bluuebunny/crossref_metadata_2025 huggingface dataset:
Eye‐movement patterns are associated with communicative competence in autistic spectrum disorders
Authors: Norbury Courtenay Frazier , Brock Jon , Cragg Lucy , Einav Shiri , Griffiths Helen , Nation Kate
Published: February 2009

Background:  Investigations using eye‐tracking have reported reduced fixations to salient social cues such as eyes when participants with autism spectrum disorders (ASD) view social scenes. However, these studies have not distinguished different cognitive phenotypes.

Methods:  The eye‐movements of 28 teenagers with ASD and 18 typically developing peers were recorded as they watched videos of peers interacting in familiar situations. Within ASD, we contrasted the viewing patterns of those with and without language impairments. The proportion of time spent viewing eyes, mouths and other scene details was calculated, as was latency of first fixation to eyes. Finally, the association between viewing patterns and social‐communicative competence was measured.

Results:  Individuals with ASD and age‐appropriate language abilities spent significantly less time viewing eyes and were slower to fixate the eyes than typically developing peers. In contrast, there were no differences in viewing patterns between those with language impairments and typically developing peers. Eye‐movement patterns were not associated with social outcomes for either language phenotype. However, increased fixations to the mouth were associated with greater communicative competence across the autistic spectrum.

Conclusions:  Attention to both eyes and mouths is important for language development and communicative competence. Differences in fixation time to eyes may not be sufficient to disrupt social competence in daily interactions. A multiple cognitive deficit model of ASD, incorporating different language phenotypes, is advocated.
Environmental influences on the longitudinal covariance of expressive vocabulary: measuring the home literacy environment in a genetically sensitive design
Authors: Hart Sara A. , Petrill Stephen A. , DeThorne Laura S. , Deater‐Deckard Kirby , Thompson Lee A. , Schatschneider Chris , Cutting Laurie E.
Published: February 2009

Background:  Despite the well‐replicated relationship between the home literacy environment and expressive vocabulary, few studies have examined the extent to which the home literacy environment is associated with the development of early vocabulary ability in the context of genetic influences. This study examined the influence of the home literacy environment on the longitudinal covariance of expressive vocabulary within a genetically sensitive design.

Methods:  Participants were drawn from the Western Reserve Reading Project, a longitudinal twin project of 314 twin pairs based in Ohio. Twins were assessed via three annual home visits during early elementary school; expressive vocabulary was measured via the Boston Naming Test (BNT), and the Home Literacy Environment (HLE) was assessed using mothers’ report.

Results:  The heritability of the BNT was moderate and significant at each measurement occasion, h2 = .29–.49, as were the estimates of the shared environment, c2 = .27–.39. HLE accounted for between 6–10% of the total variance in each year of vocabulary assessment. Furthermore, 7–9% of the total variance of the stability over time in BNT was accounted for by covariance in the home literacy environment.

Conclusions:  These results indicate that aspects of the home literacy environment, as reported by mothers, account for some of the shared environmental variance associated with expressive vocabulary in school aged children.
Ancestral xerophobia: a hypothesis on the whole plant ecophysiology of early angiosperms
Authors: FEILD T. S , CHATELET D. S. , BRODRIBB T. J
Published: February 2009

Today, angiosperms are fundamental players in the diversity and biogeochemical functioning of the planet. Yet despite the omnipresence of angiosperms in today's ecosystems, the basic evolutionary understanding of how the earliest angiosperms functioned remains unknown. Here we synthesize ecophysiological, paleobotanical, paleoecological, and phylogenetic lines of evidence about early angiosperms and their environments. In doing so, we arrive at a hypothesis that early angiosperms evolved in evermoist tropical terrestrial habitats, where three of their emblematic innovations – including net‐veined leaves, xylem vessels, and flowers – found ecophysiological advantages. However, the adaptation of early angiosperm ecophysiology to wet habitats did not initially promote massive diversification and ecological dominance. Instead, wet habitats were permissive for the ecological roothold of the clade, a critical phase of early diversification that entailed experimentation with a range of functional innovations in the leaves, wood, and flowers. Later, our results suggest that some of these innovations were co‐opted gradually for new roles in the evolution of greater productivity and drought tolerance, which are characteristics seen across the vast majority of derived and ecologically dominant angiosperms today.
Monetary Policy in a Small Open Economy with Marshallian Preferences*
Authors: ANGYRIDIS CONSTANTINE , MANSOORIAN ARMAN
Published: February 2009

We study the effects of inflation for a small open economy when the representative agent has Marshallian preferences, with which the rate of time preference is a decreasing function of savings. An increase in the inflation rate reduces the permanent income of the representative agent, which, with Marshallian preferences, also reduces the rate of time preference. Hence, savings falls and the country runs a current account deficit. The numerical evaluations of the model suggest that inflation has significant effects on welfare in the steady state.
Wealth Distributions of Migrant and Australian‐born Households*
Authors: DOIRON DENISE , GUTTMANN ROCHELLE
Published: February 2009

Wealth is an important measure of overall economic well‐being and a crucial factor in migrants’ ability to integrate into their new country. Using data from the 2002 HILDA survey, this study explores the disparity between the wealth distributions of native‐born and foreign‐born households in Australia. Using quantile regressions the results reveal that migrants have significantly less wealth than their Australian‐born counterparts throughout the wealth distribution. This is despite the greater wealth‐generating characteristics of the foreign‐born. The wealth differentials are reduced but still negative for the migrant cohorts who have been in Australia for over 25 years.
The Asset Portfolios of Native‐born and Foreign‐born Australian Households*
Authors: COBB‐CLARK DEBORAH A. , HILDEBRAND VINCENT A.
Published: February 2009

This paper analyses the net worth and asset portfolios of native‐ and foreign‐born Australian families. Specifically, we estimate a system of asset equations with an adding‐up constraint imposed to control for diversity in household wealth. We find that the wealth of mixed and native‐born couples is not significantly different; however, immigrant‐only couples have approximately $162 000 less wealth than native‐born couples. Relative to equally wealthy native‐born couples, immigrant‐only couples hold substantially more wealth in their homes and less in the form of vehicles. Mixed couples and single individuals allocate their wealth across assets in the same way their native‐born counterparts.
Assessing the Incidence and Wage Effects of Overskilling in the Australian Labour Market
Authors: MAVROMARAS KOSTAS , MCGUINNESS SEAMUS , FOK YIN KING
Published: February 2009

This paper examines the incidence and wage effects of overskilling in Australia. It finds that approximately 30 per cent of employees believed themselves to be moderately overskilled and 11 per cent believed themselves to be severely overskilled. The incidence of skills mismatch varied little when the sample was split by education. After controlling for individual and job characteristics as well as the potential bias arising from individual unobserved heterogeneity, severely overskilled workers suffer an average wage penalty of 10.2 per cent with the penalty ranging from about 6 per cent among vocationally qualified employees to just less than 20 per cent for graduates.
The role of tissue factor and tissue factor pathway inhibitor in health and disease states
Authors: DelGiudice Louis A. , White George A.
Published: February 2009

Objective
–
To review the veterinary and human literature on the role of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in health and disease states.

Data Sources
–
Original research articles and scientific reviews from both human and veterinary literature were searched for relevance to TF and TFPI.

Human Data Synthesis
–
Interest in both TF and TFPI has grown widely over the last several years. The impact TF plays in coagulation, inflammation, angiogenesis, tumor metastasis, and cellular signaling has become apparent. Treatment with TFPI for severe sepsis has been examined and is still currently under investigation. Inhibition of the TF pathway is being studied as an aid in the treatment of neoplasia. The important physiologic and pathophysiologic role these molecules play has only begun to be understood.

Veterinary Data Synthesis
–
There is a paucity of publications that discuss the importance of TF and TFPI in veterinary medicine. An enhanced understanding of the TF pathway in human medicine, in experimental animal models treating sepsis with TFPI, and in animal models demonstrating the proangiogenic properties of TF provides relevance to veterinary medicine.

Conclusion
–
It is apparent that TF and TFPI are important in health and disease. An enhanced understanding of the physiologic and pathophysiologic roles of these factors provides better insight into coagulation, inflammation, angiogenesis, disseminated intravascular coagulation, and tumor metastasis. This greater understanding may provide for the development of therapeutics for sepsis, disseminated intravascular coagulation, and neoplasia.
Thrombelastography in 26 healthy horses with and without activation by recombinant human tissue factor
Authors: Epstein Kira L. , Brainard Benjamin M. , Lopes Marco A.F. , Barton Michelle H. , Moore James N.
Published: February 2009

Objectives –To develop a standardized technique for thrombelastography (TEG) analysis in healthy adult horses, with and without the ex vivo addition of tissue factor (TF) as an activator. To determine reference intervals for TEG parameters in the horse, and to determine if traditional coagulation tests correlate with TEG.

Design –Prospective, observational.

Setting –Veterinary teaching hospital.

Animals –Twenty‐six healthy adult horses.

Interventions –None.

Measurements and Main Results –Thrombelastography with (TF‐TEG) and without (TEG) the addition of TF performed by 4 operators. Coagulation profiles (prothrombin time, activated partial thromboplastin time, platelet count, fibrinogen, antithrombin, and fibrinogen degradation products) were assessed in a subset of horses. Mean values (SD) for TEG parameters in healthy horses were: reaction time (R)=17.0 minutes (3.0 min),Ktime (K)=5.8 minutes (2.3 min), clotting rate (Ang)=42° (14°), maximum clot strength (maximum amplitude [MA])=60.3 mm (5.7 mm), CL30=97.0% (2.0%), LY30=0.8% (0.6%), CL60=92% (5.9%), LY60=3.2% (2.5%). Mean values (SD) for TF‐TEG parameters were:R‐TF=6.6 minutes (1.4 min),K‐TF=3.1 minutes (1.0 min), Ang‐TF=50.9° (9°), MA‐TF=62.3 mm (5.1 mm), CL30‐TF=97.8% (1.6%), LY30‐TF=0.6% (0.5%), CL60‐TF=90.8% (4.2%), and LY60‐TF=3.6% (1.9%). The addition of TF decreasedRandKand increased Ang. TF‐TEG had a narrower SD forR, K, Ang, CL60 and LY60 compared with TEG. Interoperator differences were reduced by the addition of TF. Regression analysis indicated a positive relationship between MA and fibrinogen concentrations (P=0.02) andR‐TF time and prothrombin time (P=0.03).

Conclusion –TF‐TEG using the described protocol may minimize variability in data obtained across institutions or users. However, due to the variability associated with different operators, it is recommended that each laboratory set up individual reference intervals with the personnel who will perform the assay, and that the assay protocols and data obtained are compared on a regular basis.
Preliminary evaluation of hemostasis in neonatal foals using a viscoelastic coagulation and platelet function analyzer
Authors: Dallap Schaer Barbara L. , Wilkins Pamela A. , Boston Ray , Palmer Jon
Published: February 2009

Objectives
–
To compare coagulation and platelet function parameters measured using a viscoelastic analyzer in 3 groups: foals presenting to a neonatal intensive care unit with presumed sepsis, normal foals, and adult horses.

Design
–
Preliminary prospective trial.

Setting
–
Veterinary teaching hospital.

Animals
–
Ten clinically healthy foals, 13 clinically healthy adult horses, and 17 foals sequentially admitted for suspected sepsis.

Intervention
–
A single citrated (3.8%) blood sample collected at admission was submitted for coagulation evaluation using a viscoelastic analyzer.

Measurements and Main Results
–
Time to initial clot formation (ACT), clot rate (CR), platelet function, and time to peak parameters were collected from the signature generated with the associated software. Peak clot strength was collected manually from signature tracings. Signalment, presenting complaint, blood culture results, clinical progression, and outcome were collected from the medical record. Kruskal‐Wallis testing was used to determine differences in coagulation parameters between groups, as well as to identify any associations between coagulation variables, foal variables, and outcome. Normal foals were more likely to have increased platelet function (P=0.04) compared with normal adult horses. Prolonged ACT (P=0.004) and decreased CR (P=0.03) were associated with foals with positive blood culture. There was a trend toward prolonged ACT and increased likelihood of death (P=0.06).

Conclusions
–
Healthy foals differ in values measured by the viscoelastic coagulation and platelet function analyzer compared with healthy adult horses. ACT and CR abnormalities were more likely to be observed in foals with positive blood cultures. The viscoelastic coagulation and platelet function analyzer may be useful in identifying early hemostasic and platelet dysfunction in critically ill foals, particularly those that are septic.
A prospective, randomized comparison of Oxyglobin (HB‐200) and packed red blood cell transfusion for canine babesiosis
Authors: Zambelli Anthony B. , Leisewitz Andrew L.
Published: February 2009

Objective
–
To establish the efficacy of Oxyglobin (HB‐200) in canine babesiosis and compare it to standard therapy, packed red blood cell transfusion (pRBCT) with respect to improvements in specific parameters of blood gas, acid‐base, blood pressure, and subjective evaluations.

Design
–
Prospective, randomized, clinical trial.

Setting
–
Onderstepoort Veterinary Academic Hospital.

Animals
–
Twelve dogs (8–25 kg) naturally infected with Babesia rossi and a hematocrit of 0.1–0.2 L/L (10–20%).

Interventions
–
Treatment groups were randomized to receive either 20 mL/kg of Oxyglobin or pRBCT over 4 hours via a central venous catheter. Transfusions were followed by lactated Ringer's solution infusion. Rectal temperature, femoral arterial and mixed venous blood sampling, oscillometric blood pressure, and subjective assessment of patient status (habitus), and appetite were performed at time points 0, 1, 4, 8, 24, 48, and 72 hours.

Main Results
–
Dogs presented with a hypoalbuminemic alkalosis; hyperchloremic, dilutional acidosis; normotensive tachycardia; pyrexia; depression; and anorexia. Both treatments produced similar results, with the exception of significant differences in pH (4 h); PCO2 (4 h); hemoglobin (8 h, 24 h); mean arterial pressure (48 h); albumin (4 h, 8 h); habitus (8 h, 48 h); and appetite (24 h). Arterial O2 content was higher for pRBCT than Oxyglobin at 72 hours, but central venous PO2 did not differ between groups or over time and was consistently subnormal.

Conclusions
–
Oxyglobin provides similar overall improvements to pRBCT in dogs with anemia from babesiosis, with respect to blood gas, acid‐base and blood pressure, although patients receiving packed cells tended to have more rapid normalization of habitus and appetite.
Pulmonary thromboembolism
Authors: Goggs Robert , Benigni Livia , Fuentes Virginia Luis , Chan Daniel L.
Published: February 2009

Objective –To review the pathophysiology, clinical signs, diagnosis, and treatment of pulmonary thromboembolism (PTE) in small animals.

Data Sources –Human and veterinary clinical studies, reviews, texts, and recent research in canine and feline PTE diagnosis and thromboembolic therapeutics.

Human Data Synthesis –In humans, clinical probability assessment and point‐of‐care D‐dimer‐based algorithms are widely used. Computed tomography pulmonary angiography is the gold standard for PTE diagnosis in humans. Echocardiography is increasingly used for bedside assessment of affected patients. In low‐risk human patients anticoagulants alone are recommended while patients with cardiogenic shock are treated with thrombolytics followed by anticoagulation.

Veterinary Data Synthesis –PTE is associated with numerous predisposing conditions causing hypercoagulability, blood flow stasis, or endothelial injury. Identifying at‐risk patients is key to diagnosis in small animals. Thromboelastography provides a method for identifying hypercoagulable patients. Computed tomography pulmonary angiography may replace selective pulmonary angiography as the imaging technique of choice for PTE diagnosis. PTE therapy consists of supportive treatment combined with appropriate, individualized thromboembolic pharmacotherapy for acute treatment and chronic management. Thrombolytic therapy for PTE remains controversial but may be indicated in hemodynamically unstable acute PTE. Thromboprophylaxis in specific conditions is rational although evidence of efficacy is limited. Prognosis depends upon degree of cardiopulmonary compromise and patient response to therapy. Mortality rates in small animals are unknown.

Conclusions –New diagnostic techniques and advances in therapy offer significant potential for improvements in the identification and treatment of PTE in small animals. Further study must be directed to validating new diagnostic modalities and evaluating therapeutic regimes.
Cathodoluminescence imaging and titanium thermometry in metamorphic quartz
Authors: SPEAR F. S. , WARK D. A.
Published: February 2009

Cathodoluminescence (CL) of quartz from metamorphic rocks representing a range of conditions from the garnet grade to the migmatite grade reveals a variety of textures, that is, a function of metamorphic grade and deformation history. Ti concentrations, determined by electron microprobe and ion microprobe, generally correlate with CL intensity (blue wavelengths), and application of the Ti‐in‐quartz thermometer (TitaniQ) reflects the temperature of quartz growth or recrystallization, and, in some settings, modification by diffusion. Quartz from garnet grade samples is not visibly zoned, records temperatures of 425–475 °C, and is interpreted to have recrystallized during fabric formation. Quartz grains from staurolite grade samples are zoned in CL with markedly darker cores and brighter rims, some of which are interpreted to have been produced by the dominant staurolite‐producing reaction, whereas others are interpreted as having formed by diffusion of Ti into quartz rims. Quartz from the matrix of kyanite and sillimanite grade samples are generally unzoned, although locally displays slightly brighter rims (higher Ti); quartz inclusions within garnet and staurolite have distinctly brighter rims, which are interpreted as having been produced by diffusive exchange with the host mineral. Quartz from migmatite grade samples displays highly variable CL intensity, which is dependent on the location of the grain. Matrix grains in melanosomes are largely unzoned or rarely zoned with darker cores. Leucosome quartz is strongly zoned with bright cores and dark rims and is interpreted as having formed during crystallization of the melt. Locally within the leucosome is observed oscillatory‐zoned quartz, which is interpreted as a subsolidus recrystallization to achieve strain relaxation. Quartz inclusions within garnet or plagioclase crystals often show bright domains separated by zones of dark CL. These enigmatic textures possibly reflect local melting fluxed by fluid inclusions. Temperatures calculated from the Ti–in–quartz thermometer are a function of the metamorphic grade of the sample, the textural setting of the quartz, the reaction history and the deformation history of the rock. The TitaniQ temperatures can be used to constrain the conditions at which various metamorphic processes have occurred.
TheP–Tpath of the ultra‐high pressure Lago Di Cignana and adjoining high‐pressure meta‐ophiolitic units: insights into the evolution of the subducting Tethyan slab
Authors: GROPPO C. , BELTRANDO M. , COMPAGNONI R.
Published: February 2009

The Lago di Cignana ultra‐high‐pressure unit (LCU), which consists of coesite–eclogite facies metabasics and metasediments, preserves the most deeply subducted oceanic rocks worldwide. New constraints on the prograde and early retrograde evolution of this ultra‐high pressure unit and adjoining units provide important insights into the evolution of the Piemontese–Ligurian palaeo‐subduction zone, active in Paleocene–Eocene times. In the LCU, a first prograde metamorphic assemblage, consisting of omphacite + Ca‐amphibole + epidote + rare biotite + ilmenite, formed during burial at estimatedP < 1.7 GPa and 350 < T < 480 °C. Similar metamorphic conditions of 400 < T < 650 °C and 1.0 < P < 1.7 GPa have been estimated for the meta‐ophiolitic rocks juxtaposed to the LCU. The prograde assemblage is partially re‐equilibrated into the peak assemblage garnet + omphacite + Na‐amphibole + lawsonite + coesite + rutile, whose conditions were estimated at 590 < T < 605 °C andP > 3.2 GPa. The prograde path was characterized by a gradual decrease in the thermal gradient from ∼9–10 to ∼5–6 °C km−1. This variation is interpreted as the evidence of an increase in the rate of subduction of the Piemonte–Ligurian oceanic slab in the Eocene. Accretion of the Piemontese oceanic rocks to the Alpine orogen and thermal relaxation were probably related to the arrival of more buoyant continental crust at the subduction zone. Subsequent deformation of the orogenic wedge is responsible for the present position of the LCU, sandwiched between two tectonic slices of meta‐ophiolites, named the Lower and Upper Units, which experienced peak pressures of 2.7–2.8 and <2.4 GPa respectively.
Exchange versus simple transfusion for acute chest syndrome in sickle cell anemia adults
Authors: Turner Jeff M. , Kaplan Jason B. , Cohen Hillel W. , Billett Henny H.
Published: February 2009

BACKGROUND: There are scant data regarding the relative efficacy of exchange transfusion (XC) versus simple transfusion (ST) for treatment of sickle cell anemia acute chest syndrome (ACS).

STUDY DESIGN AND METHODS: Twenty patients who received XC for ACS were compared with 20 ST patients. Hemoglobin (Hb) levels, platelet and white blood cell counts, lactate dehydrogenase (LDH), indirect bilirubin, and temperature were used to assess disease severity. Primary outcome was postprocedure length of hospital stay; secondary outcome was total length of stay.

RESULTS: Cohorts were similar with regard to age; sex; prior ACS episodes; echocardiogram results; and antibiotic, bronchodilator, and hydroxyurea use. Maximum temperature recorded was higher in the XC group (39.1°C vs. 38.4°C, p = 0.02), but LDH, WBCs, and indirect bilirubin were comparable. Admission Hb levels were higher for XC (XC 8.6 g/dL vs. ST 7.4 g/dL, p = 0.02) and XC had higher peak Hb levels during hospitalization (10.4 ± 1.4 g/dL vs. 9.3 ± 1.0 g/dL, p ≤ 0.01). No differences were demonstrable in postprocedure length of stay (XC 5.6 days vs. ST 5.9 days, p = 0.82) or total length of stay (XC 8.4 days vs. ST 8.0 days, p = 0.76). A total of 10.3 ± 3.0 units were transfused for XC compared to 2.4 ± 1.2 units for ST (p < 0.001).

CONCLUSIONS: Based on postprocedure length of stay or total length of stay, we could not detect a difference in the efficacy of XC compared to ST in populations despite red blood cell product usage fourfold higher in the XC group. We suggest that it is time for an adequately powered, randomized trial to examine the true risk:benefit ratio of XC in ACS.
Impact of individual‐donation nucleic acid testing on risk of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus transmission by blood transfusion in South Africa
Authors: Vermeulen Marion , Lelie Nico , Sykes Wendy , Crookes Robert , Swanevelder Johanna , Gaggia Lilian , Le Roux Martin , Kuun Eben , Gulube Sam , Reddy Ravi
Published: February 2009

BACKGROUND: In 2005, the South African National Blood Service introduced individual‐donation (ID) nucleic acid test (NAT) screening for human immunodeficiency virus (HIV) RNA, hepatitis C virus (HCV) RNA, and hepatitis B virus (HBV) DNA. At the same time the use of ethnic origin to prioritize the transfusion of blood according to a hierarchy of residual risk was discontinued.

STUDY DESIGN AND METHODS: ID‐NAT (Ultrio on Procleix Tigris, Chiron) and serology (PRISM, Abbott) repeat test and confirmation testing algorithms were designed to enable differentiation between false‐positive and true‐NAT and ‐serology yields. After 1 year, the NAT and serology yield rates in first‐time, lapsed, and repeat donors were analyzed and used to estimate the residual risk of HIV, HBV, and HCV infections by blood transfusion.

RESULTS: The HIV, HBV, and HCV ID‐NAT window phase yield rates in 732,250 blood donations were 1:45,765, 1:11,810, and 1:732,200, respectively. Seven of 16 HIV window phase donations with viral loads above 16,000 copies/mL were HIV p24 antigen enzyme‐linked immunosorbent assay positive. PRISM detected anti‐HIV and hepatitis B surface antigen (HBsAg) in 89.4 and 73.9% of early infections in repeat donors. The Procleix assay detected viremia in 99.7 and 95.5% of anti‐HIV– and HBsAg‐positive first‐time donors. In these donors, the occult HBV DNA carrier rate was 1:5200. The residual transmission risk of ID‐NAT HIV, HBV, and HCV window phase donations was estimated at 1:479,000, 1:61,500, and 1:21,000,000 respectively.

CONCLUSION: One‐year ID‐NAT screening of 732,250 donations interdicted 16 HIV, 20 HBV, and 1 HCV window phase donations and 42 anti‐hepatitis B core antigen–reactive infections during an early recovery or a later stage of occult HBV infection.
Transfusion of platelet components prepared with photochemical pathogen inactivation treatment during a Chikungunya virus epidemic in Ile de La Réunion
Authors: Rasonglès Patrice , Angelini‐Tibert Marie France , Simon Philip , Currie Caroline , Isola Herve , Kientz Daniel , Slaedts Marc , Jacquet Michele , Sundin David , Lin Lily , Corash Laurence , Cazenave Jean Pierre
Published: February 2009

BACKGROUND: During the Chikungunya virus (CHIKV) epidemic on Ile de La Réunion, France, more than 30% of 750,000 inhabitants were infected. Local blood donation was suspended to prevent transfusion‐transmitted infection (TT‐CHIKV). To sustain the availability of platelet (PLT) components, the Établissement Français du Sang implemented universal pathogen inactivation (INTERCEPT, Cerus Europe BV) of PLT components (CPAs). The study assessed the safety of PLT components treated with pathogen inactivation transfused in routine clinical practice.

STUDY DESIGN AND METHODS: This was a retrospective observational study using patient medical records and the AFSSAPS hemovigilance database (eFIT) to identify TT‐CHIKV and adverse events (AEs) classified as acute transfusion reactions (ATRs) to PLT components prepared with pathogen inactivation.

RESULTS: During 1 year, 1950 INTERCEPT‐CPAs were transfused to 335 adult, 51 pediatric, and 41 infant patients. Nineteen AEs were observed in 15 patients and 10 were classified as ATRs. Eight ATRs occurred in 6 pediatric hematology‐oncology patients. No ATRs were observed in infants. The most frequently reported signs and symptoms were Grade 1 urticaria, itching, chills, fever, and anxiety. No cases of transfusion‐related acute lung injury, TT‐sepsis, or TT‐CHIKV were detected.

CONCLUSIONS: INTERCEPT‐CPAs were well tolerated in a broad range of patients, including infants. ATR incidence was low and when present ATRs were of mild severity.
A modeling framework for evaluation and comparison of trigger strategies for switching from minipool to individual‐donation testing for West Nile virus
Authors: Biggerstaff Brad J. , Petersen Lyle R.
Published: February 2009

BACKGROUND: To decrease the likelihood of transmission from donations containing West Nile virus (WNV) levels below minipool nucleic acid test (MP‐NAT) detection limits, blood centers switch from MP‐NAT to individual‐donation testing (ID‐NAT) after detection of MP‐NAT–positive donations. The effectiveness of strategies to trigger or discontinue ID‐NAT screening is largely unknown.

STUDY DESIGN AND METHODS: Twenty‐seven strategies to trigger and discontinue ID‐NAT screening were evaluated with a statistical model based on known dynamics of WNV infection and historical data on WNV prevalence among blood donations. Breakthroughs were defined as WNV immunoglobulin M antibody–negative, viremic (RNA‐positive) donations that could only be identified by ID‐NAT, but were screened by MP‐NAT. Effectiveness (proportional reduction of breakthroughs relative to MP‐NAT screening alone) and efficiency (absolute reduction of breakthroughs relative to the number of tests performed) were estimated by simulating donation years of varying outbreak severities over a range of blood collection frequencies.

RESULTS: Most strategies were effective (>75% reduction in breakthroughs) when daily donations exceeded 560. In larger centers (1008 donations daily), effectiveness of trigger‐on strategies based on absolute number of MP‐NAT–positive donations improved, but worsened for strategies using rate‐based criteria. Effectiveness increased slightly by triggering on one MP‐NAT–positive rather than two and increased substantially by increasing the duration from 7 to 14 days that no ID‐NAT–positive donations are detected before resuming MP‐NAT.

CONCLUSION: Most trigger strategies become effective when test results from at least 560 donations daily are considered. A 14‐day ID‐NAT period may improve safety relative to the increase in the number of tests performed.
Dead man talking: sustained utility of data from archaic paternity tests
Authors: Wenk Robert E. , Chiafari Francis A.
Published: February 2009

BACKGROUND: Almost all relationship analysts now use molecular (DNA) tests to obtain necessary genetic information, yet older blood group tests remain valid. Circumstances may provide blood test results from old reports to avoid trying to sample DNA from inaccessible sources.

CASE STUDY: A mother recently claimed that a deceased man (alleged father [AF]) sired her child. Insurance investigation recovered two paternity test reports from an AABB‐accredited laboratory. The 16‐ and 18‐year‐old reports employed blood groups and protein polymorphisms to exonerate two different men. One report contained the multilocus phenotypes of the AF and the other contained the phenotypes of the mother and child at the same loci. A new case was synthesized from the old reports.

RESULTS: Genetic inconsistencies (three direct and one indirect) were demonstrated among the nine loci that had been typed in both the AF and the mother‐child pair.

CONCLUSION: New relationship tests may be reconstructed from phenotypes reported before the molecular test era. This approach avoids exhumation and other problematic methods of specimen retrieval.
Ranolazine Exerts Potent Effects on Atrial Electrical Properties and Abbreviates Atrial Fibrillation Duration in the Intact Porcine Heart
Authors: KUMAR KAPIL , NEARING BRUCE D. , CARVAS MARCELO , NASCIMENTO BRUNO C.G. , ACAR MARIANA , BELARDINELLI LUIZ , VERRIER RICHARD L.
Published: February 2009

Introduction: In vitro studies and ambulatory ECG recordings from the MERLIN TIMI‐36 clinical trial suggest that the novel antianginal agent ranolazine may have the potential to suppress atrial arrhythmias. However, there are no reports of effects of ranolazine on atrial electrophysiologic properties in large intact animals.

Methods and Results: In 12 closed‐chest anesthetized pigs, effects of intravenous ranolazine (∼9 μM plasma concentration) on multisite atrial effective refractory period (ERP), conduction time (CT), and duration and inducibility of atrial fibrillation (AF) initiated by intrapericardial acetylcholine were investigated. Ranolazine increased ERP by a median of 45 ms (interquartile range 29–50 ms; P < 0.05, n = 6) in right and left atria compared to control at pacing cycle length (PCL) of 400 ms. However, ERP increased by only 28 (24–34) ms in right ventricle (P < 0.01, n = 6). Ranolazine increased atrial CT from 89 (71–109) ms to 98 (86–121) ms (P = 0.04, n = 6) at PCL of 400 ms. Ranolazine decreased AF duration from 894 (811–1220) seconds to 621 (549–761) seconds (P = 0.03, n = 6). AF was reinducible in 1 of 6 animals after termination with ranolazine compared with all 6 animals during control period (P = 0.07). Dominant frequency (DF) of AF was reduced by ranolazine in left atrium from 11.7 (10.7–20.5) Hz to 7.6 (2.9–8.8) Hz (P = 0.02, n = 6).

Conclusions: Ranolazine, at therapeutic doses, increased atrial ERP to greater extent than ventricular ERP and prolonged atrial CT in a frequency‐dependent manner in the porcine heart. AF duration and DF were also reduced by ranolazine. Potential role of ranolazine in AF management merits further investigation.
Effect of Electroanatomically Guided Versus Conventional Catheter Ablation of Typical Atrial Flutter on the Fluoroscopy Time and Resource Use: A Prospective Randomized Multicenter Study
Authors: HINDRICKS GERHARD , WILLEMS STEFAN , KAUTZNER JOSEF , DE CHILLOU CHRISTIAN , WIEDEMANN MICHAEL , SCHEPEL SIEP , PIORKOWSKI CHRISTOPHER , RISIUS TIM , KOTTKAMP HANS ,   for the EuroFlutter Investigators
Published: February 2009

Aims: Radiofrequency catheter ablation of typical atrial flutter is one of the most frequent indications for catheter ablation in electrophysiology laboratories today. Clinical utility of electroanatomic mapping systems on treatment results and resource utilization compared with conventional ablation has not been systematically investigated in a prospective multicenter study.

Methods and Results: In this prospective, randomized multicenter study, the results of catheter ablation to cure typical atrial flutter using conventional ablation strategy were compared with electroanatomically guided mapping and ablation (Carto®). Primary endpoints of the study were procedure duration and fluoroscopy exposure time, secondary endpoints were acute success rate, recurrence rate, and resource utilization. A total of 210 patients (169 men, 41 women, mean age 63 ± 10 years) with documented typical atrial flutter were included in the study. Acute ablation success, that is, demonstration of bidirectional isthmus block, was achieved in 99 of 105 patients (94%) in the electroanatomically guided ablation group and in 102 of 105 patients (97%) in the conventional ablation group (P > 0.05). Total procedure duration was comparable between both study groups (99 ± 57 minutes vs 88 ± 54 minutes, P > 0.05). Fluoroscopy exposure time was significantly shorter in the electroanatomically guided ablation group (7.7 ± 7.3 minutes vs 14.8 ± 11.9 minutes; P < 0.05). Total recurrence rate of typical atrial flutter at 6 months of follow‐up was comparable between the 2 groups (respectively for the CARTO and conventional group 6.6% vs 5.7%, P > 0.05). The material costs per procedure in the electroanatomically guided and conventional groups (NaviStar® DS vs Celsius® DS) was €3035 (USD 3,870) and €2133 (USD 2,720), respectively.

Conclusions: This multicenter study documented that cavotricuspid isthmus ablation to cure typical atrial flutter was highly effective and safe, both in the conventional and the electroanatomically guided ablation group. The use of electroanatomical mapping system significantly reduced the fluoroscopy exposure time by almost 50%, however, at the expense of increased cost of the procedure.
Ten‐Year Follow‐Up of Cardiac Sympathectomy in a Young Woman with Catecholaminergic Polymorphic Ventricular Tachycardia and an Implantable Cardioverter Defibrillator
Authors: MAKANJEE BHAVANESH , GOLLOB MICHAEL H. , KLEIN GEORGE J. , KRAHN ANDREW D.
Published: February 2009

Current recommendations for therapy of catecholaminergic ventricular tachycardia (CPVT) include beta blockade and implantable cardioverter defibrillators (ICDs). Patients may experience recurrent arrhythmias, ICD shocks and, rarely, sudden death despite optimal medical therapy. We report a young woman with CPVT who received frequent ICD shocks despite beta blockade, who subsequently underwent cardiac sympathectomy with a dramatic reduction in shocks over 10 years of follow‐up.
Human Model Simulating Right Ventricular Outflow Tract Tachycardia by High‐Frequency Stimulation in the Left Pulmonary Artery: Autonomics and Idiopathic Ventricular Arrhythmias
Authors: HASDEMIR CAN , ALP ALPAY , AYDIN MEHMET , CAN LEVENT H.
Published: February 2009

Introduction: Frequent monomorphic premature ventricular contractions (PVC) and/or ventricular tachycardia (VT) in patients with structurally normal heart usually arise from the right ventricular outflow tract (RVOT). An animal model simulating RVOT tachycardia by high‐frequency stimulation (HFS) of the sympathetic input to the proximal pulmonary artery (PA) has been previously described. The aim of this study was to similarly induce RVOT tachycardia in humans.

Methods: In 9 patients with no history of ventricular arrhythmias, a circumferential catheter was placed in the left, main, and proximal PA to contact the endovascular circumference of the PA. A 50‐ms train of HFS (200 Hz/0.3 ms pulse duration), coupled to atrial pacing, was applied at each bipolar pair of the circumferential catheter. The coupling interval was adjusted so that the 50‐ms train occurred during the ventricular refractory period.

Results: In 6 out of 9 patients, HFS in the left PA during dobutamine infusion induced monomorphic PVCs and/or VT with left bundle branch block (LBBB) morphology and inferior axis at an average stimulation level of 12.5 ± 2.7 V. HFS in the main PA and in the proximal PA did not induce any ventricular arrhythmias with the highest energy of 15 V in baseline state and during dobutamine infusion. HFS in the left PA was associated with hiccough in all patients.

Conclusion: Stimulation of the sympathetic input to the left PA during dobutamine infusion induces PVCs and/or VT exhibiting LBBB‐morphology and inferior axis, closely simulating clinical RVOT tachycardia in humans.
Utilization of Retrograde Right Bundle Branch Block to Differentiate Atrioventricular Nodal from Accessory Pathway Conduction
Authors: KAPA SURAJ , HENZ BENHUR D. , DIB CHADI , CHA YONG‐MEI , FRIEDMAN PAUL A. , MUNGER THOMAS M. , LADEWIG DOROTHY J. , HAMMILL STEPHEN C. , PACKER DOUGLAS L. , ASIRVATHAM SAMUEL J.
Published: February 2009

Introduction:
Defining whether retrograde ventriculoatrial (V‐A) conduction is via the AV node (AVN) or an accessory pathway (AP) is important during ablation procedures for supraventricular tachycardia (SVT). With the introduction of ventricular extrastimuli (VEST), retrograde right bundle branch block (RBBB) may occur, prolonging the V‐H interval, but only when AV node conduction is present. We hypothesized that when AP conduction was present, the V‐A interval would increase less than the V‐H interval, whereas with retrograde nodal conduction, the V‐A interval would increase at least as much as the V‐H interval.

Methods and Results:
We retrospectively reviewed the electrophysiological studies of patients undergoing ablation for AVN reentrant tachycardia (AVNRT) (55) or AVRT (50), for induction of retrograde RBBB during the introduction of VEST, and the change in the measured V‐H and V‐A intervals. Results were found to be reproducible between independent observers. Out of 105 patients, 84 had evidence of induced retrograde RBBB. The average V‐H interval increase with induction of RBBB was 53.7 ms for patients with AVRT and 54.4 ms for patients with AVNRT (P = NS). The average V‐A interval increase with induction of RBBB was 13.6 ms with AVRT and 70.1 ms with AVNRT (P < 0.001). All patients with a greater V‐H than V‐A interval change had AVRT, and those with a smaller had AVNRT.

Conclusions:
Induction of retrograde RBBB during VEST is common during an electrophysiological study for SVT. The relative change in the intervals during induction of RBBB accurately differentiates between retrograde AVN and AP conduction.
Idiopathic Focal Ventricular Arrhythmias Originating from the Anterior Papillary Muscle in the Left Ventricle
Authors: YAMADA TAKUMI , MCELDERRY H. THOMAS , OKADA TARO , MURAKAMI YOSHIMASA , INDEN YASUYA , DOPPALAPUDI HARISH , YOSHIDA NAOKI , TABEREAUX PAUL B. , ALLRED JAMES D. , MUROHARA TOYOAKI , KAY G. NEAL
Published: February 2009

Introduction: Focal ventricular arrhythmias (VAs) have been reported to arise from the posterior papillary muscle in the left ventricle (LV). We report a distinct subgroup of idiopathic VAs arising from the anterior papillary muscle (APM) in the LV.

Methods and Results: We studied 432 consecutive patients undergoing catheter ablation for VAs based on a focal mechanism. Six patients were identified with ventricular tachycardia (VT, n = 1) or premature ventricular contractions (PVCs, n = 5) with the earliest site of ventricular activation localized to the base (n = 3) or middle portion (n = 3) of the LV APM. No Purkinje potentials were recorded at the ablation site during sinus rhythm or the VAs. All patients had a normal baseline electrocardiogram and normal LV systolic function. The VAs exhibited a right bundle branch block (RBBB) and right inferior axis (RIA) QRS morphology in all patients. Oral verapamil and/or Na+ channel blockers failed to control the VAs in 4 patients. VT was not inducible by programmed electrical stimulation in any of the patients. In 4 patients, radiofrequency current with an irrigated or conventional 8‐mm‐tip ablation catheter was required to achieve a lasting success. Two patients had recurrent PVCs after a conventional radiofrequency ablation with a 4‐mm‐tip ablation catheter had initially suppressed the arrhythmia.

Conclusions: VAs may arise from the base or middle portion of the APM and are characterized by an RBBB and RIA QRS morphology and focal mechanism. Catheter ablation of APM VAs is typically challenging, and creation of a deep radiofrequency lesion may be necessary for long‐term success.
Collagen Mechanics: A Rationale for Radiofrequency Energy to Treat Mitral Regurgitaton
Authors: MURARKA SHISHIR , WITZEL THOMAS , DICKENS DUANE , TAKEDA PATRICIA A. , HEUSER RICHARD R.
Published: February 2009

Despite a variety of pharmacological interventions to limit the regurgitant fraction, mitral regurgitation requires surgical intervention for definitive treatment. New nonsurgical techniques are being applied to treat mitral regurgitation. The mitral and tricuspid annuli are areas of dense collagen. Application of heat, in the form of radiofrequency energy, can be used to shrink mitral valve annuli and offers a promising approach to the treatment of mitral regurgitation.
Determining the In‐Hospital Cost of Bleeding in Patients Undergoing Percutaneous Coronary Intervention
Authors: EWEN EDWARD F. , ZHAO LIPING , KOLM PAUL , JURKOVITZ CLAUDINE , FIDAN DOGAN , WHITE HARVEY D. , GALLO RICHARD , WEINTRAUB WILLIAM S.
Published: February 2009

Background: The economic impact of bleeding in the setting of nonemergent percutaneous coronary intervention (PCI) is poorly understood and complicated by the variety of bleeding definitions currently employed. This retrospective analysis examines and contrasts the in‐hospital cost of bleeding associated with this procedure using six bleeding definitions employed in recent clinical trials.

Methods: All nonemergent PCI cases at Christiana Care Health System not requiring a subsequent coronary artery bypass were identified between January 2003 and March 2006. Bleeding events were identified by chart review, registry, laboratory, and administrative data. A microcosting strategy was applied utilizing hospital charges converted to costs using departmental level direct cost‐to‐charge ratios. The independent contributions of bleeding, both major and minor, to cost were determined by multiple regression. Bootstrap methods were employed to obtain estimates of regression parameters and their standard errors.

Results: A total of 6,008 cases were evaluated. By GUSTO definitions there were 65 (1.1%) severe, 52 (0.9%) moderate, and 321 (5.3%) mild bleeding episodes with estimated bleeding costs of $14,006; $6,980; and $4,037, respectively. When applying TIMI definitions there were 91 (1.5%) major and 178 (3.0%) minor bleeding episodes with estimated costs of $8,794 and $4,310, respectively. In general, the four additional trial‐specific definitions identified more bleeding events, provided lower estimates of major bleeding cost, and similar estimates of minor bleeding costs.

Conclusions: Bleeding is associated with considerable cost over and above interventional procedures; however, the choice of bleeding definition impacts significantly on both the incidence and economic consequences of these events.
Québec et la géographie sociale en questions
Authors: VILLENEUVE PAUL
Published: February 2009

≪  La vie se déroule, bien sûr, comme un film, mais l'observateur ne peut rien saisir sous cette forme, il doit disposer d'images fixes dont la juxtaposition lui donne l'illusion du mouvement par reconstitution. ≫

(Raffestin 2007, 157)

Au début des années 1960, deux révolutions sont en marche, la révolution tranquille au Québec et la révolution quantitative en géographie. Bien qu'en apparence non liés, ces deux épisodes de changement relevaient sans doute d'un même ensemble de valeurs axées sur la modernité. Depuis, les transformations vécues au Québec ont donné lieu à de multiples analyses dont certaines font appel à des considérations géographiques. Des cheminements de recherche, dont le mien, s'inscrivent dans cette mouvance. Une première question portait sur la place du Québec au Canada. Elle a donné lieu à des analyses de la dynamique structurelle des régions du pays. Une deuxième question partait du paradoxe contenu dans l'expression ≪ révolution tranquille  ≫: ne mettait‐elle pas en cause, du moins en partie, l'intensification des rapports entre une métropole cosmopolite et une capitale ≪ provinciale  ≫? Et cette capitale, malgré son provincialisme, était‐elle capable, troisième question, d'engendrer des mouvements sociaux progressistes? L'odyssée du Rassemblement populaire de Québec, vécue sur le mode de l'observation participante, suggère une réponse modérément positive. Elle suggère également, et c'est la quatrième question abordée ici, que de tels mouvements urbains changent les rapports entre les acteurs qui y participent, peut‐être plus encore qu'ils ne changent le cadre de vie. Du moins, ceci semble être le cas en ce qui concerne les rapports hommes‐femmes. En somme, après plus de quatre décennies, je garde la conviction qu'une pratique ouverte de la géographie sociale peut mener à des connaissances libératrices.