bluuebunny/crossref_metadata_2025 huggingface dataset:
Cholesterol-Lowering Effect of Probiotic Yogurt in Comparison with Ordinary Yogurt in Mildly to Moderately Hypercholesterolemic Subjects
Authors: Ataie-Jafari Asal , Larijani Bagher , Alavi Majd Hamid , Tahbaz Farideh
Published: February 2009

Background and Aims: Hypercholesterolemia is the most important risk factor for cardiovascular diseases. In this study, we compared the effect of consuming probiotic yogurt with that of ordinary yogurt on serum cholesterol level in mildly to moderately hypercholesterolemic subjects. Methods: This randomized and crossover trial included 14 healthy subjects with serum total cholesterol 5.17–7.76 mmol/l. They did not consume yogurt for a 2-week prestudy period and added 300 g/day of milk to their diet. After this period, they were randomly allocated to 2 groups to receive either 300 g of ordinary yogurt or probiotic yogurt (fermented with a starter composed of Lactobacillus acidophilus and Bifidobacterium lactis in addition to bacteria in ordinary yogurt) for 6 weeks as a substitution for milk. After a 4-week washout period, the crossover was made and the study lasted for another 6 weeks. Blood lipid tests were done at the beginning and at the end of each period. Results: Consumption of probiotic yogurt in comparison with ordinary yogurt caused a significant decrease in serum total cholesterol (p < 0.05). Comparison of other blood lipid indices did not show any significant differences between these 2 periods. Conclusion: Yogurt containing two probiotic bacteria strains, L. acidophilus and B. lactis, had a cholesterol-lowering effect in hypercholesterolemic subjects.
Inverse Relationship between Birth Weight and Blood Pressure in Growth-Retarded but Not in Appropriate for Gestational Age Infants during the First Week of Life
Authors: Smal Jaime C. , Uiterwaal Cuno S.P.M. , Bruinse Hein W. , Steendijk Paul , van Bel Frank
Published: February 2009

Background: Various studies have shown an association between low birth weight and the prevalence of elevated blood pressure later in life. However, a relationship between birth weight and blood pressure in the neonatal period has not been investigated yet. Objective: To study the relationship between birth weight and blood pressure during the first week of life. Methods: Systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MBP) were measured every 8 h during days 1, 2, 3, 4 and 7 in 44 small for gestational age (SGA) infants and compared with those of infants born with a birth weight appropriate for gestational age (AGA). The infants were matched for gestational age and gender. Results: Meanbirth weight (range) in the SGA group was 778 (460–1,400) g versus 1,524 (960–2,730) g in the AGA group, and mean (range) gestational age of both groups was 30.5 (27.3–35.5) weeks. In the first week of life, SGA and AGA infants had similar SBP, DBP and MBP. Also, after adjustment for confounders (maternal medication, smoking), SBP, DBP and MBP rose equally in SGA and AGA infants during the first week of life. AGA infants showed a positive correlation between birth weight and blood pressure, but SGA infants showed an inverse correlation. Conclusions: Although differences in blood pressure were found between SGA and AGA infants in the first week of life, the inverse relationship between birth weight and blood pressure in SGA infants warrants follow-up studies to investigate a possible link with late cardiovascular disease.
Assessment of the Presence of Occult Myocardial Infarction in Chronic Obstructive Pulmonary Disease Using Contrast-Enhanced Cardiac Magnetic Resonance Imaging
Authors: Murphy C. Aengus , Blyth Kevin G. , Chaudhuri Rekha , Lafferty Jane , Hothersall Eleanor , Steedman Tracey , McSharry Charles , Dargie Henry J. , Thomson Neil C.
Published: February 2009

Background: Chronic obstructive pulmonary disease (COPD) has been identified as a risk factor for ischaemic heart disease, independent of smoking history, and inflammation is thought to play a role. Objectives: We sought to ascertain whether occult myocardial infarction (MI) was present in the COPD population, and to assess its relationship with inflammation and natriuretic peptides. Method: We recruited 25 patients with moderate/severe COPD and 17 control smokers without lung disease. All participants had no known cardiac disease. Contrast-enhanced cardiac magnetic resonance imaging was performed and analysed for delayed contrast enhancement (DE), indicative of previous MI. All participants had venous blood samples taken for assessment of NT-proBNP and inflammatory markers. Results: DE was not found in any participant. Right ventricular ejection fraction was lower in COPD patients. Other cardiac measurements and NT-proBNP levels were similar in the 2 groups. C-reactive protein, IL-8, GM-CSF, IL-1β and TNF-α were all significantly higher in the COPD group. Conclusion: DE, indicating previous MI, was not found in patients with moderate/severe COPD. Occult MI does not appear to be common in this population, but a larger study would be needed to conclusively test this.
Treatment of Established Peritoneal Fibrosis by Gene Transfer of Smad7 in a Rat Model of Peritoneal Dialysis
Authors: Sun Yanyan , Zhu Fengxin , Yu Xueqing , Nie Jing , Huang Fengxian , Li Xiaoyan , Luo Ning , Lan Hui Yao , Wang Yongtao
Published: February 2009

Background/Aims: It has been shown that blockade of TGF-β1 signaling with Smad7 prevents experimental peritoneal fibrosis. The present study investigated whether Smad7 has a therapeutic effect on established peritoneal fibrosis associated with peritoneal dialysis (PD). Methods: A rat model of peritoneal fibrosis was induced by a daily intraperitoneal infusion of 4.25% Dianeal. After peritoneal fibrosis had been established on day 14, groups of 6 rats were treated intraperitoneally with gene transfer of Smad7 or control plasmids using an ultrasound-microbubble-mediated system for 2 weeks until day 28. In addition, a group of 6 diseased rats was euthanized on day 14 before treatment as the basal disease control. Results: Compared to the control-treatment animals on day 28, real-time PCR, Western blot, and confocal microscopy revealed that Smad7 gene transfer significantly attenuated the increased peritoneal fibrosis including the thickening of fibrotic peritoneum, accumulation of α-SMA and collagen I, and an improvement in peritoneal dysfunction (all p < 0.05). Importantly, Smad7 treatment also improved the severity of peritoneal fibrosis and functional impairment when compared to those on day 14 before treatment (all p < 0.05). Inhibition of the established peritoneal fibrosis by Smad7 was associated with an abrogation of TGF-β signaling and upregulation of TGF-β1 and PAI-1. Conclusions: Smad7 gene therapy is able to inhibit established peritoneal fibrosis in a rat model of PD. Results from this study suggest that Smad7 may be a therapeutic agent for the treatment of peritoneal fibrosis associated with PD.
Performance of Fully Covered Self-Expanding Metallic Stents in Benign Airway Strictures
Authors: Dooms Christophe , De Keukeleire Tom , Janssens Annelies , Carron Kris
Published: February 2009

Background: Airway stenting has become a common technique in inoperable benign strictures. An ideal stent does not yet exist for these conditions. Recently, fully covered self-expandable metallic stents (SEMS) have been commercialized with potential use in benign airway strictures. Objective: We retrospectively reviewed the clinical effectiveness of fully covered SEMS in the management of benign strictures. Methods: A total of 17 patients received 20 stents: 7 Silmet®, 8 Taewoong® and 5 Alveolus® stents. Ten stents were deployed in a structural postintubation tracheal stenosis. Other indications were multinodular goiter, anastomotic stricture, endobronchial posttuberculosis scar, damaged cartilage and relapsing polychondritis. Results: In our series, the short-term (<12 weeks after stent deployment) complication rate was 75%, requiring stent removal in 60%. Overall, stent migration was observed in 65%, stent fracture in 15%, shriveling of the stent in 10% and granulation formation in 10%. Conclusion: The use of fully covered SEMS for the treatment of benign airway strictures is associated with a high short-term complication rate requiring stent removal. We have abandoned in our clinical practice the use of fully covered SEMS for benign airway strictures.
Dietary Tocopherol Supplementation after Trabeculectomy and Phacotrabeculectomy: Double-Blind Randomized Placebo-Controlled Trial
Authors: Goldblum David , Meyenberg Alexander , Mojon Daniel , Tappeiner Christoph , Frueh Beatrice E.
Published: February 2009

Purpose: The vitamin E compound α-tocopherol inhibits fibroblast growth in vitro. To evaluate its potential benefit in preventing failure of glaucoma filtration surgery, we prospectively investigated the outcome of filtering surgery with postoperative dietary α-tocopherol supplementation. Patients and Methods: Thirty-nine patients (39 eyes) with primary open-angle glaucoma or pseudoexfoliative glaucoma were randomly assigned to two post-(phaco)-trabeculectomy treatment groups. Daily oral intake of 300 mg α-tocopheryl-acetate (absorbed as α-tocopherol in the intestine) for 2 months was compared to a placebo preparation in a double-blind trial. The follow-up time was 1 year. Success was defined as intraocular pressure (IOP) ≤18 mm Hg with no medication, no needling revision, and no subconjunctival injection. Results: In the tocopherol group, the relative risk for trabeculectomy failure decreased from 1.58 at 2 weeks (p = 0.95) to 1.0 at 1 year. Success rates (67–90%) and IOP reduction (mean 39 to 53%) were statistically comparable in the two groups. Considering postoperative complications, no relevant differences were found. Discussion: Trabeculectomy and phacotrabeculectomy outcome did not show any differences between α-tocopherol-supplemented patients and the placebo group.
Tolerance of Oat-Based Topical Products in Cereal-Sensitized Adults with Atopic Dermatitis
Authors: Goujon Catherine , Jean-Decoster Catherine , Dahel Karima , Bottigioli David , Lahbari Farida , Nicolas Jean-François , Schmitt Anne-Marie
Published: February 2009

Background: Few data suggest oat-based cosmetics may cause allergic reactions in atopic subjects, especially when sensitized to cereals. Objectives: To evaluate the risk of immediate and delayed allergic reactions to repeated and maximized applications (RMA) of oat-containing cosmetics and oat extracts and their tolerance in cereal-sensitized atopic adults. Methods: Open-label pilot study in 12 cereal-sensitized atopic adults over 45 days. Open tests and RMA were performed with Rhealba® oat-containing cosmetics at day 0 (D0) and D10, and from D10 to D31. Patch and prick tests were performed at D7 and D42 with wheat and Rhealba oat extracts and the study cream. Results: The RMA of oat-based cosmetics in cereal-sensitized atopic adults did not induce any immediate or delayed allergic reaction and was well tolerated. No immediate or delayed positive skin test to oat extracts was observed. Conclusion: Sensitization to cereals does not increase the risk of allergic reactions to oat-containing cosmetics.
Identification of Novel APP/Aβ Isoforms in Human Cerebrospinal Fluid
Authors: Portelius Erik , Brinkmalm Gunnar , Tran Ai Jun , Zetterberg Henrik , Westman-Brinkmalm Ann , Blennow Kaj
Published: February 2009

Background: Aggregation of β-amyloid (Aβ) into oligomers and plaques is the central pathogenic mechanism in Alzheimer’s disease (AD). Aβ is produced from the amyloid precursor protein (APP) by β- and γ-secretases, whereas, in the nonamyloidogenic pathway, α-secretase cleaves within the Aβ sequence, and thus precludes Aβ formation. A lot of research has focused on Aβ production and the neurotoxic 42-amino-acid form of Aβ (Aβ1–42), while less is known about the nonamyloidogenic pathway and how Aβ is degraded. Objective: To study the Aβ metabolism in man by searching for novel Aβ peptides in cerebrospinal fluid (CSF). Methods: Immunoprecipitation, using an anti-Aβ antibody, 6E10, was combined with either matrix-assisted laser desorption/ionization time-of-flight mass spectrometry or nanoflow liquid chromatography and tandem mass spectrometry. Results: We identified 12 truncated APP/Aβ peptides in the CSF, all of which end at amino acid 15 in the Aβ sequence, i.e. 1 amino acid before the proposed α-secretase site. Of these 12 APP/Aβ peptides, 11 are novel peptides and start N-terminally of the β-secretase site. The most abundant APP/Aβ peptide starts 25 amino acids before the β-secretase site, APP/Aβ (–25 to 15), and had a concentration of approximately 80 pg/ml. The identity of all the APP/Aβ peptides was verified in a cohort of AD patients and controls. A first pilot study also showed that the intensity of several APP/Aβ peaks in CSF was higher in AD cases than in controls. Conclusion: These data suggest an enzymatic activity that cleaves the precursor protein in a specific manner that may reflect a novel metabolic pathway for APP and Aβ.
A Health Services Research Agenda for Cellular, Molecular and Genomic Technologies in Cancer Care
Authors: Wideroff Louise , Phillips Kathryn A. , Randhawa Gurvaneet , Ambs Anita , Armstrong Katrina , Bennett Charles L. , Brown Martin L. , Donaldson Molla S. , Follen Michele , Goldie Sue J. , Hiatt Robert A. , Khoury Muin J. , Lewis Graham , McLeod Howard L. , Piper Margaret , Powell Isaac , Schrag Deborah , Schulman Kevin A. , Scott Joan
Published: February 2009

Background: In recent decades, extensive resources have been invested to develop cellular, molecular and genomic technologies with clinical applications that span the continuum of cancer care. Methods: In December 2006, the National Cancer Institute sponsored the first workshop to uniquely examine the state of health services research on cancer-related cellular, molecular and genomic technologies and identify challenges and priorities for expanding the evidence base on their effectiveness in routine care. Results: This article summarizes the workshop outcomes, which included development of a comprehensive research agenda that incorporates health and safety endpoints, utilization patterns, patient and provider preferences, quality of care and access, disparities, economics and decision modeling, trends in cancer outcomes, and health-related quality of life among target populations. Conclusions: Ultimately, the successful adoption of useful technologies will depend on understanding and influencing the patient, provider, health care system and societal factors that contribute to their uptake and effectiveness in ‘real-world’ settings.
The Use of Electronic Diaries in Dermatology Research
Authors: Langan S.M. , Williams H.C.
Published: February 2009

Data collection methods are critically important in observational studies. The use of electronic diaries is a novel method which to date has not been utilized in dermatology research. This method has the potential to reduce recall bias. We report on our experience in the use of electronic diaries in a panel study of children with eczema.
Pericardial Adipose Tissue Determined by Dual Source CT Is a Risk Factor for Coronary Atherosclerosis
Authors: Greif Martin , Becker Alexander , von Ziegler Franz , Lebherz Corinna , Lehrke Michael , Broedl Uli C. , Tittus Janine , Parhofer Klaus , Becker Christoph , Reiser Maximilian , Knez Andreas , Leber Alexander W.
Published: February 2009

Objectives—

Pericardial fat as a visceral fat depot may be involved in the pathogenesis of coronary atherosclerosis. To gain evidence for that concept we sought to investigate the relation of pericardial fat volumes to risk factors, serum adiponectin levels, inflammatory biomarkers, and the quantity and morphology of coronary atherosclerosis.

Methods and Results—

Using Dual source CT angiography pericardial fat volume and coronary atherosclerosis were assessed simultaneously. Plaques were classified as calcified, mixed, and noncalcified, and the number of affected segments served as quantitative score. Patients with atherosclerotic lesions had significant larger PAT volumes (226 cm
3
±92 cm
3
) than patients without atherosclerosis (134 cm
3
±56 cm
3
;
P
>0.001). No association was found between BMI and coronary atherosclerosis. PAT volumes >300 cm
3
were the strongest independent risk factor for coronary atherosclerosis (odds ratio 4.1; CI 3.63 to 4.33) also significantly stronger compared to the Framingham score. We furthermore demonstrated that elevated PAT volumes are significantly associated with low adiponectin levels, low HDL levels, elevated TNF-α levels, and hsCRP.

Conclusion—

In the present study we demonstrated that elevated PAT volumes are associated with coronary atherosclerosis, hypoadiponectinemia, and inflammation and represent the strongest risk factor for the presence of atherosclerosis and may be important for risk stratification and monitoring.
New Insights Into Cancer-Associated Thrombosis
Authors: Sousou Tarek , Khorana Alok A.
Published: February 2009

Venous thromboembolism (VTE) is an increasingly frequent complication of anticancer therapy. The underlying mechanisms are not completely understood, but are related in part to oncogene activation and tissue factor (TF) expression. Several risk factors have been identified including site and stage of cancer, patient comorbidities, and specific therapeutic agents. Candidate biomarkers such as blood counts, TF, and P-selectin have recently been identified. A risk model predictive of chemotherapy-associated VTE has been validated. Thromboprophylaxis with low molecular weight heparin (LMWH), unfractionated heparin (UFH), or fondaparinux is recommended for hospitalized medical and surgical cancer patients. Long-term anticoagulation with LMWH is safe and effective in reducing recurrent VTE in cancer. The role of thromboprophylaxis in ambulatory cancer patients receiving chemotherapy is an area of active investigation.
Activation of NAD(P)H:Quinone Oxidoreductase 1 Prevents Arterial Restenosis by Suppressing Vascular Smooth Muscle Cell Proliferation
Authors: Kim Sun-Yee , Jeoung Nam Ho , Oh Chang Joo , Choi Young-Keun , Lee Hyo-Jeong , Kim Han-Jong , Kim Joon-Young , Hwang Jung Hwan , Tadi Surendar , Yim Yong-Hyeon , Lee Ki-Up , Park Keun-Gyu , Huh Seung , Min Ki-Nam , Jeong Kyeong-Hoon , Park Myoung Gyu , Kwak Tae Hwan , Kweon Gi Ryang , Inukai Kouichi , Shong Minho , Lee In-Kyu
Published: February 2009

Abnormal proliferation and migration of vascular smooth muscle cells (VSMCs) are important pathogenic mechanisms in atherosclerosis and restenosis after vascular injury. In this study, we investigated the effects of β-lapachone (βL) (3,4-Dihydro-2,2-dimethyl-2H-naphtho[1,2-b]pyran-5,6-dione), which is a potent antitumor agent that stimulates NAD(P)H:quinone oxidoreductase (NQO)1 activity, on neointimal formation in animals given vascular injury and on the proliferation of VSMCs cultured in vitro. βL significantly reduced the neointimal formation induced by balloon injury. βL also dose-dependently inhibited the FCS- or platelet-derived growth factor-induced proliferation of VSMCs by inhibiting G
1
/S phase transition. βL increased the phosphorylation of AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase 1 in rat and human VSMCs. Chemical inhibitors of AMPK or dominant-negative AMPK blocked the βL-induced suppression of cell proliferation and the G
1
cell cycle arrest, in vitro and in vivo. The activation of AMPK in VSMCs by βL is mediated by LKB1 in the presence of NQO1. Taken together, these results show that βL inhibits VSMCs proliferation via the NQO1 and LKB1-dependent activation of AMPK. These observations provide the molecular basis that pharmacological stimulation of NQO1 activity is a new therapy for the treatment of vascular restenosis and/or atherosclerosis which are caused by proliferation of VSMCs.
Ceruloplasmin/Transferrin System Is Related to Clinical Status in Acute Stroke
Authors: Altamura Claudia , Squitti Rosanna , Pasqualetti Patrizio , Gaudino Chiara , Palazzo Paola , Tibuzzi Francesco , Lupoi Domenico , Cortesi Maurizio , Rossini Paolo Maria , Vernieri Fabrizio
Published: February 2009

Background and Purpose—

In acute stroke, Iron (Fe) may amplify reperfusion injury by catalyzing the conversion of superoxide and hydrogen peroxide into highly reactive radicals. Transferrin (Tf) is the main protein regulating Fe homeostasis, whereas Ceruplasmin (CP) is a circulating ferroxidase enzyme able to oxidize ferrous ions to less toxic ferric forms. This study aims at investigating whether CP, Copper (Cu), Tf, and Fe play a role in the pathophysiology of acute stroke.

Methods—

We enrolled 35 acute stroke patients and 44 controls. All patients underwent: neurological examination assessed by National Institutes of Health Stroke Scale (NIHSS), ultrasound evaluation of carotid atherosclerosis, brain MRI to quantify ischemic lesion volume and measurement of serum levels of CP, Cu, Tf, Fe, hydro-peroxides, and Total plasmatic antioxidant capacity.

Results—

In patients, NIHSS scores were associated with Tf (
r
=−0.48,
P
=0.004), hydro-peroxides (
r
=0.34,
P
=0.046), CP (
r
=0.43,
P
=0.012), and lesion volume (
r
=0.50,
P
=0.004). Lesion volume was inversely associated with Tf (
r
=−0.44,
P
=0.012). CP and hydro-peroxides were also largely related (
r
=0.81,
P
<0.001). The model multiple R was 0.57, resulting in a 32.5% of explained NIHSS variance with Tf accounting for 23.4% and CP for 9.1%.

Conclusions—

CP and Tf levels are representative of clinical status in acute stroke patients. Our findings suggest a protective role of Tf in acute stroke and a possible ambivalent role of CP.
Incidental Intracranial Aneurysms in Patients With Internal Carotid Artery Stenosis
Authors: Héman Laura M. , Jongen Lisa M. , van der Worp H. Bart , Rinkel Gabriel J.E. , Hendrikse Jeroen
Published: February 2009

Background and Purpose—

Smoking and hypertension are important risk factors for atherosclerotic carotid artery disease, but also for intracranial aneurysms. We studied the presence of aneurysms in a series of patients with internal carotid artery (ICA) stenosis and performed a systematic review of the literature to assess in patients with ICA stenosis the prevalence of intracranial aneurysms, gender differences in prevalence, and the size of the aneurysms found.

Methods—

In a prospectively collected series of patients with symptomatic ICA stenosis >50% on CTA we assessed the proportion with intracranial aneurysms. We performed “Embase” and “Pubmed” searches for studies on patients with ICA stenosis (domain) and intracranial aneurysms (outcome measurement). We calculated overall prevalence and relative risks for gender, both with corresponding 95% confidence intervals (CI).

Results—

We found an intracranial aneurysm in 8 of our 194 patients (4.1%; [95% CI 1.3 to 6.9]). The literature search resulted in 5 relevant and valid articles, totaling 4251 patients. The overall prevalence in all series combined was 3.2% (95% CI 2.7 to 3.7); the prevalence of aneurysms larger than 5 mm was 0.9% (95% CI 0.6 to 1.1). Women had a higher risk then men (relative risk 1.6; [59% CI 1.1 to 2.3]).

Conclusion—

About 1% of patients with a symptomatic ICA stenosis have an intracranial aneurysm with a higher than negligible risk of rupture, but in deciding aneurysms treatment the risk of cardiovascular diseases other than aneurismal rupture should be taken into account. The proportion of patients with aneurysms seems higher in series of patients with ICA stenosis than in the general population.
Risk Factors for Aneurysmal Subarachnoid Hemorrhage in a Prospective Population Study
Authors: Sandvei Marie Søfteland , Romundstad Pål Richard , Müller Tomm Brostrup , Vatten Lars , Vik Anne
Published: February 2009

Background and Purpose—

The morbidity and mortality of subarachnoid hemorrhage (SAH) are high, and established risk factors are scarce. We prospectively assessed the association of blood pressure, smoking, and body mass with the risk of aneurysmal SAH.

Methods—

All residents ≥20 years were invited to the Nord-Trøndelag Health (HUNT) Study (1984 to 1986) and 74 977 (88.1%) attended. The study included standardized measurements of blood pressure, body weight and height, and self-administered questionnaires. Participants who later had aneurysmal SAH (n=132) were identified, and hazard ratios (HRs), adjusted for age and sex, were estimated using Cox regression analysis.

Results—

The crude annual incidence of aneurysmal SAH was 9.9 per 100 000 people; the incidence was almost twice as high in women as in men (12.9 versus 6.8,
P
=0.001). Systolic blood pressure was positively associated with risk (
P
for trend=0.001). Compared with the reference (<130 mm Hg), the adjusted HR in people with systolic blood pressure of 130 to 139 mm Hg was 2.3 (95% CI, 1.4 to 3.8) and for systolic blood pressure >170 mm Hg, the HR was 3.3 (95% CI, 1.7 to 6.3). Diastolic pressure showed similar positive associations. Compared with never smokers, former (HR, 2.7; 95% CI, 1.4 to 5.1) and current (HR, 6.1; 95% CI, 3.6 to 10.4) smokers had substantially higher risk. Compared with normal weight (body mass index, 18.5 to 24.9 kg/m
2
), overweight people were at lower risk (HR, 0.6; 95% CI, 0.4 to 1.0).

Conclusions—

Systolic and diastolic blood pressure were strong predictors of aneurysmal SAH, and there was a substantially increased risk associated with smoking. However, high body mass was associated with reduced risk of aneurysmal SAH.
Sex Differences in the Use of Intravenous rt-PA Thrombolysis Treatment for Acute Ischemic Stroke
Authors: Reeves Mathew , Bhatt Archit , Jajou Peter , Brown Michael , Lisabeth Lynda
Published: February 2009

Background and Purpose—

Some studies report that women are less likely to receive IV rt-PA treatment for stroke than men. We undertook a meta-analysis to determine whether a sex disparity existed.

Methods—

We identified studies that reported sex-specific IV rt-PA treatment rates for acute stroke. Eligible studies included acute stroke admissions from single or multiple hospitals, registries, or administrative databases. Random effects odds ratios (OR) and 95% confidence intervals (CI) were generated to quantify sex differences (females versus males) among all ischemic stroke admissions and among the eligible subgroup who arrived within 3 hours without contraindications. Study design and geographic location were explored as sources of heterogeneity.

Results—

Eighteen studies were included. Study designs included single hospitals (n=5), multiple hospitals (n=6), registries (n=4), and administrative databases (n=3). The summary OR was 0.70 (95% CI=0.55 to 0.88) indicating that women had a 30% lower odds of receiving rt-PA treatment than men. However, substantial between-study variability existed. Among 13 hospital-based studies, the summary OR was 0.78 (95% CI=0.71 to 0.86) with no significant heterogeneity. Among the 3 administrative studies, the OR was 0.55 (95% CI=0.34 to 0.90) but with significant heterogeneity. Among 4 studies that included data on the eligible subgroup, women had a nonsignificant lower odds of treatment (OR=0.81, 95% CI=0.58 to 1.13).

Conclusions—

Despite the presence of significant between-study variation, women with acute stroke were consistently less likely to receive thrombolysis treatment compared with men. Further studies to explore the origins of this sex disparity are warranted.
Acute Stroke Symptoms
Authors: Lisabeth Lynda D. , Brown Devin L. , Hughes Rebecca , Majersik Jennifer J. , Morgenstern Lewis B.
Published: February 2009

Background and Purpose—

In a recent meta-analysis, women with stroke had 30% lower odds of receiving tissue plasminogen activator than did men, and some studies have reported greater in-hospital delays in women with stroke. Causes of these disparities are unclear but could result from a different symptom presentation in women. Our objective was to prospectively investigate gender differences in acute stroke symptoms.

Methods—

Ischemic stroke/TIA cases presenting to the University of Michigan Hospital (January 2005 to December 2007) were identified. Stroke/TIA symptoms, ascertained by patient interview, were classified as traditional or nontraditional (pain, mental status change, lightheadedness, headache, other neurological, nonneurological). Prevalence of any nontraditional symptom and of each symptom were calculated by gender. Logistic regression was used to compare nontraditional symptoms by gender adjusted for stroke vs TIA, proxy use, age, and discharge disposition (home vs other).

Results—

Included were 461 cases (48.6% women; median age, 67). Among women, 51.8% reported ≥1 nontraditional stroke/TIA symptom compared to 43.9% of men (
P
=0.09). The most prevalent nontraditional symptom was mental status change (women, 23.2%; men, 15.2%;
P
=0.03). The odds of reporting at least 1 nontraditional stroke/TIA symptom were 1.42 times (95% CI, 0.97–2.06) greater in women than in men.

Conclusion—

A high prevalence of nontraditional symptoms among both genders was found, with women more likely to report nontraditional symptoms and, in particular, altered mental status, compared with men. Larger-scale studies focusing on stroke in women are warranted and could confirm gender differences in symptoms in a larger, more representative stroke population and address the clinical consequences.
Rural Society and Social Networks in Nineteenth-Century Westphalia: The Role of Godparenting in Social Mobility
Authors: Fertig Christine
Published: February 2009

In nineteenth-century Westphalia (northwestern Germany), the practice of impartible inheritance excluded the siblings of farm successors from access to their parents' land. Without a land market, the only way for children who did not inherit a farm to obtain landed property, as well as high social and economic status, was to marry the heir to someone else's farm. Social-network and regression analyses show that the attainment of status depended not only on the socioeconomic standing of young people's families of origin but also on their parents' social networks. The parents who were most successful at placing their children in desirable social stations were those who occupied central positions in the godparenting network.
Vanishing Landscapes: The Atlantic Salt Marsh
Authors: Ingoldsby Joseph Emmanuel
Published: February 2009

The author, trained in art and landscape architecture, utilizes observation of nature and culture as a central focus in his art. The work involves research, scientific collaboration and examination, documentation, analysis and synthesis using art, science and technology for environmental advocacy. The focus for these works has been on the coastal landscape of New England, the imprint of humans on land and sea, and the impact of climate change on the marine landscape and fisheries of New England.
Art Thief: An Educational Computer Game Model for Art Historical Instruction
Authors: Kinkley Jonathan
Published: February 2009

Cognitive research has revealed learning techniques more effective than those utilized by the traditional art history lecture survey course. Informed by these insights, the author and fellow graduate researchers at the University of Illinois at Chicago designed a “serious” computer game demo, Art Thief, as a potential model for a learning tool that incorporates content from art history. The game design implements constructed learning, simulated cooperation and problem solving in a first-person, immersive, goal-oriented mystery set within a virtual art museum.
Catching the Light: “Doing Art” and Education
Authors: Grallert Margot
Published: February 2009

Drawing upon the author's experience as a painter and visual art consultant in a public elementary school, this paper describes how “doing art” applies to the artistic thought process. The artwork of Joseph Beuys provides an historical perspective. The author shows how Beuys' use of three-dimensional form parallels her own work with color; like Beuys, she identifies an educational value behind “doing art.” She also reviews cognitive-science literature in light of her experience. She hopes that this paper will encourage scientists to design research projects to explore the artistic thought process and ultimately demonstrate the relevance of how we learn to what we learn.
The Martian Rose
Authors: Boland Howard , Cinti Laura
Published: February 2009

This artwork explores extreme environments and life beyond terrestrial settings. Using a planetary simulation chamber, a rose was exposed to Martian environment for six hours at the Mars Simulation Laboratory, University of Aarhus, Denmark.
Interactive Art: The Art That Communicates
Authors: Wong Chee-Onn , Jung Keechul , Yoon Joonsung
Published: February 2009

This paper highlights the intrinsic communication in interactive art. The authors propose knowledge discovery or data mining as a technique to measure the communication between the spectator and the intelligent interactive artwork. Due to the nature of interactive art, this aspect of technology is an essential part to integrate the artist's representation with the spectator. An example of interactive SwarmArt using knowledge discovery for personalized interactive experience is explained in this paper.
On the Origin of the Ink of the Thanksgiving Scroll (1QHodayota)
Authors: Hahn Oliver , Weinberg Gisela , Rabin Ira , Wolff Timo , Masic Admir
Published: February 2009

In this study we demonstrate the possibility to identify the production area of the scrolls, coupling non-destructive quantitative analysis of trace elements to spectroscopic investigation of the inks. This approach, that allowed us to determine the Dead Sea area as origin of 1QHodayota, is of general validity.
A Qumran Composition of Sabbath Laws and Its Contribution to the Study of Early Halakah
Authors: Noam Vered , Qimron Elisha
Published: February 2009

This article presents a composite edition, with new reconstructions, notes, and translation, of a composition we title "Sabbath Laws" (4Q264a and 4Q421). Three of these Sabbath laws are treated at length in comparison to rabbinic halakah: carrying and playing musical instruments, reading a scroll, and leaving coals burning. Mutually beneficial, this comparison contributes to our understanding, and reconstruction, of the history of halakah.
On Pliny, the Essene Location and Kh. Qumran
Authors: Taylor Joan
Published: February 2009

Pliny wrote that the Essenes lived west of Lake Asphaltites, and that infra hos was En Gedi. Some scholars associate Pliny's reference with Qumran, others with a location above En Gedi. Given that Pliny writes about Judaea by following the course of the land's remarkable water, it would be most natural to read infra hos as "downstream from them." The Dead Sea itself has a current, and there was a belief that the lake had a subterranean exit in the south. From a survey of scholarship produced prior to the discovery of the Dead Sea Scrolls, it appears that Pliny's reference was usually believed to indicate a wide region of the Judaean wilderness, understood to stretch from En Gedi northwards and/or inland. When En Gedi was identified in the mid-19th century, the suggestion that Essenes occupied caves just north of and above the ancient settlement was made, but this was not seen as exclusive. If we again read Pliny appropriately, as referring to a region which the gens of the Essenes held, we can move away from either-or dichotomies of possible Essene sites.
The Treatment of Unregistered Commercial Joint Ventures in Jordanian Law
Authors: Bashayreh Mohammad Hussein
Published: February 2009

Joint ventures are common in Jordan, especially in the construction sector. Local firms and foreign entrepreneurs use them for different legal and competition considerations. However, joint ventures are not regulated as such, hence their disputable legal characterisation. Jordanian courts treat commercial joint ventures as valid companies with juridical personalities regardless of incorporation formalities. Courts apparently take this as a rule of law. Relevant cases reveal inconsistency and are not wholly consonant with the law. While judicial creativity may be classifying joint ventures as companies sui generis, this article seeks to establish that this is incorrect. The nature of a joint venture should rest on the underlying agreement, which may envisage a general partnership, a silent company, or another scheme. Existing legislations are satisfactory as this article explains. Accordingly, the judicial approach should be abandoned to avoid current uncertainties and to attain predictability of consistent legal solutions.
Collective Redress in Austria
Authors: Kodek Georg E.
Published: February 2009

The Austrian Code of Civil Procedure does not contain special rules for collective redress, so traditional tools of multiparty practice such as joinder, consolidation, or, in certain cases, assignment or the appointment of a curator, had to be adapted for mass cases. In response to an increase in mass litigation, a draft of a group procedure was prepared by the Austrian Ministry of Justice in 2007, which provided for a new group proceeding for cases involving three or more claimants and a large number (probably more than fifty) claims and similar questions of law and fact. Any questions not resolved in the group proceeding have to be determined in individual lawsuits.
England and Wales
Authors: Hodges Christopher
Published: February 2009

England and Wales have rules on managing multiple similar claims (the Group Litigation Order) and particular representative procedures for consumer protection cases and for competition cases. The competition procedure permits representative damages claims and reforms may introduce damages more widely. But the most interesting feature is the development of oversight of collective compensation by public regulatory authorities and alternative dispute resolution or voluntary mechanisms.
China
Authors: Palmer Michael , Chao Xi
Published: February 2009

China has three important types of opt-in representative procedures, depending on whether the number of claimants is fixed or not. In addition, a special procedure covers securities fraud claims. Mediation is emphasized in all types.
Antimicrobial Prescription Errors in Hospitalized Children: Role of Antimicrobial Stewardship Program in Detection and Intervention
Authors: Di Pentima M. Cecilia , Chan Shannon , Eppes Stephen C. , Klein Joel D.
Published: February 2009

Background. Antimicrobial stewardship programs (ASP) are an effective strategy to ensure that antibiotics are used in accordance with scientific evidence to improve patient outcome, minimize antimicrobial (AM) resistance, and reduce hospital costs. The article describes the impact of the implementation of an ASP on AM prescription errors. Methods. Prospective, single-center study performed at a tertiary pediatric teaching hospital that actively monitored 13 targeted AMs (amikacin, amphotericin B, cefepime, ceftriaxone, ciprofloxacin, fluconazole, levofloxacin, linezolid, meropenem, piperacillin-tazobactam, tobramycin, vancomycin, and voriconazole) and microbiology data. The ASP was implemented using CareNet and PharmNet. An infectious disease physician and pharmacist determined the need for intervention. Results. The authors screened 5564 dispensed prescriptions of the 13 targeted AMs. The rate of AM errors associated with these was 0.09/1000 doses administered and 5 errors/1000 patient days. Conclusions. Active surveillance and optimization of computerized physician order entry system allows early detection and intervention of AMs prescriptions errors in hospitalized children.
Process Consultation Revisited
Authors: Lambrechts Frank , Grieten Styn , Bouwen René , Corthouts Felix
Published: February 2009

Process consultation as conceived and reformulated several times by Edgar Schein constitutes a seminal contribution to the process of organization development in general and to the definition of the helping role of the consultant in particular. Under the pressure of a pragmatic turn in organizational change work, the practice of process consultation was fading away during the eighties and nineties. In some particular training and organizational consulting contexts nevertheless, the foundational principles and practices of process consultation are experienced to be more relevant than ever before. A relational constructionist theoretical lens, an emphasis on joint consultant—client practices, and a proper contextual embedding constitute a relational practice perspective that embodies in a new form and language those foundational ideas.
A Two-Dimensional Model of Teacher Retention and Mobility
Authors: Swars Susan L. , Meyers Barbara , Mays Lydia C. , Lack Brian
Published: February 2009

This mixed-methods study is a teacher-initiated, collaborative inquiry involving a professional development school (PDS) and a university. The investigation focused on teachers' perceptions of teacher retention and mobility at their PDS. Participants were 134 teachers at a high-needs elementary school with data sources including surveys, interviews, and open-ended questionnaires. The findings clustered around two primary dimensions: (a) congruency of teachers' beliefs and practices with organizational norms and (b) teachers' relational needs and administrators' willingness and ability to meet such needs. Although this study affirmed many of the findings in the extant literature, it also challenged others—namely, the links between teacher turnover and workplace conditions, student body characteristics, and student achievement. The recursive research design enabled the researchers to make accommodations in methodology in response to teachers' and administrators' concerns. The researchers documented these modifications and make recommendations for conducting inquiry in a PDS.
Novice Teachers' Attention to Student Thinking
Authors: Levin Daniel M. , Hammer David , Coffey Janet E.
Published: February 2009

Stage-based views of teacher development hold that novice teachers are unable to attend to students' thinking until they have begun to identify themselves as teachers and mastered classroom routines, and so the first emphases in learning to teach should be on forming routines and identity. The authors challenge those views, as others have done, with evidence of novices attending to students' thinking early in their teaching and offer framing as an alternative perspective on whether and how teachers attend to student thinking. By this account, most teachers work in professional contexts that focus their attention on curriculum, classroom routines, and their own behavior, rather than on student thinking. An account of framing suggests an early, strong emphasis on attention to student thinking in teacher education.
For a Sociology of India: Satish Saberwal in conversation with Nandini Sundar and Amita Baviskar
Authors: Sundar Nandini , Baviskar Amita
Published: February 2009

As part of an ongoing engagement with the sociology of India, CIS will profile the life and work of senior sociologists. This interview was conducted over three sessions at Professor Saberwal's home, on 6, 11 and 26 August 2008. We also requested Mrs. Edith Saberwal to contribute to the discussion regarding their personal life. The interviews were laced throughout with Professor Saberwal's characteristic humour—which unfortunately, we cannot fully reproduce here. We thank Professor Saberwal for answering all our questions patiently. We are very grateful to him and his daughter Gayatri Saberwal for carefully correcting the transcript.
An Evaluation of the Neuroendocrine Response to Sleep in Pediatric Burn Patients
Authors: Gottschlich Michele M. , Khoury Jane , Warden Glenn D. , Kagan Richard J.
Published: February 2009

Introduction:Previous work demonstrated reduced stage 3+4 and rapid eye movement (REM) sleep following burn injury. This study evaluated the hormonal effects of drug intervention on measures of endocrine status. A secondary objective examined the relationship between hormones and sleep stage distribution.Methods:Forty patients 3–18 years of age with a mean percent total body surface area burn of 50.1 ± 2.9 were randomly assigned to zolpidem or haloperidol utilizing a blinded crossover design. Polysomnography was performed 6 nights, 3/week over 2 weeks. Each week's first night of monitoring was conducted without medication, serving as a baseline. Hormonal levels (epinephrine, norepinephrine, growth hormone, melatonin, dehydroepiandrosterone [DHEA], serotonin, cortisol) were obtained at 0600 h each study day.Results:Both drugs were associated with increased DHEA levels (P< .03); no other hormones were affected by medication. Significant inverse correlation was observed between REM sleep and epinephrine (r= –.34,P= .004) and norepinephrine levels (r= –.45,P= .02). A positive relationship existed between serotonin and sleep stage 3+4 (r= 0.24,P= .01) and REM (r= 0.48,P= .01). No other significant associations were identified between hormones and sleep.Conclusions:This work characterizes the relationship between sleep deprivation and select endocrine parameters postburn. Drug interventions utilized in this study were either ineffective or insufficient in modulating improved hormonal response. Significance of zolpidem's and haloperidol's effect on serum levels of DHEA is unclear. The inverse correlation of epinephrine with REM may suggest that hypermetabolism associated with burns is partly due to lack of REM sleep. Questions remain regarding the effects of sleep deprivation on metabolism and clinical outcome.
Men Do Matter
Authors: Richardson Joseph B.
Published: February 2009

This article examines the role of the African American uncle as a vital yet overlooked form of social support and social capital in the lives of adolescent African American male sons living in single-female-headed households. Research rarely examines the affective roles and functions of men in Black families; moreover, poor urban Black male youth are typically portrayed as a monolithic and homogeneous group who lack positive relationships with their biological fathers. The absence of these relationships has been correlated to numerous social problems for Black male youth—specifically, delinquency and violent behavior. Although much of the work on African American fatherhood has focused on the role of the biological father (and, to some extent, the stepfather), minimal attention has been given to men within extended familial networks and their impact on successful adolescent development among young African American males.