bluuebunny/crossref_metadata_2025 huggingface dataset:
Delayed Nephron Sparing Surgery for Grade IV Renal Injury
Authors: Shah Parth K. , Frieben Ryan W. , DeSouza Rowena A.
Published: May 2013

Renal injuries are a common occurrence in many trauma cases. The management of these cases varies, but, currently, a conservative, nonoperative approach is the norm. In cases where an operative intervention may be necessary, emergency total nephrectomies are the most commonly performed procedure reported in the literature. There is a dearth in the reporting of other surgical approaches, especially the delayed nephron sparing approach. Here, we present a unique case of a 29-year-old male that underwent a delayed nephron sparing nephrectomy for a persistent urinoma despite appropriate noninvasive therapy.
Attachment to Parents and Peers as a Parameter of Bullying and Victimization
Authors: Nikiforou Militsa , Georgiou Stelios N. , Stavrinides Panayiotis
Published: May 2013

The purpose of the present study was threefold. First, we tried to investigate whether the quality of attachment with parents and peers predicts bullying and victimization. Second, we also attempted a moderation analysis in order to examine whether the relationship between quality of attachments and bullying is moderated by the child’s gender. Finally, we explored whether there are significant differences in the quality of attachment between children identified as bullies, victims, bully/victims, and uninvolved. The participants were 303 fifth and sixth grade children with a mean age of 11.06 years that completed the Revised Bullying and Victimization Questionnaire and the Inventory of Parent and Peer Attachment. The results showed that poor quality of attachment with parents and peers predicts bullying and victimization. Moderation analysis revealed that the link between quality of attachment and bullying and victimization is significantly stronger for girls. Also, as hypothesized, bullies and bully/victims manifest the worst quality of attachment with parents and peers. The results are discussed with the framework of attachment and aggression theory, exploring the pathways that explain the association between poor attachment and externalizing problems during late childhood.
Drought Tolerance in Modern and Wild Wheat
Authors: Budak Hikmet , Kantar Melda , Yucebilgili Kurtoglu Kuaybe
Published: May 2013

The genus Triticum includes bread (Triticum aestivum) and durum wheat (Triticum durum) and constitutes a major source for human food consumption. Drought is currently the leading threat on world′s food supply, limiting crop yield, and is complicated since drought tolerance is a quantitative trait with a complex phenotype affected by the plant′s developmental stage. Drought tolerance is crucial to stabilize and increase food production since domestication has limited the genetic diversity of crops including wild wheat, leading to cultivated species, adapted to artificial environments, and lost tolerance to drought stress. Improvement for drought tolerance can be achieved by the introduction of drought‐grelated genes and QTLs to modern wheat cultivars. Therefore, identification of candidate molecules or loci involved in drought tolerance is necessary, which is undertaken by “omics” studies and QTL mapping. In this sense, wild counterparts of modern varieties, specifically wild emmer wheat (T. dicoccoides), which are highly tolerant to drought, hold a great potential. Prior to their introgression to modern wheat cultivars, drought related candidate genes are first characterized at the molecular level, and their function is confirmed via transgenic studies. After integration of the tolerance loci, specific environment targeted field trials are performed coupled with extensive analysis of morphological and physiological characteristics of developed cultivars, to assess their performance under drought conditions and their possible contributions to yield in certain regions. This paper focuses on recent advances on drought related gene/QTL identification, studies on drought related molecular pathways, and current efforts on improvement of wheat cultivars for drought tolerance.
Piecewise Trend Approximation: A Ratio-Based Time Series Representation
Authors: Dan Jingpei , Shi Weiren , Dong Fangyan , Hirota Kaoru
Published: May 2013

A time series representation, piecewise trend approximation (PTA), is proposed to improve efficiency of time series data mining in high dimensional large databases. PTA represents time series in concise form while retaining main trends in original time series; the dimensionality of original data is therefore reduced, and the key features are maintained. Different from the representations that based on original data space, PTA transforms original data space into the feature space of ratio between any two consecutive data points in original time series, of which sign and magnitude indicate changing direction and degree of local trend, respectively. Based on the ratio-based feature space, segmentation is performed such that each two conjoint segments have different trends, and then the piecewise segments are approximated by the ratios between the first and last points within the segments. To validate the proposed PTA, it is compared with classical time series representations PAA and APCA on two classical datasets by applying the commonly used K-NN classification algorithm. For ControlChart dataset, PTA outperforms them by 3.55% and 2.33% higher classification accuracy and 8.94% and 7.07% higher for Mixed-BagShapes dataset, respectively. It is indicated that the proposed PTA is effective for high dimensional time series data mining.
Design and Customization of Telemedicine Systems
Authors: Martínez-Alcalá Claudia I. , Muñoz Mirna , Monguet-Fierro Josep
Published: May 2013

In recent years, the advances in information and communication technology (ICT) have resulted in the development of systems and applications aimed at supporting rehabilitation therapy that contributes to enrich patients’ life quality. This work is focused on the improvement of the telemedicine systems with the purpose of customizing therapies according to the profile and disability of patients. For doing this, as salient contribution, this work proposes the adoption of user-centered design (UCD) methodology for the design and development of telemedicine systems in order to support the rehabilitation of patients with neurological disorders. Finally, some applications of the UCD methodology in the telemedicine field are presented as a proof of concept.
Secure Method for Biometric-Based Recognition with Integrated Cryptographic Functions
Authors: Chiou Shin-Yan
Published: May 2013

Biometric systems refer to biometric technologies which can be used to achieve authentication. Unlike cryptography-based technologies, the ratio for certification in biometric systems needs not to achieve 100% accuracy. However, biometric data can only be directly compared through proximal access to the scanning device and cannot be combined with cryptographic techniques. Moreover, repeated use, improper storage, or transmission leaks may compromise security. Prior studies have attempted to combine cryptography and biometrics, but these methods require the synchronization of internal systems and are vulnerable to power analysis attacks, fault-based cryptanalysis, and replay attacks. This paper presents a new secure cryptographic authentication method using biometric features. The proposed system combines the advantages of biometric identification and cryptographic techniques. By adding a subsystem to existing biometric recognition systems, we can simultaneously achieve the security of cryptographic technology and the error tolerance of biometric recognition. This method can be used for biometric data encryption, signatures, and other types of cryptographic computation. The method offers a high degree of security with protection against power analysis attacks, fault-based cryptanalysis, and replay attacks. Moreover, it can be used to improve the confidentiality of biological data storage and biodata identification processes. Remote biometric authentication can also be safely applied.
Measuring Body Composition in Individuals with Intellectual Disability: A Scoping Review
Authors: Casey Amanda Faith
Published: May 2013

Background. Research shows obesity to be more prevalent amongst individuals with intellectual disability (ID) making correct measurement of body composition crucial. This study reviewed the validity and reliability of methods used for assessing body composition in individuals with ID.Methods. Authors conducted electronic searches through PubMed (1990 to present) and PsycINFO (1990 to present) and assessed relevant articles independently based on scoping review guidelines. Reviewers included primary research related to the validity and reliability of body composition measures on individuals with ID.Results. Searches identified six articles assessing body composition methods used on individuals with ID including body mass index (BMI), skinfold thickness, bioelectrical impedance analysis (BIA), waist circumference, tibia length, and anthropometric girth measurements. BMI and waist circumference appear suitable measures but skinfold thickness measurements may not be advisable due to participants' noncompliance resulting in a lack of precision and inaccurate results.Conclusions. The current literature contains too few well-conducted studies to determine the precision and validity of body composition measures on individuals with ID. There may be a need to devise further regression equations that apply to individuals with specific types of ID in order to increase the reliability and validity of body composition measurements.
The Potential Roles of18F-FDG-PET in Management of Acute Stroke Patients
Authors: Bunevicius Adomas , Yuan Hong , Lin Weili
Published: May 2013

Extensive efforts have recently been devoted to developing noninvasive imaging tools capable of delineating brain tissue viability (penumbra) during acute ischemic stroke. These efforts could have profound clinical implications for identifying patients who may benefit from tPA beyond the currently approved therapeutic time window and/or patients undergoing neuroendovascular treatments. To date, the DWI/PWI MRI and perfusion CT have received the most attention for identifying ischemic penumbra. However, their routine use in clinical settings remains limited. Preclinical and clinical PET studies with [18F]-fluoro-2-deoxy-D-glucose (18F-FDG) have consistently revealed a decreased18F-FDG uptake in regions of presumed ischemic core. More importantly, an elevated18F-FDG uptake in the peri-ischemic regions has been reported, potentially reflecting viable tissues. To this end, this paper provides a comprehensive review of the literature on the utilization of14C-2-DG and18F-FDG-PET in experimental as well as human stroke studies. Possible cellular mechanisms and physiological underpinnings attributed to the reported temporal and spatial uptake patterns of18F-FDG are addressed. Given the wide availability of18F-FDG in routine clinical settings,18F-FDG PET may serve as an alternative, non-invasive tool to MRI and CT for the management of acute stroke patients.
The Mammary Gland Carcinogens: The Role of Metal Compounds and Organic Solvents
Authors: Mulware Stephen Juma
Published: May 2013

The increased rate of breast cancer incidences especially among postmenopausal women has been reported in recent decades. Despite the fact that women who inherited mutations in the BRCA1 and BRCA2 genes have a high risk of developing breast cancer, studies have also shown that significant exposure to certain metal compounds and organic solvents also increases the risks of mammary gland carcinogenesis. While physiological properties govern the uptake, intracellular distribution, and binding of metal compounds, their interaction with proteins seems to be the most relevant process for metal carcinogenicity than biding to DNA. The four most predominant mechanisms for metal carcinogenicity include (1) interference with cellular redox regulation and induction of oxidative stress, (2) inhibition of major DNA repair, (3) deregulation of cell proliferation, and (4) epigenetic inactivation of genes by DNA hypermethylation. On the other hand, most organic solvents are highly lipophilic and are biotransformed mainly in the liver and the kidney through a series of oxidative and reductive reactions, some of which result in bioactivation. The breast physiology, notably the parenchyma, is embedded in a fat depot capable of storing lipophilic xenobiotics. This paper reviews the role of metal compounds and organic solvents in breast cancer development.
H∞Control for Multirate Networked Control Systems with Deadband Scheduling
Authors: Zhang Xiaobo , Chen Qingwei
Published: May 2013

This paper is concerned with the problem ofH∞control for multirate networked control systems with deadband scheduling policy and transmission delay. The transmission deadbands are set at the sensor nodes and the controller nodes to reduce the network traffic, and then the systems are modeled as discrete-time switch system with uncertain parameters. Using the Lyapunov theory, a robustH∞controller is designed to maintain the asymptotic stability of the closed-loop systems. Finally, a simulation example is presented to show the advantage of the deadband scheduling policy and the efficiency of the proposed theoretical results.
The Associations of Parenting Factors with Adolescent Body Mass Index in an Underserved Population
Authors: Schneider Elizabeth M. , Wilson Dawn K. , Kitzman-Ulrich Heather , George Sara M. St. , Alia Kassandra A.
Published: May 2013

Background. The current study examined parental factors related to risk of adolescent obesity within the context of a family systems framework.Methods. Seventy predominantly African American, low-income caregiver-adolescent dyads participated in the study. Validated measures of parental perceived child risk for development of type 2 diabetes mellitus, parental limit setting for sedentary behavior, and parental nurturance were evaluated as predictors of adolescent body mass index.Results. In this cross-sectional study, multiple linear regression demonstrated that parents of adolescents with higher zBMI reported worrying more about their child's risk of developing type 2 diabetes mellitus. Parent limit setting was also a significant predictor of adolescent zBMI. Contrary to expectations, higher levels of nurturance were associated with higher adolescent zBMI. Post hoc analyses revealed a trend towards a significant interaction between nurturance and limit setting, such that high levels of both parental nurturance and limit setting were associated with lower adolescent zBMI.Conclusions. Current findings suggest the importance of authoritative parenting and monitoring of adolescent health behaviors in the treatment of obesity.
The P66Shc/Mitochondrial Permeability Transition Pore Pathway Determines Neurodegeneration
Authors: Savino Costanza , Pelicci PierGiuseppe , Giorgio Marco
Published: May 2013

Mitochondrial-mediated oxidative stress and apoptosis play a crucial role in neurodegenerative disease and aging. Both mitochondrial permeability transition (PT) and swelling of mitochondria have been involved in neurodegeneration. Indeed, knockout mice for cyclophilin-D (Cyc-D), a key regulatory component of the PT pore (PTP) that triggers mitochondrial swelling, resulted to be protected in preclinical models of multiple sclerosis (MS), Parkinson’s disease (PD), and amyotrophic lateral sclerosis (ALS). However, how neuronal stress is transduced into mitochondrial oxidative stress and swelling is unclear. Recently, the aging determinant p66Shc that generates H2O2reacting with cytochrome c and induces oxidation of PTP and mitochondrial swelling was found to be involved in MS and ALS. To investigate the role of p66Shc/PTP pathway in neurodegeneration, we performed experimental autoimmune encephalomyelitis (EAE) experiments in p66Shc knockout mice (p66Shc−/−), knock out mice for cyclophilin-D (Cyc-D−/−), and p66Shc Cyc-D double knock out (p66Shc/Cyc-D−/−) mice. Results confirm that deletion of p66Shc protects from EAE without affecting immune response, whereas it is not epistatic to the Cyc-D mutation. These findings demonstrate that p66Shc contributes to EAE induced neuronal damage most likely through the opening of PTP suggesting that p66Shc/PTP pathway transduces neurodegenerative stresses.
US Agriculture under Climate Change: An Examination of Climate Change Effects on Ease of Achieving RFS2
Authors: Zhang Yuquan W. , McCarl Bruce A.
Published: May 2013

The challenges and opportunities facing today's agriculture within the climate change context are at least twofold: in addition to adapting to a potentially more variable climate, agriculture may also take on the addition role of mitigating GHG emissions—such as providing renewable fuels to replace fossil fuels to some extent. For the US, a large-scale GHG mitigation effort through biofuels production pursuant to the Renewable Fuel Standard (RFS2) is already unfolding. A question thus naturally arises for the RFS2-relevant US agricultural sector: will climate change make it harder to meet the volume goals set in the RFS2 mandates, considering that both climate change and RFS2 may have significant impacts on US agriculture? The agricultural component of FASOMGHG that models the land use allocation within the conterminous US agricultural sector is employed to investigate the effects of climate change (with autonomous adaptation at farm level), coupled with RFS2, on US agriculture. The analysis shows that climate change eases the burden of meeting the RFS2 mandates increasing consumer welfare while decreasing producer welfare. The results also show that climate change encourages a more diversified use of biofuel feedstocks for cellulosic ethanol production, in particular crop residues.
RHUPUS Syndrome in Children: A Case Series and Literature Review
Authors: Ziaee Vahid , Moradinejad Mohammad Hassan , Bayat Reyhaneh
Published: May 2013

Objective. Overlap of juvenile idiopathic arthritis (JIA) and juvenile systemic lupus erythematosus (JSLE) is a rare clinical condition in children. This condition has been described as RHUPUS syndrome. Prevalence of this syndrome and 3 cases are reported in this paper.Cases Presentation. During 10 years, 3 patients with SLE had chronic arthritis before or after diagnosis of SLE. Prevalence of this disorder in JSLE was 2.5%. Two patients were females and one of them was a male. According to our review, mean delay between chronic joint involvement and JSLE diagnosis was 50.1 months. In our case report, two females had joint erosion and one of them died due to heart failure, but in the literature review, just 45% cases had joint erosion and 70% cases were polyarticulare form.Conclusion. RHUPUS is unusual presentation of lupus in children. It seems that clinical feature and outcome of RHUPUS syndrome are different in children due to difference between RA and JIA. We suggest juvenile RHUPUS for overlap of JIA and JSLE.
Single Impulsive Controller for Exponential Synchronization of Stochastic Lur'e Networks with Impulsive Disturbance
Authors: Zhao Yi , Tang Ze , Feng Jianwen
Published: May 2013

The investigations are made on the exponential synchronization of the stochastic Lur'e system with nonlinear coupling and impulsive disturbance. The impulsive effects in complex networks could play a positive or a negative role for synchronization. For the sake of simplification and efficiency, a single impulsive controller is designed to realize the synchronization of the impulsive dynamical network with respect to stabilizing and destabilizing impulsive effects. Sufficient conditions are derived to guarantee the realization of the exponential synchronization for all initial values by means of the Lyapunov stability theorem, the comparison principle, and the linear matrix inequalities (LMIs). Numerical simulations are given to support the validity of the analytical results.
Antiurolithiatic Activity of Extract and Oleanolic Acid Isolated from the Roots of Lantana camara on Zinc Disc Implantation Induced Urolithiasis
Authors: Vyas Narendra , Argal Ameeta
Published: May 2013

The present study was done to evaluate the antiurolithiatic activity of ethanolic extract of roots (ELC 200 mg/kg) and oleanolic acid (OA 60 mg/kg, O.A. 80 mg/kg, O.A. 100 mg/kg) isolated from roots of Lantana camara in albino wistar male rats using zinc disc implantation induced urolithiatic model. The group in which only zinc disc was implanted without any treatment showed increase in calcium output (23  ± 2.7 mg/dL). Cystone receiving animals showed significant protection from such change (P<0.01). Treatment with OA and ELC significantly reduced the calcium output at a dose of OA 60 mg/kg (P<0.01), OA 80 mg/kg (P<0.01), ELC 200 mg/kg (P<0.01), and OA 100 mg/kg (P<0.001), as compared with zinc disc implanted group. The average weight of zinc discs along with the deposited crystals in the only disc implanted group was found to be 111±8.6 mg. Group that received Cystone 500 mg/kg showed significant reduction in the depositions (P<0.001). Similarly, the rats which received OA and ELC showed reduced formation of depositions around the zinc disc (P<0.001). The X-ray images of rats also showed significant effect of OA and ELC on urolitiasis. Thus, OA and ELC showed promising antiurolithiatic activity in dose dependant manner.
A Low Power Voltage Controlled Oscillator Design
Authors: Kumar Manoj
Published: May 2013

The performance of voltage controlled oscillator (VCO) is of great importance for any telecommunication or data transmission network. Here, voltage controlled oscillators (VCOs) using three-transistor NAND gates have been designed. New delay cell with three-transistor NAND gate has been used for designing the ring based VCO circuits. Three-, five-, and seven-stage VCOs have been proposed. Output frequency has been controlled with supply voltage variation from 1.8 V to 2.4 V. Three stage VCO shows output frequency variation in the range of 3.2909 GHz to 4.2280 GHz whereas power consumption varies in the range of 335.4071 μW to 486.1816 μW. Five-stage VCO depicts frequency in the range of 1.9406 GHz to 2.5769 GHz with power consumption variation from 559.0118 μW to 810.3027 μW. Moreover a seven-stage VCO shows frequency variation from 1.3984 GHz to 1.8077 GHz. Power consumption of seven-stage VCO varies from 782.6165 μW to 1134.400 μW. Phase noise results for these VCOs have also been obtained. Power consumption, output frequency, and phase noise results of proposed circuits have been compared with earlier reported circuits, and the proposed circuits show significant improvements.
KEAP1 Is a Redox Sensitive Target That Arbitrates the Opposing Radiosensitive Effects of Parthenolide in Normal and Cancer Cells
Authors: Xu Yong , Fang Fang , Miriyala Sumitra , Crooks Peter A. , Oberley Terry D. , Chaiswing Luksana , Noel Teresa , Holley Aaron K. , Zhao Yanming , Kiningham Kelley K. , Clair Daret K. St. , Clair William H. St.
Published: May 2013

Elevated oxidative stress is observed more frequently in cancer cells than in normal cells. It is therefore expected that additional exposure to a low level of reactive oxygen species (ROS) will push cancer cells toward death, whereas normal cells might maintain redox homeostasis through adaptive antioxidant responses. We previously showed that parthenolide enhances ROS production in prostate cancer cells through activation of NADPH oxidase. The present study identifies KEAP1 as the downstream redox target that contributes to parthenolide's radiosensitization effect in prostate cancer cells. In vivo, parthenolide increases radiosensitivity of mouse xenograft tumors but protects normal prostate and bladder tissues against radiation-induced injury. Mechanistically, parthenolide increases the level of cellular ROS and causes oxidation of thioredoxin (TrX) in prostate cancer cells, leading to a TrX-dependent increase in a reduced state of KEAP1, which in turn leads to KEAP1-mediated PGAM5 and Bcl-xL (BCL2L1) degradation. In contrast, parthenolide increases oxidation of KEAP1 in normal prostate epithelial cells, leading to increased Nrf2 (NFE2L2) levels and subsequent Nrf2-dependent expression of antioxidant enzymes. These results reveal a novel redox-mediated modification of KEAP1 in controlling the differential effect of parthenolide on tumor and normal cell radiosensitivity. Furthermore, they show it is possible to develop a tumor-specific radiosensitizing agent with radioprotective properties in normal cells. Cancer Res; 73(14); 4406–17. ©2013 AACR.
Optical Image-Guided Cancer Surgery: Challenges and Limitations
Authors: Keereweer Stijn , Van Driel Pieter B.A.A. , Snoeks Thomas J.A. , Kerrebijn Jeroen D.F. , Baatenburg de Jong Robert J. , Vahrmeijer Alexander L. , Sterenborg Henricus J.C.M. , Löwik Clemens W.G.M.
Published: May 2013

Optical image-guided cancer surgery is a promising technique to adequately determine tumor margins by tumor-specific targeting, potentially resulting in complete resection of tumor tissue with improved survival. However, identification of the photons coming from the fluorescent contrast agent is complicated by autofluorescence, optical tissue properties, and accurate fluorescent targeting agents and imaging systems. All these factors have an important influence on the image that is presented to the surgeon. Considering the clinical consequences at stake, it is a prerequisite to answer the questions that are essential for the surgeon. What is optical image-guided surgery and how can it improve patient care? What should the oncologic surgeon know about the fundamental principles of optical imaging to understand which conclusions can be drawn from the images? And how do the limitations influence clinical decision making? This article discusses these questions and provides a clear overview of the basic principles and practical applications. Although there are limitations to the intrinsic capacity of the technique, when practical and technical surgical possibilities are considered, optical imaging can be a very powerful intraoperative tool in guiding the future oncologic surgeon toward radical resection and optimal clinical results. Clin Cancer Res; 19(14); 3745–54. ©2013 AACR.
Mechanisms of the Protective Effects of Curcumin against Indomethacin-Induced Gastric Ulcer in Rats
Authors: Morsy Mohamed A. , El-Moselhy Mohamed A.
Published: May 2013

Background/Aims: Curcumin, a naturally occurring polyphenolic compound, exhibits anti-inflammatory and antioxidant properties that render it an attractive candidate for protection against gastric ulcer. The aim of this study is therefore to evaluate the protective effects of curcumin against indomethacin-induced gastric ulcer in rats. Methods: Gastric ulceration was induced by a single intraperitoneal injection of indomethacin (30 mg/kg). Curcumin (50 mg/kg, p.o.) was administered 30 min before ulcer induction. Results: Curcumin showed gastroprotective effects as evidenced by significant decreases in ulcer index, total acid output and pepsin activity in gastric juice in addition to gastric mucosal malondialdehyde concentration, and concomitant increases in gastric juice mucin concentration, gastric mucosal nitric oxide level and catalase and superoxide dismutase activities as compared to the indomethacin-induced ulcer group. Moreover, immunohistochemical investigations demonstrated that curcumin treatment markedly decreased expression of inducible nitric oxide synthase, nuclear factor-κB, and caspase-3. Conclusion: Curcumin protected the rats' gastric mucosa against indomethacin-induced gastric ulceration possibly, at least in part, by enhancement of the gastric mucosal barrier and reduction in acid secretory parameters in addition to antioxidant and antiapoptotic activities.
Association between Dietary Sodium and Potassium Intake with Chronic Kidney Disease in US Adults: A Cross-Sectional Study
Authors: Sharma Shailendra , McFann Kim , Chonchol Michel , de Boer Ian H. , Kendrick Jessica
Published: May 2013

Background/Aims: Clinical guidelines recommend a diet low in sodium and high in potassium to reduce blood pressure and cardiovascular events. Little is known about the relationship between dietary sodium and potassium intake and chronic kidney disease (CKD). Methods: 13,917 participants from the National Health and Nutrition Examination Survey (2001-2006) were examined. Sodium and potassium intake were calculated from 24-hour recall and evaluated in quartiles. CKD was defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 or eGFR ≥60 ml/min/1.73 m2 with albuminuria (>30 mg/g creatinine). Results: The mean (SE) age and eGFR of participants were 45.0 ± 0.4 years and 88.0 ± 0.60 ml/min/1.73 m2, respectively. 2,333 (14.2%) had CKD: 1,146 (7.3%) had an eGFR <60 ml/min/1.73 m2 and 1,514 (8.4%) had an eGFR ≥60 ml/min/1.73 m2 and albuminuria. After adjustment for age, sex, race, BMI, diabetes, hypertension, cardiovascular disease and congestive heart failure, subjects in the highest quartile of sodium intake had lower odds of CKD compared to subjects in the lowest quartile (adjusted OR: 0.79; 95% CI: 0.66-0.96; p < 0.016). Compared to the highest quartile, the odds of CKD increased 44% for participants in the lowest quartile of potassium intake (adjusted OR: 1.44; 95% CI: 1.16-1.79; p = 0.0011). Conclusions: Higher intake of sodium and potassium is associated with lower odds of CKD among US adults. These results should be corroborated through longitudinal studies and clinical trials designed specifically to examine the effects of dietary sodium and potassium intake on kidney disease and its progression.
Macrophage Polarization at the Crossroad Between HIV-1 Infection and Cancer Development
Authors: Alfano Massimo , Graziano Francesca , Genovese Luca , Poli Guido
Published: May 2013

Mononuclear phagocytes play a fundamental role in the tissue homeostasis and innate defenses against viruses and other microbial pathogens. In addition, they are likely involved in several steps of cancer development. Circulating monocytes and tissue macrophages are target cells of viral infections, including human cytomegalovirus, human herpes virus 8, and the HIV, and alterations of their functional and phenotypic properties are likely involved in many tissue-degenerative diseases, including atherosclerosis and cancer. Different tissue microenvironments as well as their pathological alterations can profoundly affect the polarization state of macrophages toward the extreme phenotypes conventionally termed M1 and M2. Thus, targeting disease-associated macrophages is considered a potential approach particularly in the context of cancer-associated tumor-associated macrophages, supporting malignant cell growth and progression toward a metastatic phenotype. Of note is the fact that tumor-associated macrophages isolated from established tumors display phenotypic and functional features similar to those of in vitro–derived M2-polarized cells. Concerning HIV-1 infection, viral eradication strategies in the context of combination antiretroviral therapy should also consider the possibility to deplete, at least transiently, certain mononuclear phagocytes subsets, although the possibility of distinguishing those that are either infected or pathogenically altered remains a goal of future research. In the present review, we will focus on the recent literature concerning the role of human macrophage polarization in viral infections and cancer.
Implantable Cardioverter Defibrillators in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
Authors: Schinkel Arend F.L.
Published: May 2013

Background—

Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is a cardiomyopathy characterized by ventricular arrhythmias and an abnormal right ventricle. Implantable cardioverter defibrillator (ICD) therapy may prevent sudden cardiac death in patients with ARVD/C. Currently, an overview of outcomes, appropriate and inappropriate interventions, and complications of ICD therapy in ARVD/C is lacking.

Methods and Results—

A literature search was performed to identify studies reporting outcome and complications in patients with ARVD/C who underwent ICD implantation. Of 641 articles screened, 24 studies on 18 cohorts were eligible for inclusion. In case of multiple publications on a cohort, the most recent publication was included in the meta-analysis. There were 610 patients (mean age, 40.4 years; 42% women), who had an ICD for primary or secondary prevention of sudden cardiac death. Risk factors for sudden cardiac death were presyncope (61%), syncope (31%), previous cardiac arrest (14%), ventricular tachycardia (58%), and ventricular fibrillation (6%). Antiarrhythmic medication consisted mostly of β-blockers (38%), amiodarone (14%), or sotalol (30%). During the 3.8-year follow-up, annualized cardiac mortality rate was 0.9%, annualized noncardiac mortality rate was 0.8%, and annualized heart transplant rate was 0.9%. The annualized appropriate and inappropriate ICD intervention rates were 9.5% and 3.7%, respectively. ICD-related complications consisted of difficult lead placement (18.4%), lead malfunction (9.8%), infection (1.4%), lead displacement (3.3%), and any complication (20.3%).

Conclusions—

Cardiac and noncardiac mortality rates after ICD implantation in patients with ARVD/C are low. Appropriate ICD interventions occur at a rate of 9.5%/y. Inappropriate ICD interventions and complications lead to considerable ICD-related morbidity.
The Impact of Renal Tubular Damage, as Assessed by Urinary β
2
–Microglobulin–Creatinine Ratio, on Cardiac Prognosis in Patients With Chronic Heart Failure
Authors: Otaki Yoichiro , Watanabe Tetsu , Shishido Tetsuro , Takahashi Hiroki , Funayama Akira , Narumi Taro , Kadowaki Shinpei , Hasegawa Hiromasa , Honda Shintaro , Netsu Shunsuke , Ishino Mitsunori , Arimoto Takanori , Miyashita Takehiko , Miyamoto Takuya , Konta Tsuneo , Kubota Isao
Published: May 2013

Background—

Renal dysfunction was reported to be closely associated with clinical outcomes in patients with chronic heart failure (CHF). Renal tubulointerstitial damage has been shown to be an important factor in the development of renal dysfunction as well as glomerular damage. However, the impact of renal tubular damage on clinical outcomes in patients with CHF remains to be determined.

Methods and Results—

Urinary β
2
–microglobulin–creatinine ratio was measured in 315 patients with CHF. Renal tubular damage was defined as a urinary β
2
–microglobulin–creatinine ratio ≥300 μg/g, as previously reported. Patients were prospectively followed up for a median period of 1097 days. There were 91 cardiac events, including 16 cardiac deaths and 75 rehospitalizations for worsening heart failure. Log
10
urinary β
2
–microglobulin–creatinine ratio was increased with worsening New York Heart Association functional class. Multivariate analysis revealed that renal tubular damage was an independent predictor of cardiac events. Kaplan–Meier analysis demonstrated that the rate of cardiac events was higher in patients with renal tubular damage compared with those without it. Patients were divided into 4 groups according to the presence of chronic kidney disease and renal tubular damage. The Cox proportional hazard analysis revealed that comorbidity of chronic kidney disease and renal tubular damage was associated with the highest risk for cardiac events compared with other groups.

Conclusions—

Renal tubular damage was related to the severity of heart failure and was associated with poor outcomes in patients with CHF. Renal tubular damage could add clinical information to chronic kidney disease in patients with CHF.
Preoperative INTERMACS Profiles Determine Postoperative Outcomes in Critically Ill Patients Undergoing Emergency Heart Transplantation
Authors: Barge-Caballero Eduardo , Segovia-Cubero Javier , Almenar-Bonet Luis , Gonzalez-Vilchez Francisco , Villa-Arranz Adolfo , Delgado-Jimenez Juan , Lage-Galle Ernesto , Perez-Villa Felix , Lambert-Rodríguez Jose L. , Manito-Lorite Nicolas , Arizon-Del Prado Jose M. , Brossa-Loidi Vicens , Pascual-Figal Domingo , Fuente-Galan Luis De la , Sanz-Julve Marisa , Muñiz-Garcia Javier , Crespo-Leiro Marisa
Published: May 2013

Background—

Postoperative outcomes of patients with advanced heart failure undergoing ventricular assist device implantation are strongly influenced by their preoperative Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profiles. We sought to investigate whether a similar association exists in patients undergoing emergency heart transplantation.

Methods and Results—

By means of the Spanish National Heart Transplant Registry database, we identified 704 adult patients treated with emergency heart transplantation in 15 Spanish centers between 2000 and 2009. Post-transplant outcomes were analyzed pertaining to patient preoperative INTERMACS profiles, which were retrospectively assigned by 2 blinded cardiologists. Before transplantation, INTERMACS profile 1 (critical cardiogenic shock) was present in 207 patients, INTERMACS profile 2 (progressive decline) in 291, INTERMACS profile 3 (inotropic dependence) in 176, and INTERMACS profile 4 (resting symptoms) was present in 30 patients. In-hospital postoperative mortality rates were, respectively, 43%, 26.8%, and 18% in patients with profiles 1, 2, and 3 to 4 (
P
<0.001). INTERMACS 1 patients also presented the highest incidence of primary graft failure (1: 31.3%, 2: 22.3%, 3–4: 21.8%;
P
=0.03) and postoperative need for dialysis (1: 33.2%, 2: 18.9%, 3–4: 21.5%;
P
<0.001). Adjusted odds-ratios for in-hospital postoperative mortality were 4.38 (95% confidence interval, 2.51–7.66) for profile 1 versus 3 to 4, 2.49 (95% confidence interval, 1.56–3.97) for profile 1 versus 2, and 1.76 (95% confidence interval, 1.02–3.03) for profile 2 versus 3 to 4. Long-term survival after hospital discharge was not influenced by preoperative INTERMACS profiles.

Conclusions—

Preoperative INTERMACS profiles determine outcomes after emergency heart transplantation. Results call for a change in policies related to the management of heart transplant candidates presenting with INTERMACS profiles 1 and 2.
Most Important Outcomes Research Papers on Treatment of Stable Coronary Artery Disease
Authors: Bikdeli Behnood , Ranasinghe Isuru , Chen Ruijun , Gupta Aakriti , Lampropulos Julianna F. , Kulkarni Vivek T. , Mody Purav S. , Dharmarajan Kumar ,   for the Editor
Published: May 2013

The following are highlights from the new series,
Circulation: Cardiovascular Quality and Outcomes
Topic Review. This series will summarize the most important manuscripts, as selected by the Editor, that have been published in the Circulation portfolio. The objective of this series is to provide our readership with a timely, comprehensive selection of important papers that are relevant to the quality and outcomes, and general cardiology audience. The studies included in this article represent the most significant research related to treatment of stable coronary artery disease (CAD).
Abnormal Propagation of Calcium Waves and Ultrastructural Remodeling in Recessive Catecholaminergic Polymorphic Ventricular Tachycardia
Authors: Liu Nian , Denegri Marco , Dun Wen , Boncompagni Simona , Lodola Francesco , Protasi Feliciano , Napolitano Carlo , Boyden Penelope A. , Priori Silvia G.
Published: May 2013

Rationale:

The recessive form of catecholaminergic polymorphic ventricular tachycardia is caused by mutations in the cardiac calsequestrin-2 gene; this variant of catecholaminergic polymorphic ventricular tachycardia is less well characterized than the autosomal-dominant form caused by mutations in the ryanodine receptor-2 gene.

Objective:

We characterized the intracellular Ca
2+
homeostasis, electrophysiological properties, and ultrastructural features of the Ca
2+
release units in the homozygous calsequestrin 2-R33Q knock-in mouse model (R33Q) R33Q knock-in mouse model.

Methods and Results:

We studied isolated R33Q and wild-type ventricular myocytes and observed properties not previously identified in a catecholaminergic polymorphic ventricular tachycardia model. As compared with wild-type cells, R33Q myocytes (1) show spontaneous Ca
2+
waves unable to propagate as cell-wide waves; (2) show smaller Ca
2+
sparks with shortened coupling intervals, suggesting a reduced refractoriness of Ca
2+
release events; (3) have a reduction of the area of membrane contact, of the junctions between junctional sarcoplasmic reticulum and T tubules (couplons), and of junctional sarcoplasmic reticulum volume; (4) have a propensity to develop phase 2 to 4 afterdepolarizations that can elicit triggered beats; and (5) involve viral gene transfer with wild-type cardiac calsequestrin-2 that is able to normalize structural abnormalities and to restore cell-wide calcium wave propagation.

Conclusions:

Our data show that homozygous cardiac calsequestrin-2–R33Q myocytes develop spontaneous Ca
2+
release events with a broad range of intervals coupled to preceding beats, leading to the formation of early and delayed afterdepolarizations. They also display a major disruption of the Ca
2+
release unit architecture that leads to fragmentation of spontaneous Ca
2+
waves. We propose that these 2 substrates in R33Q myocytes synergize to provide a new arrhythmogenic mechanism for catecholaminergic polymorphic ventricular tachycardia.
Immunohistochemical Analysis of Thrombi Retrieved During Treatment of Acute Ischemic Stroke
Authors: Singh Paramdeep , Doostkam Soroush , Reinhard Matthias , Ivanovas Vera , Taschner Christian A.
Published: May 2013

Background and Purpose—

To provide evidence whether mechanical thrombectomy with stent-retrievers in the treatment of acute ischemic stroke causes intimal damage.

Methods—

This study analyzed thrombi retrieved by mechanical thrombectomy from cerebral arteries in 48 consecutive patients with acute ischemic stroke for the presence of endothelial cells using CD34 antibodies.

Results—

Of 48 thrombi analyzed, CD34-positive cells were absent in 20, present as isolated cells in 21, and found in clusters in 7 thrombi. We did not find any subendothelial vessel wall structures.

Conclusions—

Our findings suggest that mechanical thrombectomy with stent-retrievers does not cause relevant intimal damage in acute ischemic stroke treatment.

Clinical Trial Registration—

URL:
http://www.germanctr.de
. Unique identifier: DRKS00004695
Explicit Consideration of Baseline Factors to Assess Recombinant Tissue-Type Plasminogen Activator Response With Respect to Race and Sex
Authors: Mandava Pitchaiah , Murthy Santosh B. , Munoz Melody , McGuire Dawn , Simon Roger P. , Alexandrov Andrei V. , Albright Karen C. , Boehme Amelia K. , Martin-Schild Sheryl , Martini Sharyl , Kent Thomas A.
Published: May 2013

Background and Purpose—

Sex and race reportedly influence outcome after recombinant tissue-type plasminogen activator (rtPA). It is, however, unclear whether baseline imbalances (eg, stroke severity) or lack of response to thrombolysis is responsible. We applied balancing methods to test the hypothesis that race and sex influence outcome after rtPA independent of baseline conditions.

Methods—

We mapped group outcomes from the National Institute of Neurological Disorders and Stroke (NINDS) dataset based on race and sex onto a surrogate-control function to assess differences from expected outcomes at their respective National Institutes of Health Stroke Scale and age. Outcomes were also compared for subjects matched individually on key baseline factors using NINDS and 2 recent datasets from southeastern United States.

Results—

At similar National Institutes of Health Stroke Scale and age, 90-day good outcomes (modified Rankin Score, 0–2) in NINDS were similarly improved after rtPA for white men and women. There was a strong trend for improvement in black men. Conversely, black women treated with rtPA showed response rates no different from the controls. After baseline matching, there were nonsignificant trends in outcomes except for significantly fewer good outcomes in black versus matched white women (37% versus 63%;
P
=0.027). Pooling the 3 datasets showed a similar trend for poorer short-term outcome for black women (
P
=0.054; modified Rankin Score, 0–1).

Conclusions—

Matching for key baseline factors indicated that race and sex influence outcome most strikingly in black women who demonstrated poorest outcomes after rtPA. This finding supports the hypothesis that poor response to rtPA, rather than differences in baseline conditions, contributes to the worse outcome. This finding requires prospective confirmation.
Is There a Stroke Belt in China and Why?
Authors: Xu Gelin , Ma Minmin , Liu Xinfeng , Hankey Graeme J.
Published: May 2013

Background and Purpose—

In 1960s, a stroke belt with high stroke mortality was discovered in the southeast United States. In China, where stroke is the leading cause of death, we aimed to determine whether a focal region of high stroke incidence (stroke belt) exits and, if so, the possible causal and modifiable factors.

Methods—

We systematically reviewed all studies of stroke incidence in China between 1980 and 2010, and included those which met our criteria for a high-quality study. Criteria for a provincial region of high stroke incidence were ranking in the top one third of all provinces for stroke incidence and ranking of more than one third of prefectural regions within the province in the top two sevenths of all prefectural regions for stroke incidence. We also reviewed regional distribution of major vascular risk factors, socioeconomic status, and demographic profiles in China.

Results—

Nine eligible studies provided data on the incidence of stroke in 32 of 34 provincial regions of China (with Hong Kong and Macao as exceptions) and 52% of the 347 prefectural regions. Nine provincial regions (Heilongjiang, Tibet, Jilin, Liaoning, Xinjiang, Hebei, Inner Mongolia, Beijing, and Ningxia) met our criteria for a region of high stroke incidence and constitute a stroke belt in north and west China. The incidence of stroke in the stroke belt was 236.2 per 100 000 population compared with 109.7 in regions outside the belt (rate ratio, 2.16; 95% confidence interval, 2.10–2.22). The mean population prevalence of hypertension and overweight (body mass index, >25) was greater in the stroke belt than that in other regions (15.3% versus 10.3%,
P
<0.001; 21.1% versus 12.3%,
P
=0.013, respectively). The prevalence of hypertension and overweight also correlated significantly with regional stroke incidence (
R
=0.642,
P
<0.001;
R
=0.438,
P
=0.014, respectively, by Spearman rank correlation).

Conclusions—

A stroke belt of high stroke incidence exists in 9 provincial regions of north and west China. The stroke belt may be caused, at least in part, by a higher population prevalence of hypertension and excess body weight. Lowering blood pressure and body weight in the stroke belt may reduce the geographic disparity in stroke risk and incidence in China.
Liar's Loan? Effects of Origination Channel and Information Falsification on Mortgage Delinquency
Authors: Jiang Wei , Nelson Ashlyn Aiko , Vytlacil Edward
Published: May 2013

This paper presents an analysis of mortgage delinquency between 2004 and 2008 using a loan-level data set from a major national mortgage bank. Our analysis highlights two problems underlying the mortgage crisis: a reliance on mortgage brokers who tend to originate lower-quality loans and a prevalence of low-documentation loans—known in the industry as “liar's loans”—that result in borrower information falsification. While over three-quarters of the difference in delinquency rates between bank and broker channels can be attributed to observable loan and borrower characteristics, the delinquency difference between full- and low-documentation mortgages is due to unobservable heterogeneity, about half of it potentially due to income falsification.
A new species of Scandarma (Crustacea: Brachyura: Sesarmidae) from Sabah, Borneo, Malaysia
Authors: NG PETER K.L.
Published: May 2013

A new species of terrestrial sesarmid crab, Scandarma raymondi, is described from Sabah, Malaysia. This is the third spe-cies in the genus; others are from Taiwan, Japan and Sarawak, Borneo. The new species differs from congeners in the live coloration, proportions of the carapace and ambulatory legs and morphologies of the male abdomen, chela and male first gonopod.