bluuebunny/crossref_metadata_2025 huggingface dataset:
A stimulatory role for the La-related protein 4B in translation
Authors: Schäffler Katrin , Schulz Kristina , Hirmer Anja , Wiesner Julia , Grimm Michael , Sickmann Albert , Fischer Utz
Published: June 2010

La-related proteins (LARPs) belong to an evolutionarily conserved family of factors with predicted roles in RNA metabolism. Here, we have analyzed the cellular interactions and function of LARP4B, a thus far uncharacterized member of the LARP family. We show that LARP4B is a cytosolic protein that accumulates upon arsenite treatment in cellular stress granules. Biochemical experiments further uncovered an interaction of LARP4B with the cytosolic poly(A) binding protein 1 (PABPC1) and the receptor for activated C Kinase (RACK1), a component of the 40S ribosomal subunit. Under physiological conditions, LARP4B co-sedimented with polysomes in cellular extracts, suggesting a role in translation. In agreement with this notion, overexpression of LARP4B stimulated protein synthesis, whereas knockdown of the factor by RNA interference impaired translation of a large number of cellular mRNAs. In sum, we identified LARP4B as a stimulatory factor of translation. We speculate that LARP4B exerts its function by bridging mRNA factors of the 3′ end with initiating ribosomes.
Turning the Educability Narrative: Samuel A. Kirk at the Intersection of Learning Disability and “Mental Retardation”
Authors: Danforth Scot , Slocum Laura , Dunkle Jennifer
Published: June 2010

It is often assumed that current disability constructs exist in conceptual isolation from one another. This article explores the tangled historical relationship between “mental retardation” and learning disability in the writings and speeches of special education pioneer Samuel A. Kirk. Beginning in the 1950s, Kirk repeatedly told an educability narrative that described children with low IQ scores as capable students worthy of instruction. However, when he tried to clearly distinguish between the new learning disability construct and the older mental retardation, Kirk altered his standard tale. True intellectual potential then shifted to the learning disability, leaving mental retardation doubly stigmatized as the disorder of educational infertility.
Adaptive Behavior Among Adults With Intellectual Disabilities and Its Relationship to Community Independence
Authors: Woolf Steve , Woolf Christine Merman , Oakland Thomas
Published: June 2010

This study examined relationships between general adaptive behavior and the degree of community independence displayed by 272 adults with intellectual disabilities. Specifically, the Adaptive Behavior Assessment System—Second Edition (ABAS-II; Harrison & Oakland, 2003) was completed for each participant and compared with actual levels of work and residential independence. The participants' adaptive behavior accounted for 40%–43% of the variance in their work and residence independence. The results from this field-based study indicated that participants who displayed higher levels of adaptive behavior generally worked and lived more independently. Participants with the lowest general adaptive behavior required the highest degree of community supports. Implications of these findings are discussed.
Factors Influencing Membership of U.S. Fish and Wildlife Service and U.S. Geological Survey Biologists in the American Fisheries Society
Authors: Lauber T. Bruce , Taylor Eric J. , Knuth Barbara A.
Published: June 2010

Membership in scientific societies is an avenue biologists may use to enhance their professional capabilities. We studied factors influencing federal biologists' membership in scientific societies, including the American Fisheries Society. We conducted an Internet survey of 3,755 U.S. Fish and Wildlife Service and 932 U.S. Geological Survey professionals. A greater proportion of U.S. Geological Survey biologists (90.2%) than U.S. Fish and Wildlife Service biologists (51.8%) were members of scientific societies. The factors most consistently correlated with membership in the American Fisheries Society included minimal external constraints, supervisor support, and membership of friends, peers, and supervisors in scientific societies. These results suggest that membership in scientific societies is influenced by the organizational culture of agencies. Agencies seeking to increase their employees' membership in scientific societies will be most successful if they create a culture in which involvement in scientific societies is expected and in which supervisors also participate.
“Even the Evil Need a Place to Live”: Wild Salmon, Salmon Farming, and Zoning of the Icelandic Coastline
Authors: Gudjonsson Sigurdur , Scarnecchia Dennis L.
Published: June 2010

In this article, we provide an historical overview of Icelandic Atlantic salmon (Salmo salar) farming, wild stock management, and the often dichotomous philosophical bases for these activities. We then discuss how Iceland has sought to balance the benefits of salmon farming with the benefits of and risk to wild stock management, valuable recreational fisheries, and protection of native wild fish fauna. Under regulations enacted in 2001 and expanded in 2004, the coastline is zoned with respect to salmon cage-rearing; cage-rearing is not permitted in the bays and fjords into which the most valuable salmon rivers drain. The zoning is provided as a compromise between opposing views. As experience is gained from salmon farming in designated areas, this information will be used to plan future development of the cage rearing industry in Iceland.
Fish Traits: A Database of Ecological and Life-history Traits of Freshwater Fishes of the United States
Authors: Frimpong Emmanual A. , Angermeier Paul L.
Published: June 2010

The need for integrated and widely accessible sources of species traits data to facilitate studies of ecology, conservation, and management has motivated development of traits databases for various taxa. In spite of the increasing number of traits-based analyses of freshwater fishes in the United States, no consolidated database of traits of this group exists publicly, and much useful information on these species is documented only in obscure sources. The largely inaccessible and unconsolidated traits information makes large-scale analysis involving many fishes and/or traits particularly challenging. We have compiled a database of > 100 traits for 809 (731 native and 78 nonnative) fish species found in freshwaters of the conterminous United States, including 37 native families and 145 native genera. The database, named Fish Traits, contains information on four major categories of traits: (1) trophic ecology; (2) body size, reproductive ecology, and life history; (3) habitat preferences; and (4) salinity and temperature tolerances. Information on geographic distribution and conservation status was also compiled. The database enhances many opportunities for conducting research on fish species traits and constitutes the first step toward establishing a central repository for a continually expanding set of traits of North American fishes.
The Adopt-a-Herring Program as a Fisheries Conservation Tool
Authors: Frank Holly J. , Mather Martha E. , Muth Robert M. , Pautzke Sarah M. , Smith Joseph M. , Finn John T.
Published: June 2010

Successful conservation depends on a scientifically literate public. We developed the Adopt-A-Herring program to educate nonscientists about fisheries and watershed restoration. This interactive educational and outreach project encouraged coastal residents to be involved in local watershed restoration. In the northeastern United States, river herring (Alosa spp.) are an important component of many coastal watersheds and often are the object of conservation efforts. In order to understand river herring spawning behavior and to improve the effectiveness of restoration efforts, our research tracked these fish via radiotelemetry in the lpswich River, Massachusetts. In our Adopt-A-Herring Program, participating stakeholder organizations adopted and named individual tagged river herring and followed their movements online. We also made information available to our adopters on our larger research goals, the mission and activities of other research and management agencies, examples of human actions that adversely affect watersheds, and opportunities for proactive conservation. Research results were communicated to adopters through our project web page and end-of-season summary presentations. Both tools cultivated a personal interest in river herring, stimulated discussion about fisheries and watershed restoration, educated participants about the goals and methods of scientists in general, and initiated critical thinking about human activities that advance or impede sustainability.
Guidelines for Propagation and Translocation for Freshwater Fish Conservation
Authors: George Anna L. , Kuhajda Bernard R. , Williams James D. , Cantrell Mark A. , Rakes Patrick L. , Shute J. R.
Published: June 2010

Reestablishment of locally extinct populations and augmentation of declining populations are management activities used with increasing frequency in the conservation of imperiled fishes in the United States. Unfortunately, these options were not always carefully or appropriately used in past cases, partly owing to a lack of guidelines that address scientifically-based protocols for propagation, translocation, reintroduction, and augmentation (PTRA). PTRA programs are an important management tool for the recovery of imperiled fishes when undertaken with careful planning, including everything from determining that PTRA is necessary to incorporating knowledge of life history and genetics into the PTRA plan. In addition, PTRA programs must also assemble advisory groups, obtain funding and permitting, construct and maintain propagation facilities, and raise community awareness of the program. Because such diverse skills are needed, successful PTRA programs should prepare for long-term partnerships to achieve the goal of recovery.
Factors Influencing Tropical Island Freshwater Fishes: Species, Status, and Management Implications in Puerto Rico
Authors: Neal J. Wesley , Lilyestrom Craig G. , Kwak Thomas J.
Published: June 2010

Anthropogenic effects including river regulation, watershed development, contamination, and fish introductions have substantially affected the majority of freshwater habitats in Europe and North America. This pattern of resource development and degradation is widespread in the tropics, and often little is known about the resources before they are lost. This article describes the freshwater resources of Puerto Rico and identifies factors that threaten conservation of native fishes. The fishes found in freshwater habitats of Puerto Rico represent a moderately diverse assemblage composed of 14 orders, 29 families, and 82 species. There are fewer than 10 species of native peripherally-freshwater fish that require a link to marine systems. Introductions of nonindigenous species have greatly expanded fish diversity in freshwater systems, and native estuarine and marine species (18 families) also commonly enter lowland rivers and brackish lagoons. Environmental alterations, including land use and development, stream channelization, pollution, and the impoundment of rivers, combined with nonnative species introductions threaten the health and sustainability of aquatic resources in Puerto Rico. Six principal areas for attention that are important influences on the current and future status of the freshwater fish resources of Puerto Rico are identified and discussed.
Differential Incorporation of Natural Spawners vs. Artificially Planted Salmon Carcasses in a Stream Food Web: Evidence from δ15N of Juvenile Coho Salmon
Authors: Shaff Courtney D. , Compton Jana E.
Published: June 2010

Placement of salmon carcasses is a common restoration technique in Oregon and Washington streams, with the goal of improving food resources and productivity of juvenile salmon. To explore the effectiveness of this restoration technique, we measured the Δ15N of juvenile coho salmon (Oncorhynchus kisutch) as an index of the incorporation of salmon-derived nutrients (SDN) in streams with varying amounts of natural spawners and artificially placed carcasses. Although Δ15N of juvenile coho salmon increased with salmon carcass mass in the stream channel, this relationship was only significant for natural spawners. Artificially placed carcasses did not appear to increase SDN utilization by juvenile coho salmon. Possible explanatory factors include the restricted spatial and temporal distribution of carcasses, general absence of eggs, and lack of substrate bioturbation associated with artificially placed carcasses. Our study suggests that artificially placed carcasses at the levels added in the Oregon Coast Range may not directly mimic the role of natural spawners in stream foodwebs.
Counterintuitive Responses of Fish Populations to Management Actions
Authors: Pine William E. , Martell Steven J. D. , Walters Carl J. , Kitchell James F.
Published: June 2010

Observed ecosystem responses to fisheries management experiments have often been either much smaller or in the opposite direction of the expected responses based on experience or population models. Examples of these responses can be found even for some very simple experimental management manipulations such as predator and prey manipulations in small lakes and ponds to fish population responses to harvest closures. Such counter-intuitive prediction failures offer opportunities to identify key processes and variables that are not widely considered in models used to evaluate ecosystem-based fisheries management policies. A common denominator in the case histories presented are unexpected behavioral responses and strong changes in juvenile survival rates of fish driven by changes in competition, predation, and behavioral responses to predation risk. These factors restructured many of the ecosystems in our simple examples, yet are not widely included in models currently used to evaluate ecosystem-based fisheries management policies. This represents a critical need in the development of modeling tools to evaluate ecosystem-based policies based on an iterative process of model building and model testing, using fisheries management actions as probing tools to learn more about the ecosystems being managed.
Risks of Introductions of Marine Fishes: Reply to Briggs
Authors: Courtenay Walter R. , Collette Bruce B. , Essington Timothy E. , Hilborn Ray , Orr James W. , Pauly Daniel , Randall John E. , Smith-Vaniz William F.
Published: June 2010

This is a rebuttal to a publication by John C. Briggs in the April 2008 issue of Fisheries in which he suggested introducing fishes and invertebrates from the North Pacific into the North Atlantic to increase diversity toward improving fisheries in the latter. We argue otherwise for reasons that Briggs downplayed or never considered. Using examples of introductions within the Pacific and the Atlantic, and movements of species from the Pacific to the Atlantic, we provide a record of failures and damage or dangers to native species from the few introductions that became successful. We argue that a lack of diversity of fishes and invertebrates in the North Atlantic versus that of the North Pacific is not the problem to be corrected by introductions as Briggs suggested. A record of overfishing and management policies is the problem in the North Atlantic. Introductions from the North Pacific to the North Atlantic are not worth the costs or the environmental risks involved.
Exploring the Peer Review Process: What is it, Does it Work, and Can it Be Improved?
Authors: De Vries Dennis R. , Marschall Elizabeth A. , Stein Roy A.
Published: June 2010

Though peer review is central to science, the process itself has received little formal evaluation. Here we provide an Overview to the literature on the peer-review process. Peer review has its drawbacks, including financial cost, time, reliability, and potential biases. An important gap in our knowledge is whether the process works. Although most manuscripts show some improvement after peer review, reviewers often disagree, and errors can escape the process. To date, we do not know whether papers published with peer review are generally improved over those without. Most journals use a single-blind approach (author blind to reviewers), whereas others use a double-blind approach, and a few use an open approach. Biases toward authors (institutional, geographic, gender) apparently exist in some fields. Unlike the formal training we receive in fisheries research and management, no formal training process exists for peer review—without mentoring, how are new reviewers produced? Based on our literature survey, we recommend consideration of double-blind review, implementation of a rating system for reviews of submitted manuscripts, and training and mentoring students to become good reviewers.
Making the Best Use of Modeled Data: Multiple Approaches to Sensitivity Analysis of a Fish-Habitat Model
Authors: Steel E. Ashley , McElhany Paul , Yoder Naomi J. , Purser Michael D. , Malone Kevin , Thompson Brad E. , Avery Karen A. , Jensen David , Blair Greg , Busack Craig , Bowen Mark D. , Hubble Joel , Kantz Tom
Published: June 2010

Fisheries management has become increasingly dependent on large and complex models; however, tools and technologies for model evaluation have lagged behind model development and application. Sensitivity analyses can test the degree to which particular model inputs or internal parameters affect model outputs and are recommended in model construction, calibration, and assessment. We describe three parallel sensitivity analyses of the Ecosystem Diagnosis and Treatment (EDT) model and draw combined conclusions. The details of how each agency conducted and utilized sensitivity analyses are outlined and the trade-offs between simpler and more intensive sensitivity analyses are described. Combined insights on the EDT model include identification of input parameters to which the model is surprisingly insensitive and quantification of prediction intervals. We conclude that known uncertainties in input data and internal parameters lead to large prediction intervals around estimates of population abundance and productivity but that the identification of high priority reaches for restoration and protection is relatively robust to these uncertainties. We recommend that sensitivity analyses are applied to all models used in fisheries management.
Invasive Species Policy at the Regional Level: A Multiple Weak Links Problem
Authors: Peters Jody A. , Lodge David M.
Published: June 2010

Policy is used to prevent the introduction and spread of invasive species. For aquatic invasive species that can easily cross political boundaries, regional policies are needed. A weak link problem occurs when regulations of individual jurisdictions increase the region-wide risk of species introductions, especially in adjacent jurisdictions. Such cross-jurisdictional weak links may be compounded by another sort of weak link within jurisdictions: inconsistent regulation among multiple vectors that may introduce the same species. We used crayfish as a model system to study regulations for anglers, bait dealers, the pet trade, and aquaculture across the Great Lakes region. We identified a continuum of regulations ranging from no regulations to those that prohibit all use of crayfish. Furthermore, regulations differed depending on state and vector. Many states had regulations that specifically targeted the invasive rusty crayfish (Orconectes rusticus). However, these regulations were enacted reactively only after rusty crayfish had become established in the state. The lack of regulatory consistency among the Great Lakes jurisdictions is creating a multiple weak links problem and making success unlikely in efforts to slow the spread of crayfishes and other invasive species throughout the region.
On the Boots of Fishermen: The History of Didymo Blooms on Vancouver Island, British Columbia
Authors: Bothwell Max L. , Lynch Donovan R. , Wright Harlan , Deniseger John
Published: June 2010

In 1989 blooms of the river benthic diatom Didymosphenia geminata (didymo) first appeared and rapidly spread among rivers on central Vancouver Island, covering the bottoms with thick, woolly-looking mats. Although didymo is native to North America, extensive field surveys of rivers on Vancouver Island and other data indicate that didymo blooms are new. No known environmental changes were associated with the onset of didymo blooms. However the pattern of didymo spread among rivers on Vancouver Island correlates with the activity of fishermen and the commercial introduction and widespread use of felt-soled waders in the late 1980s. Since 1994 nuisance blooms of didymo have appeared in numerous other places in the Northern Hemisphere and South Island, New Zealand, all areas frequented by fishermen. Actions by government agencies to educate the public and restrict the use of felt-soled waders have been undertaken in some jurisdictions and at least one commercial manufacturer of waders will discontinue production of felt-soled models in the near future.
Western Lake Trout Woes
Authors: Martinez Patrick J. , Bigelow Patricia E. , Deleray Mark A. , Fredenberg Wade A. , Hansen Barry S. , Horner Ned J. , Lehr Stafford K. , Schneidervin Roger W. , Tolentino Scott A. , Viola Art E.
Published: June 2010

In the western United States, the ability of non-native lake trout (Salvelinus namaycush) to attain large sizes, > 18 kg under favorable conditions, fueled the popularity of lake trout fisheries. In the past, restrictive regulations were adopted to increase lake trout abundance and produce trophy specimens. More recently, lake trout have become increasingly problematic because they prey upon and potentially compete with native and sport fishes. We review the experiences of agencies in seven western states which are considering or implementing strategies to address lake trout impacts despite management difficulties due to mixed public perception about lake trout's complex interactions with native or introduced fauna. Special regulations protecting lake trout have often been liberalized or rescinded to encourage their harvest and reduce their negative effects. More intensive methods to control or reduce lake trout abundance include promoting or requiring lake trout harvest, commercial-scale netting, disrupting spawning, and stocking sterile lake trout.
Efflux Pump Contribution to Multidrug Resistance in Clinical Isolates of Pseudomonas aeruginosa
Authors: Kiser Tyree H. , Obritsch Marilee D. , Jung Rose , McLaren Robert , Fish Douglas N.
Published: June 2010

Study Objective. To determine if increased expression of efflux pumps, mutations in the genes encoding regulatory proteins for efflux pumps, or the combination is associated with multidrug‐resistant (MDR) Pseudomonas aeruginosa isolates.

Design. Microbiologic evaluation of prospectively collected Pseudomonas aeruginosa isolates.

Setting. University teaching hospital.

Isolates. One hundred eight unique P. aeruginosa isolates—50 non‐MDR and 58 MDR isolates—obtained from pulmonary or blood sources from patients admitted to the intensive care unit between January 1, 1999, and December 31, 2004.

Measurements and Main Results. Isolates were considered MDR if they were resistant to at least three of the following four drugs: ciprofloxacin, tobramycin, ceftazidime, or imipenem. Possible mutations in efflux regulatory genes mexR, nfxB, and mexZ were analyzed by using polymerase chain reaction amplification and DNA sequencing. Determination of the expression of outer membrane proteins OprM and OprJ was performed by using sodium dodecyl sulfate‐polyacrylamide gel electrophoresis immunoblotting. Differences in regulatory gene mutations and outer membrane protein expression were compared between non‐MDR and MDR isolates. Among the 108 P. aeruginosa isolates, the MDR isolates were more likely to overexpress OprM compared with non‐MDR isolates (64% vs 2%, p<0.001). Mutations in mexR and mexZ were present in 64% and 26% of MDR strains, respectively, but were not associated with OprM overexpression or multidrug resistance. Expression of OprJ was not associated with MDR isolates (odds ratio [OR] 3.7, 95% confidence interval [CI] 0.7–18.5, p=0.11). Mutations in nfxB (12% of MDR strains) were also not associated with multidrug resistance (OR 3.5, 95% CI 0.7–17.8, p=0.13). Eight (100%) of 8 isolates with OprJ expression plus OprM overexpression, 12 (92%) of 13 isolates with combined mexR and mexZ mutations, 5 (100%) of 5 isolates with nfxB plus mexZ mutations, and 16 (100%) of 16 isolates with OprM overexpression plus mexZ mutations were MDR isolates.

Conclusion. The presence of one regulatory gene mutation or simple expression of a single outer membrane protein was not linked to multidrug resistance. However, OprM overexpression and multiple efflux regulatory gene mutations or efflux protein expression were associated with MDR P. aeruginosa isolates.
Impact of Enhanced External Counterpulsation on Canadian Cardiovascular Society Angina Class in Patients with Chronic Stable Angina: A Meta‐analysis
Authors: Shah Sachin A. , Shapiro Robert J. , Mehta Rina , Snyder Jeffrey A.
Published: June 2010

Study Objective. To evaluate the true magnitude of benefit from enhanced external counterpulsation (EECP) by determining the effect of EECP on Canadian Cardiovascular Society (CCS) angina class in patients with chronic stable angina.

Design. Meta‐analysis of 13 prospective studies that evaluated patients with stable angina and reported adequate data on CCS angina class.

Patients. A total of 949 adult patients with stable angina who underwent EECP treatment.

Measurements and Main Results. A systematic literature search of studies published between 1950 and February 2009 was performed. Studies were included for meta‐analysis if they were reported in the English language, included human subjects, had a prospective study design, and reported adequate data on CCS angina class. The EECP treatment consisted of 35 sessions—1 hour/day, 5 days/week, for 7 weeks. Improvement in angina class was reported as the weighted proportion of patients improving by at least one CCS class from before to after EECP treatment. Heterogeneity was assessed by performing subgroup analyses and using the Cochran Q statistic. Publication bias was assessed by inspection of funnel plots and the Egger bias statistic. Among the 13 studies incorporating 949 patients, angina class was reduced by at least one CCS score in 86% of the patients (95% confidence interval 82–90%, Q statistic p=0.008]. Inspection of funnel plots showed some asymmetry, but the Egger bias statistic showed no publication bias (p=0.97).

Conclusion. The results of our meta‐analysis call for further long‐term studies to determine the place of EECP therapy in the management of chronic stable angina. Currently, EECP therapy should be considered for patients with stable angina who are refractory to or not suitable for invasive therapy and/or medical management.
Aminoglycoside Pharmacokinetic Parameters in Neurocritical Care Patients Undergoing Induced Hypothermia
Authors: Mercer Jessica M. , Neyens Ron R.
Published: June 2010

Study Objective. To determine the effects of mild‐to‐moderate induced hypothermia—a neuroprotectant and/or therapeutic strategy for the management of intracranial hypertension in neurologically injured patients—on the pharmacokinetics of aminoglycoside therapy.

Design. Pharmacokinetic analysis.

Setting. Critical care unit at a university‐affiliated hospital.

Patients. Three patients, aged 22, 24, and 47 years, who received tobramycin and had documented tobramycin levels while undergoing induced hypothermia for more than 24 hours for intracranial hypertension.

Measurements and Main Results. For each of the three patients, predicted pharmacokinetic parameters (volume of distribution, first‐order elimination rate constant, half‐life, and renal drug clearance) based on population data were compared with their actual pharmacokinetic parameters that were calculated based on observed tobramycin serum levels. All three patients had a normal creatinine clearance, estimated according to established methods. When pharmacokinetic parameters were calculated after the first tobramycin dose using a one‐compartment method, all patients had a slower first‐order elimination rate and a larger volume of distribution compared with predicted population estimates.

Conclusion. These findings suggest that induced hypothermia may result in impaired elimination of aminoglycosides. Caution should be exercised when attempting to use predicted pharmacokinetic parameters to dose aminoglycosides in this patient population, and first‐dose pharmacokinetics should be considered to optimize the dose and dosing interval early in the course of therapy. Further investigation of this phenomenon with greater numbers of patients are needed to confirm these findings and to determine optimal dosing strategies of aminoglycosides in patients undergoing induced hypothermia.
Treatment Options for Chronic Refractory Idiopathic Thrombocytopenic Purpura in Adults: Focus on Romiplostim and Eltrombopag
Authors: Chouhan Jyoti D. , Herrington Jon D.
Published: June 2010

Idiopathic thrombocytopenic purpura (ITP) is a platelet disorder that affects approximately 1 in 10,000 people. In adults, the rate of spontaneous remission is only 5%, and generally, it is a chronic disease persisting for more than 6 months. Chronic refractory ITP may be defined as the failure of any modality to keep the platelet count above 20 × 103/mm3 for an appreciable time without unacceptable toxicity. Many pharmacologic treatments have been used to manage chronic refractory ITP by attempting to increase platelet counts by decreasing the rate of destruction of these cells. They include, but are not limited to, azathioprine, danazol, dapsone, combination chemotherapy cyclosporine, and rituximab. However, these therapies offer modest response rates and can cause adverse events that necessitate drug discontinuation. The recent United States Food and Drug Administration approval of the thrombo‐poietin mimetics, romiplostim and eltrombopag, has provided clinicians with a novel approach for treating chronic refractory ITP By stimulating platelet production, these drugs offer patients with this disease an alternative to the other agents. The preapproval phase III study with subcutaneous romiplostim showed significantly higher overall response rates versus placebo in both splenectomized and nonsplenectomized patients (83% for romiplostim vs 7% for placebo, p<0.0001). Twenty‐five percent of patients receiving romiplostim achieved a platelet count greater than 50 × 103/mm3 after 1 week, and 50% achieved this platelet count within 2–3 weeks. The preapproval phase III study with oral eltrombopag demonstrated that 70% of patients receiving 50 mg/day and 81% of patients receiving 75 mg/day achieved a platelet count of at least 50 × 103/mm3 by day 43 (p<0.001 vs placebo for both 50 and 75 mg). Forty‐four percent and 62% of patients achieved a platelet count of at least 50 × 103/mm3 by day 8 with eltrombopag 50 and 75 mg/day, respectively. When deciding which of these agents to prescribe, considerations include oral versus injectable dosage form, adverse‐event profiles, and patient adherence with both taking the drug and keeping clinic appointments for monitoring of platelet counts. Several studies are under way to evaluate these drugs in chronic refractory ITP as well as other disease states. Long‐term data will also be needed to assess the safety and efficacy of these agents.
Methylene Blue for the Treatment of Septic Shock
Authors: Paciullo Christopher A. , Horner Deanna McMahon , Hatton Kevin W. , Flynn Jeremy D.
Published: June 2010

Septic shock is a major cause of morbidity and mortality in the intensive care unit, and effective therapies are limited. Methylene blue is a selective inhibitor of guanylate cyclase, a second messenger involved in nitric oxide‐mediated vasodilation. The use of methylene blue in the treatment of septic shock has been repeatedly evaluated over the past 20 years, but data remain scarce. To evaluate the safety and efficacy of methylene blue for the treatment of septic shock, we conducted a literature search of the EMBASE (1974‐June 2009), MEDLINE (1966‐June 2009), and International Pharmaceutical Abstracts (1970‐June 2009) databases. All available studies published in English were reviewed. Observational studies with methylene blue have demonstrated beneficial effects on hemodynamic parameters and oxygen delivery, but use of methylene blue may be limited by adverse pulmonary effects. Methylene blue administration is associated with increases in mean arterial pressure while reducing catecholamine requirements in patients experiencing septic shock; however, its effects on morbidity and mortality remain unknown. Well‐designed, prospective evaluations are needed to define the role of methylene blue as treatment of septic shock.
Evaluation of Morbidity and Mortality Data Related to Cardiovascular Calcification from Calcium‐Containing Phosphate Binder Use in Patients Undergoing Hemodialysis
Authors: Mason Molly A. , Shepler Brian M.
Published: June 2010

Cardiovascular disease is the leading cause of death among patients with stage 5 chronic kidney disease. Several mechanisms are thought to contribute to vascular calcification and subsequent cardiovascular disease in patients who require hemodialysis. One of these mechanisms is the use of calcium‐containing phosphate binders to treat hyperphosphatemia. Although most phosphate binding occurs in the gastrointestinal tract, some calcium is inevitably absorbed and has the potential to perpetuate the calcium‐phosphorus product and the development of vascular and soft tissue calcification. Some phosphate binders such as sevelamer hydrochloride do not contain calcium and therefore may not carry the same risks. We examined the cardiovascular calcification effect and morbidity and mortality data with calcium‐containing phosphate binders compared with sevelamer hydrochloride when given to patients with stage 5 chronic kidney disease for the treatment of hyperphosphatemia. A literature search using the MEDLINE and PubMed databases identified relevant articles from 1989–2009; nine studies compared vascular calcification between a calcium‐containing phosphate binder and sevelamer hydrochloride. Three mortality studies were also identified. Seven of the nine studies reported a statistically significant increase in vascular calcification in patients taking calcium‐containing phosphate binders as measured by coronary artery calcification scores and aortic calcification scores. In two trials, lower mortality rates were observed in the patients receiving sevelamer hydrochloride compared with calcium‐containing phosphate binders. No significant difference in the mortality rate was observed in the third trial. Based on the current literature, it appears that calcium‐containing phosphate binders promote the progression of vascular calcification to a greater extent than does sevelamer hydrochloride. In addition, some evidence suggests that sevelamer hydrochloride may reduce all‐cause mortality rates in patients undergoing hemodialysis, particularly those aged 65 years or older. Thus, although sevelamer hydrochloride appears to be the more appropriate choice of phosphate binder for patients undergoing hemodialysis in whom cardiovascular calcification is a concern, more clinical trials are needed to further guide practitioners on the selection of phosphate binders.
Pharmacologic Prophylaxis of Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery: Beyond β‐Blockers
Authors: Davis Estella M. , Packard Kathleen A. , Hilleman Daniel E.
Published: June 2010

Postoperative atrial fibrillation (POAF) is a frequent complication of cardiac surgery that increases patient morbidity, length of stay, and hospital costs. A substantial body of evidence exists evaluating various pharmacologic and nonpharmacologic methods to decrease the occurrence of POAF in an effort to decrease its burden on the health care system. Evidence‐based guidelines support the use of β‐blockers as standard prophylaxis of POAF in patients undergoing cardiac surgery. Traditional prophylactic therapy for POAF targets the sympathetic nervous system, refractory period, and atrial conduction. However, associations between the development of POAF and the inflammatory process, oxidative stress, and atrial remodeling have prompted the investigation of novel therapies targeting these processes. To evaluate the role of pharmacologic strategies beyond β‐blockers in the prevention of POAF we conducted a search of the PubMed database to identify studies published from 1950–February 2009. Emphasis was placed on how these therapies could be used in patients intolerant to β‐blockers or as additive therapy in high‐risk patients. We found that sufficient evidence exists to recommend the use of amiodarone, sotalol, and possibly magnesium as monotherapy in patients unable to take β‐blockers or as add‐on therapy for the prevention of POAF Currently, available evidence does not support the use of propafenone, procainamide, digoxin, thiazolidinediones, triiodothyronine, or calcium channel blockers in the prevention of POAF Preliminary evidence suggests that dofetilide, angiotensin‐converting enzyme inhibitors, angiotensin II receptor blockers, 3–hydroxy‐3–methylglutaryl coenzyme A reductase inhibitors (statins), nonsteroidal antiinflammatory drugs, corticosteroids, omega‐3 fatty acids, ascorbic acid, N‐acetylcysteine, and sodium nitroprusside may be effective in preventing POAF. Additional large‐scale, adequately powered clinical studies are needed to determine the benefit of these agents before they can be considered for routine use.
Targeting the Brain: Neuroprotection and Neurorestoration in Ischemic Stroke
Authors: Saver Jeffrey L.
Published: June 2010

Many treatments for acute ischemic stroke are vessel and blood based, but brain‐based therapies also hold great promise. Acute neuroprotective therapies block the molecular elaboration of injury in hypoxic environments. Prehospital trials of magnesium sulfate are demonstrating the feasibility of delivering potentially brain‐protective agents in the first minutes after stroke onset. Subacute neurorestoration therapies enhance neuroplasticity and brain reorganization after stroke. The greatest clinical experience with agents that can potentiate brain repair has been gained with choline precursors. Therapies that target the brain in patients with stroke will increasingly complement and enhance traditional vasotherapeutics.
Ethnic Variations in the Estimated Prevalence of Orofacial Clefts in Taiwan, 2004 to 2006
Authors: Shen Yu-Ming , Wu Hsi-Wen , Deng Fong-Ling , See Lai-Chu
Published: June 2010

Background

Foreign-born mothers have been reported to have better pregnancy outcomes as measured by the preterm birth rate, neonatal mortality, and birth weight compared with native-born mothers in Belgium, France, Taiwan, and the United States. However, little is known about the association between maternal nationality and the prevalence of orofacial clefts in Asian countries.

Methods

Taiwan Birth Registry data from 2004 to 2006 were analyzed for an association between maternal nationality and orofacial clefts. Singleton live births with a gestational age ≥24 weeks were included in this study.

Results

The overall estimated prevalence percentages of orofacial clefts were 0.11 (95% confidence interval [CI] = 0.03 to 0.12) among newborns of Taiwan-born mothers (TBMs) and 0.13 (95% CI = 0.04 to 0.16) among newborns of foreign-born mothers (FBMs), respectively. The estimated prevalence of orofacial clefts of all live births of FBMs in Taiwan was similar to that of the FBMs from Southeast Asian countries.

Conclusion

There was a slightly higher but no significant difference of estimated prevalence of orofacial clefts between newborns of TBMs and newborns of FBMs in Taiwan.
New Clinical Method for Alveolar Bone Graft Evaluation in Cleft Patients: A Pilot Study
Authors: Peamkaroonrath Chonthicha , Godfrey Keith , Chatrchaiwiwatana Supaporn
Published: June 2010

The objective of this analytical cross-sectional study was to develop and test a new clinical evaluation method, using two sets of clinical criteria: (1) probing depth for teeth at either side of the grafted region and (2) residual defect at the central faciolingual region of the alveolar bone graft site, for assessing alveolar bone graft outcomes in patients with cleft of the lip and palate. Thirteen patients, 8 to 13 years old, with cleft lip and palate who underwent alveolar bone graft at Srinagarind Hospital and Faculty of Dentistry of Khon Kaen University were recruited into the study to test the agreement between two sets of data: (1) clinical examination scores and an expert's clinical judgment, (2) clinical and radiographic examination scores (Bergland and Chelsea scales). Study results showed that between the two criteria used in the new clinical method, reliability of the first criterion was higher than that of the second, .66 to 1.00 and .59 to .65, respectively. The reliability test for radiographic evaluation showed that the Chelsea scale had higher agreement than the Bergland, .80 to 1.00 and .64 to .86, respectively. Sensitivity, specificity, and likelihood ratio of the three proposed methods could not be concluded statistically due to the small sample size. In conclusion, even though the study sample was small, the method offers useful prospects as a supplement, if not an alternative, to overcome identified deficiencies of the Bergland and Chelsea scales and computed tomography scans, which raise concerns about radiation hazards and costs.
Environmental Regulation and Industry Dynamics
Authors: Sengupta Aditi
Published: June 2010

We examine the effect of more stringent environmental regulation on the dynamic structure of a deterministic competitive industry with endogenous entry and exit where firms invest in reduction of their future compliance cost. The level of regulation is exogenously fixed and constant over time. The compliance cost of a firm at each point of time depends on its current output, its accumulated past investment and the level of regulation. We outline sufficient conditions under which industries with more stringent regulation are associated with higher investment in compliance cost reduction and higher shake-out of firms over time; the opposite may be true under certain circumstances. Our analysis indicates that the effect of a change in regulation on market structure may be lagged over time.
The Effects of Fenofibric Acid Alone and With Statins on the Prevalence of Metabolic Syndrome and Its Diagnostic Components in Patients With Mixed Dyslipidemia
Authors: Bays Harold E. , Roth Eli M. , McKenney James M. , Kelly Maureen T. , Thakker Kamlesh M. , Setze Carolyn M. , Obermeyer Katie , Sleep Darryl J.
Published: June 2010

OBJECTIVE

To compare fenofibric acid (FA) + statin to respective monotherapies on the prevalence of metabolic syndrome and its diagnostic components in patients with mixed dyslipidemia.

RESEARCH DESIGN AND METHODS

Post hoc analysis of over 2,000 metabolic syndrome patients administered either FA + low- or moderate-dose statin; FA alone; or low-, moderate-, or high-dose statin alone.

RESULTS

FA + low- or moderate-dose statin combination therapy reduced the presence of metabolic syndrome (35.7 or 35.9%, respectively) more than low-, moderate-, or high-dose statin monotherapy (15.5, 16.6, or 13.8%, respectively), mostly due to improvements in triglycerides and HDL cholesterol levels. Mean glucose levels slightly decreased with FA monotherapy, slightly increased with statin monotherapy, and were essentially unchanged with FA + statin. FA with or without statin also reduced non-HDL cholesterol, apolipoprotein B, total cholesterol, VLDL cholesterol, and high-sensitivity C-reactive protein.

CONCLUSIONS

FA + statin in patients with mixed dyslipidemia reduces the prevalence of metabolic syndrome.
A1C Between 5.7 and 6.4% as a Marker for Identifying Pre-Diabetes, Insulin Sensitivity and Secretion, and Cardiovascular Risk Factors
Authors: Lorenzo Carlos , Wagenknecht Lynne E. , Hanley Anthony J.G. , Rewers Marian J. , Karter Andrew J. , Haffner Steven M.
Published: June 2010

OBJECTIVE

A1C is an optional method for diagnosing diabetes and also for detecting individuals at increased risk of the disease. However, how A1C compares with fasting (FPG) and 2-h plasma glucose for detecting at-risk individuals is not well known.

RESEARCH DESIGN AND METHODS

A 2-h glucose tolerance test, frequently sampled intravenous glucose tolerance test, and A1C were obtained at the follow-up examination in 855 participants in the Insulin Resistance Atherosclerosis Study (IRAS). For this report, 385 individuals were at increased risk of diabetes as defined by A1C between 5.7 and 6.4%, impaired glucose tolerance (IGT), and/or impaired fasting glucose (IFG).

RESULTS

IFG and IGT identified 69.1 and 59.5% of all individuals at increased risk of diabetes, respectively. A1C 5.7–6.4% detected 23.6% of all at-risk individuals, although more African Americans (31.4%) and Hispanics (35.2%) than non-Hispanic whites (9.9%). Relative to A1C, FPG was more strongly related to fasting insulin (r = 0.38 vs. 0.26; P < 0.01), acute insulin response (r = – 0.20 vs. – 0.09; P < 0.01), and waist circumference (r = 0.43 vs. 0.25; P < 0.001) by the Spearman correlation test. Similarly, 2-h plasma glucose was more strongly related to Si (r = – 0.40 vs. – 0.27; P < 0.01) and triglycerides (r = 0.30 vs. 0.08; P < 0.001).

CONCLUSIONS

A1C 5.7–6.4% is less sensitive for detecting at-risk individuals than IFG and IGT, particularly among non-Hispanic whites. Single determinations of FPG and 2-h plasma glucose seem to be more precise correlates of insulin resistance and secretion than A1C and, in general, better for other metabolic disorders.
Dynamical properties of an asymmetric bistable system with quantum fluctuations in the strong-friction limit
Authors: Zeng Chunhua , Gong Ailing , Xie Chongwei
Published: June 2010

The dynamical properties of an overdamped Brownian particle moving in an asymmetric bistable system with quantum fluctuations are investigated. Within the strong-friction limit (the quantum Smoluchowski regime), the analytic expression for the relaxation time of the system is derived by means of the projection-operator method, in which the effects of the memory kernels are taken into account. Based on the relaxation time, we consider both the overdamped quantum case and its classical counterpart.In these contexts, the effects of the quantum fluctuations and the asymmetry of the potential are discussed. It is found that: (i) The quantum effects in an asymmetric bistable system on time scales of the relaxation process are more prominent for lower temperatures and smaller asymmetries of the potential. (ii) The quantum effects speed up the rate of fluctuation decay of the state-space variable for lower temperatures. (iii) The asymmetry of the potential first slows down the rate of fluctuation decay of the state-space variable and then increases it.
Two integrable extensions of the Kadomtsev-Petviashvili equation
Authors: Wazwaz Abdul-Majid
Published: June 2010

In this work, two new completely integrable extensions of the Kadomtsev-Petviashvili (eKP) equation are developed. Multiple soliton solutions and multiple singular soliton solutions are derived to demonstrate the compatibility of the extensions of the KP equation.