bluuebunny/crossref_metadata_2025 huggingface dataset:
IgE‐mediated facilitated antigen presentation underlies higher immune responses in peanut allergy
Authors: Turcanu V. , Stephens A. C. , Chan S. M. H. , Rancé F. , Lack G.
Published: April 2010

To cite this article: Turcanu V, Stephens AC, Chan SMH, Rancé F, Lack G. IgE‐mediated facilitated antigen presentation underlies higher immune responses in peanut allergy. Allergy 2010; 65: 1274–1281.

Background:  Peanut allergy poses significant healthcare problems, because its prevalence is increasing in many countries, and it is rarely outgrown. To explore the immunological mechanisms that underlie peanut allergy and tolerance, we compared the peanut‐specific responses of peanut‐allergic (PA) and nonallergic (NA) individuals.

Methods:  We measured peanut‐specific peripheral blood mononuclear cells (PBMC) proliferation using tritiated thymidine. The frequency of peanut‐specific T cells amongst PBMC was determined by carboxyfluorescein succinimidyl ester labelling. The role of IgE‐dependent facilitated antigen presentation (FAP) in modulating proliferation was investigated by depleting IgE from plasma with anti‐IgE‐coated beads and then assessing PBMC proliferation in the presence of IgE‐depleted or nondepleted plasma.

Results:  We found that peanut‐specific PBMC proliferation is higher and peaks earlier in PA than in NA donors. We investigated the immunological mechanisms that could underlie these differences. We found that both PA and NA have memory responses to peanut, but the frequency of peanut‐specific T cells is higher in PA than in NA. Facilitated antigen presentation could cause both the higher proliferation and precursor frequency in PA. Facilitated antigen presentation activity in vitro was confirmed by showing that IgE depletion decreases proliferation, while adding IgE back restores it.

Conclusion:  Our results identify FAP as a mechanism that underlies higher responses to peanut in PA. In these individuals, high levels of peanut‐specific IgE could furthermore maintain long‐term allergic T‐cell responses. We raise the question whether, in the future, therapies targeting IgE such as anti‐IgE antibodies may be used to suppress these T‐cell responses.
C2orf37 mutational spectrum in Woodhouse–Sakati syndrome patients
Authors: Alazami AM , Schneider SA , Bonneau D , Pasquier L , Carecchio M , Kojovic M , Steindl K , De Kerdanet M , Nezarati MM , Bhatia KP , Degos B , Goh E , Alkuraya FS
Published: April 2010

Alazami AM, Schneider SA, Bonneau D, Pasquier L, Carecchio M, Kojovic M, Steindl K, de Kerdanet M, Nezarati MM, Bhatia KP, Degos B, Goh E, Alkuraya FS. C2orf37 mutational spectrum in Woodhouse–Sakati syndrome patients.

Woodhouse–Sakati syndrome (WSS) is a rare autosomal recessive disorder that encompasses hypogonadism, deafness, alopecia, mental retardation, diabetes mellitus and progressive extrapyramidal defects. The syndrome is caused by mutation of the C2orf37 gene. Here we studied a cohort of seven new cases from three ethnic backgrounds, presenting with the hallmarks of WSS, in an effort to extend the mutational spectrum of this disorder. Genetic analysis revealed a novel mutation in each of the four families investigated, of which three were nonsense mutations and the fourth was a splice site ablation. We also examined a separate collection of 11 cases presenting with deafness and dystonia, two constituents of WSS, but found no pathogenic changes. This study doubles the number of known mutations for this disorder, confirms that truncating mutations in C2orf37 are the only known cause of WSS, and suggests that mutations in this gene do not contribute significantly to cases presenting with isolated elements of WSS such as deafness and dystonia. The lack of correlation between clinically expressivity of WSS and the site of the eight truncating mutations strongly supports that they are equally null, while the intrafamilial variability argues for an important role of modifiers in this disease.
Treatment of ureteral complications after kidney transplantation with native ureteropyelostomy reduces the risk of pyelonephritis
Authors: Lehmann Kuno , Müller Markus K. , Schiesser Marc , Wildi Stefan , Fehr Thomas , Wüthrich Rudolf P. , Clavien Pierre‐Alain , Weber Markus
Published: April 2010

Lehmann K, Müller MK, Schiesser M, Wildi S, Fehr T, Wüthrich RP, Clavien P‐A, Weber M. Treatment of ureteral complications after kidney transplantation with native ureteropyelostomy reduces the risk of pyelonephritis.  Clin Transplant 2011: 25: 201–206. © 2010 John Wiley & Sons A/S.

Abstract:  Urological complications contribute to morbidity and graft loss after kidney transplantation. Aim of this study was to assess the role of revisional surgery on patient outcome. From 1997 to 2007, 887 patients underwent kidney transplantation in our institution. Clinical data of patients with urological complications were analyzed. Ureteral complications were observed in 50 of 887 (5.6%) recipients, including ureteral necrosis (0.9%), stenosis (3.6%) and ureteral reflux with recurrent graft pyelonephritis (1.1%). Thirty‐five patients underwent native ureteropyelostomy, and 14 patients had redo‐ureterocystostomy. All patients treated for recurrent graft pyelonephritis had no further episodes. Overall, the rate of ureteral stenosis was significantly higher after secondary surgery, compared to the primary anastomosis (10% vs. 3.6%, p = 0.039). A significantly lower incidence of graft pyelonephritis was observed in patients after native ureteropyelostomy compared to patients treated with redo‐ureterocystostomy (p = 0.019). In conclusion, reflux and recurrent graft pyelonephritis can be treated effectively by secondary surgery. The use of native ureteropyelostomy may offer protection from graft pyelonephritis after secondary surgery.
Recurrent neonatal seizures result in long‐term increases in neuronal network excitability in the rat neocortex
Authors: Isaeva Elena , Isaev Dmytro , Savrasova Alina , Khazipov Rustem , Holmes Gregory L.
Published: April 2010

Neonatal seizures are associated with a high likelihood of adverse neurological outcomes, including mental retardation, behavioral disorders, and epilepsy. Early seizures typically involve the neocortex, and post‐neonatal epilepsy is often of neocortical origin. However, our understanding of the consequences of neonatal seizures for neocortical function is limited. In the present study, we show that neonatal seizures induced by flurothyl result in markedly enhanced susceptibility of the neocortex to seizure‐like activity. This change occurs in young rats studied weeks after the last induced seizure and in adult rats studied months after the initial seizures. Neonatal seizures resulted in reductions in the amplitude of spontaneous inhibitory postsynaptic currents and the frequency of miniature inhibitory postsynaptic currents, and significant increases in the amplitude and frequency of spontaneous excitatory postsynaptic currents (sEPSCs) and in the frequency of miniature excitatory postsynaptic currents (mEPSCs) in pyramidal cells of layer 2/3 of the somatosensory cortex. The selective N‐methyl‐d‐aspartate (NMDA) receptor antagonist d‐2‐amino‐5‐phosphonovalerate eliminated the differences in amplitude and frequency of sEPSCs and mEPSCs in the control and flurothyl groups, suggesting that NMDA receptors contribute significantly to the enhanced excitability seen in slices from rats that experienced recurrent neonatal seizures. Taken together, our results suggest that recurrent seizures in infancy result in a persistent enhancement of neocortical excitability.
Temporal patterns in overweight and obesity in Type 1 diabetes
Authors: Conway B. , Miller R. G. , Costacou T. , Fried L. , Kelsey S. , Evans R. W. , Orchard T. J.
Published: April 2010

Diabet. Med. 27, 398–404 (2010)

Aims  Time trends in overweight and obesity in the general population have been well documented; however, temporal patterns in Type 1 diabetes (T1DM) have not been thoroughly investigated. We therefore assessed temporal patterns in overweight and obesity and predictors of weight change in 589 individuals from the Pittsburgh Epidemiology of Diabetes Complications Study, a cohort of childhood‐onset T1DM.

Methods  Participants were first seen in 1986–1988, when mean age and diabetes duration were 29 and 20 years, respectively, and biennially thereafter for 18 years. Overweight was defined as 25.0 ≤ body mass index (BMI) < 30.0 kg/m2. Obesity was defined as BMI ≥ 30.0 kg/m2.

Results  At baseline, the prevalence of overweight and obesity were 28.6% and 3.4%, respectively. After 18 years’ follow‐up, the prevalence of overweight increased by 47% while the prevalence of obesity increased sevenfold. Seven per cent were on intensive insulin therapy (≥ 3 insulin injections per day or on insulin pump) at baseline; by 2004–2007, this was 82%. Predictors of weight change were a higher baseline HbA1c, symptomatic autonomic neuropathy (inversely), overt nephropathy (inversely), and going onto intensive insulin therapy during follow‐up.

Conclusions  These data demonstrate dramatic weight gain in T1DM and underscore the complexity of weight change in this disease.
Field and climate‐based model for predicting the density of host‐seeking nymphal Ixodes scapularis, an important vector of tick‐borne disease agents in the eastern United States
Authors: Diuk‐Wasser Maria A. , Vourc'h Gwenaël , Cislo Paul , Hoen Anne Gatewood , Melton Forrest , Hamer Sarah A. , Rowland Michelle , Cortinas Roberto , Hickling Graham J. , Tsao Jean I. , Barbour Alan G. , Kitron Uriel , Piesman Joseph , Fish Durland
Published: April 2010

Aim  Ixodes scapularis is the most important vector of human tick‐borne pathogens in the United States, which include the agents of Lyme disease, human babesiosis and human anaplasmosis, among others. The density of host‐seeking I. scapularis nymphs is an important component of human risk for acquiring Borrelia burgdorferi, the aetiological agent of Lyme disease. In this study we used climate and field sampling data to generate a predictive map of the density of host‐seeking I. scapularis nymphs that can be used by the public, physicians and public health agencies to assist with the diagnosis and reporting of disease, and to better target disease prevention and control efforts.

Location  Eastern United States of America.

Methods  We sampled host‐seeking I. scapularis nymphs in 304 locations uniformly distributed east of the 100th meridian between 2004 and 2006. Between May and September, 1000 m2 were drag sampled three to six times per site. We developed a zero‐inflated negative binomial model to predict the density of host‐seeking I. scapularis nymphs based on altitude, interpolated weather station and remotely sensed data.

Results  Variables that had the strongest relationship with nymphal density were altitude, monthly mean vapour pressure deficit and spatial autocorrelation. Forest fragmentation and soil texture were not predictive. The best‐fit model identified two main foci – the north‐east and upper Midwest – and predicted the presence and absence of I. scapularis nymphs with 82% accuracy, with 89% sensitivity and 82% specificity. Areas of concordance and discordance with previous studies were discussed. Areas with high predicted but low observed densities of host‐seeking nymphs were identified as potential expansion fronts.

Main conclusions  This model is unique in its extensive and unbiased field sampling effort, allowing for an accurate delineation of the density of host‐seeking I. scapularis nymphs, an important component of human risk of infection for B. burgdorferi and other I. scapularis‐borne pathogens.
Classifying tagging experiments for commercial fisheries into three fundamental types based on design, data requirements and estimable population parameters
Authors: Polacheck Tom , Paige Eveson J , Laslett Geoff M
Published: April 2010

Mark–recapture experiments have the potential to provide direct estimates of fundamental parameters required for fishery stock assessment and provision of subsequent management advice in fisheries. The literature on mark–recapture experiments is enormous, with a variety of different experimental designs and estimation models; thus, it can be difficult to grasp the primary features of different approaches, the inter‐relationship among them and their potential utility in different situations. Here, we present an overview of the tagging experimental designs that are appropriate for use in commercial fishery situations. We suggest that most mark–recapture experiments in a large‐scale fishery context can be classified into one of three basic types – Petersen, tag‐attrition or Brownie – based on the fundamental design employed for releases and recaptures. The release and recapture strategy (e.g. the number of release events, whether the size of the sample examined for recaptured tags is known) determines which parameters can be estimated and from where the information for estimating them arises. We conclude that an integrated Brownie and Petersen approach is the most powerful of the different approaches in terms of the range of parameters that can be estimated without underlying assumptions or constraints on parameters. Such an approach can provide direct estimates of fishing mortality, natural mortality and population size, which are the main population dynamics parameters that traditional fishery stock assessments attempt to estimate.
The Contard Affair: Private Power, State Control, and Paternal Authority in Fin‐de‐Siècle France
Authors: TOTH STEPHEN A.
Published: April 2010

This paper examines how the suicide of a teenager illuminated a longstanding ideological divide in fin‐de‐siècle France. Five days after his arrival at the Maison Paternelle, an internationally renowned, privately‐operated establishment for bourgeois boys, Gaston Contard committed suicide. The suicide was quickly sensationalized in the press and resulted in a wide‐ranging investigation by public prosecutors who charged the institution's director with illegal imprisonment. Although acquitted, this was a pyrrhic victory as the event marked a critical turning point in the relationship between private power, state control and paternal authority as it pertained to the incarceration and socialization of troubled youths.
Audit of nutritional and dietary outcomes of bariatric surgery patients
Authors: Harbottle L.
Published: April 2010

Bariatric surgery is the most effective means of achieving sustainable weight loss for the morbidly obese but resultant gastrointestinal functional changes and altered diet may lead to a number of eating and nutritional problems. This audit was conducted to evaluate Guernsey outcomes in relation to UK national standards and to determine the adequacy of current dietetic provision. A postal questionnaire was sent to 177 patients. Sixty‐eight responded (48 gastric bypass, 15 banding and five other procedures). Mean body mass index preoperatively was 44.2 (five had body mass index <35). Five respondents (7%) had received preoperative and 26 post‐operative dietary advice. Only 12 (18%) received any dietetic follow‐up. Only one patient had any psychological support. Mean maximal weight loss and regain was 42.7 kg and 4.5 kg, respectively. Micronutrient supplementation and monitoring was variable. Deficiencies of B12 (44%), iron (25%), vitamin D (10.2%) and folate (6.2%) were recorded. Problems with food intolerances were common and often protracted. The majority of respondents expressed satisfaction with the procedure, but many recognized that it had not solved their food‐related issues. There was dissatisfaction with dietetic intervention. Overall, current treatment was shown to fall short of UK standards. A number of recommendations have been made to improve future outcomes, including re‐audit and improved dietetic service provision.
Childhood body mass index and risk of asthma in adolescence: a systematic review
Authors: Noal R. B. , Menezes A. M. B. , Macedo S. E. C. , Dumith S. C.
Published: April 2010

Asthma and obesity, both of which are considered global health issues, affect approximately 300 million individuals worldwide. The observation that asthma and obesity tend to increase in parallel may indicate a potential link between these two conditions. The aim of this systematic review of the literature was to investigate the relationship between childhood nutritional status and incidence or persistence of asthma during adolescence. The principal eligibility criteria for selection of articles were including longitudinal analysis, and which measured of exposure during childhood or adolescence and outcome during adolescence. The systematic search initially returned 1563 unique articles. After inspection of titles and reading the abstracts of these articles, we chose 27 for full reading. Of these, 10 were selected to be included in the present review. Of the 10 selected studies, eight showed positive associations between overweight/obesity and asthma. Of these, two were independent of sex, three were found only among men and another three only among women. The present study shows strong evidence that, although the role of sex is not clear, obesity precedes, and is associated with, the persistence and intensity of symptoms of asthma.
Reader and text factors in reading comprehension processes
Authors: Kendeou Panayiota , Muis Krista R. , Fulton Sandra
Published: April 2010

The effects of epistemic beliefs and text structure on cognitive processes during comprehension of scientific texts were investigated. On‐line processes were measured using think‐aloud (Experiment 1) and reading time (Experiment 2) methodologies. Measures of off‐line comprehension, prior knowledge and epistemic beliefs were obtained. Results indicated that readers adjust their processing as a function of the interaction between epistemic beliefs and text structure. Readers with misconceptions and more sophisticated epistemic beliefs engage in conceptual change processes, but only when reading refutation texts. Results also showed that memory for text is not affected by differences in epistemic beliefs or text structure. These findings contribute to our understanding of the relations among factors associated with text comprehension and have implications for theories of conceptual change.
Police Disclosures: A Critical Analysis of Some Recent Police Autobiographies
Authors: HOWE NICK , WILSON DAVID , KEMP DIANE
Published: April 2010

Abstract: Using a critical analysis of three recent British police memoirs this article considers some aspects of how the police memoir has changed over time, and specifically how these recent memoirs differ from the ‘up from the streets’ autobiographies of the past. The article uses this critical analysis to pursue further the idea of cop culture.
Modulation of heteromeric P2X1/5 receptors by phosphoinositides in astrocytes depends on the P2X1 subunit
Authors: Ase Ariel R. , Bernier Louis‐Philippe , Blais Dominique , Pankratov Yuriy , Séguéla Philippe
Published: April 2010

J. Neurochem.(2010)113, 1676–1684.

Purinergic signaling is critical for neuron‐glia communication. Glial cells participate in synaptic transmission and express metabotropic P2Y as well as ionotropic P2X ATP receptors. In astrocytes, endogenous ATP‐evoked currents with kinetics and pharmacology characteristic of the heteromeric P2X1/5 receptor channel have recently been reported. We investigated the interaction of major phosphoinositides with heteromeric P2X1/5 channels. Using patch‐clamp electrophysiology on enhanced green fluorescent protein‐expressing astrocytes acutely isolated from cortical slices of transgenic mice, we report a strong modulation of P2X1/5‐like currents by phosphoinositides. Wortmannin‐induced depletion of phosphoinositides decreases the amplitude of both the fast and sustained component of the P2X1/5‐like currents although recovery and kinetics remain intact. In transfected human embryonic kidney cells, we provide evidence that depleting phosphatidylinositol 4,5‐bisphosphate [PI(4,5)P2] levels significantly decreases P2X1/5 currents while intracellular application of PI(4,5)P2completely rescued P2X1/5 currents, ruling out the involvement of phosphatidylinositol 3,4,5‐trisphosphate. In contrast to P2X1, homomeric P2X5 current responses were found insensitive to phosphoinositides, and the C‐terminus of P2X5 subunit lacked binding to phospholipids in an overlay assay. Our results suggest that the contribution of calcium‐permeable heteromeric P2X1/5 receptor channels to the excitability of astrocytes is modulated by PI(4,5)P2through the P2X1 lipid‐binding domain.
Tear lipocalin and lysozyme concentrations in postmenopausal women
Authors: Srinivasan Sruthi , Joyce Elizabeth , Boone Adrienne , Simpson Trefford , Jones Lyndon , Senchyna Michelle
Published: April 2010

Purpose:  To investigate the potential relationship between subjective symptomatology, tear volume, and tear break up time with tear film lipocalin and lysozyme concentrations in a group of symptomatic dry‐eyed postmenopausal (PM) women compared to age‐matched controls.

Methods:  Eighty‐five healthy PM females (>50 years of age) were categorized as mild or moderate dry eye (DE), or asymptomatic [non‐dry eye (NDE)] based on their responses to the Ocular Surface Disease Index (OSDI) questionnaire. Non invasive tear breakup time (NITBUT) and tear secretion were measured. Tears were collected via capillary tube and an eye wash method. Tear lysozyme and lipocalin concentrations were determined via Western blotting.

Results:  Ocular Surface Disease Index responses revealed 16 mild DE, 30 moderate DE, and 39 NDE. The OSDI total score and sub scores for the DE groups were significantly greater than for the NDE group (p < 0.001). The mild and moderate DE groups exhibited significantly shorter NITBUTs compared to NDE (p < 0.004). Tear secretion using the Phenol Red Thread (PRT) test was found to be significantly lower in the moderate DE group compared to NDE (p < 0.001). No difference in tear lysozyme or lipocalin concentration was found between DE and NDE groups, irrespective of tear collection method, although method of collection significantly influenced absolute concentrations (p < 0.008). Significant correlations were not found between symptoms or signs of DE compared to either lipocalin or lysozyme concentration.

Conclusion:  Within a PM population, lipocalin and lysozyme are invariant, irrespective of the presence and severity of DE symptoms. This is the first comprehensive study of lipocalin and lysozyme in dry‐eyed PM women and our results suggest that neither protein would offer utility as a biomarker of DE.
Comparison of alternate cover test reliability at near in non‐strabismus between experienced and novice examiners
Authors: Hrynchak Patricia K. , Herriot Christopher , Irving Elizabeth L.
Published: April 2010

Purpose:  The purpose of this study was to determine the reliability of the prism neutralized alternate cover test (ACT) used to measure near phoria in non‐strabismic participants as measured by experienced and novice examiners and to compare the values to results obtained by eye tracking.

Methods:  Two experienced optometrists and two optometry students performed the ACT at 40 cm on 50 non‐strabismic participants. The ACT was then repeated with the subjects wearing an eye tracker. The saccade amplitude of the eye movement recordings was used to determine the phoria. The reliability was determined using Bland–Altman analysis to determine the mean of the differences in the groups and the 95% limits of agreement.

Results:  The phoria range determined by the eye tracker was between 6 pd eso and 19 pd exo. The mean of the difference in values and 95% limits of agreement between the experienced examiners was 0.7 ± 3.0 pd; between the novice examiners was −0.1 ± 4.4 pd; between the experienced and novice examiners was 0.8 ± 3.5 pd; between the eye tracker and the experienced examiners was 0.6 ± 3.5 pd; between the eye tracker and novice examiners was 1.4 ± 3.6 pd.

Conclusions:  The mean differences of the ACT result between experienced examiners, novice examiners, and the eye tracker, were not clinically meaningful. However, the 95% limits of agreement were quite high (±3.0–4.4 pd). This information is useful for clinical decision making, student education and student evaluation.
Soil erosion, muddy floods and the need for institutional memory
Authors: Boardman John , Vandaele Karel
Published: April 2010

The flooding of property by runoff from agricultural fields is an increasing problem in Europe. In two areas, southern England and central Belgium, the frequency of cases is high and relatively good databases exist. We examine the role of institutional memory in the success and failure to deal with muddy flooding. There appear to be four reasons for memory failure: inadequate transfer of information to the relevant people; lack of a legislative framework, particularly in the UK; a shortage of trained personnel; and institutional difficulties in dealing with an interdisciplinary problem. A successful institutional framework requires national or regional‐level legislation and funding; support for expert groups at the local level; availability of information on successful projects; a system of information dissemination to stakeholders; and active implementation of legislation by regulatory bodies. We suggest that a successful project involving cooperation between municipalities in the Melsterbeek catchment, Flanders, offers a model for action in other areas. Existing projects, such as the Catchment Sensitive Farming scheme in the UK, could learn from this success in Flanders.
Linking sustainable consumption and production: The government role
Authors: Stevens Candice
Published: April 2010

Achieving sustainable development depends on comprehensive approaches which integrate consumption and production initiatives. At present, sustainable consumption is being overemphasized to the neglect of the more important production side. This paper examines the role of governments in promoting sustainable consumption and production to identify gaps in national schemes which reduce their overall effectiveness. Public policy tools promoting sustainable consumption and production are discussed in terms of whether they are aimed at correcting: 1) market failures (regulations, taxes, subsidies); or 2) systems failures (labels, communications, education, public procurement). The challenge for governments is to link sustainable consumption initiatives to policies aimed at increasing the sustainability of production in the private sector in both their national and international dimensions. In this way, governments can enlist the aid of consumers in pushing producers towards sustainability and to achieve the ultimate goal of sustainable development.
Familial neonatal seizures with intellectual disability caused by a microduplication of chromosome 2q24.3
Authors: Heron Sarah E. , Scheffer Ingrid E. , Grinton Bronwyn E. , Eyre Helen , Oliver Karen L. , Bain Sharon , Berkovic Samuel F. , Mulley John C.
Published: April 2010

A family with dominantly inherited neonatal seizures and intellectual disability was atypical for neonatal and infantile seizure syndromes associated with potassium (KCNQ2 and KCNQ3) and sodium (SCN2A) channel mutations. Microsatellite markers linked to KCNQ2, KCNQ3, and SCN2A were examined to exclude candidate locations, but instead revealed a duplication detected by observation of three alleles for two markers flanking SCN2A. Characterization revealed a 1.57 Mb duplication at 2q24.3 containing eight genes including SCN2A, SCN3A, and the 3′ end of SCN1A. The duplication was partially inverted and inserted within or near SCN1A, probably affecting the expression levels of associated genes, including sodium channels. Rare or unique microchromosomal copy number mutations might underlie familial epilepsies that do not fit within the clinical criteria for the established syndromes.
Vigabatrin‐associated reversible MRI signal changes in patients with infantile spasms
Authors: Dracopoulos Aphrodite , Widjaja Elysa , Raybaud Charles , Westall Carol A. , Snead O. Carter
Published: April 2010

Purpose:  To evaluate the magnetic resonance imaging (MRI) of pediatric patients with infantile spasms (IS) treated with vigabatrin (VGB) in order to investigate whether VGB affects the brain.

Methods:  One hundred seven pediatric patients diagnosed with IS and treated with (n = 95) ≥120 mg/kg/day VGB or without (n = 12) VGB were included. MRI and diffusion‐weighted imaging (DWI) were retrospectively analyzed.

Results:  Of the patients who had MRI scans during, but not before, VGB treatment (n = 81), 25 (30.9%) exhibited abnormal MRI signal intensity and/or restricted DWI in the deep gray nuclei and brainstem. Follow‐up scans (performed in 15 of the 25 patients) revealed that these changes were reversible upon withdrawal of the medication. Analysis of patients undergoing scans before, during, and after VGB treatment (n = 14) revealed that four patients had abnormal MRI signal during treatment with VBG, two of whom reversed with cessation of VGB, one reversed without cessation of VGB, and another had persistent abnormal signal while being weaned from the VGB. Patients who had not received VGB treatment (n = 12) displayed normal imaging. Younger infants (≤12 months) and those with cryptogenic IS were more likely to develop abnormal signal changes on MRI during VGB treatment.

Discussion:  In pediatric patients, VGB induces reversible MRI signal changes and reversible diffusion restriction in the globi pallidi, thalami, brainstem, and dentate nuclei. The risk for this phenomenon was greater in younger infants and patients with cryptogenic IS.
The Relationship Between Self‐Reported Drinking and BAC Level in Emergency Room Injury Cases: Is it a Straight Line?
Authors: Bond Jason , Ye Yu , Cherpitel Cheryl J. , Room Robin , Rehm Jürgen , Borges Guilherme , Cremonte Mariana , Gmel Gerhard , Hao Wei , Sovinova Hana , Stockwell Tim
Published: April 2010

Background:  While the validity of self‐reported consumption based on blood alcohol concentration (BAC) has been found to be high in emergency room (ER) samples, little research exists on the estimated number of drinks consumed given a BAC level. Such data would be useful in establishing a dose–response relationship between drinking and risk (e.g., of injury) in those studies for which the number of drinks consumed is not available but BAC is.

Methods:  Several methods were used to estimate the number of drinks consumed in the 6 hours prior to injury based on BAC obtained at the time of ER admission of n = 1,953 patients who self‐reported any drinking 6 hours prior to their injury and who arrived to the ER within 6 hours of the event, from the merged Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the World Health Organization Collaborative Study on Alcohol and Injury across 16 countries.

Results:  The relationship between self‐reported consumption and averaged BAC within each consumption level appeared to be fairly linear up to about 7 drinks and a BAC of approximately 100 mg/dl. Above about 7 reported drinks, BAC appeared to have no relationship with drinking, possibly representing longer consumption periods than only the 6 hours before injury for those reporting higher quantities consumed. Both the volume estimate from the bivariate BAC to self‐report relationship as well as from a Widmark calculation using BAC and time from last drink to arrival to the ER indicated a somewhat weak relationship to actual number of self‐reported drinks.

Conclusions:  Future studies may benefit from investigating the factors suspected to be driving the weak relationships between these measures, including the actual time over which the reported alcohol was consumed and pattern of drinking over the consumption period.
Evaluation of the Tire Industry of China based on Physical Input–Output Analysis
Authors: YANG Ning , CHEN Dingjiang , HU Shanying , LI Yourun , JIN Yong
Published: April 2010

With the rapid development of the rubber industry and its downstream sectors in China, the resulting sharp increase in the number of scrap tires is creating great environmental pressure. By considering the tire production, consumption, collection, and reuse processes as a whole system of tire material flows, and based on physical input–output analysis (IOA), this article analyzes the status quo of China's tire industry and performs a comparative study between China and Europe. The study shows that the tire industry of China in 2005 and that of Europe in 1996 are similar in material‐flow characteristics. To make the best use of materials, it is necessary to strengthen the reuse of scrap tires in China. A scenario analysis is presented to show the effects of improving the reuse process from the viewpoint of IOA.
Effect of Medicare Part D on Potentially Inappropriate Medication Use by Older Adults
Authors: Fu Alex Z. , Tang Anne S. , Wang Nan , Du Dongyi (Tony) , Jiang Jenny Z.
Published: April 2010

OBJECTIVES: To empirically estimate changes of potentially inappropriate medication (PIM) use attributable to the Medicare Part D prescription drug benefit.

DESIGN: Difference‐in‐difference strategy in the quasi‐experimental design with a control group.

SETTING: U.S. nationally representative community‐dwelling sample of older adults.

PARTICIPANTS: One thousand seven hundred seventy‐four adults aged 65 and older in the 2005 and 2006 Medical Expenditure Panel Surveys were followed up for 2 years with five rounds of interviews.

MEASUREMENTS: PIM use was identified based on the 2002 Beers criteria. Analyses were conducted for likelihood of PIM use and number of PIM prescriptions using logit models and negative binomial models, respectively.

RESULTS: There was a trend of less likelihood of PIM use for all older adults from 2005 to 2006 (odds ratio=0.67, 95% confidence interval (CI)=0.52–0.86). After accounting for this secular trend and potential confounders, no significant difference of the likelihood of PIM use was found between Part D enrollees and nonenrollees, although enrollees were found to use significantly more PIM prescriptions in round 5 (in 2006) than nonenrollees (incidence rate ratio=1.56, 95% CI=1.08–2.25).

CONCLUSION: This initial evidence suggests that Medicare Part D could result in more PIM use in older enrollees than in nonenrollees, although the overall likelihood of PIM use has decreased in all older community‐dwelling adults. Future research is needed to examine the effect over the longer term and focusing on particular categories of PIMs.
Generic‐Only Drug Coverage in the Medicare Part D Gap and Effect on Medication Cost‐Cutting Behaviors for Patients with Diabetes Mellitus: The Translating Research into Action for Diabetes Study
Authors: Duru O. Kenrik , Mangione Carol M. , Hsu John , Steers W. Neil , Quiter Elaine , Turk Norman , Ettner Susan L. , Schmittdiel Julie A. , Tseng Chien‐Wen
Published: April 2010

OBJECTIVES: To examine the association between drug coverage during the Medicare Part D coverage gap and medication cost‐cutting behaviors of beneficiaries with diabetes mellitus who use and do not use insulin.

DESIGN: The study was cross‐sectional.

SETTING: A network‐model health system.

PARTICIPANTS: 2007 survey of Medicare Advantage Part D (MAPD) and Prescription Drug Plan (PDP) beneficiaries who entered the gap by October 2006 (N=1,468, 57% response rate).

MEASUREMENTS: The primary predictor variable was no gap coverage versus generic‐only gap coverage. Seven cost‐cutting behaviors were examined as dependent variables, including cost‐related nonadherence (CRN) to any medication. Covariates included race or ethnicity, education, health status, income, and comorbidities, as well as generic medication use in the first quarter. Logistic regression models were constructed using nonresponse weights to generate predicted percentages.

RESULTS: In multivariate analyses, beneficiaries taking insulin were less likely to report CRN if they had generic‐only gap coverage than if they had no gap coverage (16% vs 29%, P=.03). No differences in CRN according to type of gap coverage were seen between beneficiaries not taking insulin.

CONCLUSION: Medicare beneficiaries using insulin are at high risk of CRN. Generic‐only coverage during the gap is associated with an attenuated risk of CRN in insulin users, possibly because of savings on other, generic medications. Future research should evaluate CRN within alternative benefit designs covering selected brand name medications, such as insulin, during the gap.
A Longitudinal Analysis of Total 3‐Year Healthcare Costs for Older Adults Who Experience a Fall Requiring Medical Care
Authors: Bohl Alex A. , Fishman Paul A. , Ciol Marcia A. , Williams Barbara , LoGerfo James , Phelan Elizabeth A.
Published: April 2010

OBJECTIVES:To compare longitudinal changes in healthcare costs between fallers admitted to the hospital at the time of the fall (admitted), those not admitted to the hospital (nonadmitted), and nonfaller controls; test hypotheses related to differences in mean costs between and within these groups over time; and estimate the costs attributable to falling.

DESIGN:Longitudinal cohort.

SETTING:Group Health Cooperative of Puget Sound.

PARTICIPANTS:Seven thousand nine hundred ninety‐three nonadmitted fallers, 976 admitted fallers, and 8,956 nonfallers aged 67 and older enrolled in an integrated healthcare delivery system. Fallers were identified according to fall‐related E‐Codes and International Classification of Diseases, Ninth Revision codes recorded between January 1, 2004, and December 31, 2006. Nonfallers were frequency matched on age group and sex.

MEASUREMENTS:Quarterly costs during a 3‐year period were modeled using generalized estimating equations. Covariates included index age, sex, RxRisk (a comorbidity adjuster), fall status, time, and interactions between fall status and time.

RESULTS:Cost differences between the faller cohorts and nonfallers were greatest in quarters closest to the fall (allP<.01) and persisted throughout the entire year of follow‐up. Although nonfaller costs increased with time, faller cohort costs increased more quickly (allP<.01). For admitted fallers, 92% of costs incurred in the quarter of the fall were estimated to be attributable to falling ($27,745 of $30,038,P<.001).

CONCLUSION:Falls for which medical attention are sought resulted in higher costs than for nonfallers for up to 12 months after a fall, particularly for falls requiring hospitalization. Prevention efforts should focus on reducing fall‐related injuries requiring hospitalization because they produce the highest excess costs and have a higher likelihood of 1‐year mortality.
The Effect of Maintaining Cognition on Risk of Disability and Death
Authors: Yaffe Kristine , Lindquist Karla , Vittinghoff Eric , Barnes Deborah , Simonsick Eleanor M. , Newman Anne , Satterfield Suzanne , Rosano Caterina , Rubin Susan M. , Ayonayon Hilsa N. , Harris Tamara ,   for the Health, Aging and Body Compsition Study
Published: April 2010

OBJECTIVES: To determine whether long‐term maintenance of cognition is associated with health advantages such as lower mortality or incident disability in older adults.

DESIGN: Longitudinal cohort study.

SETTING: Community clinics at two sites.

PARTICIPANTS: Two thousand seven hundred thirty‐three adults with a mean age of 74 at baseline and 80 at follow‐up.

MEASUREMENTS: Cognitive function was assessed using the Modified Mini‐Mental State Examination (3MS), a test of global cognition, at least two times. Three cognitive groups were defined based on 4‐year participant‐specific slopes (maintainers, slopes of ≥0; minor decliners, slopes <0 but no more than 1 standard deviation (SD) below the mean; major decliners, slopes >1 SD below the mean). Whether the cognitive groups differed in mortality and incident disability during the subsequent 3 years was determined.

RESULTS: Nine hundred eighty‐four (36%) participants were maintainers, 1,314 (48%) were minor decliners, and 435 (16%) were major decliners. Maintainers had lower mortality (7% vs 14%, hazard ratio (HR)=0.48, 95% confidence interval (CI)=0.36–0.63) and incident disability (22% vs 29%, HR=0.74, 95% CI=0.62–0.89) than minor decliners. After adjustment for age, race, sex, education, apolipoprotein E ɛ4, depression, body mass index, stroke, hypertension, and diabetes mellitus, these differences remained. As expected, major decliners had greater mortality (20%) and incident disability (40%) than minor decliners.

CONCLUSION: A substantial proportion of older adults maintain cognitive function in their eighth and ninth decades of life. These older adults demonstrate lower risk of death and functional decline than those with minor cognitive decline, supporting the concept of “successful” cognitive aging.
Isolated Potentials and Pace‐Mapping as Guides for Ablation of Ventricular Tachycardia in Various Types of Nonischemic Cardiomyopathy
Authors: KÜHNE MICHAEL , ABRAMS GERALD , SARRAZIN JEAN‐FRANCOIS , CRAWFORD THOMAS , GOOD ERIC , CHUGH AMAN , EBINGER MATTHEW , JONGNARANGSIN KRIT , PELOSI, Jr. FRANK , ORAL HAKAN , MORADY FRED , BOGUN FRANK M.
Published: April 2010

Nonischemic Cardiomyopathy and Ventricular Tachycardia.  Background: In patients with prior infarction, isolated potentials (IPs) during sinus rhythm reflect fixed scar and often indicate sites critical for ventricular tachycardia (VT). The purpose of this study was to determine the value of IPs in conjunction with pace‐mapping to guide VT ablation in patients with various types of nonischemic cardiomyopathy.

Methods: Mapping and ablation of VT were performed in 35 consecutive patients (26 men, age 55 ± 13 years, ejection fraction 0.31 ± 0.14) with VT and various etiologies of nonischemic cardiomyopathy. Pace‐mapping was performed at sites with low voltage. Radiofrequency energy was delivered at sites with concealed entrainment or matching pace‐maps.

Results: One hundred ninety‐five VTs (mean cycle length 363 ± 88 ms) were induced. Sites with prespecified ablation criteria displaying IPs during sinus rhythm were recorded in 21 of 35 patients (60%, IP‐positive). In these patients, a total of 216 sites meeting prespecified ablation criteria were identified and 146 of 216 sites (68%) displayed IPs. Fifteen of 21 IP‐positive patients (71%) no longer had inducible VT after ablation. In 14 of 35 patients, no sites with IPs where prespecified ablation criteria were met were identified (IP‐negative) despite combined endocardial and epicardial mapping in 7 of 14 patients. Only 1 of 14 IP‐negative patients (7%) no longer had inducible VT at the end of the ablation procedure. During a mean follow‐up of 18 ± 13 months, 14 of 21 IP‐positive patients (67%) remained arrhythmia‐free, compared to 1 of 14 IP‐negative patients (7%; P < 0.01). Half of the IP‐negative patients had major adverse events due to recurrent arrhythmias, compared to none in IP‐positive patients.

Conclusion: IPs in conjunction with pace‐mapping are helpful for identifying critical isthmus areas for ablation of VT in patients with various types of nonischemic cardiomyopathy. Patients with nonischemic cardiomyopathy in whom the arrhythmogenic substrate is characterized by IPs have a more favorable outcome than patients in whom IPs are absent. J Cardiovasc Electrophysiol, Vol. 21, pp. 1017‐1023, September 2010)
False‐Aneurysm of the Mammary Artery: A Rare Complication of Pacemaker Implantation
Authors: PLOUX SYLVAIN , MUNOS EMMANUEL , BARANDON LAURENT , BORDACHAR PIERRE
Published: April 2010

J Cardiovasc Electrophysiol, Vol. 21, p. 1061, September 2010.
Mutation‐Specific Effects of Polymorphism H558R in SCN5A‐Related Sick Sinus Syndrome
Authors: GUI JUNHONG , WANG TAO , TRUMP DOROTHY , ZIMMER THOMAS , LEI MING
Published: April 2010

Effects of H558R on SSS‐Related Mutant Channels. Introduction: Mutations in SCN5A, the gene encoding α subunit of cardiac type sodium channel, Nav1.5, lead to familial sick sinus syndrome (SSS). Although several molecular mechanisms for this genetic condition have been explored, the underlying mechanisms for the variable genotype–phenotype relationships have not been well addressed. One of the important contributors to such relationships is the genetic background such as single‐nucleotide polymorphisms.

Methods and Results:
To clarify the effects of a common polymorphism in SCN5A gene, H558R, on SCN5A‐related SSS phenotype, we investigated the electrophysiological properties of all of the 13 known SSS‐related hNav1.5 mutant channels on both H558 and R558 background. Electrophysiological properties of hNav1.5 mutant channels were investigated by the whole‐cell patch clamp technique in HEK293 cells. When peak currents were affected by the mutation, cell surface biotinylation was performed to quantify the fraction of correctly cell membrane‐targeted mutant channels. Loss‐of‐function defect of D1275N in SCN5A was rescued by R558 through enhancing cell surface targeting and improving steady‐state activation of the mutant channels. In contrast, the defects of mutants E161K, P1298L, and R1632H were aggravated in the R558 background, mainly due to the reduced steady‐state availability of mutant channels. The electrophysiological properties of the remaining SSS‐related hNav1.5 mutants including the missense mutants (L212P, T220I, DelF1617, T187I, R878C, G1408R), and the truncated mutants (W1421X, K1578fs/52, R1623X) were not significantly affected by H558R.

Conclusion:
We conclude that polymorphism H558R has mutation‐specific effects on SCN5A‐related SSS. Our data highlight the importance of common genetic variants in modulating phenotypes of genetic diseases. (J Cardiovasc Electrophysiol, Vol. 21, pp. 564‐573, May 2010)
Embolization of the Stent to the Right Heart After a Motor Vehicle Accident
Authors: Hsiung Ming C. , Chang Yi Cheng , Wei Jeng , Lan Gong‐You , Lee Kuo Chen , Chang Chung‐Yi , Ou Ching‐Huei , Chou Yi‐Pen , Tsai Shen kou
Published: April 2010

Endovascular stent grafts have become increasingly used in the management of arterial trauma, chronic vascular occlusive diseases, and deep vein thrombosis (DVT). Here, we describe a case of stent migration to the right heart due to a motor vehicle accident in a patient with iliac venous stent implanted for venous stenosis. Computed tomography (CT) scan imaging identification of a metallic stent was superior to the standard two‐dimensional transesophageal echocardiography (TEE) techniques without imaging artifact from reverberation. However, real time three‐dimensional (3D) TEE can precisely defined a metallic stent in right heart oriented with shape and direction without consuming time compared to that of CT scanning. The use of 3DTEE can facilitate identification of intracardiac metallic foreign bodies perioperatively in a patient with accident and emergent unstable condition. (Echocardiography 2010;27:587‐589)