bluuebunny/crossref_metadata_2025 huggingface dataset:
Kidney Dysfunction and Deterioration of Ejection Fraction Pose Independent Risk Factors for Mortality in Implantable Cardioverter‐Defibrillator Recipients for Primary Prevention
Authors: Kreuz Jens , Horlbeck Fritz , Schrickel Jan , Linhart Markus , Fimmers Rolf , Mellert Fritz , Nickenig Georg , Schwab Jörg Otto
Published: June 2012

Background:

A growing number of patients with advanced heart failure fulfill a primary‐prevention indication for an implantable cardioverter‐defibrillator (ICD). This study seeks to identify new predictors of overall mortality in a Sudden Cardiac Death in Heart Failure Trial (SCD‐HeFT)‐like collective to enhance risk stratification.

Hypothesis:

An impaired renal function and severely depressed left ventricular ejection fraction pose relevant risk factors for mortality in primary prevention ICD recipients.

Methods:

Ninety‐four consecutive ICD patients with New York Heart Association class II–III heart failure and depressed left ventricular function (left ventricular ejection fraction [LVEF] ≤35%) with no history of malignant ventricular arrhythmias were followed for 34 ± 20 months.

Results:

During this period, 30 patients died (32%). Deceased patients revealed a significantly worse renal function before ICD implantation (1.55 ± 0.7 mg/dL vs 1.1 ± 0.4 mg/dL; P = 0.007), suffered more often from coronary artery disease (53 vs 29; P = 0.006), and were older (69.5 ± 8 y vs 67 ± 12 y; P = 0.0002) than surviving patients. Furthermore, increased serum creatinine at baseline (2 mg/dL vs 1 mg/dL; odds ratio [OR]: 3.96, 95% confidence interval [CI]: 1.2–13.04, P = 0.02), presence of coronary artery disease (OR: 8.6, 95% CI: 1.1–65, P = 0.036), and low LVEF (OR per 5% baseline LVEF deterioration: 1.4, 95% CI: 1–1.8, P = 0.034) represented strong and independent predictors for overall mortality.

Conclusions:

Impaired renal function, the presence of coronary artery disease, and reduced LVEF before implantation represent independent predictors for mortality in a cohort of patients with advanced systolic heart failure. These conditions still bear a high mortality risk, even if ICD implantation effectively prevents sudden arrhythmic death. Indeed, in patients suffering from several of the identified “high‐risk” comorbidities, primary‐prevention ICD implantation might have a limited survival benefit. The possible adverse effects of these comorbidities should be openly discussed with the potential ICD recipient and his or her close relatives. Clin. Cardiol. 2012 doi: 10.1002/clc.22018

The authors have no funding, financial relationships, or conflicts of interest to disclose.
Favorable Effects of Vasodilators on Left Ventricular Remodeling in Asymptomatic Patients With Chronic Moderate‐Severe Aortic Regurgitation and Normal Ejection Fraction: A Meta‐Analysis of Clinical Trials
Authors: Shah Rachit M. , Singh Mukesh , Bhuriya Rohit , Molnar Janos , Arora Rohit R. , Khosla Sandeep
Published: June 2012

Background:

The role of vasodilator therapy in asymptomatic patients with chronic moderate to severe aortic regurgitation (AR) and normal left ventricular (LV) function is uncertain. We assessed the effects of vasodilator therapy (hydralazine, calcium channel blockers, and angiotensin‐converting enzyme inhibitors) in this subgroup of patient population.

Hypothesis:

Vasodilators have favorable effects on LV remodelling in asymptomatic patients with chronic moderate to severe aortic regurgitation and normal LV function.

Methods:

We performed a systematic literature search for randomized clinical trials using long‐term vasodilator therapy in asymptomatic patients with chronic severe AR and normal LV function. The magnitude of difference between the vasodilator and nonvasodilator groups was assessed by computing the mean difference (MD). Heterogeneity of the studies was analyzed by Cochran Q statistics. The MD for LV ejection fraction, LV end systolic volume index, and LV end diastolic volume index were computed by random effects model. The MD for LV end‐systolic diameter and LV end‐diastolic diameter were computed by fixed effects model. A 2‐sided alpha error <0.05 was considered to be statistically significant.

Results:

Seven studies with 460 patients were included. Meta‐analysis of the studies revealed a significant increase in LVEF (MD: 5.32, 95% confidence interval [CI]: 0.37 to 10.26, P = 0.035), a significant decrease in LV end diastolic volume index (MD: −16.282, 95% CI: −23.684 to −8.881, P < 0.001), and a significant decrease in LV end diastolic diameter (MD: −2.343, 95% CI: −3.397 to −1.288, P < 0.001) in the vasodilator group compared with the nonvasodilator group. However, there was no significant decrease in LV end systolic volume index (MD: −6.105, 95% CI: −12.478 to 0.267, P = 0.060) or in LV end systolic diameter (MD: 0.00, 95% CI: −0.986 to 0.986, P = 1.0) in the vasodilator group compared with the nonvasodilator group.

Conclusions:

In asymptomatic patients with chronic severe AR and normal LV function, vasodilators have favorable effects on LV remodeling. Clin. Cardiol. 2012 doi: 10.1002/clc.22019

The authors have no funding, financial relationships, or conflicts of interest to disclose.
Impact of Acute Coronary Syndrome Classification and Procedural Technique on Clinical Outcomes in Patients With Coronary Bifurcation Lesions Treated With Drug‐Eluting Stents
Authors: Sang Song Pil , Ryeol Ryu Dong , Choi Seung‐Hyuk , Yang Jeong Hoon , Song Young Bin , Hahn Joo‐Yong , Choi Jin‐Ho , Seung Ki Bae , Park Seung‐Jung , Gwon Hyeon‐Cheol
Published: June 2012

Background:

We examined the impact of non–ST‐segment elevation acute coronary syndrome (NSTE‐ACS) on clinical outcomes in patients with bifurcation lesions treated with drug‐eluting stents.

Hypothesis:

We hypothesized that NSTE‐ACS would be attributable to the increased risk of major adverse cardiac events (MACE) in bifurcation percutaneous coronary intervention.

Methods:

We enrolled 1668 patients, using data from a multicenter real‐world bifurcation registry. The primary objective was to compare the 2‐year cumulative risk of MACE in patients with NSTE‐ACS to those with stable angina. Major adverse cardiac events were defined as the composite endpoint of cardiac death, myocardial infarction (MI), and target‐lesion revascularization.

Results:

Non–ST‐segment elevation acute coronary syndrome was seen in 969 (58.1%) patients and stable angina in 699. Major adverse cardiac events occurred in 7.3% of NSTE‐ACS patients and in 5.2% with stable angina (P = 0.042). However, cardiac death, MI, and target‐lesion revascularization were similar between the 2 groups. We stratified patients with NSTE‐ACS into those with non–ST‐segment elevation MI and those with unstable angina. Cumulative risks of 2‐year MACEs were 7.0% in non–ST‐segment elevation MI patients and 7.5% in unstable angina patients (P = 0.87). In the NSTE‐ACS cohort, the baseline lesion length in the side branch (adjusted hazard ratio [HR]: 1.04, 95% confidence interval [CI]: 1.01‐1.07, P = 0.022), paclitaxel‐eluting stents in the main vessel (adjusted HR: 2.02, 95% CI: 1.21‐3.40, P = 0.008), and final kissing ballooning (adjusted HR: 1.88, 95% CI: 1.10‐3.21, P = 0.021) were independent predictors of MACE.

Conclusions:

Compared with stable angina patients, the NSTE‐ACS patients who underwent bifurcation percutaneous coronary intervention had an increased risk of MACE during the 2‐year follow‐up. Clin. Cardiol. 2012 doi: 10.1002/clc.22020

Drs Pil Sang Song and Dong Ryeol Ryu contributed equally to this work. Coronary Bifurcation Stenting (COBIS) Registry in South Korea, US Department of Health and Human Services, US National Institutes of Health, ClinicalTrials.gov no. NCT00851526.

This work was supported by the Korean Society of Interventional Cardiology, Seoul, South Korea. The authors have no other funding, financial relationships, or conflicts of interest to disclose.
Identification of High‐Risk Chronic Heart Failure Patients in Clinical Practice: Role of Changes in Left Ventricular Function
Authors: Cicoira Mariantonietta , Rossi Andrea , Chiampan Andrea , Frigo Giulia , Bergamini Corinna , Rigolli Marzia , Zanolla Luisa , Vassanelli Corrado
Published: June 2012

Background:

Left ventricular (LV) dysfunction and remodeling are key pathophysiological features underlying disease progression in chronic heart failure (CHF).

Hypothesis:

To describe the course of LV dysfunction and identify predictors and prognostic impact of changes in LV volumes and function in stable CHF patients under optimal therapy.

Methods:

There were 318 consecutive CHF outpatients who underwent a repeated echocardiographic evaluation at baseline and at 1 year and subsequently followed‐up for at least 12 months. The end point of the study was all‐cause mortality.

Results:

Mean LV ejection fraction (LVEF) was 33 ± 7% at baseline and 36 ± 9% at follow‐up. Twenty‐four percent of patients had an improvement of LVEF >5 absolute points (group 1); 58% remained stable (group 2), 17% worsened at >5 absolute points (group 3). Age, New York Heart Association class, diuretic dose, renal function, and baseline LVEF were independent predictors of LVEF improvement at 1 year. At the Cox analysis, patients in group 3 had a 4‐fold higher risk of death when compared with group 1 (hazard ratio: 3.99, 95% confidence interval: 1.6‐9.9, P = 0.002), independently of age, etiology, and symptoms severity.

Conclusions:

In stable CHF outpatients, LV function improves in 24% of cases; a modest decrease in LV systolic function is associated with a significantly higher risk of all‐cause mortality, independent of other markers of disease severity. Clin. Cardiol. 2012 doi: 10.1002/clc.22024

The authors have no funding, financial relationships, or conflicts of interest to disclose.
Leukoencephalopathy after whole‐brain radiation therapy plus radiosurgery versus radiosurgery alone for metastatic lung cancer
Authors: Monaco Edward A. , Faraji Amir H. , Berkowitz Oren , Parry Phillip V. , Hadelsberg Uri , Kano Hideyuki , Niranjan Ajay , Kondziolka Douglas , Lunsford L. Dade
Published: June 2012

BACKGROUND:

As systemic therapies improve and patients live longer, concerns mount about the toxicity of whole‐brain radiation therapy (WBRT) for treatment of brain metastases. Development of delayed white matter abnormalities indicative of leukoencephalopathy have been correlated with cognitive dysfunction. This study assesses the risk of imaging‐defined leukoencephalopathy in patients whose management included WBRT in addition to stereotactic radiosurgery (SRS). This risk is compared to patients who only underwent SRS.

METHODS:

We retrospectively compared 37 patients with non–small cell lung cancer who underwent WBRT plus SRS to 31 patients who underwent only SRS. All patients survived at least 1 year after treatment. We graded the development of delayed white matter changes on magnetic resonance imaging using a scale to evaluate T2/FLAIR (fluid attenuated image recovery) images: grade 1 = little or no white matter hyperintensity; grade 2 = limited periventricular hyperintensity; and grade 3 = diffuse white matter hyperintensity.

RESULTS:

Patients treated with WBRT and SRS had a significantly greater incidence of delayed white matter leukoencephalopathy compared to patients who underwent SRS alone (P < .001). On final imaging, 36 of 37 patients (97.3%) treated by WBRT developed leukoencephalopathy (25% with grade 2; 70.8% with grade 3). Only 1 patient treated with SRS alone developed leukoencephalopathy.

CONCLUSIONS:

Risk of leukoencephalopathy in patients treated with SRS alone for brain metastases was significantly lower than that for patients treated with WBRT plus SRS. A prospective study is necessary to correlate these findings with neurocognition and quality of life. These data supplement existing reports regarding the differential effects of WBRT and SRS on normal brain structure and function. Cancer 2013. © 2012 American Cancer Society.
Widening socioeconomic disparities in cervical cancer mortality among women in 26 states, 1993‐2007
Authors: Simard Edgar P. , Fedewa Stacey , Ma Jiemen , Siegel Rebecca , Jemal Ahmedin
Published: June 2012

BACKGROUND:

Despite substantial declines in cervical cancer mortality because of widespread screening, socioeconomic status (SES) disparities persist. The authors examined trends in cervical cancer mortality rates and the risk of late‐stage diagnoses by SES.

METHODS:

Using data from the National Vital Statistics System, trends in age‐standardized mortality rates among women ages 25 to 64 years (1993‐2007) by education level (≤12 years, 13‐15 years, and ≥16 years) and race/ethnicity for non‐Hispanic white (NHW) women and non‐Hispanic black (NHB) women in 26 states were assessed using log‐linear regression. Rate ratios (RRs) and 95% confidence intervals (CIs) were used to assess disparities between those with ≤12 years versus ≥16 years of education during 1993 to 1995 and 2005 to 2007. Avertable deaths were calculated by applying mortality rates from the most educated women to others in 48 states. Trends in the risk of late‐stage diagnosis by race/ethnicity and insurance status were evaluated in the National Cancer Data Base.

RESULTS:

Declines in mortality were steepest for those with the highest education levels (3.2% per year among NHW women and 6.8% per year among NHB women). Consequently, the education disparity widened between the periods 1993 to 1995 and 2005 to 2007 from 3.1 (95% CI, 2.4‐3.9) to 4.4 (95% CI, 3.5‐5.6) for NHW women and from 3.8 (95% CI, 2.0‐7.0) to 5.6 (95% CI, 3.1‐10.0) for NHB women. The risk of late‐stage diagnosis increased for uninsured versus privately insured women over time. During 2007, 74% of cervical cancer deaths in the United States may have been averted by eliminating SES disparities.

CONCLUSIONS:

SES disparities in cervical cancer mortality and the risk of late‐stage diagnosis increased over time. Most deaths in 2007 may have been averted by eliminating SES disparities. Cancer 2012. © 2012 American Cancer Society.
Acute promyelocytic leukemia: A population‐based study on incidence and survival in the United States, 1975‐2008
Authors: Chen Yiming , Kantarjian Hagop , Wang Haijun , Cortes Jorge , Ravandi Farhad
Published: June 2012

BACKGROUND:

With the introduction of all‐trans retinoic acid and arsenic trioxide, the management of acute promyelocytic leukemia (APL) has changed dramatically. We performed a population‐based study of APL in the United States to determine its incidence and relative survival (RS) during a 34‐year period.

METHODS:

We identified 1397 patients diagnosed with APL between 1975 and 2008 in the Surveillance, Epidemiology, and End Results database. Patients were categorized into 4 age groups and 3 calendar periods. As a comparison, we also reviewed the outcome of APL patients treated at our institution during approximately the same time interval.

RESULTS:

The incidences of APL increased with time period and patient age. Short‐ and long‐term RS improved with each calendar period, with the greatest improvement occurring between 1991 and 1999; 5‐year RS rates were 0.18 for patients diagnosed in 1975‐1990, 0.52 in 1991‐1999, and 0.64 in 2000‐2008. Age was an important predictor of survival. For example, the 5‐year RS rate in patients diagnosed in 2000‐2008 was 0.38 for patients aged ≥60 years and 0.73 and 0.75 for patients aged <20 years and 20‐39 years, respectively. Similar treads of improvements in the survival were observed in APL patients treated at our institution.

CONCLUSIONS:

The incidence of APL has increased, especially in the last decade. Clinical outcome improved remarkably in patients with APL diagnosed from 1991 to 1999, mainly because of the increased use of all‐trans retinoic acid. Cancer 2012;. © 2012 American Cancer Society.
Percutaneous endoscopic gastrostomy in oropharyngeal cancer patients treated with intensity‐modulated radiotherapy with concurrent chemotherapy
Authors: Romesser Paul B. , Romanyshyn Jonathan C. , Schupak Karen D. , Setton Jeremy , Riaz Nadeem , Wolden Suzanne L. , Gelblum Daphna Y. , Sherman Eric J. , Kraus Dennis , Lee Nancy Y.
Published: June 2012

BACKGROUND:

The clinical benefit of routine placement of prophylactic percutaneous endoscopic gastrostomy (pPEG) tubes was assessed in patients with oropharyngeal cancer (OPC) who are undergoing intensity‐modulated radiotherapy (IMRT) with concurrent chemotherapy.

METHODS:

From 1998 through 2009, 400 consecutive patients with OPC who underwent chemoradiation were included. Of these, 325 had a pPEG and 75 did not (nPEG). Weight and albumin change from baseline to mid‐IMRT, end of IMRT, 1 month post‐IMRT, and 3 months post‐IMRT were evaluated. The treating physicians prospectively recorded acute and late toxicities.

RESULTS:

Significantly lower absolute weight loss at end of IMRT (6.80 kg vs 8.38 kg, P = .007), 1 month post‐IMRT (9.06 kg vs 11.33 kg, P = .006), and 3 months post‐IMRT (11.10 kg vs 13.09 kg, P = .044) was noted in the pPEG versus nPEG groups. This benefit in reduction of percent weight loss was consistently significant only among patients with BMI < 25. Significant differences were noted in hospital admission rate (15.1% vs 26.7%, P = .026) and volume of nonchemotherapy hydration (8.9 liters vs 17.2 liters, P = .004). There were no differences in percent albumin change, acute dysphagia, acute mucositis, acute xerostomia, chronic dysphagia, radiation treatment duration, and overall survival. Multivariate analysis noted age >55 years (P < .001), female sex (P < .001), and T3/4 category disease (P < .001) were significantly associated with prolonged PEG use.

CONCLUSIONS:

Although pPEG reduced absolute and percent weight loss and need for hospitalizations in our cohort of patients with OPC undergoing chemoradiation, no differences were noted in radiation treatment duration, toxicity, and overall survival. Prolonged PEG use correlated with age >55 years, female sex, and T3/T4 tumors. Cancer 2012. © 2012 American Cancer Society.
Prevalence and characteristics of patients with metastatic cancer who receive no anticancer therapy
Authors: Small Alexander C. , Tsao Che‐Kai , Moshier Erin L. , Gartrell Benjamin A. , Wisnivesky Juan P. , Godbold James H. , Smith Cardinale B. , Sonpavde Guru , Oh William K. , Galsky Matthew D.
Published: June 2012

BACKGROUND:

A subset of patients who present with metastatic solid tumors never receive anticancer therapy. Reasons may include poor functional status, comorbidities, and patient preference. To the authors' knowledge, the prevalence and characteristics of this population have not previously been described.

METHODS:

The National Cancer Data Base was queried for patients diagnosed with metastatic (stage IV according to the American Joint Committee on Cancer) solid tumors (including those of the breast, cervix, colon, and kidney; small cell and nonsmall cell lung cancer [NSCLC]; and tumors of the prostate, rectum, and uterus) who received neither radiotherapy nor systemic therapy. Log‐binomial regression analysis was used to estimate prevalence ratios (PRs) for the percentage of untreated to treated patients with stage IV cancer.

RESULTS:

Between 2000 and 2008, 773,233 patients with stage IV cancer were identified, 159,284 of whom (20.6%; 95% confidence interval, 20.5%‐20.7%) received no anticancer therapy. Patients with NSCLC accounted for 55% of the untreated population. Patients with cancers of the kidney and lung had the highest rates of no treatment at 25.5% and 24.0%, respectively, whereas patients with prostate cancer had the lowest rate of no treatment at 11.1%. Across all cancer types, older age (PR range, 1.37‐1.49; all P < .001), black race (PR range, 1.05‐1.32; all P < .001), lack of medical insurance (PR range, 1.47‐2.46; all P < .001), and lower income (except for cancer of the uterus; PR range, 0.91‐0.98 for every $10,000‐increase in income [all P < .001]) were associated with a lack of treatment.

CONCLUSIONS:

Approximately 20% of patients who present with stage IV solid tumors do not receive anticancer therapy. Although there are likely multiple reasons for this lack of treatment, including appropriate indications, these findings have potential implications with regard to health care policy and access to care. Cancer 2012. © 2012 American Cancer Society.
Ten‐year survival after autologous stem cell transplantation for immunoglobulin light chain amyloidosis
Authors: Cordes Stefan , Dispenzieri Angela , Lacy Martha Q. , Hayman Suzanne R. , Buadi Francis K. , Dingli David , Kumar Shaji K. , Hogan William J. , Gertz Morie A.
Published: June 2012

BACKGROUND:

The current study was conducted to determine characteristics distinguishing the 10‐year survivor group in patients with systemic immunoglobulin light chain (AL) amyloidosis who underwent autologous stem cell transplantation (SCT).

METHODS:

The study group included all 74 patients with AL amyloidosis who underwent high‐dose melphalan treatment supported by autologous SCT since the beginning of the Mayo Clinic's SCT program until prior to August 2001.

RESULTS:

A total of 32 patients (43%) patients survived for > 10 years. Statistically significant baseline differences in the 10‐year survivor group included: 1) the number of organs involved; 2) septal thickness; 3) total cholesterol; and 4) urine total protein. The number of organs involved was the only predictor found on multivariable analysis. Depth of the response to therapy, as measured by the lowest posttransplantation serum free light chain level, was found to be the most significant indicator of durability of response.

CONCLUSIONS:

Autologous SCT can offer durable benefit for patients with AL amyloidosis. The number of organs involved offers the greatest pretreatment prognostic value, whereas the lowest posttransplantation serum free light chain level offers the best posttreatment prognostic value. Cancer 2012. © 2012 American Cancer Society.
Loss of efficacy and cost‐effectiveness when screening colonoscopy is performed by nongastroenterologists
Authors: Hassan Cesare , Rex Douglas K. , Zullo Angelo , Cooper Gregory S.
Published: June 2012

BACKGROUND:

Specialty of the endoscopist has been related to the postcolonoscopy interval risk of colorectal cancer (CRC). However, the impact of such a difference on the long‐term CRC prevention rate by screening colonoscopy is largely unknown.

METHODS:

A Markov model was constructed to simulate the efficacy and cost of colonoscopy screening according to the specialty of the endoscopist in 100,000 individuals aged 50 years until death. The postcolonoscopy interval CRC risk (0.02%) and the relative risk (1.4) of interval CRC between gastroenterologist (GI) endoscopists and non‐GI endoscopists were extracted from the literature. Both efficacy and costs were projected over a steady‐state US population. Eventual increase in endoscopic capacity when assuming all procedures to be performed by GI endoscopists was simulated.

RESULTS:

According to the simulation model, screening colonoscopy performed by non‐GI endoscopists resulted in a 11% relative reduction in the long‐term CRC incidence prevention rate compared with the same procedure performed by GI endoscopists. When projected on the US population, the reduced non‐GI efficacy resulted in an additional 3043 CRC cases and the loss of $200 million per year. When increasing the relative risk from 1.4 to 2.0, the difference in the prevention rate between GI endoscopists and non‐GI endoscopists increased to 19%. It increased further to 38% when also assuming a 3‐fold increase in the risk of interval CRC. An additional 165 screening colonoscopies per endoscopist per year would be required to shift all non‐GI procedures to GI endoscopists.

CONCLUSIONS:

When screening colonoscopy is performed by non‐GI endoscopists, a substantial reduction in the long‐term CRC prevention rate may be expected. Such difference appeared to be greater when a suboptimal efficacy of colonoscopy in preventing CRC was assumed. A 10‐year saving of $2 billion may be expected when shifting all screening colonoscopies from non‐GI endoscopists to GI endoscopists. Cancer 2012. © 2012 American Cancer Society.
Formulation of Two‐Dimensional Transport in Tokamak Plasmas for Integrated Analysis of Core and Edge Plasmas
Authors: Seto H. , Fukuyama A.
Published: June 2012

For integrated modeling of both core and edge plasmas, a two‐dimensional description of transport phenomena over the entire tokamak is desirable and is becoming feasible owing to recent progress in computational performance. A set of two‐dimensional transport equations that allow for dependence on the poloidal angle is formulated from Braginskii's equations and neoclassical theory and is coupled to a set of electromagnetic equations in order to develop an integrated two‐dimensional transport simulation code. The set of transport equations consist of equations for particle density and pressure, equations for force balance in the radial direction, and equations for momentum in the parallel and toroidal directions, for both electrons and ions. The set of electromagnetic equations consist of an equation for the static electric field, the magnetic diffusion equation, and the Grad‐Shafranov equation (© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Numerical Modeling of the Impact of Geometry and Wall Components on Transport in the Tokamak Edge
Authors: Serre E. , Bufferand H. , Paredes A. , Schwander F. , Ciraolo G. , Ghendrih Ph. , Tamain P.
Published: June 2012

The SOLEDGE suite of codes has been specially designed to model the transition region from the hot core plasma to the first wall of tokamak, through the Last Closed Flux Surface (LCFS). It is designed to model electrostatic fluid turbulence for an isothermal plasma or for a plasma with temperature variations. Dedicated discretization algorithms have been implemented to handle equations for ion density, electron/ion temperatures and parallel momentum, both for the realistic cross‐section of a diverted tokamak and for a three‐dimensional cylindrical annulus. The efficient penalization method introduced in Ref. [5] has been implemented, allowing straightforward handling of solid obstacles by treating them as sink regions corresponding to strong plasma recombination in the solid state material. The SOLEDGE capability is exemplified here by simulating two equilibria: (i) a 3D cylindrical annulus and (ii) the cross‐section of a diverted tokamak. In the annulus, the analysis of the impact of a secondary discrete limiter shows that the toroidal symmetry usually assumed for density and Mach profiles is broken. The density exhibits significant variations in the toroidal direction that extend over a large region of the scrape‐off layer where magnetic field lines are connected to a secondary limiter. In the diverted geometry, computations show a transition from subsonic to supersonic flow in the vicinity of the X‐point that is related to the location of particle sources and sinks between the edge connected region and the divertor region (© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Flow cytometry analysis of murine hematopoietic stem cells
Authors: Mayle Allison , Luo Min , Jeong Mira , Goodell Margaret A.
Published: June 2012

Hematopoietic stem cells (HSCs) remain the most well‐characterized adult stem cell population both in terms of markers for purification and assays to assess functional potential. However, despite over 40 years of research, working with HSCs in the mouse remains challenging because of the relative abundance (or lack thereof) of these cells in the bone marrow. The frequency of HSCs in murine bone marrow is about 0.01% of total nucleated cells and ∼5,000 can be isolated from an individual mouse depending on the age, sex, and strain of mice as well as purification scheme utilized. Adding to the challenge is the continual reporting of new markers for HSC purification, which makes it difficult for the uninitiated in the field to know which purification strategies yield the highest proportion of long‐term, multilineage HSCs. In this updated version of our review from 2009, we review different strategies for hematopoietic stem and progenitor cell identification and purification. We will also discuss methods for rapid flow cytometric analysis of peripheral blood cell types, and novel strategies for working with rare cell populations such as HSCs in the analysis of cell cycle status by BrdU, Ki‐67, and Pyronin Y staining. The purpose of updating this review is to provide insight into some of the recent experimental and technical advances in mouse hematopoietic stem cell biology. © 2012 International Society for Advancement of Cytometry
Influence of the capillary diameter on the separation efficiency and sensitivity: A systematic approach
Authors: Ilko David , Holzgrabe Ulrike
Published: June 2012

In this study, the influence of the capillary inner diameter (id) on the efficiency and sensitivity of a capillary zone electrophoresis separation was investigated. Four local anaesthetic drugs (lidocaine, prilocaine hydrochloride, procaine and tetracaine) were separated with a validated method using capillaries of different id. The separation parameter N and the resolution of the critical peak pair were monitored. It was found that N increases in tighter capillaries, while sensitivity decreases indicated by the increased detection limit for lidocaine. This loss in sensitivity can partially be compensated by loading more sample into the capillary by means of an increased injection time and pressure. However, when it comes to the evaluation of the drug quality according to a monograph in the European Pharmacopoeia, we cannot recommend to vary the capillary id in order to meet the system suitability criteria.
Standardized methods for acute and semichronic toxicity tests with the copepod Acartia tonsa
Authors: Gorbi Gessica , Invidia Marion , Savorelli Federica , Faraponova Olga , Giacco Elisabetta , Cigar Monica , Buttino Isabella , Leoni Tristano , Prato Ermelinda , Lacchetti Ines , Sei Sandra
Published: June 2012

The availability of standardized protocols for both organism culture and bioassay with ecologically relevant species is of great concern in ecotoxicology. Acartia tonsa represents an important, often dominant, member of zooplankton communities and meets all the practical criteria suggested for model species. New standardized procedures for laboratory culturing of the copepod A. tonsa and standardized methods for acute (24- and 48-h) and semichronic (7-d, static-renewal) toxicity tests with the nauplius stage are described. In both cases, eggs are the starting stage, and nauplius immobilization is the endpoint. The methods were the object of an intercomparison test involving nine laboratories, and nickel was the reference toxicant. Relative reproducibility was 24, 25, and 34% for 24-h, 48-h, and 7-d tests, respectively. Environ. Toxicol. Chem. 2012; 31: 2023–2028. © 2012 SETAC
Acute toxicity of herbicide formulations and chronic toxicity of technical-grade trifluralin to larval green frogs (Lithobates clamitans)
Authors: Weir Scott M. , Yu Shuangying , Salice Christopher J.
Published: June 2012

Fewer toxicity studies have been performed on herbicides than on insecticides despite heavier use of herbicides and evidence of herbicide formulation toxicity to amphibians. We conducted acute and chronic toxicity tests with the herbicide trifluralin (2,6-dinitro-N,N-dipropyl-4-(trifluoromethyl)aniline) on tadpoles. Herbicide formulations had lower median lethal concentrations than an insecticide formulation and technical-grade trifluralin. Chronic trifluralin exposure resulted in significantly smaller tadpoles at low concentrations (20 µg/L) compared with controls and 200-µg/L treatments. Environ. Toxicol. Chem. 2012; 31: 2029–2034. © 2012 SETAC
Bioaccessible heavy metals-sediment particles from Reconquista River induce lung inflammation in mice
Authors: Ferraro Sebastián A. , Curutchet Gustavo , Tasat Deborah R.
Published: June 2012

The Reconquista River (RR), one of the most polluted watercourses in Argentina, receives effluent discharges from heavily industrialized and highly populated settlements. During winter and summer, the floodplain remains dry, producing the oxidation of sulfide and organic matter present in the sediment, making heavy metals more bioaccessible. Dispersion of this sediment occurs, and thus harmful effects on the pulmonary health of residents and workers inhabiting the RR bank may take place. The authors characterized the sediment particles of the RR (RR-PM) morphologically by scanning electron microscopy and its elemental composition by energy dispersive X-ray spectroscopy (EDX) and Community Bureau of Reference (BCR) sequential extraction. Furthermore, the authors evaluated its biological impact on the respiratory system of BALB/c mice, generating four groups: control healthy, sensibilized with ovalbumin, exposed to particles, and sensibilized and exposed to particles. Sediment particles of the Reconquista River contained fine particulate matter, with a high concentration of bioaccessible Cu and Zn. The authors found that animal exposure to RR-PM caused polymorphonuclear cell lung infiltration, augmentation of O 2−, increase of proinflammatory cytokines (tumor necrosis factor alpha [TNFα], interleukin-6 [IL-6]) and apoptosis. This adverse response was more dramatic in the sensibilized and exposed to particles group. Even more, they proved the bioaccessible fraction present in the RR-PM to be responsible for these harmful effects. The authors conclude that RR-PM produces an adverse biological impact on the airways of healthy animals, which is largely aggravated in previously sensibilized animals. Environ. Toxicol. Chem. 2012; 31: 2059–2068. © 2012 SETAC
An interlaboratory comparison study for the determination of dialkyl phthalate esters in environmental and biological samples
Authors: Ikonomou Michael G. , Kelly Barry C. , Blair Joel D. , Gobas Frank A.P.C.
Published: June 2012

A series of interlaboratory comparison exercises were conducted to assess the accuracy of dialkyl phthalate ester (DPE) concentration measurements in environmental and biological samples. Five laboratories participated in analyses to determine DPE concentrations in standard test solutions; marine sediments; three certified reference materials, including CARP-2 (fish muscle) and BCR-07 (fortified milk powder); and several livestock samples (sheep's milk, liver, and muscle). In addition, one laboratory determined DPE residue concentrations in 20 municipal sewage sludge samples, previously analyzed as part of the 2006/2007 U.S. Environmental Protection Agency's Targeted National Sewage Sludge Survey (TNSSS). The results showed relatively good interlaboratory agreement for analyses of di-ethylhexyl phthalate (DEHP). Three independent laboratories (Labs A, B, and C) reported concentrations of DEHP (ng/g wet wt) in fish muscle (CARP-2) of 1,550 ± 148, 1,410 ± 193, and 1,380 ± 187, respectively. Similarly, DEHP concentration measurements in sewage sludge samples showed good agreement with those reported in the 2006/2007 TNSSS report. Measured concentrations of individual DPEs and C6–C10 isomeric mixtures in these samples of municipal sewage sludge, which have not been previously reported, ranged between 1 and 200,000 ng/g dry weight. The results demonstrate that environmental monitoring of DPEs is often hampered by high method detection limits (MDLs), due to contamination of procedural blanks. It is important to note, however, that when background contamination is minimized (<10 ng/sample), relatively low MDLs (<0.1 ng/g) can be achieved, allowing for low-level quantification of DPEs in environmental and biological samples. Future efforts to develop better protocols to lower MDLs, as well to develop reference materials, would greatly benefit future DPE monitoring initiatives. Environ. Toxicol. Chem. 2012; 31: 1948–1956. © 2012 SETAC
Inorganic mercury accumulation in rice (Oryza sativa L.)
Authors: Meng Bo , Feng Xinbin , Qiu Guangle , Wang Dingyong , Liang Peng , Li Ping , Shang Lihai
Published: June 2012

To investigate the source and process of inorganic mercury (IHg) accumulation in rice, we monitored the concentrations of IHg in tissues of rice plants (Oryza sativa L.) from four experimental plantation plots. Biweekly during the rice-growing season, tissues of rice plants, corresponding soil, precipitation, and irrigation water samples were collected. The sampling data support the following: (1) the atmosphere is the principal source of IHg to the aboveground parts of the rice plant; (2) both the atmosphere and soil contribute to IHg content in stalks, but the former source tends to be more important; and (3) soil is the major source of root IHg content. These observations and the fact that the gradually increasing concentration and mass of IHg in stalks and leaves during the rice-growing season suggested that atmospheric Hg could be absorbed by and incorporated into the aboveground parts of the rice plant and that limited or no Hg emission to the air or translocation to the soil occurred after deposition of atmospheric Hg. The root surface acted as a potential Hg barrier and consequently reduced the translocation of Hg ion mass through the root system to the aboveground parts. Accumulated IHg in aboveground parts of rice plants cannot be transported to seeds, which is completely different from the case of methylmercury. Environ. Toxicol. Chem. 2012; 31: 2093–2098. © 2012 SETAC
Changes in benthic nutrient sources within a wetland after hydrologic reconnection
Authors: Kuwabara James S. , Topping Brent R. , Carter James L. , Wood Tamara M. , Cameron Jason M. , Asbill-Case Jessica R. , Carlson Rick A.
Published: June 2012

Removing dams and levees to restore hydrologic connectivity and enhance ecosystem services such as nutrient removal has been an increasingly common management practice. In the present study, the authors assessed geochemical and biological changes following engineered levee breaches that reconnected eutrophic Upper Klamath Lake and Agency Lake, Oregon, USA, to an adjacent, historic wetland that had been under agricultural use for the last seven decades. Over the three-year study, the reconnected wetland served as a benthic source for both macronutrients (dissolved organic carbon [DOC], soluble reactive phosphorus [SRP], and ammonia) and micronutrients (dissolved iron and manganese). The magnitude of those benthic sources was similar to or greater than that of allochthonous sources. The highest DOC benthic flux to the water column occurred immediately after rewetting occurred. It then decreased during the present study to levels more similar to the adjacent lake. Dissolved ammonia fluxes, initially negative after the levee breaches, became consistently positive through the remainder of the study. Nitrate fluxes, also initially negative, became negligible two years after the levee breaches. In contrast to previous laboratory studies, SRP fluxes remained positive, as did fluxes of dissolved iron and manganese. Our results indicate that the timescales of chemical changes following hydrologic reconnection of wetlands are solute-specific and in some cases extend for multiple years beyond the reconnection event. During the present study, colonization of the reconnected wetlands by aquatic benthic invertebrates gradually generated assemblages similar to those in a nearby wetland refuge and provided further evidence of the multiyear transition of this area to permanent aquatic habitat. Such timescales should be considered when developing water-quality management strategies to achieve wetland-restoration goals. Environ. Toxicol. Chem. 2012; 31: 1995–2013. © 2012 SETAC
Thyroid endocrine dysregulation and erythrocyte DNA damage associated with PBDE exposure in juvenile crucian carp collected from an e-waste dismantling site in Zhejiang Province, China
Authors: Song Yang , Wu Nanxiang , Tao He , Tan Yufeng , Gao Ming , Han Jianlong , Shen Haitao , Liu Kecheng , Lou Jianlin
Published: June 2012

In the present study, 40 juvenile crucian carp (Carassius auratus) were caught from a river close to an electronic waste (e-waste) site (exposed group) and another located 80 km away from the e-waste site (control group) in Zhejiang, China. Results indicated that muscle levels of polybrominated diphenyl ethers (median PBDEs, 235.98 ng/g wet wt; range, 7.70–703.31 ng/g wet wt), serum levels of thyroid-stimulating hormone (median TSH, 2.32 µIU/ml; range, 2.05–2.72 µIU/ml) and erythrocyte DNA damage level (median Olive tail movement, 16.27 µm; range, 4.28–27.51 µm) were higher in the exposed group than those in the control group (0.56 ng/g wet wt, range, 0.34–1.24 ng/g wet wt, p < 0.01; 1.70 µIU/ml, range, 1.40–2.08 µIU/ ml, p < 0.01; 6.06 µm, range, 2.01–10.72 µm, p < 0.01, respectively). Thyroxine (T4) was significantly lower in the exposed group (8.97 µIU/ml) than in the control group (12.47 µIU/ml). In addition, thyroid endocrine disorder and erythrocyte DNA damage levels were significantly associated with polybrominated diphenyl ether exposure. Hence, PBDEs may affect wild fish populations in real ecosystems with thyroid endocrine disruption and DNA damage. Environ. Toxicol. Chem. 2012; 31: 2047–2051. © 2012 SETAC
Photocatalytic reactive oxygen species production and phototoxicity of titanium dioxide nanoparticles are dependent on the solar ultraviolet radiation spectrum
Authors: Ma Hongbo , Brennan Amanda , Diamond Stephen A.
Published: June 2012

Generation of reactive oxygen species (ROS) by titanium dioxide nanoparticles (nano-TiO2) and its consequent phototoxicity to Daphnia magna were measured under different solar ultraviolet (UV) spectra by applying a series of optical filters in a solar simulator. Removing UV-B (280–320 nm) from solar radiation had no significant impact on photocatalytic ROS production of nano-TiO2, whereas removal of UV-A (320–400 nm) decreased ROS production remarkably. Removal of wavelengths below 400 nm resulted in negligible ROS production. A linear correlation between ROS production and D. magna immobilization suggests that photocatalytic ROS production may be a predictor of phototoxicity for nano-TiO2. Intracellular ROS production within D. magna was consistent with the immobilization of the organism under different solar UV spectra, indicating that oxidative stress was involved in phototoxicity. The dependence of nano-TiO2 phototoxicity on environmentally realistic variations in solar radiation suggests that risk assessment of these nanomaterials requires careful evaluation of exposure conditions in the environment. Environ. Toxicol. Chem. 2012; 31: 2099–2107. © 2012 SETAC
Bioaccumulation and distribution of perfloroalkyl acids in seafood products from Bohai Bay, China
Authors: Yang Liping , Tian Shengyan , Zhu Lingyan , Liu Zhengtao , Zhang Yahui
Published: June 2012

Ten perfluoroalkyl acids (PFAAs) were measured in seafood collected from Bohai Bay, China in 2010. The summed concentrations of the PFAAs were in the ranges of not detected to 194 ng/g dry weight and 4.0 to 304 ng/g dry weight for invertebrates and fish, respectively. The levels of perflurooctanesulfonate (PFOS) and perfluorooctanoic acid (PFOA) in the seafood were lower than those from North America, the Mediterranean Sea, and South Korea. Living habitat, trophic level, and feeding habits had important impacts on the bioaccumulation and distribution of PFAAs in the seafood. The species at higher trophic levels had the potential to accumulate more PFAAs than benthic invertebrates. Tidal-flat organisms tended to accumulate more PFOA than PFOS, whereas the opposite was seen for shallow-water species. For all the species, PFOS and PFOA were partitioned preferentially in the liver or viscera. Risk assessment indicated that the current level of PFAAs in the seafood of Bohai Bay does not represent an immediate source of harm to public health. Environ. Toxicol. Chem. 2012; 31: 1972–1979. © 2012 SETAC
A two‐step method for predicting time to flashover in room corner test fires using cone calorimeter data
Authors: Wang Zhaozhi , Hu Xiaoqin , Jia Fuchen , Galea Edwin R.
Published: June 2012

A method to predict time to flashover in ISO 9705 room corner fire tests based on cone calorimeter data is proposed in this paper. The method involves classification of materials and estimation of time to flashover as two steps in sequence. In the first step, the investigated material is classified into discriminating material groups. In the second step, the time to flashover is calculated with a derived formula for the corresponding material group, which contains material density, time to ignition and heat release rate collected from small‐scale experiments. Compared with two existing models, the proposed method has improved the prediction precisions in both the time to flashover and classification of material categories for a wide range of materials. Copyright © 2012 John Wiley & Sons, Ltd.
Bayesian networks in environmental and resource management
Authors: Barton David N , Kuikka Sakari , Varis Olli , Uusitalo Laura , Henriksen Hans Jørgen , Borsuk Mark , de la Hera Africa , Farmani Raziyeh , Johnson Sandra , Linnell John DC
Published: June 2012

This overview article for the special series, “Bayesian Networks in Environmental and Resource Management,” reviews 7 case study articles with the aim to compare Bayesian network (BN) applications to different environmental and resource management problems from around the world. The article discusses advances in the last decade in the use of BNs as applied to environmental and resource management. We highlight progress in computational methods, best-practices for model design and model communication. We review several research challenges to the use of BNs in environmental and resource management that we think may find a solution in the near future with further research attention. Integr Environ Assess Manag 2012; 8: 418–429. © 2012 SETAC
Development and initial validation of an outcome measure for home visitation: The healthy families parenting inventory
Authors: Krysik Judy , Lecroy Craig W.
Published: June 2012

The Healthy Families Parenting Inventory (HFPI) is a 63‐item outcome measure that was designed to examine change in nine parenting‐related domains. The HFPI was developed to respond to the need for an outcome measure for home visitation programs that is relevant to the intervention, sensitive to change, and appropriate with a diverse participant base, and would produce data that are immediately useful in practice. The authors detail the steps in the development and initial validation of the HFPI. The pattern of inter‐item and item‐to‐subscale correlations as well as an exploratory factor analysis and sensitivity to change analysis support the nine‐factor model of the HFPI.
Maternal attachment representations and the development of very low birth weight premature infants at two years of age
Authors: González‐Serrano Fernando , Lasa Alberto , Hernanz Manuel , Tapia Xabier , Torres Maria , Castro Carolina , Ibañez Berta
Published: June 2012

There is a consensus that prematurity could increase the risk of attachment impairment. We studied 90 premature children with very low birth weights (<1,500 g) and 96 healthy children born at term with similar age and sociodemographic characteristics. Our objective was to assess maternal stress and attachment representations, and compare development indices on both groups at 2 years of age. Premature infants had a medium‐to‐severe degree of immaturity and biological risk (M gestational age = 29.98 weeks; birth weight = 1,159.76 g), with 57% staying in the ICU ≥1 week. These children born prematurely had lower scores on the development indices within the normal range. Mothers of premature infants (n = 74) reported higher levels of stress during their first year of life (59%) than did controls (41%), but no significant differences were detected in maternal attachment discourse between the two groups. The findings confirm that premature birth has a great influence on maternal emotional responses and the health and development of children in the first years of life, and indicate that stress responses in parents and warning signs for attachment problems should be assessed as early as possible.