bluuebunny/crossref_metadata_2025 huggingface dataset:
Atrial Pacing in the Prevention of Paroxysmal Atrial Fibrillation: First Results of a New Combined Algorithm
Authors: ISRAEL C.W. , LAWO T. , LEMKE B. , GRÖNEFELD G. , HOHNLOSER S.H.
Published: October 2013

Pacing algorithms for prevention of atrial tachyarrhythmia (AT) are under clinical evaluation. The present study prospectively evaluated the efficacy of three simultaneously active algorithms for AT prevention and aimed at identifying patients in whom atrial preventive pacing (APP) may be particularly successful. Methods: In 31 patients with conventional pacing indications and paroxysmal AT, a DDDRP pacing system was implanted, which stores 35 AT episodes with atrial electrograms and marker annotations. Counters and stored AT episodes were retrieved 30 days after implant. APP algorithms (atrial preference pacing, atrial rate stabilization, postmode switching overdrive) were activated. Counters and stored AT episodes were again retrieved 60 days later. The number and duration of AT episodes was measured. Several clinical variables were examined with respect to their ability to identify candidates for APP. Results: During APP, the mean number of AT episodes/patient/day decreased from 7.67 to 1.68 (P = 0.04). However, time in AT was not significantly reduced (9.45% versus 10.41%). APP decreased the number of episodes/day in 11 patients and increased it in 9 patients. No clinical parameters predicting APP success was identified. Conclusions: APP using three algorithms significantly reduced the mean number of AT episodes/patient/day. However, the time during which patients were in AT was not reduced. No clinical variable predicted the success or failure of APP.
Atrial Overdriving Is Beneficial in Patients with Atrial Arrhythmias: First Results of the PROVE Study
Authors: FUNCK REINHARD C. , ADAMEC RICHARD , LURJE LEON , CAPUCCI ALESSANDRO , RITTER PHILIPPE , SHEKAN DOUG , SLEGERS LEOPOLD C. , TAVERNIER RENE , ISHIKAWA TOSHINORI ,   On behalf of the prove study group
Published: October 2013

The AF Prevention by Overdriving (PROVE) trial is an ongoing prospective study of the effectiveness of atrial overdrive pacing combined with an Automatic Rest Rate function in the prevention of atrial arrhythmias. All patients who have received a Talent DR 213 pacemaker are eligible for enrollment into the study. After a 1‐month monitoring period, the patients are divided into two groups. Group I includes patients with ≥ 2 appropriate mode‐switch (MS) episodes, or 1 MS episode of ≥ 10 minutes, and/or > 300 atrial runs of > 5 beats/month. Group II includes all other patients. The number and duration of atrial arrhythmias are measured the pacemaker's Automatic Interpretation and Data Analysis software (AIDA). Patients' quality‐of‐life is measured by a validated functional status questionnaire. After having been grouped, the patients are randomly assigned, in a crossover design, to standard DDDR or overdrive pacing + Rest Rate, each programmed for a 3‐month period. Preliminary results in 78 patients show a 34% reduction in the mean number of MS, and a mean 48% shortening of the overall duration of the episodes by overdrive pacing + Rest Rate, achieved by a mean 84% prevalence of atrial pacing. Overdrive pacing + Rest Rate was well tolerated and associated with a slight improvement in quality‐of‐life.
Reflex Autonomic Modulation of Automatically Measured Repolarization Parameters
Authors: GHURAN AZAD , BATCHVAROV VELISLAV , DILAVERIS POLYCHRONIS , FÄRBOM PATRIK , CAMM A. JOHN , MALIK MAREK
Published: October 2013

Automatic recognition of repolarization abnormalities from the standard electrocardiogram (ECG) is of considerable clinical importance. This study examined the autonomic variations in automatically measured repolarization parameters, including maximum QT interval (QTmax), global QT dispersion (QTd), T area dispersion (T area D) and principal component analysis ratio 2 (PCA‐2). Twelve‐lead ECGs were recorded continuously in 40 healthy subjects during supine, sitting and standing positions, and during the Valsalva maneuver. With the exception of PCA‐2, the other repolarization parameters correlated either moderately or strongly during the steady‐state supine position. QTmax, PCA‐2, and T area D decreased significantly between supine and sitting position (P < 0.001, P < 0.001 and P < 0.01, respectively). QTmax, QTD, and T area D decreased significantly between sitting and standing (P < 0.001, P < 0.05 and P < 0.01, respectively). All parameters significantly decreased between supine and standing position: QTmax (P < 0.001), QTD (P < 0.05), PCA‐2 (P < 0.05) and T area D (P < 0.001). During Valsalva, only PCA‐2 increased significantly (P < 0.001) between supine and standing position. There were no significant changes in QT dispersion and dispersion of T wave area during Valsalva, compared to baseline, in both supine and standing positions. Automatic conventional measures of repolarization heterogeneity have limited practical value in detecting the effects of autonomic changes on ventricular repolarization. Newer concepts evaluating spatial and temporal irregularity of ventricular repolarization are still needed to reliably detect the effects of autonomic activity on ventricular repolarization.
Efficacy of Biventricular Sensing and Treatment of Ventricular Arrhythmias
Authors: BOCCHIARDO MARIO , ACHTELIK MICHAEL , GAITA FIORENZO , TRAPPE HANS‐JOACHIM , LOZANO IGNAGIO , HIGGINS STEVEN , DAOUD EMILE , YONG PATRICK , DUBY CHRISTIAN ,   On behalf of the VENTAK CHF/CONTAK CD INVESTIGATORS
Published: October 2013

While much is known concerning the hemodynamic effects of biventricular (BV) pacing, little has been reported concerning the efficacy of BV sensing and pacing in the detection and treatment of ventricular tachyarrhythmias. Two hundred nineteen heart failure (HF) patients with VT or VF and a QRS ≥ 120 ms during sinus rhythm received an ICD capable of BV pacing and sensing. Detection times of induced VF and success rates for terminating induced VT were measured. The ICD system used a left ventricular epi‐cardial lead implanted via thoracotomy (52 patients) or a specially designed percutaneous, over‐the‐wire lead inserted in the coronary venous system. VF detection times and VT termination rates by antitachycardia pacing (ATP) were compared with those measured in a population of recipients of ICD using a RV lead alone. Median induced VF detection times were comparable (2.0‐s BV vs 1.8‐s RV). Termination of induced VT on the first attempt was comparable with BV pacing (87.4%) versus RV pacing (89.6%). The time to detect induced VF was not different with ICDs using BV sensing versus conventional ICDs using RV sensing alone. Similarly, the rates of successful termination of induced VT by ATP with BV or RV pacing were comparable.
ICD Waveform Optimization: A Randomized, Prospective, Pair‐Sampled Multicenter Study
Authors: MOUCHAWAR GABRIEL , KROLL MARK , VAL‐MEJIAS J. E. , SCHWARTZMAN DAVID , MCKENZIE JOHN , FITZGERALD DAVID , PRATER STEPHEN , KATCHER MICHAEL , FAIN ERIC , SYED ZAFFER
Published: October 2013

The theoretical tissue model‐based estimates of phase 1 and phase 2 duration of biphasic waveforms are considerably shorter than the pulse widths currently used in ICDs with standard tilt. This study used a tissue resistance/capacitance (RC) model to identify optimal biphasic pulse widths. By paired step‐down defibrillation threshold (DFT) testing, the efficacy of standard versus “tuned” biphasic waveforms was evaluated in 91 patients. Standard waveforms consisted of a phase 1 set to 65% tilt and phase 2 = phase 1. The tuned waveform was based on an RC model of membrane characteristics with a time constant of 3.5 ms. The optimal phase 1 truncation point is at the peak of membrane response. The optimal phase 2 duration ends with a membrane response near or just below 0. In paired analysis, no significant differences were found in DFT or impedance between standard and tuned waveforms. In patients with DFTs > 400 V, the tuned waveform lowered the DFT by an average of 38 V (P < 0.05). Multivariate analyses showed a significant inverse relationship between DFT and impedance (P < 0.001). As impedance increased, the tuned waveform was associated with DFTs comparable to the standard waveform with shorter pulse duration and lower delivered energy. No single tilt value allowing an easy calculation of delivered energy was related to ICD waveform efficacy. The use of ICDs with tuned optimal pulse durations offer a greater flexibility of choice for patients with high DFTs.
Comforting the Parents by Administering Neuromuscular Blockers to the Dying Child: A Conflict Between Ethics and Law?
Authors: den Hartogh Govert
Published: October 2013

When the decision has been made to stop treatment of a newborn child with a bad prognosis, the child usually dies in a short time. Sometimes, however, gasping occurs, and although it is usually thought that this is not a sign of suffering, the parents can hardly fail to interpret it as such. Could that be a reason to administer muscle relaxants to the child? It would not harm the child and may greatly benefit the parents. So it seems the humane thing to do.

Legally, however, the action would count as killing, and the prohibition of killing normally implies a denial of the authority to decide on exceptions, which should be understood as a protection of public trust.

I discuss three ways of arguing why the law, nevertheless, should allow for an exception in this case. The discussion identifies and describes this kind of conflict, and shows how to evaluate proposals for solving it, using a particularly clear exemplary case by way of illustration.
Outcomes and Feasibility of a Manualized Cognitive‐Behavioral Skills Building Intervention: Group COPE for Depressed and Anxious Adolescents in School Settings
Authors: Mazurek Melnyk Bernadette , Kelly Stephanie , Lusk Pamela
Published: October 2013

Problem

Despite the increasing prevalence of depressive and anxiety disorders in adolescents, less than 25% of affected teens receive any treatment.

Methods

A preexperimental one‐group pre‐ and posttest pilot study design with 4‐week follow‐up was used to assess the feasibility and preliminary effects of the COPE (Creating Opportunities for Personal Empowerment) brief‐focused manualized seven‐session cognitive‐behavioral skills building group intervention delivered in two high schools to 16 adolescents referred by a school‐based nurse practitioner for depression or elevated anxiety symptoms.

Findings

Adolescents reported significant decreases in depression and anxiety on the Beck Youth Inventory as well as increases in personal beliefs about managing negative emotions. Evaluations indicated that the group COPE intervention was a positive experience for the teens.

Conclusions

COPE is a promising brief‐focused cognitive behavioral therapy‐based intervention that can be delivered effectively to teens in school settings using a group format.
Moderate and severe periodontitis are independent risk factors associated with low cardiorespiratory fitness in sedentary non‐smoking men aged between 45 and 65 years
Authors: Eberhard Jörg , Stiesch Meike , Kerling Arno , Bara Christoph , Eulert Christine , Hilfiker‐Kleiner Denise , Hilfiker Andres , Budde Eva , Bauersachs Johann , Kück Momme , Haverich Axel , Melk Anette , Tegtbur Uwe
Published: October 2013

Aim

To investigate the association between periodontal disease severity and cardiorespiratory fitness (CRF) in a cross‐sectional study of sedentary men.

Materials & Methods

Seventy‐two healthy men (45–65 years) who did not join any sport activity and had a preferentially sitting working position were recruited. Periodontal status was recorded and CRF was measured by peak oxygen uptake (VO2peak) during exercise testing on a cycle ergometer. Physical activity was assessed by a validated questionnaire and data were transformed to metabolic equivalent of task scores. Univariate and multivariate regression analyses were performed to investigate associations.

Results

Differences between VO2peak levels in subjects with no or mild, moderate or severe periodontitis were statistically significant (p = 0.026). Individuals with low VO2peak values showed high BMI scores, high concentrations of high‐sensitive C‐reactive protein, low levels of high‐density lipoprotein‐cholesterol, and used more glucocorticoids compared to individuals with high VO2peak levels. Multivariate regression analysis showed that high age (p = 0.090), high BMI scores (p < 0.001), low levels of physical activity (p = 0.031) and moderate (p = 0.087), respectively, severe periodontitis (p = 0.033) were significantly associated with low VO2peak levels.

Conclusions

This study demonstrated that moderate and severe periodontitis were independently associated with low levels of CRF in sedentary men aged between 45 and 65 years.
Does underwater flash photography affect the behaviour, movement and site persistence of seahorses?
Authors: Harasti D. , Gladstone W.
Published: October 2013

The effect of flash photography on seahorse species has never been tested. An experiment was established to test the effect of flash photography and the handling of Hippocampus whitei, a medium‐sized seahorse species endemic to Australia, on their behavioural responses, movements and site persistence. A total of 24 H. whitei were utilized in the experiment with eight in each of the three treatments (flash photography, handling and control). The effect of underwater flash photography on H. whitei movements was not significant; however, the effect of handling H. whitei to take a photograph had a significant effect on their short‐term behavioural responses to the photographer. Kaplan–Meier log‐rank test revealed that there was no significant difference in site persistence of H. whitei from each of the three treatments and that flash photography had no long‐term effects on their site persistence. It is concluded that the use of flash photography by divers is a safe and viable technique with H. whitei, particularly if photographs can be used for individual identification purposes.
Cloning and expression of a surface immunogenic protein in Streptococcus dysgalactiae isolated from fish and its application in enzyme‐linked immunosorbent assays to diagnose S. dysgalactiae infections in fish
Authors: Nishiki I , Minami T , Itami T , Yoshida T
Published: October 2013

Lancefield group C Streptococcus dysgalactiae (GCSD) causes severe necrotic lesions in the caudal peduncle in the genus Seriola farmed in Japan. To develop a sero‐diagnostic method for GCSD infection in farmed fish, we attempted to identify a surface immunogenic protein that induces an antibody after infection with GCSD by immunoblot analysis using sera collected from infected fish. A protein obtained from sodium dodecyl sulfate (SDS) extracts of GCSD was identified as S. dysgalactiae surface immunogenic protein (Sd‐Sip). Sd‐Sip exhibited more than 94% homology with a surface antigen or a hypothetical protein from S. dysgalactiae mammalian isolates at the nucleotide sequence level. Expression of the recombinant Sd‐Sip (rSd‐Sip) was confirmed by immunoblot analysis, that is, its reactivity to GCSD‐infected sera. Antibody detection ELISA using rSd‐Sip and their usefulness for diagnosis of GCSD infection were examined. GCSD‐infected sera collected from farmed amberjack, Seriola dumerili (Risso), showed strong reaction with immobilized rSd‐Sip. Meanwhile, sera immunized by other pathogenic bacteria of fish were showed ELISA values similar to those of non‐infected sera. These results of this study suggest that the antibody detection ELISA using rSd‐Sip is an effective diagnostic method for GCSD infection in fish.
Intensification of Starch Processing Using Apparatus with Couette–Taylor Flow
Authors: Hubacz Robert , Ohmura Naoto , Dluska Ewa
Published: October 2013

Couette–Taylor flow (CTF), which is characterized by the presence of Taylor vortices, ensures effective mixing, fast heat transfer and improved rheological properties of starch slurry. Therefore, this type of flow can be expected to provide favorable conditions for starch processing. In order to check how to intensify the process, starch gelatinization has been studied experimentally and using computer simulation in two CTF apparatuses of different volumes. The results show that, when the volume of apparatus was small, high value of degree of starch gelatinization could be achieved at relatively low temperature or at relatively low rotor rotation frequency. The increase in the apparatus volume ensures higher rate of gelatinized starch production and the reduction in dissipation of mechanical energy connected with rotor rotation, however, it also amplifies the detrimental inlet and gravitation effects. To overcome both of these negative effects, the increase in the rotor frequency is required.

Practical Application

Starch gelatinization is a process frequently encountered in food industry, e.g., food sterilization or starch hydrolysis. Therefore, a new way of starch processing could be interesting in the context of growing consumer interest in natural food. It is expected that CTF apparatus could enable to process much more concentrated starch slurry than a jet cooker or coil heater typically used in industrial setting. Starch granules should also be less damaged during treatment in CTF apparatus than in an extruder. The results presented in this paper are relevant for process intensification and scale‐up of starch gelatinization in CTF apparatus and will be extended to simultaneous starch gelatinization with enzymatic hydrolysis in the future work.
Improvement in Shelf Life and Safety of Pasteurized Palm Sap (Borassus flabellifer Linn.) by the Addition of Nisin
Authors: Naknean Phisut
Published: October 2013

The objective of this study was to improve the quality and safety of pasteurized palm sap by the addition of various concentrations of nisin. The pasteurization condition was 75C for 10 min as considered from no growth of pathogens was detected while the concentrations of nisin in the range of 0–40 IU/mL were selected for addition in palm sap as considered from sensory evaluation. The initial pH of pasteurized palm sap was 6.6 and the addition of nisin caused a decrease in the pH to 6.2, 6.0, 5.8 and 5.6 for the samples added 10, 20, 30 and 40 IU/mL, respectively. The initial polyphenol oxidase activity decreased by approximately 55 and 76% for the sample without nisin added and the sample added 40 IU/mL nisin, respectively, from the original value measured in fresh palm sap while the initial invertase activity was not affected by nisin. During storage, the loss of sucrose, polyphenol content, DPPH‐RSA and the increment in browning intensity were minimized by nisin treatment, particularly at 30–40 IU/mL. The combination of pasteurization with the addition of nisin (30 IU/mL) and low temperature storage could preserve palm sap for 10 weeks whereas the control sample was spoiled within 2 weeks.

Practical Applications

The sale of pasteurized palm sap is a common practice in Thailand and its consumption has increased over the past years. However, pasteurized palm sap has a short shelf life (approximately 1–2 weeks). In order to control the growth of spoilage microorganisms, the use of natural antimicrobial preservatives has been preferred in the food industry. For this purpose, nisin was preferred in this study. Although there are many reports on the use of nisin to prolong the shelf life of food, research on the utilization of nisin in palm sap is limited. According to the results, the addition of nisin could reduce the pasteurization temperature and time. In addition, the use of nisin (30 IU/mL) significantly reduced spoilage microorganism counts and extended the refrigerated shelf life of pasteurized palm sap for at least 10 weeks. Therefore, the safety of pasteurized palm sap during storage could be improved by the addition of nisin. This result may be a practical application for the producer because of the short shelf life of this product.
What Does This Mean for Graduate Education in Marriage and Family Therapy? Commentary on “The Divide Between ‘Evidenced–Based’ Approaches and Practitioners of Traditional Theories of Family Therapy”
Authors: Stith Sandra M.
Published: October 2013

The Dattilio, Piercy, and Davis article is a welcome addition to the conversation focusing on how to bridge the divide in the MFT field between research and practice. The present commentary challenges us to see the divide as an indictment of our training programs resulting from a lack of focus on MFT research. Suggestions for increasing expectations for students to monitor client progress, get involved in research at all levels, and for doctoral students to expect to be able to conduct independent, fundable research in the MFT field when they leave their programs are offered.
The contribution of the HIV specialist nurse to HIV care: a scoping review
Authors: Tunnicliff Sarah A , Piercy Hilary , Bowman Christine A , Hughes Charlie , Goyder Elizabeth C
Published: October 2013

Aims and objectives

To systematically identify and critically examine the evidence of the contribution of the HIV nurse specialist to provision of HIV care in the UK and other developed countries.

Background

The HIV clinical nurse specialist role has evolved over the past two decades in response to changes in two areas of HIV care: first, changes in the treatment and care of those with HIV and second, changes and development in advanced nursing practice. The challenges facing HIV care require the development of innovative services including a greater contribution of HIV specialist nurses. A review of current evidence is required to inform developments.

Design

A review.

Methods

A broad search strategy was used to search electronic databases. Grey literature was accessed through a variety of approaches. Preference was given to UK literature with inclusion of international publications from other developed countries where relevant.

Results

Fourteen articles were included. Four themes were identified: the diversity of the clinical role; a knowledge and skills framework for HIV nursing practice; the education and training role of the HIV nurse specialist; and the effectiveness of the HIV nurse specialist. The findings mainly focus on the clinical aspects of the role with little evidence concerning other aspects. There is limited evidence to indicate clinical effectiveness.

Conclusions

HIV care is facing substantial challenges, and there is a clear need to develop effective and efficient services, including expanding the contribution of HIV nurse specialists. Such developments need to occur within a framework that optimises nursing contribution and measures their impact on HIV care. This review provides a baseline to inform such developments.

Relevance to clinical practice

This review of the literature details current understanding of the role of HIV specialist nurses and the contribution that they make to HIV care.
Exercise in children with common congenital heart lesions: Balancing benefits with risks
Authors: Halliday Melanie , Selvadurai Hiran , Sherwood Megan , Fitzgerald Dominic A
Published: October 2013

Children with corrected common congenital heart lesions are often withheld from regular exercise by their parents. While there are some modest risks with exercise, they should be seen in perspective, and the life‐long benefits of regular exercise on general health, mood and well‐being should be emphasised.
Managing snoring and obstructive sleep apnoea in childhood
Authors: Fitzgerald Nicholas M , Fitzgerald Dominic A
Published: October 2013

Snoring assessment and its differentiation from obstructive sleep apnoea are difficult based upon a parent history and physical examination of the size of the tonsils. Not only is the presence of obstructive sleep apnoea important to diagnose, but confirming its severity is the key determinant in prioritising treatment in a resource‐limited setting. This review provides current knowledge on the utility of common diagnostic tests, results of treatment options available and implications of treatment and unrecognised or untreated obstructive sleep apnoea.
P144, A TGF-β1 Antagonist Peptide, Synergizes with Sildenafil and Enhances Erectile Response via Amelioration of Cavernosal Fibrosis in Diabetic Rats
Authors: Li Wen Ji , Wang Hao , Zhou Juan , Li Bao , Zhang Jun , Lu Mujun , Wang Zhong
Published: October 2013

Introduction

Patients with diabetes exhibit more severe erectile dysfunction (ED) and are less responsive to first-line oral phosphodiesterase type 5 inhibitor (PDE5i). It has been suggested that increased collagen deposition and reduced smooth muscle content in the corpus cavernosum are important mechanisms for diabetes-associated ED and that transforming growth factor-β1 (TGF-β1) is a potent fibrotic factor responsible for the structural alterations in the corpus cavernosum.

Aims

The aims of this study are to determine whether activation of TGF-β1 and its downstream pathways is responsible for the reduced efficacy of the PDE5is in diabetic ED via abnormalities in cavernosal structures and to investigate the synergistic effects of the TGF-β1 antagonist P144 and sildenafil on erectile response.

Methods

Six weeks after inducting diabetes with streptozotocin in male Sprague-Dawley rats, age-matched control and diabetic rats were treated with vehicle, sildenafil, or P144 alone or in combination for 4 weeks, respectively.

Main Outcome Measures

Intracavernous pressure, dynamic infusion cavernosometry, and histological and molecular alterations of the corpus cavernosum were analyzed.

Results

Diabetic rats exhibited a decreased erectile response, severe corporal veno-occlusive dysfunction (CVOD), and structural alterations including cavernosal fibrosis and decreased smooth muscle content. Expression and activation of TGF-β1 and its downstream Smad and non-Smad pathways increased in diabetic rats. Treatment with sildenafil showed modest effect on erectile response and a less suppressive effect on CVOD, cavernosal fibrosis, and molecular alterations. Treatment with P144 had lower effect on erectile response, even greatly improved the histological and molecular alterations and CVOD than sildenafil. The combined treatment with P144 and sildenafil effectively restored erectile response, CVOD, and histological and molecular alterations.

Conclusion

An insufficient suppressive effect of sildenafil on cavernosal fibrosis, severe CVOD, and TGF-β1 pathways was implicated in reduced efficacy of the PDE5i in diabetic ED. Treatment with P144 synergized sildenafil and significantly increased erectile response by the potential antifibrotic activity.
Chronic High Dose Intraperitoneal Bisphenol A (BPA) Induces Substantial Histological and Gene Expression Alterations in Rat Penile Tissue Without Impairing Erectile Function
Authors: Kovanecz Istvan , Gelfand Robert , Masouminia Maryam , Gharib Sahir , Segura Denesse , Vernet Dolores , Rajfer Jacob , Li De-Kun , Liao Chun Yang , Kannan Kurunthachalam , Gonzalez-Cadavid Nestor F.
Published: October 2013

Introduction

Bisphenol A (BPA), released from plastics and dental sealants, is a suspected endocrine disruptor and reproductive toxicant. In occupationally exposed workers, BPA has been associated with erectile dysfunction (ED).

Aims

To determine whether long-term exposure to high doses of BPA in the rat affects serum levels of testosterone (T) and estradiol (E2), and induces corporal histopathology and resultant ED.

Methods

Young rats were injected intraperitoneal (IP) injection daily with BPA at 25 mg/kg/day or vehicle (n = 8/group). Erectile function was measured at 3 months by cavernosometry and electrical field stimulation (EFS). BPA was assayed in serum, urine, and penile tissue, and serum T and E2 were determined. Quantitative Masson trichrome, terminal deoxynucleotidyl transferase dUTP nick end labeling, Oil Red O, immunohistochemistry for calponin, α-smooth muscle actin, and Oct 4 were applied to penile tissue sections. Protein markers were assessed by Western blots and 2−D minigels, and RNA by DNA microarrays.

Main Outcome Measures

Erectile function, histological, and biochemical markers in corporal tissue.

Results

In the BPA-treated rats, total and free BPA levels were increased in the serum, urine, and penile tissue while serum T and E2 levels were reduced. In addition, the corpora cavernosa demonstrated a reduction in smooth muscle (SM) content, SM/collagen ratio, together with an increase in myofibroblasts, fat deposits, and apoptosis, but no significant change in collagen content or stem cells (nuclear/perinuclear Oct 4). In the penile shaft, BPA induced a downregulation of Nanog (stem cells), neuronal nitric oxide synthase (nitrergic terminals), and vascular endothelial growth factor (angiogenesis), with genes related to SM tone and cytoskeleton upregulated 5- to 50-fold, accompanied by changes in the multiple protein profile. However, both cavernosometry and EFS were unaltered by BPA.

Conclusions

While rats treated chronically with a high IP dose of BPA developed hypogonadism and a corporal histo- and molecular-pathology usually associated with ED, no changes were detected in erectile function as measured by EFS and cavernosometry. Further studies using alternate routes of BPA administration with various doses and length of exposure are needed to expand these findings.
Job Satisfaction and Perceived Gender Equality in Advanced Promotion Opportunities: An Empirical Investigation
Authors: Semykina Anastasia , Linz Susan J.
Published: October 2013

Does gender equality in advanced promotion opportunities in the workplace have consequences for job satisfaction? We use data collected from workers in six formerly socialist economies (Armenia, Azerbaijan, Kazakhstan, Kyrgyzstan, Russia, and Serbia) to investigate the link between job satisfaction and the perceived chance that a woman would hold a senior‐level position at the firm. Among many survey participants, such a link exists and is positive; that is, these survey participants enjoy working at firms that promote gender balance at the top. The positive link is explained in part by worker personality/attitudes and firm characteristics, and in part by the result that participating workers often enjoy higher job satisfaction because they perceive the lack of ‘glass ceiling’ as a signal of improved own career opportunities. Among women, positive effects are more significant for younger workers. We discuss possible explanations for these findings, as well as cross‐country differences and policy implications.
Beta‐blockers in portal hypertension: new developments and controversies
Authors: Tripathi Dhiraj , Hayes Peter C.
Published: October 2013

There are many studies investigating the role of non‐selective beta‐blockers in portal hypertension. Satisfactory reduction in portal pressure is possible in a third to half of patients with propranolol and nadolol, although combining these drugs with nitrates may be more effective. Carvedilol is a more potent agent than propranolol in reducing portal pressure, particularly in non‐responders, and is better tolerated. All these drugs have been studied in primary and secondary prophylaxis, sometimes in combination with band ligation and/or nitrates. There is some evidence to support combining these agents with band ligation, despite a lack of survival benefit and increased adverse events. Hemodynamic monitoring can help select non‐responders who may benefit from additional therapies such as band ligation, as lack of response is associated with worse outcomes. Propranolol should be used with caution in patients with refractory ascites, although the current evidence is not of sufficient quality to justify not using these drugs in such situations. Beta‐blockers have been shown to reduce bacterial translocation and spontaneous bacterial peritonitis in cirrhosis.
Staging, prognostic factors and adjuvant therapy of intrahepatic cholangiocarcinoma after curative resection
Authors: Li Tao , Qin Lun‐Xiu , Zhou Jian , Sun Hui‐Chuan , Qiu Shuang‐Jian , Ye Qing‐Hai , Wang Lu , Tang Zhao‐You , Fan Jia
Published: October 2013

Background & Aims

Prognostic factors and adjuvant therapy of intrahepatic cholangiocarcinoma (ICC) after curative resection were not clear. We aim to analyse prognostic factors after curative resection and evaluate adjuvant therapy and survival based on the new staging system.

Methods

A retrospective analysis of 283 patients who underwent surgical exploration for ICC was performed. Staging was performed according to the 7th edition AJCC staging manual. Univariate and multivariate analyses were used to evaluate independent prognostic factors.

Results

The difference for OS at different TNM stages after R0 resection was significant (P < 0.001). Despite regional lymph node metastasis, tumour number and vascular invasion, serum GGT level was also an independent prognostic factor for OS of patients after R0 resection. The incidence of biliary and vascular invasion was significantly higher in high GGT group than in normal GGT group. Factors predictive of recurrence were multiple tumours and regional lymph node metastasis. After R0 resection, adjuvant TACE not only did not improve the OS of patients at TNM stage I (P = 0.508), but significantly promoted recurrence of these patients (P = 0.006). Only patients at TNM stage II, III and IV benefited from adjuvant TACE for longer survival, while the recurrence rates were not affected.

Conclusions

The new staging system can predict the survival of ICC patients after R0 resection. High GGT level may be suggestive of biliary and vascular invasion and was an independent risk factor for OS after R0 resection. Adjuvant TACE may be indicated only for patients at advanced stages for better survival.
Islamic Law in Action: A Historical Discussion
Authors: Ergene Boğaç A.
Published: October 2013

This review essay engages Kristen Stilt's recent book,Islamic Law in Action: Authority, Discretion, and Everyday Experiences in Mamluk Egypt(2011), in a fashion that highlights its contributions to the study of Islamic law. In particular, it underlines the methodological arguments made in the book that might help us think about Islamic legal practice in sophisticated and historically grounded ways. As elaborated in the article, these arguments have important implications for modern as well historical settings. Specifically, Stilt's discussion of “Islamic law in action” reveals the inherent flexibility of Islamic legal practice to accommodate political change. The article also discusses how further research on the topic could benefit from specific approaches and orientations.
The meaning and importance of vigilant attendance for the relatives of intensive care unit patients
Authors: Plakas Sotirios , Taket Ann , Cant Bob , Fouka Georgia , Vardaki Zambia
Published: October 2013

Aim

To explore the meaning of vigilant attendance for relatives of critically ill patients in Greece.

Background

A plethora of international research has identified proximity to the patient to be a major concern for relatives of critically ill patients. Greece however follows a strict visiting policy in intensive care units (ICUs) so Greek relatives spend great amounts of time just outside the ICUs.

Design

This qualitative study adopted the social constructionist version of grounded theory.

Method

Data were collected from three ICUs in Athens through in depth interviews with 25 informants and approximately 10 h of observations outside the ICUs on 159 relatives.

Findings

Vigilant attendance was one of the main coping mechanisms identified for relatives. Four subcategories were found to comprise vigilant attendance: (1) being as close as possible to feel relief, (2) being there to find out what is going on, (3) monitoring changes in the loved one and making own diagnosis and (4) interacting with the ICU professionals.

Conclusion

Vigilant attendance describes the way in which relatives in Greece stayed outside the ICUs. Relatives felt satisfaction from being close as the best alternative for not actually being inside the ICU and they tried to learn what was going on by alternative methods. By seeing the patients, relatives were also able to make their own diagnoses and could therefore avoid relying solely on information given to them. However, a prerequisite for successful vigilant attendance was to get on well with doctors and nurses.

Recommendations for clinical practice

Changes in visiting policies in Greece are needed to meet the needs of relatives adequately. Recommendations for changes with minimal investment of time and funding are made.
Fasting and postprandial volumes of the undisturbed colon: normal values and changes in diarrhea‐predominant irritable bowel syndrome measured using serial MRI
Authors: Pritchard S. E. , Marciani L. , Garsed K. C. , Hoad C. L. , Thongborisute W. , Roberts E. , Gowland P. A. , Spiller R. C.
Published: October 2013

Background

Previous assessments of colon morphology have relied on tests which were either invasive or used ionizing radiation. We aimed to measure regional volumes of the undisturbed colon in healthy volunteers (HV) and patients with diarrhea‐predominant irritable bowel syndrome (IBS‐D).

Methods

3D regional (ascending, transverse, and descending) colon volumes were measured in fasting abdominal magnetic resonance (MR) images of 75 HVs and 25 IBS‐D patients. Thirty‐five of the HV and all 25 IBS‐D subjects were fed a standard meal and postprandial MRI data obtained over 225 min.

Key Results

Colonic regions were identified and 3D maps from cecum to sigmoid flexure were defined. Fasted regional volumes showed wide variation in both HVs being (mean ± SD) ascending colon (AC) 203 ± 75 mL, transverse (TC) 198 ± 79 mL, and descending (DC) 160 ± 86 mL with no difference from IBS‐D subjects (AC 205 ± 69 mL, TC 232 ± 100 mL, and DC 151 ± 71 mL, respectively). The AC volume expanded by 10% after feeding (p = 0.007) in the 35 HV possibly due to increased ileo‐colonic inflow. A later rise in AC volume occurred from t = 90 to t = 240 min as the meal residue entered the cecum. In contrast, IBS‐D subjects showed a much reduced postprandial response of the AC (p < 0.0001) and a greater increase in TC volume after 90 min (p = 0.0244) compared to HV.

Conclusions & Inferences

We have defined a normal range of the regional volumes of the undisturbed colon in fasted and fed states. The AC in IBS‐D appeared less able to accommodate postprandial inflow which may account for faster colonic transit.
Antidepressants in the Treatment for Chronic Low Back Pain: Questioning the Validity of Meta‐Analyses
Authors: Williamson Owen D. , Sagman Doron , Bruins Robert H. , Boulay Luc J. , Schacht Alexander
Published: October 2013

Objectives

To contrast the analgesic effect of duloxetine with antidepressants reported in other published randomized clinical trials (RCTs) and review articles in patients with chronic low back pain (CLBP).

Methods

In this narrative review, the results of 13 RCTs and 5 systematic reviews examining the analgesic effect of various antidepressants in CLBP were contrasted with those of 3 placebo‐controlled duloxetine RCTs. Treatment effects based on the Brief Pain Inventory (BPI) average score in the duloxetine RCTs were assessed in all completers (by study and overall) and in last‐observation‐carried‐forward (LOCF) analyses (extracted from study reports). 30%‐ and 50%‐reduction response rates were compared between duloxetine and placebo.

Results

Eleven different antidepressants were examined in 13 individual RCTs. Sample sizes, treatment durations, and analysis methods varied across studies. Reviews each included 5 to 9 of the RCTs and came to different conclusions regarding the analgesic effect of antidepressants: 2 found no evidence while 3 reported some evidence. The completer analysis showed greater improvements in BPI average scores with duloxetine vs. placebo (significant in 2 studies). Overall, the least square mean (standard error) difference between treatments was − 0.7 (0.15) (P < 0.0001). Overall response rates were significantly larger with duloxetine than with placebo.

Conclusions

Due to the diversity of previous studies and the pooling methods used, the conclusions regarding the analgesic effect of antidepressants in CLBP drawn from systematic reviews must be interpreted with caution. Appropriately designed and powered studies similar to recently published duloxetine studies are recommended to demonstrate the analgesic effect of antidepressants.
Translation, Cross‐Cultural Adaptation, and Validity of the Korean Version of the Pain Sensitivity Questionnaire in Chronic Pain Patients
Authors: Kim Ho‐Joong , Ruscheweyh Ruth , Yeo Ji‐Hyun , Cho Hyeon‐Guk , Yi Je‐Min , Chang Bong‐Soon , Lee Choon‐Ki , Yeom Jin S.
Published: October 2013

The purpose of this study was to translate pain sensitivity questionnaires (PSQ) into the Korean language, perform a cross‐cultural adaption of the PSQ, and validate the Korean version of PSQ in patients with degenerative spinal disease. The PSQ was translated forward and backward, cross‐culturally adapted by 2 independent translators, and approved by an expert committee. The final Korean version of the PSQ was tested on 72 patients with degenerative spinal disease. Test–retest reliability was evaluated for 60 patients (83%) who completed the second assessment in an interval of 4 weeks. The mean PSQ‐minor, PSQ‐moderate, and PSQ‐total (standard deviation [SD]) were 5.40 (2.02), 6.46 (1.98), and 5.93 (1.93), respectively. The PSQ‐total, PSQ‐minor, and PSQ‐moderate of the Korean version showed very good internal consistencies determined by the Cronbach's α of 0.926, 0.869, and 0.877, respectively. For convergent validity, the PSQ scores of the Korean version showed significant correlations with pain catastrophizing scale (PCS) (r = 0.377, P = 0.002; r = 0.365, P = 0.003; r = 0.362, P = 0.003 for PSQ‐total, PSQ‐minor, and PSQ‐moderate of the Korean version, respectively). For test–retest reliability, the intraclass correlation coefficients were 0.782 for PSQ‐total, 0.752 for PSQ‐minor, and 0.793 for PSQ‐moderate. In conclusion, the validated Korean version of PSQ is a transculturally equivalent, reliable, and valid tool to assess individual pain sensitivity.
The secondary metabolism glycosyltransferases UGT73B3 and UGT73B5 are components of redox status in resistance of Arabidopsis to Pseudomonas syringae pv. tomato
Authors: SIMON CLARA , LANGLOIS‐MEURINNE MATHILDE , DIDIERLAURENT LAURE , CHAOUCH SEJIR , BELLVERT FLORIANT , MASSOUD KAMAL , GARMIER MARIE , THAREAU VINCENT , COMTE GILLES , NOCTOR GRAHAM , SAINDRENAN PATRICK
Published: October 2013

Secondary metabolism plant glycosyltransferases (UGTs) ensure conjugation of sugar moieties to secondary metabolites (SMs) and glycosylation contributes to the great diversity, reactivity and regulation of SMs. UGT73B3 and UGT73B5, two UGTs of Arabidopsis thaliana (Arabidopsis), are involved in the hypersensitive response (HR) to the avirulent bacteria Pseudomonas syringae pv. tomato (Pst‐AvrRpm1), but their function in planta is unknown. Here, we report that ugt73b3, ugt73b5 and ugt73b3 ugt73b5 T‐DNA insertion mutants exhibited an accumulation of reactive oxygen species (ROS), an enhanced cell death during the HR to Pst‐AvrRpm1, whereas glutathione levels increased in the single mutants. In silico analyses indicate that UGT73B3 and UGT73B5 belong to the early salicylic acid (SA)‐induced genes whose pathogen‐induced expression is co‐regulated with genes related to cellular redox homeostasis and general detoxification. Analyses of metabolic alterations in ugt mutants reveal modification of SA and scopoletin contents which correlate with redox perturbation, and indicate quantitative modifications in the pattern of tryptophan‐derived SM accumulation after Pst‐AvrRpm1 inoculation. Our data suggest that UGT73B3 and UGT73B5 participate in regulation of redox status and general detoxification of ROS‐reactive SMs during the HR to Pst‐AvrRpm1, and that decreased resistance to Pst‐AvrRpm1 in ugt mutants is tightly linked to redox perturbation.
Transient Spectroscopy of 5,7‐diiodo‐3‐butoxy‐6‐fluorone (DIBF)
Authors: Zheldakov Igor L. , Grinevich Oleg , Mejiritski Alexander , Elles Christopher G. , Neckers Douglas C.
Published: October 2013

DIBF (5,7‐diiodo‐3‐butoxy‐6‐fluorone) is a visible light photosensitizer for diaryliodonium salts, the latter being used in cationic photopolymerizations. Although photopolymerization of cycloaliphatic epoxide resins can be initiated by direct excitation of UV‐absorbing diaryliodonium salts, such as (p‐octyloxy)phenyliodonium hexafluoroantimonate (OPPI), the short wavelengths required cause some practical problems. Sensitizers, of which DIBF is among the best, obviate the deep UV problem by allowing visible‐wavelength activation of the photoinitiator. Addition of 9,10‐diethoxyanthracene (AN 910 E) dramatically accelerates photopolymerization under visible irradiation of the DIBF/OPPI system. We report herein the transient spectroscopy of the photosensitizer DIBF and discuss likely mechanisms for sensitization of OPPI.
Taxonomic reassessment of Chondrus verrucosus (Rhodophyta, Gigartinales), with a description of Chondrus retortus sp. nov
Authors: Matsumoto Kaoru , Shimada Satoshi
Published: October 2013

Phylogenetic and morphological reinvestigation of Chondrus verrucosus Mikami was conducted in the Pacific coast of southeastern Honshu, Japan, including the holotype specimen and samples near the type locality. Two entities were recognized by phylogenetic analyses of plastid rbcL and nuclear EF2 sequences. In morphological analyses, the two entities were distinguished by: (i) thallus size and form, and (ii) cell shape of the medullary layer surrounding young carposporangia: one has larger thalli, is regularly canaliculated, with linear medullary cells (large‐type); the other is smaller, canaliculated with crispation and has roundish medullary cells (small‐type). The large‐type was common in southern to eastern Boso Peninsula including near the type locality; the small‐type was typical in the southwest Boso Peninsula and Sagami Bay. The large‐type was shown to be equivalent to C. verrucosus by examination of the holotype specimen. The small‐type is described as a new species, C. retortus Matsumoto et Shimada.
Consistent Truth
Authors: Slater Hartley
Published: October 2013

Modern Logic has generated a lot of problems for itself through inattention to natural forms of speech. In particular it has had difficulties with a large group of ‘logical paradoxes’ through its preoccupation with the Predicate Calculus and related structures to the exclusion of other formal structures that represent natural language more fully, and thereby escape these paradoxes. In natural speech the unrecognized forms involved are principally individual referring terms with a non‐specific or fictional reference. For, under the influence of the Logical Empiricists, the focus in formal logic has been on individual terms with a specific, factual reference. But a similar point arises with certain predicates, and indeed even the proper concept of a predicate has been lost, producing the most notorious of the standard puzzles: Russell's Paradox. The paper inevitably makes reference to contemporary logical symbolism in places, but its purpose is to show that the only way forward is to use a symbolism that is abbreviatory only, i.e. maps directly onto natural speech.