bluuebunny/crossref_metadata_2025 huggingface dataset:
Ryanodine receptor function in newborn rat heart
Authors: Pérez Claudia G. , Copello Julio A. , Li Yanxia , Karko Kimberly L. , Gómez Leticia , Ramos-Franco Josefina , Fill Michael , Escobar Ariel L. , Mejía-Alvarez Rafael
Published: December 2004

The role of ryanodine receptor (RyR) in cardiac excitation-contraction (E-C) coupling in newborns (NB) is not completely understood. To determine whether RyR functional properties change during development, we evaluated cellular distribution and functionality of sarcoplasmic reticulum (SR) in NB rats. Sarcomeric arrangement of immunostained SR Ca2+-ATPase (SERCA2a) and the presence of sizeable caffeine-induced Ca2+ transients demonstrated that functional SR exists in NB. E-C coupling properties were then defined in NB and compared with those in adult rats (AD). Ca2+ transients in NB reflected predominantly sarcolemmal Ca2+ entry, whereas the RyR-mediated component was ∼13%. Finally, the RyR density and functional properties at the single-channel level in NB were compared with those in AD. Ligand binding assays revealed that in NB, RyR density can be up to 36% of that found in AD, suggesting that some RyRs do not contribute to the Ca2+ transient. To test the hypothesis that RyR functional properties change during development, we incorporated single RyRs into lipid bilayers. Our results show that permeation and gating kinetics of NB RyRs are identical to those of AD. Also, endogenous ligands had similar effects on NB and AD RyRs: sigmoidal Ca2+ dependence, stronger Mg2+-induced inhibition at low cytoplasmic Ca2+ concentrations, comparable ATP-activating potency, and caffeine sensitivity. These observations indicate that NB rat heart contains fully functional RyRs and that the smaller contribution of RyR-mediated Ca2+ release to the intracellular Ca2+ transient in NB is not due to different single RyR channel properties or to the absence of functional intracellular Ca2+ stores.
The Protective Effect of Alpha-Lipoic Acid against Oxidative Damage in Rabbit Conjunctiva and Cornea Exposed to Ultraviolet Radiation
Authors: Demir Ülkü , Demir Tamer , Ilhan Nevin
Published: December 2004

Purpose: The purpose of this study was to determine the protective effect of α-lipoic acid against oxidative damage in rabbit conjunctiva and cornea exposed to ultraviolet radiation. Methods: 20 rabbits weighing 2,500– 3,000 g were used, and we divided them into 4 groups with 5 randomly selected rabbits. The rabbits were exposed to 2 J/cm2/h of ultraviolet A radiation (UVA) in the range of 320–405 nm for 12 h per day within 90 days. The control group did not undergo any procedure, the UVA group was only exposed to UVA radiation. The PUVA group was treated with 8-methoxypsoralen and UVA. The α-lipoic acid group was administered 8-methoxypsoralen + UVA + α-lipoic acid. At the end of 90 days, the rabbits were killed by decapitation, and the eyes were enucleated. Both eyes of each rabbit were used for biochemical evaluation. Conjunctival and corneal free malondialdehyde (MDA), glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) levels were compared among the groups. Results: Conjunctival free MDA levels were lower in the α-lipoic acid group compared with the UVA and PUVA groups (p < 0.05, p < 0.001, respectively). Both conjunctival SOD levels (p < 0.05, p < 0.01, respectively) and conjunctival GSH-PX levels (p < 0.01, p < 0.001, respectively) were higher in the α-lipoic acid group compared with other groups. Corneal free MDA levels were lower in the α-lipoic acid group compared with the UVA and PUVA groups (p < 0.01, p < 0.001, respectively). Both corneal SOD levels (p < 0.01, p < 0.01, respectively) and corneal GSH-PX levels (p < 0.01, p < 0.01, respectively) were higher in the α-lipoic acid group compared with the other groups. Conclusion: α-Lipoic acid which is considered as potent antioxidant protects the eye from the damaging effect of ultraviolet exposure.
Novel Therapies for Hemodialysis Vascular Access Dysfunction: Fact or Fiction!
Authors: Roy-Chaudhury Prabir , Kelly Burnett S. , Melhem Murad , Zhang Jianhua , Li Jinsong , Desai Pankaj , Munda Rino , Heffelfinger Sue C.
Published: December 2004

Hemodialysis vascular access dysfunction is a major cause of morbidity in the hemodialysis population and contributes significantly to the overall cost of end-stage renal disease programs. At a histological level, most hemodialysis vascular access dysfunction (in both native arteriovenous fistulae and PTFE dialysis access grafts) is due to venous stenosis and thrombosis, secondary to venous neointimal hyperplasia. However, despite a wealth of experimental and clinical data on the use of novel therapeutic interventions that target neointimal hyperplasia in the setting of coronary artery disease, there are unfortunately no effective therapeutic interventions for hemodialysis vascular access dysfunction at the present time. This is particularly unfortunate, since neointimal hyperplasia in the setting of hemodialysis vascular access fistulae and grafts could be the ideal clinical model to test novel therapeutic interventions for neointimal hyperplasia.
C-Reactive Protein in End-Stage Renal Disease: Are There Reasons to Measure It?
Authors: Stenvinkel Peter , Lindholm Bengt
Published: December 2004

Cardiovascular disease (CVD) remains the major cause of morbidity and mortality in end-stage renal disease (ESRD) patients. As traditional risk factors cannot alone explain the unacceptable high prevalence and incidence of CVD in this population, inflammation (a common phenomenon in ESRD), and other non-traditional risk factors are likely to contribute. Among several inflammatory biomarkers used to assess inflammation, high-sensitivity C-reactive protein (hs-CRP) has attracted the most interest. Indeed, in the general population the consistency of prognostic data for hs-CRP and the practicality of its use have led to suggestions that CRP should be used as a clinical criterion for global cardiovascular risk prediction. As CRP is so strongly associated with vascular disease, it has been suggested that this protein is not only a marker, but also a mediator, of atherogenesis. Indeed, recent in vitro data from studies on endothelial cells, monocytes-macrophages and smooth muscle cells support a direct role for CRP in atherogenesis. In ESRD, hs-CRP has been proven to be a strong predictor of both cardiovascular and all-cause mortality, and associated with oxidative stress, vascular calcification and endothelial dysfunction. As recent studies suggest that interleukin-6 may be a somewhat better outcome predictor than hs-CRP, comparative studies are needed to evaluate which inflammation biomarker is the most cost-effective predictor of outcome in the ESRD patient population.
Phosphate Kinetics during Different Dialysis Modalities
Authors: Ratanarat Ranistha , Brendolan Alessandra , Volker Gopel , Bonello Monica , Salvatori Gabriella , Andrikos Emilio , Yavuz Asuman , Crepaldi Carlo , Ronco Claudio
Published: December 2004

Background: An abnormal serum phosphate concentration is common in acute renal failure patients, with a reported incidence of 65–80%. Phosphate removal and kinetics during intermittent hemodialysis (IHD) have been investigated, but there is no information on its kinetics during slow low-efficiency dialysis (SLED) and continuous renal replacement therapy (CRRT). Methods: Eight IHD, 8 SLED, and 10 continuous venovenous hemofiltration (CVVH) patients with a residual renal clearance of <4.0 ml/min were studied during a single treatment to evaluate phosphate removal and kinetics. CVVH was studied the first 24 h after initiation. Dialysis/replacement fluid contained no phosphate. Kt/V, clearance of urea (Ku), inorganic phosphate (Kp) and solute removal was determined by direct dialysate quantification (DDQ). Results: Kp recorded with the three techniques were: IHD, 126.9 ± 18.4 ml/min; SLED, 58.0 ± 15.8 ml/min, and CVVH, 31.5 ± 6.0 ml/min. However, in shorter dialysis treatment the total removal of phosphate was significantly lower than in longer dialysis (IHD, 29.9 ± 7.7 mmol; SLED, 37.6 ± 9.6 mmol; CVVH, 66.7 ± 18.9 mmol, p = 0.001). The duration of treatment is the only factor determining phosphate removal (r = 0.7, p < 0.0001 by linear correlation model). Like IHD, phosphate kinetics during SLED could not be explained by the two-pool kinetic model, and the rebound of phosphate extended beyond 1 h after dialysis. Rebound, however, is less marked than in short dialysis. Conclusion: These results are reliable evidence about amount of phosphate removal and behavior of intradialytic phosphate kinetics in renal failure patients undergoing different dialysis modalities. These data will help clinicians plan phosphate supplementation and treatment intensity.
Animal-Assisted Therapy Ameliorates Anhedonia in Schizophrenia Patients
Authors: Nathans-Barel Inbar , Feldman Pablo , Berger Barry , Modai Ilan , Silver Henry
Published: December 2004

Background: Anhedonia, a component of the negative symptom dimension and a core phenomenon in schizophrenia, is associated with poor social functioning and is resistant to treatment. We tested the hypothesis that animal-assisted therapy (AAT) may improve anhedonia. Objective: To compare the effect of psychosocial treatment sessions in which a dog was an active participant (AAT) with comparable sessions without a dog, using a controlled protocol. Method: The hedonic tone of 10 chronic schizophrenia patients who participated in 10 weekly interactive sessions of AAT was compared to a control group treated without animal assistance. The hedonic tone was measured with the Snaith-Hamilton Pleasure Scale. Subjective quality of life variables and clinical symptoms were also assessed. Results: The AAT group showed a significant improvement in the hedonic tone compared to controls. They also showed an improvement in the use of leisure time and a trend towards improvement in motivation. Conclusion: AAT may contribute to the psychosocial rehabilitation and quality of life of chronic schizophrenia patients.
Effects of Cataractogenesis on the CDP-Choline Pathway: Increased Phospholipid Synthesis in Lenses from Galactosemic Rats and 13/N Guinea Pigs
Authors: Jernigan Jr. Howard M. , Blum Penny S. , Chakrabarti Ipsit , Su Yin , Zigler Jr. J. Samuel
Published: December 2004

We investigated the effects of cataractogenesis on phospholipid (P-lipid) synthesis in sugar cataracts from galactosemic rats and in hereditary cataracts from 13/N guinea pigs. Cataractous lenses from rats fed a 50% galactose diet for 7 days were incubated 24 h with radiolabeled choline or ethanolamine and the P-lipids were extracted. The galactosemic cataracts synthesized twice as much phosphatidylcholine (PtdCho) as control rat lenses, and phosphatidylethanolamine synthesis also was increased. Similar analysis of cataractous lenses from 3-week-old 13/N guinea pigs showed a 3-fold increase in PtdCho synthesis compared with control lenses. In all cases, the P-lipid precursor pool was lower in cataracts than in control lenses. The increased P-lipid synthesis in these cataracts may represent a membrane repair response to cataractogenic stress.
Lower Extremity Bypass Procedures in Diabetic Patients with End-Stage Renal Disease: Is It Worthwhile?
Authors: Georgopoulos S. , Filis K. , Vourliotakis G. , Bakoyannis C. , Papapetrou A. , Klonaris C. , Papalambros E. , Bastounis E.
Published: December 2004

Backgroud/Aims: Limb-threatening ischemia in patients with end-stage renal disease (ESRD) represents a challenging therapeutic problem. Furthermore, diabetes mellitus is frequently associated with ischemic gangrene, persistent infection and impaired wound healing. The present study was undertaken to examine graft patency, limb salvage and survival in patients with ESRD and diabetes following bypass grafting to treat lower limb critical ischemia. Methods: A retrospective analysis of 56 arterial reconstructions performed in 39 patients with diabetes mellitus and ESRD during a period of 8 years. The indications for bypass grafting were: ischemic rest pain (n = 13), non-healing ulcer (n = 18) or foot gangrene (n = 25). Risk factors in association with surgical morbidity and mortality, limb loss and graft patency were evaluated. Results: Thirty-four patients were on hemodialysis and 5 on peritoneal dialysis. Forty-nine infrainguinal reconstructions were performed; the site of distal anastomosis was the below knee popliteal artery (n = 22), the anterior tibial artery (n = 12), the posterior tibial artery (n = 8), and the peroneal artery (n = 7). Seven axillofemoral reconstructions were also performed; the site of distal anastomosis was the common femoral artery (n = 5) and the above knee popliteal artery (n = 2). The 30-day operative mortality rate was 18% (7 patients). The mean follow-up was 11.5 (range 1–93) months. Patient survival rate at 1 and 2 years was 63 and 45%, respectively. Primary patency rate was 64% at 1 year and 58% at 2 years. The limb salvage rate was 65% in the first year. Conclusion: Limb salvage rate in patients with ESRD and diabetes justifies an aggressive policy of revascularization, despite decreased survival of this population.
Influence of β3 Integrin Gene Leu33/Pro33 Polymorphism on Primary Glomerulonephritis
Authors: Bantis Christos , Heering Peter J. , Aker Sendogan , Kuhr Nicola , Grabensee Bernd , Ivens Katrin
Published: December 2004

Background: β3 integrin subunit is expressed as αIIbβ3 integrin on platelets and as αvβ3 integrin on a variety of cells including renal endothelial, mesangial and tubular cells. Leu33/Pro33 polymorphism of β3 integrin has been associated with altered platelet functions, cardiovascular complications and the incidence of acute rejection episodes in renal transplantation. We investigated its influence on IgA nephropathy (IgAN), focal segmental glomerulosclerosis (FSGS) and membranous glomerulonephritis (MGN). Methods: We studied 251 patients with biopsy-proven primary glomerulonephritis (IgAN n = 127, FSGS n = 71, MGN n = 53) followed up for 6.3 ± 5.3 years and 100 control subjects. Patients were classified according to the slope of reciprocal serum creatinine into slow (n = 162) and fast progressors (n = 89). Leu33/Pro33 polymorphism was determined by PCR amplification followed by restriction with the endonuclease Bcnl. Results: The genotype frequencies were similar in patients and controls (n.s.). Initial renal function, proteinuria and blood pressure did not differ significantly between patients with different genotypes (n.s.). The genotype frequencies were similar in slow and fast progressors (n.s.). Furthermore, Leu33/Pro33 polymorphism had no impact on renal survival in the Kaplan-Meier analysis (n.s.). Conclusion: Our results indicate that β3 integrin Leu33/Pro33 polymorphism is not a risk factor or a marker of progression in primary glomerulonephritis.
Renal Dopaminergic System Activity in the Rat Remnant Kidney
Authors: Sampaio-Maia B. , Serrão P. , Guimarães J.T. , Vieira-Coelho M.A. , Pestana M.
Published: December 2004

Background: Renal dopamine exerts natriuretic and diuretic effects by activating D1-like receptors. Uninephrectomy results in increased renal dopaminergic activity and dopamine-sensitive enhanced natriuresis. Methods: The present study evaluated renal adaptations in sodium handling and the role of dopamine in rats submitted to ¾ nephrectomy: right nephrectomy and excision of both poles of the left kidney (¾nx rats). Results: Two weeks after surgery the absolute urinary levels of dopamine were markedly reduced in ¾nx rats whereas the urinary dopamine excretion per % of residual nephrons was significantly increased in the remnant kidney of ¾nx rats. The Vmax values for renal aromatic L-amino acid decarboxylase, the enzyme responsible for the synthesis of renal dopamine, were decreased in ¾nx rats. Renal catechol-O-methyltransferase activity, the enzyme responsible for the methylation of dopamine, was increased in ¾nx rats whereas the renal activities of monoamine oxidases A and B did not differ between ¾nx and Sham animals. Volume expansion (5% body weight) resulted in similar natriuretic responses in ¾nx and Sham rats. During D1 antagonist administration (Sch-23390, 30 µg·h–1·kg–1) the natriuretic response to volume expansion was reduced in ¾nx rats more pronouncedly than in Sham animals. Conclusion: The decrease in absolute renal dopamine output in ¾nx rats is related with reduced renal synthesis and enhanced O-methylation of the amine. However, this is accompanied in ¾nx rats by increased renal dopamine excretion per residual nephrons and dopamine-sensitive enhanced natriuresis.
Neurological Examination in Healthy Term Infants Aged 3–10 Weeks
Authors: Guzzetta Andrea , Haataja Leena , Cowan Frances , Bassi Laura , Ricci Daniela , Cioni Giovanni , Dubowitz Lilly , Mercuri Eugenio
Published: December 2004

Objectives: The neurodevelopmental progress of newborn term infants is checked routinely at around 6 weeks of postnatal age. The maturation of neurological signs in this age range however has not been systematically studied and normative data are not available. The aim of this study was to document any changes in posture, tone, reflexes, behaviour and movements in low-risk full-term infants between 3 and 10 weeks of postnatal age. Study Design: We performed a structured neurological examination previously standardised in full-term newborns in the first 48 h after birth. In the current study, a total of 76 examinations were performed between 3 and 10 weeks of age in low-risk full-term infants. Results: The results of the examinations were divided according to postnatal age. In most items, the scores changed with time, with a definite shift in their distribution occurring around 6 weeks. At this age, a reduction in flexor tone of the limbs was observed, together with an increase in active neck tone. Visual orientation in contrast had already improved by 3 weeks when all infants were able to follow a target in a full circle compared to newborns that are often only able to follow a target in an arc. Conclusions: Our results suggest that 6 weeks post-term birth is an important milestone for changes in neurological signs, particularly those related to muscle tone and posture, probably reflecting maturation of the nervous system. These findings provide important guidelines for the interpretation of the neurological examination performed at this age.
Distribution of GABA-Like Immunoreactive Cell Bodies in the Brains of Two Amphibians, Rana catesbeiana and Xenopus laevis
Authors: Hollis David M. , Boyd Sunny K.
Published: December 2004

The distribution of the neurotransmitter gamma-aminobutyric acid (GABA) is not well understood for non-mammalian vertebrates. We thus used immunocytochemistry to locate putative GABAergic cells in the brains of male bullfrogs (Rana catesbeiana) and South African clawed frogs (Xenopus laevis). GABA-immunoreactive cell bodies were broadly distributed throughout the brains of both species with similar general patterns. In both, the greatest numbers of GABA-positive cells were found in the olfactory bulb, thalamus, and optic tectum, but virtually no major brain region lacked GABAergic cells. Species differences were also apparent. The density of GABA-immunoreactive cells was substantially higher in many areas of the bullfrog brain, compared to Xenopus. Bullfrogs possessed extensive cell populations in the medial pallium, preoptic area, optic tectum, torus semicircularis and tegmentum but cells were fewer in these locations in Xenopus. In the bullfrog hindbrain, GABA-immunoreactive cell bodies were restricted to very narrow and distinct populations. In Xenopus, however, cells in a similar position were fewer and spread more extensively. The distribution of GABA cells in the brain of these two species supports the hypotheses that GABA is involved in control of olfaction, audition, vision and vocalization. However, differences in the distribution of GABA between the bullfrog and Xenopus suggest that the extent of the GABAergic influence might vary between species.
Circulating Insulin-Like Growth Factor-1 and Insulin-Like Growth Factor Binding Protein-3 Are Associated With Early Carotid Atherosclerosis
Authors: Kawachi Shin-ichi , Takeda Noriyuki , Sasaki Akihiko , Kokubo Yoshiaki , Takami Kazuhisa , Sarui Hiroshi , Hayashi Makoto , Yamakita Noriyoshi , Yasuda Keigo
Published: December 2004

Objective—

Growth hormone (GH)–insulin-like growth factor (IGF)-1 axis regulates growth and survival of vascular cells and cardiomyocytes. The role of GH–IGF-1 axis in cardiovascular disease is controversial.

Methods and Results—

We assessed the association of circulating levels of IGF-1 and IGF binding protein-3 (IGFBP-3) with early carotid atherosclerosis and atherosclerotic risk factors in 330 Japanese men (age 51.6±8.6 years, range 29 to 77, body mass index [BMI] 23.6±2.9 kg/m
2
). Intima-media thickness (IMT) of the common carotid artery was measured by ultrasound. Abdominal visceral adipose and subcutaneous adipose tissue area by computer-assisted tomographic scan were determined. Correlation coefficients were calculated by partial correlation analysis. BMI and plasma insulin showed positive associations with circulating IGF-1 and IGFBP-3. Subcutaneous adipose tissue was correlated with IGF-1. High-density lipoprotein cholesterol was inversely associated with IGF-1. Blood pressure, total cholesterol, triglyceride, and visceral adipose tissue were positively associated with IGFBP-3. IGF-1 and IGFBP-3 were associated with carotid IMT independent of age, BMI, blood pressure, and insulin. Insulin was associated with carotid IMT in univariate analysis. However, it was not correlated with carotid IMT in the multivariate analyses which included IGF-1 or IGFBP-3 as a covariate.

Conclusion—

Increased circulating IGF-1 and IGFBP-3 may be stimulators of atherosclerosis.
Expression of the LXRα Protein in Human Atherosclerotic Lesions
Authors: Watanabe Yuichiro , Jiang Shuying , Takabe Wakako , Ohashi Riuko , Tanaka Toshiya , Uchiyama Yasutoshi , Katsumi Keiko , Iwanari Hiroko , Noguchi Noriko , Naito Makoto , Hamakubo Takao , Kodama Tatsuhiko
Published: December 2004

Objective—

Liver X–activated receptor α (LXRα) regulates multiple genes controlling cholesterol metabolism and transport. To clarify its role in atherogenesis, we established a monoclonal antibody recognizing native human LXRα protein and studied the expression pattern in human atherosclerotic lesions.

Methods and Results—

A novel monoclonal antibody PPZ0412 was raised against the ligand-binding domain of LXRα, which can be used for immunostaining of human LXRα protein. LXRα protein was detected in the nucleus of macrophages in the liver, spleen, or lung and also in hepatocytes and adipocytes. In atherosclerotic lesions, the LXRα protein was detected in macrophages positive for scavenger receptor class A and/or CD68.

Conclusions—

In the human body, the LXRα protein is highly expressed in macrophage lineage cells and foam cells in atherosclerotic lesions and is identified as a target for intervention in atherosclerotic disease.
Chlamydia pneumoniae, Mycoplasma pneumoniae
, and
Legionella pneumophila
in Elderly Patients With Stroke (C-PEPS, M-PEPS, L-PEPS)
Authors: Ngeh Joseph , Goodbourn Colin
Published: December 2004

Background and Purpose—

Multiple studies have suggested an association between
Chlamydia pneumoniae
and
Mycoplasma pneumoniae
infection and cardiovascular disease. We investigated whether the risk of cerebrovascular disease is associated with
Legionella pneumophila
infection and the aggregate number/infectious burden of these atypical respiratory pathogens.

Methods—

One hundred patients aged >65 years admitted with acute stroke or transient ischemic attack (TIA) and 87 control patients admitted concurrently with acute noncardiopulmonary, noninfective conditions were recruited prospectively. Using enzyme-linked immunosorbent assay (ELISA) kits, we previously reported the seroprevalences of
C pneumoniae
and
M pneumoniae
in these patients. We have now determined the seroprevalences of
L pneumophila
IgG and IgM in this cohort of patients using ELISA.

Results—

The seroprevalences of
L pneumophila
IgG and IgM were 29% (n=91) and 12% (n=81) in the stroke/TIA group and 22% (n=86) and 10% (n=72) in the controls, respectively. Using logistic regression to adjust for age, sex, hypertension, smoking, diabetes, ischemic heart disease, and ischemic ECG, the odds ratios for stroke/TIA in relation to
L pneumophila
IgG and IgM were 1.52 (95% CI, 0.70 to 3.28;
P
=0.29) and 1.49 (95% CI, 0.45 to 4.90;
P
=0.51), respectively. The odds ratios in relation to IgG seropositivity for 1, 2, or 3 atypical respiratory pathogens after adjustment were 3.89 (95% CI, 1.13 to 13.33), 2.00 (95% CI, 0.64 to 6.21), and 6.67 (95% CI, 1.22 to 37.04), respectively (
P
=0.06).

Conclusions—

L pneumophila
seropositivity is not significantly associated with stroke/TIA. However, the risk of stroke/TIA appears to be associated with the aggregate number of chronic infectious burden of atypical respiratory pathogens such as
C pneumoniae
,
M pneumoniae
, and
L pneumophila
.
Influence of Socioeconomic Status on Mortality After Stroke
Authors: Arrich Jasmin , Lalouschek Wolfgang , Müllner Marcus
Published: December 2004

Background and Purpose—

Low socioeconomic status is associated with increased morbidity and mortality from stroke. The purpose of this study was to investigate the association between 4 independent measures of socioeconomic status and mortality of patients with acute ischemic stroke and transient ischemic attack.

Methods—

Socioeconomic status was assessed by taking into account levels of education, occupation, occupational status, and income. The end point was overall mortality. We used Cox proportional hazard models to adjust for age, sex, and severity of stroke on admission.

Results—

A total of 2606 stroke patients were followed up for a median of 2.5 years. Unskilled workers had a hazard ratio of 1.87 for death after stroke (95% CI, 1.37 to 2.55) and skilled workers had a hazard ratio of 1.61 (95% CI, 1.23 to 2.11) compared with white-collar workers. Of 4 income groups, patients with the second lowest level of income had a hazard ratio of 1.60 (95% CI, 1.10 to 2.33) and patients with the third lowest level of income had a hazard ratio of 1.71 (95% CI, 1.25 to 2.32) compared with patients with the highest income. The hazard ratio for death after stroke for early retired patients was 1.75 (95% CI, 1.01 to 3.04) compared with stroke patients in the active workforce at the time of the event.

Conclusions—

Socioeconomic status is associated with survival of patients with acute stroke after adjustment for age, sex, and severity of stroke. The influence of socioeconomic status seems to continue to affect the outcome largely independent of stroke severity.
Telemedicine for Safe and Extended Use of Thrombolysis in Stroke
Authors: Audebert Heinrich J. , Kukla Christian , Clarmann von Claranau Stephan , Kühn Johannes , Vatankhah Bijan , Schenkel Johannes , Ickenstein Guntram W. , Haberl Roman L. , Horn Markus
Published: December 2004

Background and Purpose—

Systemic thrombolysis represents the only proven therapy for acute ischemic stroke, but safe treatment is reported only in established stroke units. One major goal of the ongoing Telemedic Pilot Project for Integrative Stroke Care (TEMPiS) in Bavaria is to extend the use of tissue plasminogen activator (tPA) treatment in nonurban areas through telemedic support.

Methods—

The stroke centers in Munich-Harlaching and in Regensburg established a telestroke network to provide consultations for 12 local hospitals in eastern Bavaria. The telemedic system consists of a digital network that includes a 2-way video conference system and CT/MRI image transfer with a high-speed data transmission up to 2 Mb/s. Each network hospital established specialized stroke wards in which qualified teams treat acute stroke patients. Physicians in these hospitals are able to contact the stroke centers 24 hours per day.

Results—

A total of 106 systemic thrombolyses were indicated via teleconsultations between February 1, 2003, and April 7, 2004. During the first 12 months, the rate of thrombolyses was 2.1% of all stroke patients. Mean age was 68 years, and median National Institutes of Health Stroke Scale score was 13. Mean delay between onset and hospital admission was 65 minutes, and door-to-needle time was on average 76 minutes, which included 15 minutes for the teleconsultation. Symptomatic hemorrhage occurred in 8.5% of patients, and in-hospital mortality was 10.4%.

Conclusions—

The present data suggest that systemic thrombolysis indicated via stroke experts in the setting of teleconsultation exhibits similar complication rates to those reported in the National Institute of Neurological Disorders and Stroke trial. Therefore, tPA treatment is also safe in this context and can be extended to nonurban areas.
Sensitivity Analysis of Cirrus Cloud Properties from High-Resolution Infrared Spectra. Part I: Methodology and Synthetic Cirrus
Authors: Kahn Brian H. , Eldering Annmarie , Ghil Michael , Bordoni Simona , Clough Shepard A.
Published: December 2004

A set of simulated high-resolution infrared (IR) emission spectra of synthetic cirrus clouds is used to perform a sensitivity analysis of top-of-atmosphere (TOA) radiance to cloud parameters. Principal component analysis (PCA) is applied to assess the variability of radiance across the spectrum with respect to microphysical and bulk cloud quantities. These quantities include particle shape, effective radius (reff), ice water path (IWP), cloud height Zcld and thickness ΔZcld, and vertical profiles of temperature T(z) and water vapor mixing ratio w(z). It is shown that IWP variations in simulated cloud cover dominate TOA radiance variability. Cloud height and thickness, as well as T(z) variations, also contribute to considerable TOA radiance variability.

The empirical orthogonal functions (EOFs) of radiance variability show both similarities and differences in spectral shape and magnitude of variability when one physical quantity or another is being modified. In certain cases, it is possible to identify the EOF that represents variability with respect to one or more physical quantities. In other instances, similar EOFs result from different sets of physical quantities, emphasizing the need for multiple, independent data sources to retrieve cloud parameters. When analyzing a set of simulated spectra that include joint variations of IWP, reff, and w(z) across a realistic range of values, the first two EOFs capture approximately 92%–97% and 2%–6% of the total variance, respectively; they reflect the combined effect of IWP and reff. The third EOF accounts for only 1%–2% of the variance and resembles the EOF from analysis of spectra where only w(z) changes. Sensitivity with respect to particle size increases significantly for reff several tens of microns or less. For small-particle reff, the sensitivity with respect to the joint variation of IWP, reff, and w(z) is well approximated by the sum of the sensitivities with respect to variations in each of three quantities separately.
Mechanisms Controlling the Annual Cycle of Precipitation in the Tropical Atlantic Sector in an Atmospheric GCM*
Authors: Biasutti M. , Battisti D. S. , Sarachik E. S.
Published: December 2004

A set of AGCM experiments is used to study the annual cycle of precipitation in the region surrounding the tropical Atlantic Ocean. The experiments are designed to reveal the relative importance of insolation over land and the (uncoupled) SST on the annual cycle of precipitation over the tropical Atlantic Ocean, Africa, and the tropical Americas.

SST variations impact the position of the maritime ITCZ by forcing the hydrostatic adjustment of the atmospheric boundary layer and changes in surface pressure and low-level convergence. The condensation heating released in the ITCZ contributes substantially to the surface circulation and the maintenance of the SST-induced ITCZ anomalies.

The remote influence of SST is felt in equatorial coastal areas and the Sahel. The circulation driven by condensation heating in the maritime ITCZ extends to the coastal regions, thus communicating the SST signal onshore. Conversely, the Sahel responds to variations in SST through boundary layer processes that do not involve the maritime ITCZ. The atmospheric response to changes in subtropical SST is advected inland and forces changes in sea level pressure and low-level convergence across a large part of tropical Africa.

The impact of local insolation on continental precipitation can be explained by balancing net energy input at the top of the atmospheric column with the export of energy by the divergent circulation that accompanies convection. Increased insolation reduces the stability of the atmosphere in the main continental convection centers, but not in monsoon regions.

Insolation over land impacts the intensity of the maritime ITCZ via its influence on precipitation in Africa and South America. Reduced land precipitation induces the cooling of the Atlantic upper troposphere and the enhancement of convective available potential energy in the maritime ITCZ.
Comparison of NOAA's Operational AVHRR-Derived Cloud Amount to Other Satellite-Derived Cloud Climatologies
Authors: Thomas Sarah M. , Heidinger Andrew K. , Pavolonis Michael J.
Published: December 2004

A comparison is made between a new operational NOAA Advanced Very High Resolution Radiometer (AVHRR) global cloud amount product to those from established satellite-derived cloud climatologies. The new operational NOAA AVHRR cloud amount is derived using the cloud detection scheme in the extended Clouds from AVHRR (CLAVR-x) system. The cloud mask within CLAVR-x is a replacement for the Clouds from AVHRR phase 1 (CLAVR-1) cloud mask. Previous analysis of the CLAVR-1 cloud climatologies reveals that its utility for climate studies is reduced by poor high-latitude performance and the inability to include data from the morning orbiting satellites. This study demonstrates, through comparison with established satellite-derived cloud climatologies, the ability of CLAVR-x to overcome the two main shortcomings of the CLAVR-1-derived cloud climatologies. While systematic differences remain in the cloud amounts from CLAVR-x and other climatologies, no evidence is seen that these differences represent a failure of the CLAVR-x cloud detection scheme. Comparisons for July 1995 and January 1996 indicate that for most latitude zones, CLAVR-x produces less cloud than the International Satellite Cloud Climatology Project (ISCCP) and the University of Wisconsin High Resolution Infrared Radiation Sounder (UW HIRS). Comparisons to the Moderate Resolution Imaging Spectroradiometer (MODIS) for 1–8 April 2003 also reveal that CLAVR-x tends to produce less cloud. Comparison of the seasonal cycle (July–January) of cloud difference with ISCCP, however, indicates close agreement. It is argued that these differences may be due to the methodology used to construct a cloud amount from the individual pixel-level cloud detection results. Overall, the global cloud amounts from CLAVR-x appear to be an improvement over those from CLAVR-1 and compare well to those from established satellite cloud climatologies. The CLAVR-x cloud detection results have been operational since late 2003 and are available in real time from NOAA.
White Privilege, Color Blindness, and Services to Battered Women
Authors: Donnelly Denise A. , Cook Kimberly J. , van Ausdale Debra , Foley Lara
Published: December 2004

White privilege is a system of benefits, advantages, and opportunities experienced by White persons in our society simply because of their skin color. In this article, the authors present the results of a descriptive, exploratory study of White privilege in battered women’s shelters in the Deep South. Based on a qualitative analysis, the authors show how White privilege is intricately connected to executive directors’ claims of color blindness, the othering of women of color, and viewing White as the norm. The authors conclude the article with implications for service provision to battered women and directions for future research.
The Economics of Service Upgrades
Authors: Biyalogorsky Eyal , Gerstner Eitan , Weiss Dan , Xie Jinhong
Published: December 2004

Many service providers offer different service classes (e.g., first class, second class). Because the capacity of each class is set in advance, providers may end up with unfilled first-class capacity at the time of service delivery. When this happens, providers often upgrade some of their customers from a lower service class to a higher one. One way in which service providers manage upgrades is by selling, in advance, tickets that entitle the holder to an upgrade if space becomes available in a higher service class. This article investigates the circumstances under which upgradeable tickets are profitable, how to price them, and how many to issue. Upgradeable tickets increase the provider’s profits when the probability of obtaining full price for first-class service is sufficiently high. With upgradeable tickets, more of the available capacity can be reserved for potential customers who are willing to pay a high price for high-end service.
An Analytical Approach for Allocating Service Recovery Efforts to Reduce Internal Failures
Authors: Simons Jacob V. , Kraus Mark E.
Published: December 2004

Prior research substantiates the value of compensating customers for poor quality. However, little guidance has been provided for the recovery of errors while service delivery is in progress. The authors provide analytical models inspired by reliability theory to guide managers in allocating their investments in service recovery. Models are constructed to achieve four different objectives and converted to Lagrangian formulations for solution. Example solutions illustrate the contrast in investment allocations.
E-S-QUAL
Authors: Parasuraman A. , Zeithaml Valarie A. , Malhotra Arvind
Published: December 2004

Using the means-end framework as a theoretical foundation, this article conceptualizes, constructs, refines, and tests a multiple-item scale (E-S-QUAL) for measuring the service quality delivered by Web sites on which customers shop online. Two stages of empirical data collection revealed that two different scales were necessary for capturing electronic service quality. The basic E-S-QUAL scale developed in the research is a 22-item scale of four dimensions: efficiency, fulfillment, system availability, and privacy. The second scale, E-RecS-QUAL, is salient only to customers who had nonroutine encounters with the sites and contains 11 items in three dimensions: responsiveness, compensation, and contact. Both scales demonstrate good psychometric properties based on findings from a variety of reliability and validity tests and build on the research already conducted on the topic. Directions for further research on electronic service quality are offered. Managerial implications stemming from the empirical findings about E-S-QUAL are also discussed.
The Walt Disney World Underground
Authors: Pike David L.
Published: December 2004

This article has grown out of a larger project on representations of subterranean space in the modern city. It explores the meanings of the “utilidors,” the underground infrastructure of the Magic Kingdom, within the broader experience of the space of Walt Disney World. It relates this experience to a particular mode of representing the modern city as divided between its respectable, aboveground spaces and its hidden, underground spaces. The author concludes by suggesting some of the insights the power of Disney’s spatial divisions can provide in thinking about current images of the city as simultaneously a site of “Disneyfication” (e.g., the new Times Square) and as a place of ruin, crime, and decay.
“The Serbian Bastille”
Authors: Lavrence Christine
Published: December 2004

This article examines the relationship between memory, agency, and place in a central “ lieu de mémoire ” in downtown Belgrade called Republic Square. On the basis of archival and ethnographic research, the “symbolically charged” nature of the square is examined in terms of how its meaning has fluctuated over time and how it has been appropriated by the state and social actors at various historical moments. The national memory inscribed in the square is explored in relation to the city as a social space and, at times, a competing community of memory. The square is examined as a space where divided memories are negotiated and where the desire for entry into the symbolic terrain of Europe has been staged over the past century.
Why a Stakeholder Approach to Evaluating Training
Authors: Nickols Fred W.
Published: December 2004

The problem and the solution. After more than 40 years, the reigning framework for evaluating training—the four-level Kirkpatrick model—rarely gets beyond the first level: trainee reactions or the “smiles test.” The author argues that this is because current approaches to training evaluation are primarily of interest to trainers but not to the many constituencies served by training, trainers, and the training function. To these other constituencies, current approaches to evaluating training are largely irrelevant. Adopting a different approach to the evaluation of training, a stakeholder-based approach, can solve this problem of irrelevance. Using a stakeholder-based approach requires trainers to incorporate stakeholder requirements into the design, development, and delivery of training, increasing stakeholder interest in the outcomes and in evaluating those outcomes in ways that offer meaning, value, and relevance to all of the stakeholders.
Revenue Sharing and Competitive Balance
Authors: Késenne Stefan
Published: December 2004

This short article, challenging the so-called invariance proposition, argues that, for a general n-team model with profit-maximizing clubs and concave revenue functions, there are reasons to believe that revenue sharing can worsen the competitive balance among teams in a professional sports league. If clubs are win maximizers, revenue sharing improves the competitive balance.
Ability, Age, and Performance
Authors: Sowell Clifford B. , Mounts Wm. Stewart
Published: December 2004

A person’s age is used in many ways in economic decisions due to the belief that it is a low cost proxy for ability. Even with this importance assigned to age, however, little economic research has investigated the underlying relationship between age and output. Our purpose is to consider this relationship using data from the Ironman Triathlon World Championship. Our findings indicate that men age faster than the rates estimated by others. Also, unlike other studies, these data allow inferences to be drawn about the linkage between age and ability for women. We find that women age only slightly faster than men, showing some relative increase in aging in later years. At younger ages, however, women appear more responsive to training and maturation (forms of human capital investment) than young men.
Comment: The Economics of Professional Sports Leagues
Authors: Rockerbie Duane W.
Published: December 2004

The author discusses the methodological problems of the Bougheas and Downward model of the European transfer market, then shows that their model is a description of the dynamics of the Quirk and Fort model. The two models are consistent with one another despite the claim of Bougheas and Downward.
Status of Surgical Margins and Prognosis in Adult Soft Tissue Sarcomas of the Extremities: A Series of Patients Treated at a Single Institution
Authors: Gronchi A. , Casali P.G. , Mariani L. , Miceli R. , Fiore M. , Lo Vullo S. , Bertulli R. , Collini P. , Lozza L. , Olmi P. , Rosai J.
Published: December 2004

Purpose

To explore the prognostic effect of microscopic marginal status after surgery for extremity soft tissue sarcomas.

Patients and Methods

We analyzed 911 consecutive patients surgically treated throughout a 20-year span at a single referral center. Six hundred forty-two were first seen with a primary tumor, and 269, with a locally recurrent tumor. All patients underwent macroscopically complete resection. Microscopic marginal status was negative (tumor size > 1 mm) in 748 patients and positive (≤ 1 mm) in 163 patients. Median follow-up was 107 months.

Results

Patients with primary disease had a lower disease-specific mortality in comparison to those first examined for recurrence (25% v 37%, respectively, at 10 years). Size, malignancy grade, depth, histotype, and local recurrence had a statistically significant prognostic effect at multivariable analysis, while microscopically positive surgical margins had not, though a trend in favor of negative margins was observed. However, an extra risk was observed for patients with positive margins after 3 to 5 years (hazard ratio, 1.8 after 5 years v 0.8 before 5 years). In patients treated for a local recurrence, the prognostic impact of positive margins was higher (hazard ratio, 1.6).

Conclusion

Positive surgical margins had a weak adverse prognostic effect, which was more pronounced for those patients escaping an early relapse. This would seem to justify a policy of surgical adequacy in adult soft tissue sarcomas, though clinical decision making in borderline presentations for conservative surgery might be reasonably flexible and shared with the patient. Once a local relapse has occurred, the impact of local treatments seems more critical.
Cloning and Nucleotide Sequence Analysis of the Ampicillin Resistance Gene on a Conjugative R Plasmid from the Fish Pathogen Photobacterium damselae subsp. piscicida
Authors: Morii Hideaki , Bharadwaj Manish Surendra , Eto Naoya
Published: December 2004

Transferable resistance to various drugs was investigated in strains of Photobacterium damselae subsp. piscicida from Japan. Drug resistance was transferred via two plasmids of 100 and 50 kilobases (kb) or three plasmids of 100, 50, and 40 kb. Resistance to ampicillin was transferred on the 50-kb plasmid. An ampicillin resistance gene in the 50-kb plasmid pPDP8517 from strain PP8517 was cloned from a 1.8-kb Hinc II fragment of the plasmid. The nucleotide sequence of the coding and flanking region of the ampicillin resistance gene was determined to be 1,736 base pairs. The nucleotide sequence identified an open reading frame (ORF) encoding 282 amino acid residues with a calculated molecular mass of 31,292 daltons. The ampicillin resistance gene's ORF was found to be a β-lactamase bearing low levels of amino acid identities (<63%) relative to other β-lactamases. This ORF was very high in amino acid identities with class A β-lactamases compared with those of class B, C, and D β-lactamases. Four important structural features were conserved in all class A β-lactamases present in the deduced amino acid sequence of the ampicillin resistance gene. These results suggest that the P. damselae subsp. piscicida ampicillin resistance gene is a class A β-lactamase encoded on an R plasmid that is distinctly different from other known β-lactamases. Moreover, Southern blot analysis suggested that P. damselae strains with the ampicillin resistance gene are widely distributed in marine fish farms in the Kyushu area in Japan.