bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in Aerobic Fitness and Lifestyle Characteristics in Preschoolers according to their Weight Status and Sports Club Participation
Authors: Ebenegger Vincent , Marques-Vidal Pedro , Kriemler Susi , Nydegger Andreas , Zahner Lukas , Niederer Iris , Bürgi Flavia , Puder Jardena J.
Published: March 2012

Objective: This study assesses differences in adiposity, aerobic fitness, and lifestyle characteristics in preschoolers according to their weight status and sports club (SC) participation. Method: As part of the Ballabeina study, 600 randomly selected preschoolers (mean age 5.1 ± 0.6 years; 50.2% girls) were analyzed. Body composition was measured by bioelectrical impedance, aerobic fitness by the 20-meter shuttle run test, and physical activity by accelerometers. Eating habits, media use, and SC participation were assessed by questionnaires. Results: Overweight children (Swiss national percentiles) and children not participating in SC had both lower aerobic fitness and higher % body fat compared to their respective counterparts (all p ≤ 0.028). In addition, children not participating in SC were less physically active, had more media use, and ate less healthy compared to children participating in SC (all p ≤ 0.023). Controlling for parental sociocultural determinants attenuated differences in % body fat, in physical activity, and in eating habits. Conclusion: Aerobic fitness differs both according to weight status and SC participation in preschoolers. Furthermore, in view of the many differences in lifestyle behaviors, SC participation at this age could represent a more discriminatory indicator of healthy lifestyle characteristics than weight status.
Prevalence of the Metabolic Syndrome and Its Components among Obese Men and Women in Italy
Authors: Lafortuna Claudio L. , Agosti Fiorenza , De Col Alessandra , Pera Franca , Adorni Fulvio , Sartorio Alessandro
Published: March 2012

Objective: Assessment of the prevalence of the metabolic syndrome (MetS) and its components in Italian obese individuals. Methods: Cross-sectional estimate of MetS prevalence using the IDF definition in 635 obese (BMI ≧ 35 kg/m2) individuals (286 men, 349 women) aged 19–78 years hospitalised for mass excess treatment. Results: MetS prevalence was significantly (p < 0.001) higher in males (75.9%) than in females (61.9%), due to the increased prevalence of 4/5 involved abnormalities. A multivariate binary logistic regression analysis disclosed a contributory independent effect of ageing (p < 0.01–0.001), but not of BMI, whereas large waist circumference (p < 0.01) and high waist-to-hip ratio (p < 0.01) contributed to MetS prevalence only in women. Affected individuals were significantly older (males p = 0.022; females p < 0.001), affected men being younger than affected women (p < 0.01). The prevailing clinical picture included all abnormalities (21.2% in men, 22.2% in women); in minimal trait MetS (3/5 abnormalities), the prevailing combination was, beside central obesity, hypertension-hyperglycaemia in men (12.4%), and hypertension-dyslipidemia in women (19.4%). Conclusions: MetS is a highly prevalent condition among Italian obese individuals. Prevalence and combinations of involved abnormalities differ considerably between genders and suggest a different pathophysiology of the MetS in men and women, with possible relevance for prevention and treatment of the condition.
Body Fat Percentiles for German Children and Adolescents
Authors: Plachta-Danielzik Sandra , Gehrke Marie Isabel , Kehden Britta , Kromeyer-Hauschild Katrin , Grillenberger Monika , Willhöft Corinna , Bosy-Westphal Anja , Müller Manfred J.
Published: March 2012

Objective: The aim of this study was to define body fat percentiles for German children and adolescents aged 3–16 years using the largest German database. Methods: The study population included 11,632 girls and 11,604 boys. Data were pooled from: i) Kiel Obesity Prevention Study (KOPS), acquisition period: 1996–2008, n = 12,237; ii) ‘Better diet. More exercise. KINDERLEICHT-REGIONS’, acquisition period: 2007, n = 9,405; and iii) examination of Jena schoolchildren, acquisition period: 2005, n = 1,594. Body fat mass was measured by bioelectrical impedance analysis using a population-specific algorithm. Data were weighted to achieve a representative sample for Germany. Percentile curves were constructed by the LMS method and proved by Worm plots and Q-statistic. Results: In both genders, the higher body fat percentile curves sloped downwards to age 7 years, whereas the lower percentiles declined up to 8.5 years. Thereafter fat mass remained nearly constant with age in boys and increased in girls. The 10th percentile achieved a minimum of 10–11% body fat in both genders, whereas the 90th percentile curve fluctuated between 29 and 44% in boys or 30–43% in girls. The association between fat mass and blood pressure was too weak to define disease-related cut-offs. Conclusion: These body fat percentiles are suitable reference values for German children and adolescents.
A Validation Study of the Japanese Version of the Addenbrooke’s Cognitive Examination-Revised
Authors: dos Santos Kawata Kelssy Hitomi , Hashimoto Ryusaku , Nishio Yoshiyuki , Hayashi Atsuko , Ogawa Nanayo , Kanno Shigenori , Hiraoka Kotaro , Yokoi Kayoko , Iizuka Osamu , Mori Etsuro
Published: March 2012

The aim of this study was to validate the Japanese version of the Addenbrooke’s Cognitive Examination-Revised (ACE-R) [Mori: Japanese Edition of Hodges JR’s Cognitive Assessment for Clinicians, 2010] designed to detect dementia, and to compare its diagnostic accuracy with that of the Mini-Mental State Examination. The ACE-R was administered to 85 healthy individuals and 126 patients with dementia. The reliability assessment revealed a strong correlation in both groups. The internal consistency was excellent (α-coefficient = 0.88). Correlation with the Clinical Dementia Rating sum of boxes score was significant (rs = –0.61, p < 0.001). The area under the curve was 0.98 for the ACE-R and 0.96 for the Mini-Mental State Examination. The cut-off score of 80 showed a sensitivity of 94% and a specificity of 94%. Like the original ACE-R and the versions designed for other languages, the Japanese version of the ACE-R is a reliable and valid test for the detection of dementia.
Leptin in Early Life: A Key Factor for the Development of the Adult Metabolic Profile
Authors: Granado Miriam , Fuente-Martín Esther , García-Cáceres Cristina , Argente Jesús , Chowen Julie A.
Published: March 2012

Leptin levels during the perinatal period are important for the development of metabolic systems involved in energy homeostasis. In rodents, there is a postnatal leptin surge, with circulating leptin levels increasing around postnatal day (PND) 5 and peaking between PND 9 and PND 10. At this time circulating leptin acts as an important trophic factor for the development of hypothalamic circuits that control energy homeostasis and food seeking and reward behaviors. Blunting the postnatal leptin surge results in long-term leptin insensitivity and increased susceptibility to diet-induced obesity during adulthood. Pharmacologically increased leptin levels in the postnatal period also have long-term effects on metabolism. Nevertheless, this effect is controversial as postnatal hyperleptinemia is reported to both increase and decrease the predisposition to obesity in adulthood. The different effects reported in the literature could be explained by the different moments at which this hormone was administered, suggesting that modifications of the neonatal leptin surge at specific time points could selectively affect the development of central and peripheral systems that are undergoing modifications at this moment resulting in different metabolic and behavioral outcomes. In addition, maternal nutrition and the hormonal environment during pregnancy and lactation may also modulate the offspring’s response to postnatal modifications in leptin levels. This review highlights the importance of leptin levels during the perinatal period in the development of metabolic systems that control energy homeostasis and how modifications of these levels may induce long-lasting and potentially irreversible effects on metabolism.
Animal Models of Atherosclerosis
Authors: Getz Godfrey S. , Reardon Catherine A.
Published: March 2012

Atherosclerosis is a chronic inflammatory disorder that is the underlying cause of most cardiovascular disease. Both cells of the vessel wall and cells of the immune system participate in atherogenesis. This process is heavily influenced by plasma lipoproteins, genetics, and the hemodynamics of the blood flow in the artery. A variety of small and large animal models have been used to study the atherogenic process. No model is ideal as each has its own advantages and limitations with respect to manipulation of the atherogenic process and modeling human atherosclerosis or lipoprotein profile. Useful large animal models include pigs, rabbits, and nonhuman primates. Due in large part to the relative ease of genetic manipulation and the relatively short time frame for the development of atherosclerosis, murine models are currently the most extensively used. Although not all aspects of murine atherosclerosis are identical to humans, studies using murine models have suggested potential biological processes and interactions that underlie this process. As it becomes clear that different factors may influence different stages of lesion development, the use of mouse models with the ability to turn on or delete proteins or cells in tissue specific and temporal manner will be very valuable.
Bcl-x Inactivation in Macrophages Accelerates Progression of Advanced Atherosclerotic Lesions in Apoe
−/−
Mice
Authors: Shearn Andrew I.U. , Deswaerte Virginie , Gautier Emmanuel L. , Saint-Charles Flora , Pirault John , Bouchareychas Laura , Rucker Edmund B. , Beliard Sophie , Chapman John , Jessup Wendy , Huby Thierry , Lesnik Philippe
Published: March 2012

Objective—

Bcl-x is the most abundantly expressed member of the Bcl-2 gene family in macrophages, but its role in macrophage apoptosis during atherogenesis is unknown.

Methods and Results—

We previously reported dual pro- and antiatherogenic effects of macrophage survival in early versus advanced atherosclerotic lesions, respectively, potentially reflecting growing impairment of efferocytosis during plaque progression. Here, we specifically inactivated Bcl-x in macrophages and evaluated its impact on atherosclerotic lesion formation in Apoe
−/−
mice at various stages of the disease. Bcl-x deficiency in macrophages increased their susceptibility to apoptosis, resulting in the depletion of tissue macrophages in vivo, including its major pool, Küppfer cells in the liver. We also observed increased cholesterol levels that were, however, not associated with any acceleration of early atherosclerotic plaque progression. This observation suggests that the atheroprotective effect of macrophage apoptosis at that stage of disease was counterbalanced by enhanced cholesterol levels. Bcl-x KO
mac
/Apoe
−/−
mice exhibited significantly larger advanced lesions than control mice. These lesions showed vulnerable traits. Such enhanced lesion size may occur as a result not only of apoptotic cell accumulation but also of elevated cholesterol levels.

Conclusion—

Modulation of macrophage resistance to apoptosis through targeted deletion of Bcl-x has a major impact on the entire macrophage cell population in the body, including Küpffer cells. Macrophage survival may, therefore, not only influence atherosclerotic plaque development and vulnerability but also cholesterol metabolism.
Biphasic Time Course of the Changes in Aldosterone Biosynthesis Under High-Salt Conditions in Dahl Salt-Sensitive Rats
Authors: Morizane Shintaro , Mitani Fumiko , Ozawa Kae , Ito Kentaro , Matsuhashi Tomohiro , Katsumata Yoshinori , Ito Hideyuki , Yan Xiaoxiang , Shinmura Ken , Nishiyama Akira , Honma Seijiro , Suzuki Takeshi , Funder John W. , Fukuda Keiichi , Sano Motoaki
Published: March 2012

Objective—

The comorbidity of excess salt and elevated plasma aldosterone has deleterious effects in cardiovascular disease. We evaluated the mechanisms behind the paradoxical increase in aldosterone biosynthesis in relation to dietary intake of salt.

Methods and Results—

Dahl salt-sensitive (Dahl-S) and salt-resistant (Dahl-R) rats were fed a high-salt diet, and plasma and tissue levels of aldosterone in the adrenal gland and heart were quantified by liquid chromatography–electrospray ionization–tandem mass spectrometry. In Dahl-S rats, we found that the delayed and paradoxical increase in aldosterone biosynthesis after the initial and appropriate response to high salt. The late rise in aldosterone biosynthesis was accompanied by upregulation of CYP11B2 expression in the zona glomerulosa and increased adrenal angiotensin II levels and renin-angiotensin system components. It preceded the appearance of left ventricular systolic dysfunction and renal insufficiency. Blockade of angiotensin AT
1
receptors reversed the paradoxical increase in aldosterone biosynthesis. In contrast, Dahl-R rats maintained the initial suppression of aldosterone biosynthesis. Aldosterone levels in the heart closely paralleled those in the plasma and adrenal gland and disappeared after bilateral adrenalectomy.

Conclusion—

Chronic salt overload in Dahl-S rats stimulates aberrant aldosterone production via activation of the local renin-angiotensin system in the adrenal gland, thereby creating the comorbidity of excess salt and elevated plasma aldosterone.
Kv1.3 Channels Can Modulate Cell Proliferation During Phenotypic Switch by an Ion-Flux Independent Mechanism
Authors: Cidad Pilar , Jiménez-Pérez Laura , García-Arribas Daniel , Miguel-Velado Eduardo , Tajada Sendoa , Ruiz-McDavitt Christian , López-López José R. , Pérez-García M. Teresa
Published: March 2012

Objective—

Phenotypic modulation of vascular smooth muscle cells has been associated with a decreased expression of all voltage-dependent potassium channel (Kv)1 channel encoding genes but Kcna3 (which encodes Kv1.3 channels). In fact, upregulation of Kv1.3 currents seems to be important to modulate proliferation of mice femoral vascular smooth muscle cells in culture. This study was designed to explore if these changes in Kv1 expression pattern constituted a landmark of phenotypic modulation across vascular beds and to investigate the mechanisms involved in the proproliferative function of Kv1.3 channels.

Methods and Results—

Changes in Kv1.3 and Kv1.5 channel expression were reproduced in mesenteric and aortic vascular smooth muscle cells, and their correlate with protein expression was electrophysiologicaly confirmed using selective blockers. Heterologous expression of Kv1.3 and Kv1.5 channels in HEK cells has opposite effects on the proliferation rate. The proproliferative effect of Kv1.3 channels was reproduced by “poreless” mutants but disappeared when voltage-dependence of gating was suppressed.

Conclusion—

These findings suggest that the signaling cascade linking Kv1.3 functional expression to cell proliferation is activated by the voltage-dependent conformational change of the channels without needing ion conduction. Additionally, the conserved upregulation of Kv1.3 on phenotypic modulation in several vascular beds makes this channel a good target to control unwanted vascular remodeling.
Contribution of Platelet CX
3
CR1 to Platelet–Monocyte Complex Formation and Vascular Recruitment During Hyperlipidemia
Authors: Postea Otilia , Vasina Elena M. , Cauwenberghs Sandra , Projahn Delia , Liehn Elisa A. , Lievens Dirk , Theelen Wendy , Kramp Birgit K. , Butoi Elena D. , Soehnlein Oliver , Heemskerk Johan W.M. , Ludwig Andreas , Weber Christian , Koenen Rory R.
Published: March 2012

Objective—

The chemokine receptor CX
3
CR1 is an inflammatory mediator in vascular diseases. On platelets, its ligation with fractalkine (CX
3
CL1) induces platelet activation followed by leukocyte recruitment to activated endothelium. Here, we evaluated the expression and role of platelet-CX
3
CR1 during hyperlipidemia and vascular injury.

Methods and Results—

The existence of CX
3
CR1 on platelets at mRNA and protein level was analyzed by RT-PCR, quantitative (q)PCR, FACS analysis, and Western blot. Elevated CX
3
CR1 expression was detected on human platelets after activation and, along with increased binding of CX
3
CL1, platelet CX
3
CR1 was also involved in the formation of platelet–monocyte complexes. Interestingly, the expression of CX
3
CR1 was elevated on platelets from hyperlipidemic mice. Accordingly, CX
3
CL1-binding and the number of circulating platelet–monocyte complexes were increased. In addition, CX
3
CR1 supported monocyte arrest on inflamed smooth muscle cells in vitro, whereas CX
3
CR1-deficient platelets showed decreased adhesion to the denuded vessel wall in vivo.

Conclusion—

Platelets in hyperlipidemic mice display increased CX
3
CR1-expression and assemble with circulating monocytes. The formation of platelet–monocyte complexes and the detection of platelet-bound CX
3
CL1 on inflamed smooth muscle cells suggest a significant involvement of the CX
3
CL1–CX
3
CR1 axis in platelet accumulation and monocyte recruitment at sites of arterial injury in atherosclerosis.
Transition From Obesity to Metabolic Syndrome Is Associated With Altered Myocardial Autophagy and Apoptosis
Authors: Li Zi-Lun , Woollard John R. , Ebrahimi Behzad , Crane John A. , Jordan Kyra L. , Lerman Amir , Wang Shen-Ming , Lerman Lilach O.
Published: March 2012

Objective—

Transition from obesity to metabolic-syndrome (MetS) promotes cardiovascular diseases, but the underlying cardiac pathophysiological mechanisms are incompletely understood. We tested the hypothesis that development of insulin resistance and MetS is associated with impaired myocardial cellular turnover.

Methods and Results—

MetS-prone Ossabaw pigs were randomized to 10 weeks of standard chow (lean) or to 10 (obese) or 14 (MetS) weeks of atherogenic diet (n=6 each). Cardiac structure, function, and myocardial oxygenation were assessed by multidetector computed-tomography and Blood Oxygen Level-Dependent–MRI, the microcirculation with microcomputed-tomography, and injury mechanisms by immunoblotting and histology. Both obese and MetS showed obesity and dyslipidemia, whereas only MetS showed insulin resistance. Cardiac output and myocardial perfusion increased only in MetS, yet Blood Oxygen Level-Dependent–MRI showed hypoxia. Inflammation, oxidative stress, mitochondrial dysfunction, and fibrosis also increased in both obese and MetS, but more pronouncedly in MetS. Furthermore, autophagy in MetS was decreased and accompanied by marked apoptosis.

Conclusion—

Development of insulin resistance characterizing a transition from obesity to MetS is associated with progressive changes of myocardial autophagy, apoptosis, inflammation, mitochondrial dysfunction, and fibrosis. Restoring myocardial cellular turnover may represent a novel therapeutic target for preserving myocardial structure and function in obesity and MetS.
Targeted Focal Adhesion Kinase Activation in Cardiomyocytes Protects the Heart From Ischemia/Reperfusion Injury
Authors: Cheng Zhaokang , DiMichele Laura A. , Hakim Zeenat S. , Rojas Mauricio , Mack Christopher P. , Taylor Joan M.
Published: March 2012

Objective—

We previously reported that cardiac-restricted deletion of focal adhesion kinase (FAK) exacerbated myocyte death following ischemia/reperfusion (I/R). Here, we interrogated whether targeted elevation of myocardial FAK activity could protect the heart from I/R injury.

Methods and Results—

Transgenic mice were generated with myocyte-specific expression of a FAK variant (termed SuperFAK) that conferred elevated allosteric activation. FAK activity in unstressed transgenic hearts was modestly elevated, but this had no discernable effect on anabolic heart growth or cardiac function. Importantly, SuperFAK hearts exhibited a dramatic increase in FAK activity and a reduction in myocyte apoptosis and infarct size 24 to 72 hours following I/R. Moreover, serial echocardiography revealed that the transgenic mice were protected from cardiac decompensation for up to 8 weeks following surgery. Mechanistic studies revealed that elevated FAK activity protected cardiomyocytes from I/R-induced apoptosis by enhancing nuclear factor-κB (NF-κB)–dependent survival signaling during the early period of reperfusion (30 and 60 minutes). Moreover, adenoviral-mediated expression of SuperFAK in cultured cardiomyocytes attenuated H
2
O
2
or hypoxia/reoxygenation-induced apoptosis, whereas blockade of the NF-κB pathway using a pharmacological inhibitor or small interfering RNAs completely abolished the beneficial effect of SuperFAK.

Conclusion—

Enhancing cardiac FAK activity attenuates I/R-induced myocyte apoptosis through activation of the prosurvival NF-κB pathway and may represent a novel therapeutic strategy for ischemic heart diseases.
Fibrin D-Dimer, Tissue-Type Plasminogen Activator, von Willebrand Factor, and Risk of Incident Stroke in Older Men
Authors: Wannamethee S. Goya , Whincup Peter H. , Lennon Lucy , Rumley Ann , Lowe Gordon D.
Published: March 2012

Background and Purposes—

Abnormalities in blood coagulation and the fibrinolytic system have been associated with increased risk of stroke, but few prospective studies have studied the associations in older adults. We have examined the associations between fibrin D-dimer, tissue-type plasminogen activator, and von Willebrand factor (vWF) and risk of stroke in older men and examined their predictive roles separately in normotensive and hypertensive men.

Methods—

Prospective study of 3358 men aged 60 to 79 years with no previous diagnosis of myocardial infarction or stroke and without atrial fibrillation followed-up for an average of 9 years, during which there were 187 incident stroke events.

Results—

Increased levels of D-dimer and vWF were associated with significantly increased risk of major stroke events after adjustment for potential confounders, including systolic blood pressure (adjusted hazard ratios and 95% confidence interval per standard deviation increase in D-dimer and vWF were 1.24 [95% confidence interval, 1.08–1.44] and 1.25 [95% confidence interval, 1.09–1.45], respectively). No associations were seen with tPA after adjustment. The positive associations between D-dimer and vWF and incident stroke remained after additional adjustment for markers of inflammation (C-reactive protein, IL-6). D-dimer was associated with stroke in both normotensive and hypertensive men; vWF showed stronger associations in normotensive than in hypertensive men (test for interaction:
P
=0.52 for D-dimer;
P
<0.01 for vWF).

Conclusions—

Fibrin D-dimer and vWF are associated with increased risk of stroke in older men. These associations were not explained by their associations with inflammation. D-dimer may be a useful marker to identify those at high risk for stroke among hypertensive men.
Prevalence and Length of Recovery of Pusher Syndrome Based on Cerebral Hemispheric Lesion Side in Patients With Acute Stroke
Authors: Abe Hiroaki , Kondo Takeo , Oouchida Yutaka , Suzukamo Yoshimi , Fujiwara Satoru , Izumi Shin-Ichi
Published: March 2012

Background and Purpose—

The aim of this study was to determine if side of cerebral hemisphere lesion affects the prevalence and time course of pushing behavior (PB) after stroke.

Methods—

A total of 1660 patients with acute stroke were investigated. PB was assessed using the standardized Scale for Contraversive Pushing. Risk ratios were used to evaluate the differences in the prevalence of PB between right cerebral hemisphere-damaged (RCD) and left cerebral hemisphere-damaged (LCD) patients. The differences in the time course among 35 (27 RCD and 8 LCD) patients were evaluated by analyzing Scale for Contraversive Pushing scores with the Kaplan–Meier method using a log-rank test.

Results—

PB was observed in 156 (9.4%) patients. The prevalence of PB was significantly higher in RCD (97 of 556 [17.4%]) than in LCD (57 of 599 [9.5%]) patients; risk ratio was 1.83 (95% CI, 1.35–2.49). The log-rank test indicated that RCD patients exhibited a significantly slower recovery than LCD patients (
P
=0.027).

Conclusions—

The number of RCD patients who exhibited PB was higher than that of LCD patients. The duration of recovery from PB was longer in RCD patients than in LCD patients.
Factors Affecting Clot Lysis Rates in Patients With Spontaneous Intraventricular Hemorrhage
Authors: Ziai Wendy C. , Muschelli John , Thompson Carol B. , Keyl Penelope M. , Lane Karen , Shao Shuai , Hanley Daniel F.
Published: March 2012

Background and Purpose—

In the treatment of severe intraventricular hemorrhage (IVH), thrombolytic use and clot size are known to influence clot lysis rates. We evaluated the effect of other variables on IVH clot lysis rates among patients treated with recombinant tissue-type plasminogen activator or placebo.

Methods—

One hundred patients with IVH and intracerebral hemorrhage volume <30 mL requiring emergency external ventricular drainage from 2 multicenter trials were treated with intraventricular administration of recombinant tissue-type plasminogen activator (n=78; 53 males, 25 females) or placebo (n=22; 7 males, 15 females). IVH volume was quantified daily by head CT. A segmented linear regression using an optimized spline knot for each patient was fit. Random effects linear regression was used to estimate the effect of prespecified patient characteristics on clot lysis rates over the first 6 days.

Results—

Stability IVH volumes were larger in males (N=60; 54±5 mL) than females (N=40; 36±5 mL;
P
=0.01). Intraventricular thrombolytic treatment was associated with an increase in clot lysis rate of 14.6% of stability IVH volume/day before the spline knot compared with the placebo group (
P
<0.001). After adjustment for thrombolytic, higher baseline serum plasminogen and lower baseline platelet count were independently associated with an increase in clot lysis of 1.28%/day per 10-g/dL increase (
P
<0.001) and 0.70% /day per 10×10
3
/uL decrease (
P
<0.001) before the knot, respectively.

Conclusions—

Although thrombolysis remains the major determinant of IVH clot lysis rate, higher baseline serum plasminogen and lower platelet count also predict faster clot lysis. Further studies are needed to confirm whether plasminogen availability and thrombus structure impact IVH clot removal.

Clinical Trial Registration—

URL:
http://clinicaltrials.gov
. Unique identifier: NCT00650858.
Duration of Diabetes and Risk of Ischemic Stroke
Authors: Banerjee Chirantan , Moon Yeseon P. , Paik Myunghee C. , Rundek Tatjana , Mora-McLaughlin Consuelo , Vieira Julio R. , Sacco Ralph L. , Elkind Mitchell S.V.
Published: March 2012

Background and Purpose—

Diabetes increases stroke risk, but whether diabetes status immediately before stroke improves prediction and whether duration is important are less clear. We hypothesized that diabetes duration independently predicts ischemic stroke.

Methods—

Among 3298 stroke-free participants in the Northern Manhattan Study, baseline diabetes and age at diagnosis were determined. Incident diabetes was assessed annually (median, 9 years). Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% CI for incident ischemic stroke using baseline diabetes, diabetes as a time-dependent covariate, and duration of diabetes as a time-varying covariate; models were adjusted for demographic and cardiovascular risk factors.

Results—

Mean age was 69±10 years (52% Hispanic, 21% white, and 24% black); 22% had diabetes at baseline and 10% had development of diabetes. There were 244 ischemic strokes, and both baseline diabetes (HR, 2.5; 95% CI, 1.9–3.3) and diabetes considered as a time-dependent covariate (HR, 2.4; 95% CI, 1.8–3.2) were similarly associated with stroke risk. Duration of diabetes was associated with ischemic stroke (adjusted HR, 1.03 per year with diabetes; 95% CI, 1.02–1.04). Compared to nondiabetic participants, those with diabetes for 0 to 5 years (adjusted HR, 1.7; 95% CI, 1.1–2.7), 5 to 10 years (adjusted HR, 1.8; 95% CI, 1.1–3.0), and ≥10 years (adjusted HR, 3.2; 95% CI, 2.4–4.5) were at increased risk.

Conclusions—

Duration of diabetes is independently associated with ischemic stroke risk adjusting for risk factors. The risk increases 3% each year, and triples with diabetes ≥10 years.
High Levels of S100A12 Are Associated With Recent Plaque Symptomatology in Patients With Carotid Atherosclerosis
Authors: Abbas Azhar , Aukrust Pål , Dahl Tuva B. , Bjerkeli Vigdis , Sagen Ellen B. Lund , Michelsen Annika , Russell David , Krohg-Sørensen Kirsten , Holm Sverre , Skjelland Mona , Halvorsen Bente
Published: March 2012

Background and Purpose—

Atherosclerosis is a progressive chronic disease, in which inflammation plays a key role. The calcium-binding proteins calgranulins including S100A8, S100A9, and S100A12 are involved in many cellular activities and pathological processes including inflammation. We therefore hypothesized that calgranulins may be markers of plaque instability in patients with carotid atherosclerosis.

Methods—

Plasma levels of S100A8/A9 and S100A10 were measured in 159 consecutive patients with high-grade carotid stenosis and in 22 healthy control subjects. The mRNA levels of calgranulins were also measured within the atherosclerotic carotid plaques, and their regulation was analyzed in vitro in monocytes.

Results—

Our main findings were: (1) plasma levels of S100A12 were significantly higher in patients with carotid atherosclerosis compared with healthy control subjects with the highest levels in patients with the most recent symptoms (ie, within 2 months); (2) plasma levels of S100A8/S100A9 showed a modest increase in patients with symptoms in the previous 2 to 6 months but not in the other patients; (3) mRNA levels of S100A8, S100A9, and S100A12 showed increased expression in atherosclerotic carotid plaques from patients with the most recent symptoms compared with the remaining patients; (4) in THP-1 monocytes, activation of Toll-like receptors 2 and 4 increased mRNA levels of S100A8, S100A9, and S10012 and interleukin-1β, interferon γ, and releasate from thrombin-activated platelets significantly enhanced the expression of S100A12.

Conclusions—

Our findings support a link between calgranulins and atherogenesis and suggest that these mediators, and in particular S100A12, may be related to plaque instability.
Covert Neurological Symptoms Associated With Silent Infarcts From Midlife to Older Age
Authors: Windham Beverly G. , Griswold Michael E. , Shibata Dean , Penman Alan , Catellier Diane J. , Mosley Thomas H.
Published: March 2012

Background and Purpose—

Unrecognized or unreported stroke-like symptoms, called covert symptoms, occur in persons free of clinical stroke. Whether covert symptoms are associated with subclinical brain infarcts (SBIs) is unknown. This study examined the association between covert stroke-like symptoms and SBI/stroke in persons with no history of stroke or transient ischemic attack.

Methods—

A total of 1881 Atherosclerosis Risk in Communities (ARIC) participants free of clinical stroke or transient ischemic attack (40% male, 50% black, 47–70 years) were queried for covert symptoms and underwent cerebral MRI during the baseline MRI visit. Symptoms were reassessed after 3 years at Visit 4 (n=1001; 39% male, 50% black) and approximately 10 years with a follow-up MRI (n=1006; 40% male, 50% black, 61–83 years).

Results—

Covert symptoms were associated with prevalent SBI (OR, 1.94; 95% CI, 1.21–3.11;
P
=0.006). No support was found for associations between baseline MRI symptoms and SBI at the follow up MRI visit. In participants without SBI at baseline, symptoms at Visit 4 (OR, 2.96; 1.23–7.13;
P
=0.016) and symptoms at the follow-up MRI visit (OR, 4.29; 2.51–7.33;
P
<0.001) were associated with a combined outcome of new SBI/clinical stroke on follow-up MRI. Covert symptoms at follow-up MRI visit were also associated with having new SBI (OR, 2.26; 1.18–4.32;
P
=0.014) on the follow-up MRI that were not seen on the baseline MRI.

Conclusions—

Covert neurological symptoms were associated with prevalent SBI, and when ascertained at the time of follow-up MRI, with new SBI. Covert symptoms may reflect heightened risk for infarcts.
Patient-Reported Auditory Functions After Stroke of the Central Auditory Pathway
Authors: Bamiou Doris-Eva , Werring David , Cox Karen , Stevens John , Musiek Frank E. , Brown Martin M. , Luxon Linda M.
Published: March 2012

Background and Purpose—

Auditory functional limitations experienced by patients after stroke of the central auditory pathways remain underinvestigated.

Purpose—

To measure patient-reported hearing difficulties in everyday life in nonaphasic patients with stroke of the auditory brain versus normal control subjects. To examine how hearing difficulties correlate with auditory tests and site of lesion in individual cases.

Methods—

We recruited 21 individuals with auditory brain stroke (excluding those with aphasia) diagnosed on the basis of a brain MRI conducted 1 to 2 weeks after the stroke and assessed in the chronic stage of stroke. Twenty-three controls matched for age and hearing were also recruited. All subjects completed the Amsterdam Inventory for Auditory Disability (consisting of subscales of sound detection, recognition, localization, speech in quiet, speech in noise) and underwent baseline audiometry and central auditory processing tests (dichotic digits, frequency and duration patterns, gaps in noise).

Results—

Sound recognition and localization subscores of the inventory were significantly worse in case subjects versus control subjects, with severe and significant functional limitation (z score >3) reported by 9 out of 21 case subjects. None of the inventory subscales correlated with audiometric thresholds, but localization and recognition subscales showed a moderate to strong correlation with dichotic digits (left ear) and pattern tests.

Conclusions—

A substantial proportion of patients may experience and report severe auditory functional limitations not limited to speech sounds after stroke of the auditory brain. A hearing questionnaire may help identify patients who require more extensive assessment to inform rehabilitation plans.
Manual Aspiration Thrombectomy
Authors: Jankowitz Brian , Aghaebrahim Amin , Zirra Alexandra , Spataru Oana , Zaidi Syed , Jumaa Mouhammad , Ruiz-Ares Gerardo , Horowitz Michael , Jovin Tudor G.
Published: March 2012

Background and Purpose—

We evaluated recanalization rates, clinical outcomes, and safety when manual aspiration thrombectomy is used in conjunction with other thrombolytic modalities in a consecutive case series of patients with large vessel intracranial occlusion.

Methods—

We conducted a retrospective review of a prospectively acquired acute endovascular stroke database. Manual aspiration thrombectomy was carried out with Distal Access and Penumbra reperfusion catheters of different sizes placed in the thrombus and aspirated with a syringe.

Results—

We identified 191 patients: Occlusion locations were as follows: M1% to 50%, M2% to 10%, internal carotid artery terminus 25%, and vertebrobasilar 15%. Median treatment duration was 90 minutes. Recanalization results were Thrombolysis in Myocardial Ischemia 2/3 93%, Thrombolysis in Myocardial Ischemia 3 27%, Thrombolysis In Cerebral Infarction 2a/2b/3 91%, Thrombolysis In Cerebral Infarction 2b/3 71%, and Thrombolysis In Cerebral Infarction 3 25%. Larger catheters were associated with higher recanalization rates. Parenchymal hematoma rate was 13.6%. The favorable outcome (90-day modified Rankin Scale ≤2) rate was 54%. Mortality at 90 days was 25%.

Conclusions—

Manual aspiration thrombectomy is a useful addition to the armamentarium of endovascular treatment modalities for acute stroke.
Do Different Metabolic Syndrome Definitions Predict Cerebrovascular Events and Coronary Heart Disease Independent of Their Components?
Authors: Hadaegh Farzad , Mohebi Reza , Cheraghi Leila , Tohidi Maryam , Moghaddam Nahid Beladi , Bozorogmanesh Mohammadreza , Sheikholeslami Farhad , Azizi Fereidoun
Published: March 2012

Background and Purpose—

The purpose of this study was to examine whether metabolic syndrome (MetS), applying different definitions, predicts incident coronary heart disease (CHD) and cerebrovascular events (CVAs) independent of its components.

Methods—

Among 2548, aged ≥50 years, World Health Organization, International Diabetes Federation, and Joint Interim Statement criteria were used to define MetS. Cox proportional hazards regression was implemented to estimate hazard ratios of incident CVA and CHD.

Results—

During 9.3 years of follow-up, 72 and 343 cases of CVA and CHD events occurred. The multivariate hazard ratios (95% CI) of incident CVA and CHD were 2.71 (1.57–4.68) and 2.07 (1.63–2.64) for MetS as defined by the Joint Interim Statement, respectively. There was no difference among the 3 definitions of MetS regarding the prediction of the CVA incidence. However, MetS as defined by the Joint Interim Statement predicted CHD better than the International Diabetes Federation definition. After adjustment for components, MetS lost its association with CHD and CVA; in this model, the elevated blood pressure and high fasting plasma glucose (International Diabetes Federation definition) showed significant risk for CVA events; regarding CHD events, the elevated blood pressure, high fasting plasma glucose, and, for World Health Organization definition, obesity and dyslipidemia remained as predictors.

Conclusions—

All definitions of MetS were associated with CVA and CHD events. After adjusting its components, MetS lost its association with incident CVA and CHD; however, elevated blood pressure for both CVA and CHD events and high fasting plasma glucose for CHD events remained as independent predictors in all definitions.
When Preference Is Not Satisfied but the Individual Is
Authors: Lee Yih-teen , Antonakis John
Published: March 2012

One aspect of person–job fit reflects congruence between personal preferences and job design; as congruence increases so should satisfaction. The authors hypothesized that power distance would moderate whether fit is related to satisfaction with degree of job formalization. They obtained measures of job formalization, fit, and satisfaction, as well as organizational commitment, from employees ( N = 772) in a multinational firm with subsidiaries in six countries. Confirming previous findings, individuals from low-power-distance cultures were most satisfied with increasing fit. However, the extent to which individuals from high-power-distance cultures were satisfied did not necessarily depend on increasing fit but mostly on whether the degree of formalization received was congruent with cultural norms. Irrespective of culture, satisfaction with formalization predicted a broad measure of organizational commitment. Apart from the novel extension of fit theory, the authors show how moderation can be tested in the context of polynomial response surface regression and how specific hypotheses can be tested regarding different points on the response surface.
Does Passive Smoking Have an Effect on Nasal Mucociliary Clearance?
Authors: Habesoglu Mehmet , Demir Kadri , Yumusakhuylu Ali Cemal , Sahin Yilmaz Asli , Oysu Cagatay
Published: March 2012

Objective

The aim of this study is to review the literature about nasal mucociliary clearance (MCC) and passive smoking in otorhinolaryngology by clearly explaining their relationship in a cross‐sectional study.

Study Design and Setting

This cross‐sectional study was conducted at the Umraniye Education and Research Hospital in Turkey. Umraniye Education and Research Hospital Ethical Committee approved the study, and informed consents of the patients were obtained.

Methods

Our study consisted of patients who presented to the Ear‐Nose‐Throat Department of Istanbul Umraniye Education and Research Hospital between February 2011 and July 2011. Three groups of subjects were evaluated: 15 passive smokers (group 1), 17 active smokers (group 2), and 15 healthy matched controls (group 3). All patients were asked to answer our questions regarding their smoking history, and nasal MCC time was assessed for all individuals of the 3 groups.

Results

The mean MCC value was 23.59 ± 12.41 in the smoking group, 12.6 ± 4.67 in the passive smoking group, and 6.4 ± 1.55 in the healthy group. The comparison of MCC values between the smoking group and passive smoking group and between the smoking group and healthy group revealed statistically significant differences (P <. 01). There was also a significant difference between the MCC values of the passive smoking group and the healthy group (P <. 01). In addition, we compared MCC values according to exposure number of cigarettes.

Conclusion

In this study, we conclude that passive smoking affects nasal MCC. Both active and passive smoking increases nasal MCC time when compared with healthy controls.
The career identities of ‘mumpreneurs’: Women’s experiences of combining enterprise and motherhood
Authors: Duberley Joanne , Carrigan Marylyn
Published: March 2012

This article examines the experiences of women who establish new ventures in order to combine income generation with childcare responsibilities. Based on interviews with 20 ‘mumpreneurs’, we examined career narratives to show how these women described the transition to entrepreneurship and their experiences of this new mode of working. The findings suggest that the women weave a path between the discourses of intensive mothering and enterprise. Becoming self-employed was deemed preferable to being perceived as a housewife as it enabled identification with a discourse of intensive mothering, facilitating far greater engagement with children than was possible during previous corporate lives. However, the findings revealed tensions which required individualized strategies to address excessive working hours and constrain business growth.
Trends in labour market flexibilization among Dutch school-leavers: The impact of economic globalization on educational differences
Authors: de Lange Marloes , Gesthuizen Maurice , Wolbers Maarten HJ
Published: March 2012

This study examines to what extent there is a trend towards increasing labour market flexibility among Dutch school-leavers between 1992 and 2007, particularly among less educated ones. In addition, the article aims to explain this trend and increasing educational differences by economic globalization, controlled for business cycle effects. Multinomial logistic regression models are estimated using 16 cross-sections of the Dutch Labour Force Survey (1992–2007), including 16,447 labour market entrants. The results show that there is an increase in the likelihood of flexible employment between 1992 and 2007, which implies less standard employment, particularly among less educated individuals, and less unemployment, particularly among higher educated individuals. The less educated are hence doubly disadvantaged by the process of labour market flexibilization. It appears that economic globalization provides an explanation for these findings, except for the increasing educational differences in flexible employment compared to unemployment.
Ultrasonographic Assessment of Humeral Retrotorsion in Baseball Players
Authors: Myers Joseph B. , Oyama Sakiko , Clarke John P.
Published: March 2012

Background: Recently, clinicians and researchers started using diagnostic ultrasound to measure humeral torsion as an alternative to radiological assessments in overhead-throwing athletes and other clinical populations. Ultrasound appears to be a reliable, nonradiological alternative, but ultrasound assessment has not been validated against computed tomography (CT), the current gold standard.

Purpose: This study aimed to establish the validity of an ultrasound assessment of humeral torsion by comparing data obtained using both ultrasound and CT, the current standard.

Study Design: Cohort study (Diagnosis); Level of evidence, 2.

Methods: Humeral torsion was measured using both ultrasound and CT in 24 collegiate-aged baseball players. Comparisons between the assessments were made using both regression and Bland-Altman plots. Reliability and precision were also established.

Results: A strong relationship existed between humeral torsion variables obtained with ultrasound and CT ( R = .797, R2 = .635, P < .001). The ultrasound assessment yielded reliability coefficients ranging from .991 to .997, with approximately 1° of measurement error. The CT method’s reliability coefficients ranged from .805 to .933, with approximately 3.5° of measurement error.

Conclusion: There was a strong relationship between humeral torsion obtained with ultrasound and CT, the current standard of assessment. Ultrasound provides a reliable, valid alternative to CT for obtaining an indication of the amount of humeral torsion in the upper extremity.
Dynamic Sagittal Plane Trunk Control During Anterior Cruciate Ligament Injury
Authors: Sheehan Frances T. , Sipprell William H. , Boden Barry P.
Published: March 2012

Background: Recent studies have demonstrated that trunk control likely plays a role in anterior cruciate ligament (ACL) injury. Yet, the majority of ACL research remains focused on the lower limb, with limited information on the trunk position at the time of injury.

Hypotheses: Athletes experiencing a noncontact ACL injury after a 1-legged landing position their center of mass (COM) more posterior from the base of support (BOS) at initial ground contact in comparison with uninjured athletes. The distance from the COM to the BOS (COM_BOS) is larger in female, as compared with male, athletes during 1-legged landing.

Study Design: Case control study; Level of evidence, 3.

Methods: Movie captures of 20 athletes performing a 1-legged landing maneuver resulting in a torn ACL were compared with matched (for gender, sport, and activity just before landing) movie captures of 20 athletes performing a similar maneuver that did not result in an ACL disruption (controls). The COM_BOS, trunkG angle, and limbG angle (both relative to the gravity vector) were measured in the sagittal plane at initial ground-foot contact. A 2-way ANOVA (injury status × gender) was used to examine the hypotheses.

Results: There was a significant difference in all 3 measures based on injury status but not on gender. The COM_BOS, normalized by femur length, and limbG angle were greater (Δ = 0.9, P < .001 and Δ = 16°, P = .004, respectively), and the trunkG angle was smaller (Δ = 12°, P = .016) in the participants who sustained an ACL injury as compared with controls. The average COM was calculated as 38 cm more posterior relative to the BOS in the participants who sustained an ACL injury as compared with controls.

Conclusion: Landing with the COM far posterior to the BOS may be a risk factor for noncontact ACL injury and potentially can be addressed in prevention programs.