase reaction terminates signaling and controls transport. Dysfunctions of GTP hydrolysis in these proteins are linked to serious diseases including cancer. Using FTIR, we resolved both the intrinsic and GAP-catalyzed GTPase reaction of the small GTPase Ras with high spatiotemporal resolution and atomic detail. This provided detailed insight into the order of events and how the active site is completed for catalysis. Comparisons of Ras with other small GTPases revealed conservation and variation in the catalytic mechanisms. The approach was extended to more nearly physiological conditions at a membrane. Interactions of membrane-anchored GTPases and their extraction from the membrane are studied using the attenuated total reflection (ATR) technique.
Chilean Spanish version of the State Trait Cheerfulness Inventory (STCI-T-60, trait form): Individual and couple forms
Authors: Tapia-Villanueva Luis , Armijo Ivan , Pereira Ximena , Molina Maria Elisa
Published: August 2014

The adaptation and validation of a Chilean Spanish version of the State Trait Cheerfulness Inventory (STCI-T-60) including a couple evaluation, is presented. The inventory was developed by Ruch (1990) to measure three traits (cheerfulness, seriousness, and bad mood), considered to enable exhilaration, which is the main indicator of the sense of humor experience. Ruch suggested studying basic temperamental traits and stable dispositions involved in the possibility of experiencing humor. The inventory was applied to three Chilean samples: a validation sample of 500 adults individuals, evaluated in a stratified manner considering gender, age and socio-economic level; a replication sample of 298 middle-class adults; and a couple sample of 53 middle-class couples. The results showed adequate internal consistency and solid validity of the constructs in all groups. The study contributes to research in the field of the sense of humor from local and transcultural perspectives. The validation of a couple form will contribute specifically contribute to the study of the sense of humor as a couple relational dynamic and its relations with other relational variables.
Welding of Aluminum Alloys to Steels: An Overview
Authors: Atabaki M. Mazar , Nikodinovski M. , Chenier P. , Ma J. , Harooni M. , Kovacevic R.
Published: August 2014

Since the need for the joining of dissimilar materials is increasing, the wide range of requirements of the numerous industries would lead to the development of new welding techniques or at least to improvement of the existing technologies capable of joining the components from the miniature assemblies to extremely large earth-moving vehicles. Among the different materials, iron-based alloys and aluminum-based alloys are the most significant materials that are finding applications in the various industries to offer more viable and sustainable products. However, welding of these metals has been always a kind of dilemma for the engineers. There are a certain number of methods to join these dissimilar metals but no one could establish a reliable or a sort of credible welding method for the industrial applications while quality, cost, human resources and facilities are taken into the main considerations. This paper reviews the recent works on the joining of different aluminum alloys to different steels. The effect of the joining conditions on the formation of intermetallics and microstructural development, mechanical properties and applications of the joints are discussed.
Study of ethane hydrate formation kinetics using the chemical
affinity model with and without presence of surfactants
Authors: Karimi Reza , Varaminian Farshad , Izadpanah Amir A.
Published: August 2014

In this article, we examine ethane hydrate formation kinetics with and without
the presence of various surfactants. Firstly, the influences of
stirring rate and initial pressure without the presence of surfactants are
studied. The effects of four surfactants containing Sodium dodecyl sulfate
(SDS), sodium dodecyl benzene sulfonate (SDBS), Polyoxyethylene (20)
sorbitanmonopalmitate (Tween® 40), and TritonX-100 (TX-100)
on ethane hydrate formation kinetics were experimentally investigated. Then
the chemical affinity model is applied to model the ethane hydrate formation
kinetics with and without surfactants. The kinetic parameters of the
chemical affinity model were computed for the ethane hydrate formation with and
without surfactants. We will see that the results of the modeling are in good
agreement with the experimental data.
Long Memory and Asymmetry for Matrix-Exponential Dynamic Correlation Processes
Authors: Asai Manabu , So Mike K.P.
Published: August 2014

We propose a fractionally integrated matrix-exponential dynamic conditional correlation (FIEDCC) model to capture the asymmetric effects and long- and short-range dependence of a correlation process. We also propose employing an inverse Wishart distribution for the disturbance of a covariance structure, which gives an alternative interpretation for a multivariate
Unterliegt die Alzheimer-Erkrankung einer überzogenen Dämonisierung? Eine philosophisch-kritische Reflexion in Orientierung an Argumentationsmustern von Epikur, Lukrez und Erasmus
Authors: Knell Sebastian
Published: August 2014

Bei vielen Menschen löst die Diagnose einer beginnenden Alzheimer-Demenz starke Ängste und ein erhebliches Maß an Verstörung aus. Aus philosophischer Sicht stellt sich die Frage, ob das extreme subjektive Leiden an der Diagnose, so prekär das Schicksal einer Demenzerkrankung fraglos ist, nicht zum Teil auch einer überzogenen Dämonisierung der Krankheit geschuldet sein könnte. Der Beitrag geht dieser Frage nach, indem er prüft, ob sich antike Argumente, die sich gegen die Dämonisierung des Todes richten, ihrer logischen Struktur nach auf die Angst vor der drohenden Lebenswirklichkeit einer Alzheimer-Erkrankung übertragen lassen. Sowohl Epikurs Argument gegen die Todesfurcht als auch das Symmetrieargument von Lukrez werden dabei eingehend analysiert. Es werden systematische Analogien und Differenzen herausgearbeitet, die sich ergeben, wenn man die Grundgedanken dieser Argumente im veränderten Kontext der Bewertung von Alzheimer zum Einsatz bringt. Der Beitrag schließt mit dem ergänzenden Versuch, im Anschluss an Erasmus von Rotterdam zwei Gesichtspunkte zu benennen, unter denen der sukzessive Abschied vom Personsein das Übel des Todes lindert.
Validation of Assessment Vignettes and Scoring Rubric of Multicultural and International Competency in Faculty Teaching
Authors: Henderson Sheila J. , Horton Ruth A. , Saito Paul K. , Shorter-Gooden Kumea
Published: August 2014

The purpose of this research was to develop a new tool for assessing multicultural and international competency in faculty teaching through vignette scenarios of university classroom critical incidents – across disciplines of clinical and forensics psychology, business, and education. Construct and content validity of the initial draft vignettes and the associated scoring rubric was established by a panel of experts who approved the vignettes as consistent with current teaching models and multicultural and international competency models. Each vignette presented a critical incident needing resolution – a rupture in the relationship between the instructor and students vis-à-vis a diversity issue. These hypothetical ruptures took place in university classrooms in four different disciplines: clinical and forensic psychology, business, and education. The authors recruited ten faculty participants for the online study, who were personally known to the authors as interested in competency-related issues and who were teaching in graduate programs. Each participant responded to three questions for each vignette, which prompted their written feedback on (a) process and content issues surrounding the critical incident as well as (b) coaching for the hypothetical instructor on how to resolve the incident. Five scorers rated the participants’ written responses according to a five-point scoring rubric. In the data analysis, once statistical conclusion validity and interscorer reliability was established (Krippendorff’s α = 0.887), content validity was again explored by assessing whether the written responses were indeed captured by the guiding models. The results, which indicated preliminary validity and reliability of the vignettes and the rubric, suggest that the vignettes are worthy of further testing. These vignettes can also be used as discussion tools to stimulate dialogue in competency trainings for faculty.
Risk Stratification and Therapeutic Approach in Brugada Syndrome
Authors: Probst Vincent , Chatel Stéphanie , Gourraud Jean-Baptiste , Le Marec Hervé ,   Professor of Cardiology and Head of Reference Centre for Hereditary Arrhythmia, Service de cardiologie du CHU de Nantes, CHU de Nantes, Hôpital Nord, Bd Jacques Monod, 44093 Nantes Cedex, France. E: vincent.probst@chu-nantes.fr,   Project Manager,   Assistant Professor,   Professor of Cardiology and Head, Thorax Institute, Nantes, France
Published: August 2014

Brugada syndrome (BrS) is a clinical entity characterised by an incomplete right bundle branch block associated with an ST segment elevation in the right precordial leads and a risk of ventricular arrhythmia and sudden death in the absence of structural abnormalities. Patients with a personal history of sudden death have an annual arrhythmia risk of recurrence as high as 10 %. Similarly, the presence of syncope is consistently associated with an increased arrhythmic risk. This risk can be estimated at about 1.5 % per year. The risk is lower in asymptomatic patients. Regarding the relatively high rate of complication of Implantable cardioverter defibrillator (ICD) implantation, in most of the cases, asymptomatic patients with a Brugada syndrome revealed during ajmaline challenge do not need to be implanted. The situation is more complex in patients with a spontaneous type 1 aspect since the risk could be estimated to be around 0.8 % per year. For these patients, a careful evaluation of the arrhythmic risk using all the different tools available is mandatory.
Risk Stratification in Atrial Fibrillation Patients – A Review Focused on Mortality
Authors: Lombardi Federico ,   Professor of Cardiology; Director of Cardiology Unit, San Paolo Hospital, Department of Health Sciences, Cardiologia, Osp San Paolo DISS, University of Milan Via A di Rudinì 8 20142 Milan, Italy. E: federico.lombardi@unim.it
Published: August 2014

Atrial fibrillation (AF) is associated with increased mortality that is largely due to the severe co-morbidities of patients with this rhythm disturbance rather than to its electrocardiographic features. Available evidence indicated that ageing, heart failure and stroke are the most important predictors of all-cause mortality. Additional clinical parameters such as smoking, renal impairment, chronic obstructive pulmonary disease may also identify patients at risk. The prevention of thromboembolic events is based on oral anticoagulant therapy, which reduces the severity and mortality of ischaemic strokes but slightly increase the rate of haemorrhagic events. Most of the traditional risk stratifiers commonly used in patients in sinus rhythm such as New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF) and resting heart rate seem to be less effective in AF patients thus leaving to the physician judgment the main responsibility of identifying patients with an increased mortality risk.
Body Surface Electrocardiographic Mapping for Non-invasive Identification of Arrhythmic Sources
Authors: Shah Ashok J , Hocini Meleze , Pascale Patrizio , Roten Laurent , Komatsu Yuki , Daly Matthew , Ramoul Khaled , Denis Arnaud , Derval Nicolas , Sacher Frederic , Dubois Remi , Bokan Ryan , Eliatou Sandra , Strom Maria , Ramanathan Charu , Jais Pierre , Ritter Philippe , Haissaguerre Michel ,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   CardioInsight Technologies Inc, Cleveland, Ohio, US,   CardioInsight Technologies Inc, Cleveland, Ohio, US,   CardioInsight Technologies Inc, Cleveland, Ohio, US,   CardioInsight Technologies Inc, Cleveland, Ohio, US,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France,   Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, 33604 Bordeaux-Pessac, France. E: michel.haissaguerre@chu-bordeaux.fr
Published: August 2014

The authors describe a novel three-dimensional, 252-lead electrocardiography (ECG) and computed tomography (CT)-based non-invasive cardiac imaging and mapping modality. This technique images potentials, electrograms and activation sequences (isochrones) on the epicardial surface of the heart. This tool has been investigated in the normal cardiac electrophysiology and various tachyarrhythmic, conduction and anomalous depo-repolarisation disorders. The clinical application of this system includes a wide range of electrical disorders like atrial arrhythmias (premature atrial beat, atrial tachycardia, atrial fibrillation), ventricular arrhythmias (premature ventricular beat, ventricular tachycardia) and ventricular pre-excitation (Wolff-Parkinson-White syndrome). In addition, the system has been used in exploring abnormalities of the His-Purkinje conduction like the bundle branch block and intraventricular conduction disturbance and thereby useful in electrically treating the associated heart failure (cardiac resynchronisation). It has a potential role in furthering our understanding of abnormalities of ventricular action potential (depolarisation [Brugada syndrome and repolarisation], long QT and early repolarisation syndromes) and in evaluating the impact of drugs on His-Purkinje conduction and cardiac action potential.
Mimics of Hypertrophic Cardiomyopathy – Diagnostic Clues to Aid Early Identification of Phenocopies
Authors: Sankaranarayanan Rajiv , Fleming Eleanor J , Garratt Clifford J ,   Manchester Heart Centre, Institute of Cardiovascular Sciences, University of Manchester, Manchester, UK,   University College London Medical School, London, UK,   Manchester Heart Centre, Institute of Cardiovascular Sciences, Central Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9TL, UK. E: clifford.garratt@cmft.nhs.uk
Published: August 2014

Hypertrophic cardiomyopathy (HCM) is the most common genetic cause of cardiomyopathy worldwide. Significant advances and widespread availability of genetic testing have improved detection of the sarcomeric mutations that cause HCM, but have also highlighted the significance of inborn errors of metabolism (IEM) or metabolic storage disorders that can mimic HCM (‘HCM phenocopies’). These conditions cannot always be reliably differentiated on the basis of imaging alone. Whilst HCM phenocopies are relatively rare, it is crucial to distinguish these conditions at an early stage as their natural history, management and prognosis vary significantly from that of HCM with sarcomeric mutations. This review illustrates the salient features of HCM phenocopies and stresses the need for a high level of suspicion for these conditions in the assessment of cardiac hypertrophy.
Catheter Ablation for Ventricular Arrhythmias
Authors: Nof Eyal , Stevenson William G , John Roy M ,   Department of Medicine, Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, US,   Department of Medicine, Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, US,   Department of Medicine, Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Cardiac Arrhythmia Service, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, US. E: rjohn2@partners.org
Published: August 2014

Catheter ablation has emerged as an important and effective treatment option for many recurrent ventricular arrhythmias. The approach to ablation and the risks and outcomes are largely determined by the nature of the severity and type of underlying heart disease. In patients with structural heart disease, catheter ablation can effectively reduce ventricular tachycardia (VT) episodes and implantable cardioverter defibrillator (ICD) shocks. For VT and symptomatic premature ventricular beats that occur in the absence of structural heart disease, catheter ablation is often effective as the sole therapy. Advances in catheter technology, imaging and mapping techniques have improved success rates for ablation. This review discusses current approaches to mapping and ablation for ventricular arrhythmias.
Remote Navigation for Complex Arrhythmia
Authors: Suman-Horduna Irina , Babu-Narayan Sonya V , Ernst Sabine ,   Department of Cardiology, Royal Brompton Hospital,   Department of Cardiology, Royal Brompton Hospital; NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and National Heart and Lung Institute, Imperial College London, London, UK,   Department of Cardiology, Royal Brompton Hospital; NIHR Cardiovascular Biomedical Research Unit, Royal Brompton, Consultant Cardiologist/Electrophysiologist, Reader in Cardiology, National Heart and Lung Institute, Imperial College, Royal Brompton and Harefield Hospital, Sydney Street, SW3 6NP, London, UK. E: s.ernst@rbht.nhs.uk
Published: August 2014

Magnetic navigation has been established as an alternative to conventional, manual catheter navigation for invasive electrophysiology interventions about a decade ago. Besides the obvious advantage of radiation protection for the operator who is positioned remotely from the patient, there are additional benefits of steering the tip of a very floppy catheter. This manuscript reviews the published evidence from simple arrhythmias in patients with normal cardiac anatomy to the most complex congenital heart disease. This progress was made possible by the introduction of improved catheters and most importantly irrigated-tip electrodes.
The Future of Pulmonary Vein Isolation – Single-shot Devices, Remote Navigation or Improving Conventional Radiofrequency Delivery by Contact Monitoring and Lesion Characterisation?
Authors: Filgueiras-Rama David , Merino Jose L ,   Cardiac Electrophysiologist,   Head of the Robotic Cardiac Electrophysiology and Arrhythmia Unit, Department of Cardiology, Hospital Universitario La Paz, Robotic Cardiac Electrophysiology and Arrhythmia Unit, Paseo de la Castellana 261, 1st floor, 28046 Madrid, Spain. E: jlmerino@arritmias.net
Published: August 2014

Pulmonary vein isolation is the main goal of atrial fibrillation (AF) ablation to date. Lack of isolation is associated with an increased risk of AF recurrences. Precise navigation to specific target sites, catheter stability and appropriate contact force are requisites for effective radiofrequency applications. Conventional manual-guided point-by-point radiofrequency energy delivery shows limitations to reach them, especially when performed by non-experienced electrophysiologists. New technological alternatives are rapidly arising and becoming clinically available to overcome some of the manual-guided radiofrequency delivery shortcomings. Here, we review the most recent clinical data, potential advantages, shortcomings and future directions of the new ablation strategies for pulmonary vein isolation.
Recent Atrial Fibrillation Guidelines – Looking at Both Sides of the Atlantic
Authors: Lévy Samuel ,   Professor of Cardiology, Aix-Marseille Université, School of Medicine, 2 Place Delibes, 13008 Marseille, France. E: samuel@samuel-levy.com
Published: August 2014

The American College of Cardiology (ACC), the American Heart Association (AHA) and the European Society of Cardiology (ESC) reported joint guidelines on atrial fibrillation (AF) in 2001 and a revised version in 2006. In 2010 new guidelines on AF were published by the ESC, and in 2011 by the American College of Cardiology Foundation (ACCF)/AHA/Heart Rhythm Society (HRS) and by the Canadian Cardiac Society (CCS). Focused updates have also appeared more recently. We reviewed these three sets of AF guidelines and compared their rating systems and their recommendations regarding four major AF management aspects (i.e. long-term rate control strategy, long-term rhythm control strategy, oral anticoagulation and AF catheter ablation). Significant differences were found between guidelines in the quality of evidence or level of evidence and on the strength of recommendations. Use of new anticoagulants and of new antiarrhythmic drug therapy is also discussed in the light of recent trial results. Whether multiplication of guidelines and differences in recommendation impact their implementation in clinical practice, remains to be assessed.
Natriuretic Peptides as Predictors of Atrial Fibrillation Recurrences Following Electrical Cardioversion
Authors: Zografos Theodoros A , Katritsis Demosthenes G ,   Athens Euroclinic, Department of Cardiology, Athens, Greece,   Athens Euroclinic, Department of Cardiology, 9 Athanasiadou Street, Athens 11521, Greece. E: dkatritsis@euroclinic.gr
Published: August 2014

Electrical cardioversion (ECV) can be effective in restoring sinus rhythm (SR) in the majority of patients with atrial fibrillation (AF). Several factors that predispose to AF recurrences, such as age, AF duration and left atrial size have been used to guide a decision for cardioversion, but increasing evidence suggests that they may be rather poor markers of left atrial structural remodeling that determines the long-term success of a rhythm control strategy. In this context, the use of easily obtainable biomarkers, such as the levels of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP), to predict AF recurrences may be preferable. Since ANP production is associated with the extent of functional atrial myocardium, and both ANP and BNP reflect atrial pressure and mechanical stretching, these peptides are good candidate biomarkers to assess predisposition to AF recurrences. In this review we focus on the pathophysiological mechanisms and the available clinical evidence regarding the prediction of AF recurrences following successful ECV from pre-procedural ANP and BNP levels.
The European Heart Rhythm Association Practical Guide on the Use of New Oral Anticoagulants in Patients with Non-valvular Atrial Fibrillation – A Brief Summary
Authors: Mountfort Katrina , Kirchhof Paulus ,   Medical Writer, Radcliffe Cardiology,   University of Birmingham Centre for Cardiovascular Sciences, Birmingham, UK
Published: August 2014

New oral anticoagulants (NOACs) are an alternative to vitamin K antagonists (VKAs) in the prevention of stroke in patients with non-valvular atrial fibrillation (AF). The European Heart Rhythm Association (EHRA) has produced a practical guide to detail the use of NOACs in clinical practice. The guide includes a practical start-up and follow-up scheme, emphasising the importance of strict adherence to the regimen – the anticoagulant effect drops rapidly after 12–24 hours. There is also guidance on how to measure the anticoagulant effect of NOACs, switching between anticoagulant regimes and dealing with dosing errors. Physicians will have to consider the pharmacokinetic effect of drugs and co-morbidities when prescribing NOACs – plasma levels of NOACs may be affected by P-glycoprotein (P-gp) substrates, as well as cytochrome P450 (CYP3A4) inducers or inhibitors. In patients with chronic kidney disease, reduced doses of NOACs may be indicated. Guidance is also given on the management of bleeding complications, and the cessation and reinitiation of NOACs in patients undergoing surgical interventions. Finally, the use of NOACs in specific clinical situations is considered; these include patients with AF and coronary artery disease (CAD), patients presenting with acute stroke while taking NOACs and patients with cancer.
Imaging-guided Ventricular Tachycardia Ablation
Authors: Piers Sebastiaan RD , Zeppenfeld Katja ,   Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands,   Department of Cardiology (C-05-P), Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands. E: k.zeppenfeld@lumc.nl
Published: August 2014

Over the past decades important advances have been made in the field of ventricular tachycardia (VT) ablation, and as a result, VT ablation is now more widely being performed. The identification of ablation target sites still relies on electroanatomical substrate mapping, which is time-consuming, hampered by the intramural location of some scars and limited by epicardial fat. The potential of various imaging modalities to overcome these limitations have stimulated clinical electrophysiologists to perform studies on image integration during VT ablation. Imaging guidance has been used to identify, delineate and characterise the substrate for VT; to provide detailed anatomical information; to avoid ablation on coronary arteries; to delineate epicardial fat tissue; and to assess ablation lesions. In this review, reported applications and the potential advantages and limitations of different imaging modalities are discussed.