bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence-Based Approaches to Remedy and Also to Prevent Abuse of Community-Dwelling Older Persons
Authors: Wilson Donna M. , Ratajewicz Sandra E. , Els Charl , Asirifi Mary A.
Published: August 2011

Elder abuse is a global issue, with an estimated 4–10% of older persons in Canada abused each year. Although Canadian legislation has been created to prevent and punish the abuse of older persons living in nursing homes and other care facilities, community-dwelling older persons are at greater risk of abuse. This paper highlights the importance of evidence-based actions targeted at three determinants of health: (a) personal health practices and coping skills, (b) social support networks, and (c) social environments. Two research studies are profiled as case studies that illustrate the ready possibility and value of two specific types of actions on community-based older-person abuse. This paper argues for the immediate and widespread adoption of these evidence-based measures and for additional empirical evidence to guide the correction of underreporting of abuse, raise awareness of its serious nature, and increase options to not only stop it but ultimately prevent it.
Phantom Limb Pain: Mechanisms and Treatment Approaches
Authors: Subedi Bishnu , Grossberg George T.
Published: August 2011

The vast amount of research over the past decades has significantly added to our knowledge of phantom limb pain. Multiple factors including site of amputation or presence of preamputation pain have been found to have a positive correlation with the development of phantom limb pain. The paradigms of proposed mechanisms have shifted over the past years from the psychogenic theory to peripheral and central neural changes involving cortical reorganization. More recently, the role of mirror neurons in the brain has been proposed in the generation of phantom pain. A wide variety of treatment approaches have been employed, but mechanism-based specific treatment guidelines are yet to evolve. Phantom limb pain is considered a neuropathic pain, and most treatment recommendations are based on recommendations for neuropathic pain syndromes. Mirror therapy, a relatively recently proposed therapy for phantom limb pain, has mixed results in randomized controlled trials. Most successful treatment outcomes include multidisciplinary measures. This paper attempts to review and summarize recent research relative to the proposed mechanisms of and treatments for phantom limb pain.
Retrospective Comparison of Non-Skin-Sparing Mastectomy and Skin-Sparing Mastectomy with Immediate Breast Reconstruction
Authors: Kinoshita Satoki , Nojima Kimihiro , Takeishi Meisei , Imawari Yoshimi , Kyoda Shigeya , Hirano Akio , Akiba Tadashi , Kobayashi Susumu , Takeyama Hiroshi , Uchida Ken , Morikawa Toshiaki
Published: August 2011

Background. We compared Skin-sparing mastectomy (SSM) with immediate breast reconstruction and Non-skin-sparing mastectomy (NSSM), various types of incision in SSM.Method. Records of 202 consecutive breast cancer patients were reviewed retrospectively. Also in the SSM, three types of skin incision were used. Type A was a periareolar incision with a lateral extension, type B was a periareolar incision and axillary incision, and type C included straight incisions, a small elliptical incision (base line of nipple) within areolar complex and axillary incision.Results. Seventy-three SSMs and 129 NSSMs were performed. The mean follow-up was 30.0 (SSM) and 41.1 (NSSM) months. Respective values for the two groups were: mean age 47.0 and 57; seven-year cumulative local disease-free survival 92.1% and 95.2%; post operative skin necrosis 4.1% and 3.1%. In the SSM, average areolar diameter in type A & B was 35.4 mm, 43.0 mm in type C and postoperative nipple-areolar plasty was performed 61% in type A & B, 17% in type C, respectively.Conclusion. SSM for early breast cancer is associated with low morbidity and oncological safety that are as good as those of NSSM. Also in SSM, Type C is far superior as regards cost and cosmetic outcomes.
Seeing through the Ground: The Potential of Gravity Gradient as a Complementary Technology
Authors: Metje N. , Chapman D. N. , Rogers C. D. F. , Bongs K.
Published: August 2011

In the UK there is a huge legacy of buried utility service pipelines and cables beneath our streets and new services, such as fibre optic cables, are being added all the time. Much of this utility network is poorly mapped and recorded. It is therefore important to accurately locate and map these services to aid the installation of new, and repair and maintenance of existing, assets. This will help avoid damage to adjacent services and reduce the direct and social costs associated with finding buried utilities. This paper describes two major UK initiatives—Mapping the Underworld (MTU) and Gravity Gradient Technologies and Opportunities Programme (GG-TOP)—that aim to improve the way that we locate, map, and share information on buried utility services. MTU aims to develop a multisensor device to locate buried services, while GG-TOP aims to develop gravity gradient technology to deliver a (three orders of magnitude) step change in performance.
Prevalence of Congenital Malaria in Minna, North Central Nigeria
Authors: Omalu Innocent Chukwuemeka James , Mgbemena Charles , Mgbemena Amaka , Ayanwale Victoria , Olayemi Israel Kayode , Lateef Adeniran , Chukwuemeka Victoria I.
Published: August 2011

The study was designed to determine the true prevalence of congenital, cord, and placental malaria in General Hospital Minna, North Central Nigeria. Peripheral blood smears of near-term pregnant women, as well as the placental, cord, and peripheral blood smears of their newborn babies, were examined for malaria parasites, using the Giemsa staining technique. Out of 152 pregnant women screened, 21 (13.82%) of them were infected with malaria parasites. Of the 152 new born babies, 4 (2.63%) showed positive peripheral parasitaemia. Placental parasitaemia was 7/152 (4.61%), while cord blood parasitaemia was 9/152 (5.92%). There were strong associations between peripheral and cord malaria parasitaemia and congenital malaria (P<0.05).Plasmodium falciparumoccurred in all, and none had mixed infection. The average birth weights of the babies delivered of nonmalarious pregnant women were higher than those delivered by malarious pregnant women, though not significant (P>0.05). Malaria parasitaemia occurred more frequently in primigravidae than multigravidae.
EUS-Guided Biliary Drainage
Authors: Giovannini Marc , Bories Erwan
Published: August 2011

The echoendoscopic biliary drainage is an option to treat obstructive jaundices when ERCP drainage fails. These procedures compose alternative methods to the side of surgery and percutaneous transhepatic biliary drainage, and it was only possible by the continuous development and improvement of echoendoscopes and accessories. The development of linear setorial array echoendoscopes in early 1990 brought a new approach to diagnostic and therapeutic dimenion on echoendoscopy capabilities, opening the possibility to perform punction over direct ultrasonographic view. Despite of the high success rate and low morbidity of biliary drainage obtained by ERCP, difficulty could be found at the presence of stent tumor ingrown, tumor gut compression, periampulary diverticula, and anatomic variation. The echoendoscopic technique starts performing punction and contrast of the left biliary tree. When performed from gastric wall, the access is made through hepatic segment III. From duodenum, direct common bile duct punction. Dilatation is required before stent introduction, and a plastic or metallic stent is introduced. This phrase should be replaced by: diathermic dilatation of the puncturing tract is required using a 6F cystostome. The technical success of hepaticogastrostomy is near 98%, and complications are present in 36%: pneumoperitoneum, choleperitoneum, infection, and stent disfunction. To prevent bile leakage, we have used the 2 stent techniques, the first stent introduced was a long uncovered metallic stent (8 or 10 cm), and inside this first stent a second fully covered stent of 6 cm was delivered to bridge the bile duct and the stomach. Choledochoduodenostomy overall success rate is 92% and described complications include, in frequency order, pneumoperitoneum and focal bile peritonitis, present in 19%. By the last 10 years, the technique was especially performed in reference centers, by ERCP experienced groups, and this seems to be a general guideline to safer procedure execution.
Focused Ion Beam in the Study of Biomaterials and Biological Matter
Authors: Grandfield Kathryn , Engqvist Håkan
Published: August 2011

The application of focused ion beam (FIB) techniques in the life sciences has progressed by leaps and bounds over the past decade. A once dedicated ion beam instrument, the focused ion beam today is generally coupled with a plethora of complementary tools such as dual-beam scanning electron microscopy (SEM), environmental SEM, energy dispersive X-ray spectroscopy (EDX), or cryogenic possibilities. All of these additions have contributed to the advancement of focused ion beam use in the study of biomaterials and biological matter. Biomaterials, cells, and their interfaces can be routinely imaged, analyzed, or prepared for techniques such as transmission electron microscopy (TEM) with this comprehensive tool. Herein, we review the uses, advances, and challenges associated with the application of FIB techniques to the life sciences, with particular emphasis on TEM preparation of biomaterials, biological matter, and their interfaces using FIB.
Cross-talk between Phospho-STAT3 and PLCγ1 Plays a Critical Role in Colorectal Tumorigenesis
Authors: Zhang Peng , Zhao Yiqing , Zhu Xiaofeng , Sedwick David , Zhang Xiaodong , Wang Zhenghe
Published: August 2011

Hyperphosphorylation at the Y705 residue of signal transducer and activator of transcription 3 (STAT3) is implicated in tumorigenesis of leukemia and some solid tumors. However, its role in the development of colorectal cancer is not well defined. To rigorously test the impact of this phosphorylation on colorectal tumorigenesis, we engineered a STAT3 Y705F knock-in to interrupt STAT3 activity in HCT116 and RKO colorectal cancer cells. These STAT3 Y705F mutant cells fail to respond to cytokine stimulation and grow slower than parental cells. These mutant cells are also greatly diminished in their abilities to form colonies in culture, to exhibit anchorage-independent growth in soft agar, and to grow as xenografts in nude mice. These observations strongly support the premise that STAT3 Y705 phosphorylation is crucial in colorectal tumorigenesis. Although it is generally believed that STAT3 functions as a transcription factor, recent studies indicate that transcription-independent functions of STAT3 also play an important role in tumorigenesis. We show here that wild-type STAT3, but not STAT3 Y705F mutant protein, associates with phospholipase Cγ1 (PLCγ1). PLCγ1 is a central signal transducer of growth factor and cytokine signaling pathways that are involved in tumorigenesis. In STAT3 Y705F mutant colorectal cancer cells, PLCγ1 activity is reduced. Moreover, overexpression of a constitutively active form of PLCγ1 rescues the transformation defect of STAT3 Y705F mutant cells. In aggregate, our study identifies previously unknown cross-talk between STAT3 and the PLCγ signaling pathways that may play a critical role in colorectal tumorigenesis. Mol Cancer Res; 9(10); 1418–28. ©2011 AACR.
Metabolic Programming in the Immediate Postnatal Life
Authors: Patel Mulchand S. , Srinivasan Malathi
Published: August 2011

The metabolic programming effects of nutritional modifications in the immediate postnatal life are increasingly recognized to independently contribute to the development of metabolic syndrome in later life. Adjustment of litter size in rodents has been used to induce either under- or overnourishment in the immediate postnatal life of the offspring. While undernourishment led to growth retardation in the offspring, overnourishment produced increased body weight gains, hyperinsulinemia and hyperleptinemia. Overnourishment during the suckling period induced several adaptations in the energy circuitry in the hypothalamus of the offspring predisposing them for the onset of obesity later in life. Another approach for a nutritional modification in the immediate postnatal period is the artificial rearing of newborn rat pups on a high-carbohydrate (HC) milk formula without changes in the total calorie availability. Hyperinsulinemia, immediately evident in the HC pups, persisted in the post-weaning period even after withdrawal of the HC milk. Significant alterations in pancreatic islets supported chronic hyperinsulinemia in the HC rats. Alterations in the gene expression of hypothalamic neuropeptides predisposing to hyperphagia were evident during the period of the HC dietary modification. The persistence of these hypothalamic adaptations supported the obese phenotype in adult HC rats. A transgenerational effect gave rise to the development of chronic hyperinsulinemia and adult-onset obesity in the offspring of the HC female rats. Other studies have shown that lactation by a diabetic, obese or malnourished mother resulted in predisposition for the onset of metabolic disorders in the offspring. These observations from animal studies on the metabolic programming effects due to altered nutritional experiences in the immediate postnatal life strongly suggest that altered feeding practices for infants (formula feeding and early introduction of infant foods) could contribute to the rising incidence of overweight/obesity in children and adults.
Identification by Differential Tissue Proteome Analysis of Talin-1 as a Novel Molecular Marker of Progression of Hepatocellular Carcinoma
Authors: Kanamori Hideaki , Kawakami Takao , Effendi Kathryn , Yamazaki Ken , Mori Taisuke , Ebinuma Hirotoshi , Masugi Yohei , Du Wenlin , Nagasaka Keiko , Ogiwara Atsushi , Kyono Yutaka , Tanabe Minoru , Saito Hidetsugu , Hibi Toshifumi , Sakamoto Michiie
Published: August 2011

Objective: Hepatocellular carcinoma (HCC) is characterized by a multistage process of tumor progression. This study addressed its molecular features to identify novel protein candidates involved in HCC progression. Methods: Using liquid chromatography-tandem mass spectrometry, proteomes of 4 early HCCs and 4 non-HCC tissues derived from 2 cases of liver transplant surgery were compared with respect to the separation profiles of their tryptic peptides. Immunohistochemistry was performed on 106 HCC nodules to confirm the results of the proteomic analysis. Results: Statistical analysis of the profiles selected the peptide peaks differentiating HCC from non-HCC. A database search of the tandem mass spectrometry data from those peptide peaks identified 61 proteins, including a cytoskeletal protein, talin-1, as upregulated in HCC. Talin-1 expression levels in HCC nodules were significantly associated with the dedifferentiation of HCC (p = 0.001). A follow-up survey of the examined clinical cases revealed a correlation between talin-1 upregulation and a shorter time to recurrence after resection (p = 0.039), which may be related to the higher rate of portal vein invasion in HCCs with talin-1 up-regulation (p = 0.029). Conclusions: Proteomic analysis led to identification of talin-1 as a promising HCC marker. Talin-1 upregulation is associated with HCC progression and may serve as a prognostic marker.
Repeated Provocation of Time- and ATP-Induced Early Pulmonary Vein Reconnections After Pulmonary Vein Isolation
Authors: Yamane Teiichi , Matsuo Seiichiro , Date Taro , Lellouche Nicolas , Hioki Mika , Narui Ryosuke , Ito Keiichi , Tanigawa Shin-ichi , Yamashita Seigo , Tokuda Michifumi , Yoshida Hiroshi , Inada Keiichi , Shibayama Kenri , Miyanaga Satoru , Miyazaki Hidekazu , Abe Kunihiko , Sugimoto Ken-ichi , Yoshimura Michihiro
Published: August 2011

Background—

Recurrence of atrial fibrillation (AF) after successful pulmonary vein isolation (PVI) occurs mainly due to the reconnection of the once isolated PV. Although provocation and elimination of the early pulmonary vein reconnection (EPVR) soon after PVI has been widely performed to improve the outcome, AF recurrence due to subsequent PV reconnections still occurs. In this study, we repeatedly provoked and eliminated the EPVR to determine the appropriate procedural end point.

Methods and Results—

Seventy-five patients with paroxysmal AF underwent PVI. EPVR was provoked by both time and ATP induction every 30 minutes until 90 minutes after the individual isolation of all PVs. The number of reconnected atrio-PV gaps were evaluated and reablated at each provocation step. Although both time- and ATP-dependent EPVR was induced most frequently at 30 minutes after PVI (75 and 76 gaps, respectively), the prevalence of induced EPVR at 60 minutes was still high (64 and 36 gaps induced by time and ATP, respectively). Only a small number of EPVR appeared at 90 minutes after the elimination of all EPVR by 60 minutes (8 gaps,
P
<0.01). During the mean follow-up period of 370 days, 92% of cases were free from AF without antiarrhythmic drugs.

Conclusions—

Provocation and elimination of time- and ATP-induced EPVR not only at 30 minutes but also at 60 minutes is recommended after PVI to improve its efficacy.
Human Ventricular Fibrillation During Global Ischemia and Reperfusion
Authors: Bradley Chris P. , Clayton Richard H. , Nash Martyn P. , Mourad Ayman , Hayward Martin , Paterson David J. , Taggart Peter
Published: August 2011

Background—

Ischemic ventricular fibrillation in experimental models has been shown to progress through a series of stages. Progression of ischemic VF in the in vivo human heart has not been determined.

Methods and Results—

We studied 10 patients undergoing cardiac surgery. Ventricular fibrillation was induced by burst pacing. After 30 seconds, global myocardial ischemia was induced by aortic cross-clamp and maintained for 2.5 minutes, followed by coronary reflow. Epicardial activity was sampled (1 kHz) with a sock that contained 256 unipolar contact electrodes. Dominant frequencies were calculated with a fast Fourier transform with a moving window. The locations of phase singularities and activation wavefronts were identified at 10-ms intervals. Preischemic (perfused) ventricular fibrillation was maintained by a disorganized mix of large and small wavefronts. During global myocardial ischemia, mean dominant frequencies decreased from 6.4 to 4.7 Hz at a rate of −0.011±0.002 Hz s
−1
(
P
<0.001) and then increased rapidly to 7.4 Hz within 30 seconds of reflow. In contrast, the average number of epicardial phase singularities increased during ischemia from 7.7 to 9.7 at a rate of 0.013±0.005 phase singularities per second (
P
<0.01) and remained unchanged during reflow, at 10.3. The number of wavefronts showed a similar time course to the number of phase singularities.

Conclusions—

In human ventricular fibrillation, we found an increase in complexity of electric activation patterns during global myocardial ischemia, and this was not reversed during reflow despite an increase in activation rate.
Epicardial Ablation for Ventricular Tachycardia
Authors: Della Bella Paolo , Brugada Josep , Zeppenfeld Katja , Merino Jose , Neuzil Petr , Maury Philippe , Maccabelli Giuseppe , Vergara Pasquale , Baratto Francesca , Berruezo Antonio , Wijnmaalen Adrianus P.
Published: August 2011

Background—

The purpose of this study was to describe the epicardial percutaneous ablation experience of 6 European high-volume ventricular tachycardia (VT) ablation centers.

Methods and Results—

Data from 218 patients with coronary artery disease (CAD, n=85 [39.0%]), idiopathic dilated of patients with idiopathic VT cardiomyopathy (IDCM, n=67 [30.7%]), arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARCD/C, n=13 [6%]), hypertrophic cardiomyopathy (HCM, n=5 [2.3%]), and absence of structural heart disease (n=48 [22%]) undergoing epicardial subxyphoid access for VT ablation were collected. The epicardial approach was attempted as first-line treatment in 78 patients (35.8%). Acute prevention of VT inducibility was obtained in 156 patients (71.6%). There were no procedure-related deaths. Cardiac tamponade occurred in 8 patients, and abdominal hemorrhage in 1 patient. Six patients died of electrical storm recurrence within 48 hours from the procedure. After a mean follow-up of 17.3±18.2 months, 60 patients (31.4%) presented with VT recurrence (39.3% of IDCM patients; 34.7% of CAD patients; 30.8% of ARVD/C patients; 25% of HCM patients; 17.1% of patients with idiopathic VT). Twenty patients (10.4%) died during follow-up (12 of heart failure, 2 of cardiac arrest, and 6 of extracardiac causes).

Conclusions—

In experienced centers, epicardial ablation of VT has an acceptable risk and favorable outcome. In selected patients, it is reasonable to consider as a first-line ablation approach.
Influence of Race on Atrial Fibrillation After Cardiac Surgery
Authors: Rader Florian , Van Wagoner David R. , Ellinor Patrick T. , Gillinov A. Marc , Chung Mina K. , Costantini Otto , Blackstone Eugene H.
Published: August 2011

Background—

Despite having fewer risk factors for atrial fibrillation (AF), white patients have a greater prevalence of AF in the community than black patients, and a genetic basis has been postulated. However, it is unknown whether occurrence of new-onset AF after cardiac surgery is different in white versus black patients, and secondarily, other non-Caucasian patients.

Methods and Results—

From 1995 through 2005, 20 282 white, 1323 black, and 1919 other non-Caucasian patients in sinus rhythm underwent coronary artery bypass grafting with or without valve surgery. To adjust for clinical and socioeconomic confounders, we performed propensity-adjusted analyses; 7093 white patients (35%) had postoperative AF, compared with 255 (22%) black patients and 550 (29%) other non-Caucasians (
P
<0.0001). Whites were older than black patients, had higher socioeconomic position, and greater left atrial size but were less likely to have hypertension or congestive heart failure. In 847 propensity-matched patient pairs, postoperative AF occurred more frequently in white than in black patients (odds ratio, 1.74; 95% confidence interval, 1.7–1.78). Other than higher occurrence of bradycardia requiring pacing and reintubation in white patients, occurrence of other postoperative complications, hospital mortality, and length of postoperative stay were similar. Age and valvular surgery were the strongest predictors of AF irrespective of race.

Conclusions—

White patients had a markedly higher risk of postoperative AF than black and other non-Caucasian patients. The cause for racial differences of arrhythmic risk is unknown, but a genetic predisposition is plausible. Our results have implications for risk stratification and mechanistic understanding of postoperative AF.
Very Low Risk of Thromboembolic Events in Patients Undergoing Successful Catheter Ablation of Atrial Fibrillation With a CHADS
2
Score ≤3
Authors: Saad Eduardo B. , d'Avila André , Costa Ieda P. , Aryana Arash , Slater Charles , Costa Rodrigo E. , Inácio Luiz A. , Maldonado Paulo , Neto Dario M. , Camiletti Angelina , Camanho Luiz E. , Polanczyk Carisi A.
Published: August 2011

Background—

Long-term cessation of oral anticoagulation (OAC) after catheter ablation of atrial fibrillation (AF) has been deemed controversial. The safety of this management strategy in patients without recurrent AF and with historically elevated risks for thromboembolism remains largely unknown. In this study, we sought to evaluate the long-term results of OAC cessation after successful catheter ablation of AF.

Methods and Results—

OAC and antiarrhythmic drugs (AADs) were discontinued irrespective of AF type or baseline CHADS
2
(congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack) risk score in 327 patients (mean age, 63±13 years; 79% men) with drug-refractory AF after catheter ablation (mean CHADS
2
score, 1.89±0.95; median, 2.0). Patients with a CHADS
2
score of 2 (45.4%) and 3 (23.2%) accounted for 68.8% of this cohort. In patients with a high risk of recurrence or prior thromboembolic complications, OAC was continued for up to 6 to 12 months postablation and antiplatelet therapy was administered to all patients who maintained sinus rhythm upon OAC interruption. After a follow-up of 46±17 months (range, 13–82 months), 82% remained AF free (off AADs). Significant predictors of late AF recurrence (
P
<0.05) were nonparoxysmal AF (hazard ration [HR], 1.83), female sex (HR, 2.19), age ≥60 years (HR, 1.81), left atrial size >40 mm (HR, 3.52), CHADS
2
score ≥2 (HR, 1.81), and early recurrences (HR, 5.52). No symptomatic ischemic cerebrovascular events were detected during follow-up despite interruption of OAC in 298 (91%) patients and AADs in 293 (89%) patients.

Conclusions—

No significant thromboembolic-related morbidity is observed when AADs and OAC are discontinued after successful catheter ablation of AF in patients with a CHADS
2
score ≤3 who are maintained on antiplatelet therapy during long-term follow-up.
Evaluation of Pulmonary Vein Stenosis After Pulmonary Vein Isolation Using a Novel Circular Mapping and Ablation Catheter (PVAC)
Authors: von Bary Christian , Weber Stefan , Dornia Christian , Eissnert Christoph , Fellner Claudia , Latzin Philipp , Fredersdorf Sabine , Stadler Stefan , Hamer Okka W.
Published: August 2011

Background—

Pulmonary vein stenosis (PVST) is a well-known complication of pulmonary vein isolation (PVI). Specific anatomically designed ablation catheters for antral PVI have not been evaluated with regard to the incidence of PVST. We investigated the incidence, severity, and characteristics of PVST after PVI with the Pulmonary Vein Ablation Catheter (PVAC) and phased radiofrequency technology.

Methods and Results

A total of 100 patients (55 men) underwent PVI for atrial fibrillation using the PVAC. PVI was guided by selective angiography of each pulmonary vein (PV) in 70 (70%) patients and by reconstructed 3D atriography (ATG) in 30 (30%) patients. Gadolinium-enhanced MRI or multidetector CT was performed in all patients before treatment and 93±78 days after PVI. PVST was classified as follows: insignificant (<25%), mild (25%–50%), moderate (50%–75%), or severe (>75%). A total of 410 PVs were analyzed. Cardiac imaging demonstrated a detectable narrowing of the PV diameter in 23 (23%) patients and in 28 (7%) PVs. In detail, insignificant PVST was observed in 12 (2.9%) PVs, mild PVST in 15 (3.7%), and moderate PVST in 1 (0.2%). No instances of severe PVST were observed. The use of 3D-ATG was associated with a lower incidence of PVST (0.8% [95% CI, 0.0%–2.2%] versus 5.4% [95% CI, 2.7%–8.1%],
P
=0.027).

Conclusions

To our knowledge, this study is the first to report the incidence of PVST using the PVAC. In this regard, the PVAC seems to be safe if used in an experienced center. In addition, the use of 3D-ATG may decrease the risk of PVST.
Intraventricular Conduction Delay in a Standard 12-Lead Electrocardiogram as a Predictor of Mortality in the General Population
Authors: Aro Aapo L. , Anttonen Olli , Tikkanen Jani T. , Junttila M. Juhani , Kerola Tuomas , Rissanen Harri A. , Reunanen Antti , Huikuri Heikki V.
Published: August 2011

Background—

Prolonged duration of QRS complex in a 12-lead ECG is associated with adverse prognosis in patients with cardiac disease, but its significance is not well established in the general population. In particular, there is a paucity of data on the prognostic significance of nonspecific intraventricular conduction delay in apparently healthy subjects.

Methods and Results—

We evaluated the 12-lead ECGs of 10 899 Finnish middle-aged subjects from the general population (52% of whom were men; mean age 44±8.5 years) between 1966 and 1972 and followed them for 30±11 years. Primary end points were all-cause mortality, cardiac mortality, and arrhythmic death. Prolonged QRS duration was defined as QRS ≥110 ms and intraventricular conduction delay as QRS ≥110 ms, without the criteria of complete or incomplete bundle-branch block. QRS duration ≥110 ms was present in 1.3% (n=147) and intraventricular conduction delay in 0.6% (n=67) of the subjects. Prolonged QRS duration predicted all-cause mortality (multivariate-adjusted relative risk [RR] 1.48; 95% confidence interval [CI] 1.22–1.81;
P
<0.001), cardiac mortality (RR 1.94; CI 1.44–2.63;
P
<0.001), and sudden arrhythmic death (RR 2.14; CI 1.38–3.33;
P
=0.002). Subjects with intraventricular conduction delay had increased all-cause mortality (RR 2.01; CI 1.52–2.66;
P
<0.001), increased cardiac mortality (RR 2.53; CI 1.64–3.90;
P
<0.001), and an elevated risk of arrhythmic death (RR 3.11; CI 1.74–5.54;
P
=0.001). Left bundle-branch block also weakly predicted arrhythmic death (
P
=0.04), but right bundle-branch block was not associated with increased mortality.

Conclusions—

Prolonged QRS duration in a standard 12-lead ECG is associated with increased mortality in a general population, with intraventricular conduction delay being most strongly associated with an increased risk of arrhythmic death.
Association of Adiponectin With Left Ventricular Mass in Blacks
Authors: Bidulescu Aurelian , Liu Jiankang , Musani Solomon K. , Fox Ervin R. , Samdarshi Tandaw E. , Sarpong Daniel F. , Vaccarino Viola , Wilson Peter W. , Arnett Donna K. , Din-Dzietham Rebecca , Taylor Herman A. , Gibbons Gary H.
Published: August 2011

Background—

Blacks have a higher prevalence of left ventricular hypertrophy than whites. Several population-based studies have reported an inverse association between adiponectin and left ventricular mass (LVM); however, the relationship between adiponectin levels and LVM has yet to be defined in blacks. The Jackson Heart Study cohort provides an opportunity to test the hypothesis that the inverse association between adiponectin and LVM may be modified by risk factors common among blacks.

Methods and Results—

The study population included 2649 black Jackson Heart Study participants (mean age 51±12 years, 63% women, 51% obese, 54% with hypertension, and 16% with diabetes). Multiple linear and spline regression was used to assess the association, with adjustment for demographic, clinical, and behavioral covariates. Among all the participants, there was a statistically significant but modest inverse association between adiponectin and LVM index. Hypertension and insulin resistance emerged as statistically significant effect modifiers of this relationship. The inverse association present among the normotensive participants was explained by obesity measures such as the body mass index. Among participants with both hypertension and insulin resistance, there was a significant direct association between adiponectin and the LVM index after multivariable adjustment (β=1.55,
P
=0.04, per 1-SD increment in the adiponectin log value).

Conclusions—

The association between serum adiponectin and LVM among blacks in the Jackson Heart Study cohort was dependent on hypertension and insulin resistance status. Normotensive blacks exhibited an inverse adiponectin-LVM association, whereas participants with hypertension and insulin resistance had a direct association.
Cohabitation, Gender, and Happiness
Authors: Stavrova Olga , Fetchenhauer Detlef , Schlösser Thomas
Published: August 2011

Research commonly finds married people to be slightly happier than unmarried cohabitors—the phenomenon referred to as the cohabitation gap. In this article, we examine several relationships. First, we consider whether there are gender differences in the cohabitation gap; second, whether these gender differences are the same in different countries; and third, whether national differences in the gender role norms and gender equity in economic empowerment can explain these cross-national variations. Relying on the psychological theories of social norms, we differentiate between societal and personal gender role norms. We found that in societies with more liberal societal gender role norms, the cohabitation gap for women but not for men is substantially reduced. This effect was independent from women’s personal gender role norms as well as a country’s gender equity in economic empowerment. The findings are discussed in relation to the theories of social norms and gender conformity.
Single-Molecule Imaging of Bmp4 Dimerization on Human Periodontal Ligament Cells
Authors: Mi H.-W. , Lee M.-C. , Chiang Y.-C. , Chow L.-P. , Lin C.-P.
Published: August 2011

We expressed bone morphogenetic protein 4 (BMP4) fused with enhanced green fluorescent protein (BMP4-EGFP) in the secretory pathways of producer cells. Fluorescent EGFP was acquired only after we interrupted the transport of BMP4-EGFP by culturing cells at a lower temperature (20°C), and the dynamics of BMP4-EGFP could be monitored by single-molecule microscopy. Western blotting analysis confirmed that exposure to low temperature helped the integrated formation of BMP4-EGFP fusion proteins. In this study, for the first time, we could image the fluorescently labeled BMP4 molecules localized on the plasma membrane of living hPDL cells. The one-step photobleaching with EGFP and the “blinking” behavior of quantum dots suggest that the fluorescent spots represent the events of single BMP4 molecules. Single-molecule tracking showed that the BMP receptors (BMPR) dimerize after BMP4 stimulation, or that a complex of one BMP4 molecule and a pre-formed BMPR dimer develops first, followed by the binding of the second BMP4 molecule. Furthermore, BMP4-EGFP enhanced the osteogenic differentiation of hPDL cells via signal transduction involving BMP receptors. This single-molecule imaging technique might be a valuable tool for the future development of BMP4 gene therapy and regenerative medicine mediated by hPDLs.

Abbreviations: BMP4, bone morphogenetic protein 4; BMPR, BMP receptor; EGFP, enhanced green fluorescent protein; hPDL cells, human periodontal ligament cells; QDs, quantum dots; TIRFM, total internal reflection fluorescence microscopy; 293 cells, human embryonic kidney cells; oDM, osteogenic differentiation medium; HcoI, type I collagen; ALP, alkaline phosphatase; BSP, bone sialoprotein; GAPDH, glyceraldehyde-3-phosphate dehydrogenase.
The Effect of Critical Thinking Instruction on Verbal Descriptions of Music
Authors: Johnson Daniel C.
Published: August 2011

The purpose of this study was to determine the effect of critical thinking instruction on music listening skills of fifth-grade students as measured by written responses to music listening. The researcher compared instruction that included opportunities for critical thinking (Critical Thinking Instruction, CTI) with parallel instruction without critical thinking opportunities (Activity-Based Instruction, ABI). The same music teacher delivered both instructional treatments concurrently in a series of sixteen 45-minute classroom lessons. Two randomly assigned, intact classes of participants ( n = 41 and 40) made up the CTI and ABI treatment groups, respectively. Three independent judges scored participants’ pretest and posttest responses using a researcher-designed instrument. Using a multivariate analysis of variance (MANOVA), the researcher found a significant test by treatment interaction. The post hoc analysis indicated that while the CTI participants scored higher on the posttest as compared with the pretest, ABI participants demonstrated no significant differences by test. Readers should note the larger than expected standard deviations when considering the positive effects of the CTI treatment. Implications include recommendations for future research and for designing music listening lessons to incorporate critical thinking skills in classroom music instruction.
Effect of fibre transverse isotropy on micro-residual stresses in polymeric composites
Authors: Shokrieh M M , Safarabadi M
Published: August 2011

In this paper, the influence of transversely isotropic behaviour of the fibre on micro-residual stress fields is investigated. For this purpose, the energy method is utilized to predict the micro-structural stresses in polymer matrix composites under uniform thermal loads. The representative volume element (RVE) considered here includes a transversely isotropic fibre embedded in an isotropic polymer matrix. Based on the energy method, a three-dimensional closed-form solution for micro-residual stresses is obtained. The analytical results are evaluated with a finite element solution. The analysis shows that the transversely isotropic behaviour of the fibre greatly increases the fibre and matrix axial residual stresses in comparison with the isotropic fibre assumption. Fibre anisotropy has a significant effect on the interfacial shear stress distribution, in contrast with the interfacial radial stress field. Both the finite element solution and analytical method result in a similar behaviour for micro-residual stresses distribution along the fibre length. However, the finite element method cannot satisfy the stress-free condition for the residual shear stress at the fibre end due to the stress singularity.
Variability in the Determination of Death After Cardiac Arrest
Authors: Dhanani Sonny , Hornby Laura , Ward Roxanne , Shemie Sam
Published: August 2011

Introduction: The reemergence of organ donation after circulatory determination of death (DCDD) in Canada demands the establishment of clear, evidence-based guidelines for the determination of death. The primary purpose of this study was to investigate the variability in specific criteria, diagnostic tests, and recommended wait periods for the determination of death after cardiac arrest. Methods: We used PubMed and Web of Science to perform a structured search of the medical literature for articles published up to January 1, 2010. We also performed an unstructured search of the internet for unrestricted, readily available, nonjournal sources. We limited the search to countries that are most active in DCDD. Results: A total of 26 documents were retrieved; 21 medical professional society/institution statements and 5 national/international guidelines. Specific criteria for the determination of death after cardiac arrest were cited in 24 documents: 14 recommend cardiocirculatory criteria alone; 6 oblige the requirement of a prolonged waiting period after declaration to ensure neurological death; 3 recommend following “accepted medical practice” without specific details; and 1 leaves the definition up to “national authorities.” Only 16 of the documents require specific diagnostic procedures with unresponsiveness, absent arterial pulse and apnea cited the most consistently. Specific wait periods after declaration are required for the determination of death after cardiac arrest in 24 documents, cited times range from 2 to 10 minutes, with a 5-minute period the most frequent. Conclusions: This review is the first to document the variability of guidelines and statements for the determination of death after cardiac arrest, in countries where the practice of DCDD is becoming increasingly common. The scarcity of peer-reviewed published guidelines in the medical literature exemplifies the need for further investigation. We believe these results will inform the ethical discussions surrounding the determination of death after cardiac arrest. Clear and consistent guidelines based on evidence are needed to fulfill medical, ethical, and legal obligation and to ensure public trust.
Hypocalcemia in the Critically Ill patient
Authors: Kelly Andrea , Levine Michael A.
Published: August 2011

Hypocalcemia is common in the critically ill patient. In this population, however, the diagnosis of hypocalcemia is complicated by limitations in the interpretation of the total plasma calcium concentration. These limitations are principally the result of the effects of hypoalbuminemia and disorders of acid-base balance on the total calcium concentration. Thus, measurement of ionized calcium can be critical in determining an individual’s true serum calcium status. In this review, we first describe the regulation of normal calcium metabolism and then focus on the various etiologies of hypocalcemia, including congenital and acquired disorders of parathyroid hormone and vitamin D, which are encountered in the neonatal, pediatric, and adult critical care settings. The approach to the treatment of hypocalcemia and the current consensus on treatment of hypocalcemia in the critically ill patient is also presented.
Evolutionary design of a full-envelope full-authority flight control system for an unstable high-performance aircraft
Authors: Avanzini G , Minisci E A
Published: August 2011

The use of an evolutionary algorithm in the framework of H∞ control theory is being considered as a means for synthesizing controller gains that minimize a weighted combination of the infinite norm of the sensitivity function (for disturbance attenuation requirements) and complementary sensitivity function (for robust stability requirements) at the same time. The case study deals with a complete full-authority longitudinal control system for an unstable high-performance jet aircraft featuring (i) a stability and control augmentation system and (ii) autopilot functions (speed and altitude hold). Constraints on closed-loop response are enforced, that representing typical requirements on airplane handling qualities, that makes the control law synthesis process more demanding.

Gain scheduling is required, in order to obtain satisfactory performance over the whole flight envelope, so that the synthesis is performed at different reference trim conditions, for several values of the dynamic pressure, used as the scheduling parameter. Nonetheless, the dynamic behaviour of the aircraft may exhibit significant variations when flying at different altitudes, even for the same value of the dynamic pressure, so that a trade-off is required between different feasible controllers synthesized at different altitudes for a given equivalent airspeed. A multi-objective search is thus considered for the determination of the best suited solution to be introduced in the scheduling of the control law. The obtained results are then tested on a longitudinal non-linear model of the aircraft.
Natural-Scene Perception Requires Attention
Authors: Cohen Michael A. , Alvarez George A. , Nakayama Ken
Published: August 2011

Is visual attention required for visual consciousness? In the past decade, many researchers have claimed that awareness can arise in the absence of attention. This claim is largely based on the notion that natural scene (or “gist”) perception occurs without attention. This article presents evidence against this idea. We show that when observers perform a variety of demanding, sustained-attention tasks, inattentional blindness occurs for natural scenes. In addition, scene perception is impaired under dual-task conditions, but only when the primary task is sufficiently demanding. This finding suggests that previous studies that have been interpreted as demonstrating scene perception without attention failed to fully engage attention and that natural-scene perception does indeed require attention. Thus, natural-scene perception is not a preattentive process and cannot be used to support the idea of awareness without attention.
Experimental and computational fluid dynamics investigation of the efficiency of an unshrouded transonic high pressure turbine
Authors: Beard P F , Smith A D , Povey T
Published: August 2011

This article presents an experimental and computational study of the efficiency of an unshrouded transonic turbine. This research formed part of the EU Turbine Aero-Thermal External Flows II programme. The experiments were performed in the Oxford Turbine Research Facility (previously the Turbine Test Facility at QinetiQ, Farnborough). This facility is an engine scale, short duration, rotating transonic facility, in which M, Re, [Formula: see text], and [Formula: see text] are matched to engine conditions. For these experiments, the MT1 turbine stage was installed. Historically, turbine efficiency measurements are conducted in steady state adiabatic facilities. However, short-duration facilities allow simultaneous aerodynamic and heat transfer measurements with a significant reduction in cost. An efficiency measurement system was developed for this investigation, and this is briefly described. The system allows efficiency to be evaluated to bias and precision errors of approximately ±1.45 per cent and ±0.16 per cent, respectively, to 95 per cent confidence. The results of accurate area surveys of the turbine inlet and exit flows are presented and discussed. At the turbine exit, data were taken at two traverse planes, approximately 0.5 and 4.5 rotor axial chords downstream of the rotor. The turbine efficiency was experimentally evaluated based on the data at both planes, using a number of mixing models, which are discussed and compared. The experimental result of turbine efficiency is also compared to that estimated from a mean-line prediction. Full-stage steady and unsteady computational fluid dynamics of the experiment using the Rolls-Royce HYDRA code was conducted and is also presented. The predicted and measured rotor exit flow-fields are compared at both downstream traverse planes.
Vehicle stability enhancement by using an active differential
Authors: Mashadi B , Mostaani S , Majidi M
Published: August 2011

The paper investigates the improvement of vehicle dynamic performance by the use of a rear, electronically controlled, limited slip differential. This control is based on the vehicle yaw rate, rear wheel slip values, and braking subsystem on the front wheels. An optimal linear quadratic regulator (LQR) controller is employed together with an elaborate six-degree-of-freedom linear vehicle model. The objective is to include the important effects of roll and steering dynamics into the controller design. For simulation purposes, the optimal controller is included in a nine-degree-of-freedom, non-linear vehicle-handling model developed for the study. Simulation results are obtained using MATLAB/Simulink for different vehicle manoeuvres. Results indicate that use of the active differential improves the handling qualities and driver perception especially at cornering situations while accelerating, at which other control methods based on braking decelerate the vehicle not in favour of the driver’s desires.
Design of a piezostack-based inertial actuator and application to vibration control: experimental investigation
Authors: Choi S-B , Seong M-S , Ha S H , Jeon J , Sohn J W
Published: August 2011

In this work, an inertial actuator featuring a piezoceramic stack is proposed and applied to vibration control of a flexible beam structure. After identifying the field-dependent displacement of the piezoceramic stack, an inertial actuator consisting of the stack and an inertial mass is constructed and its actuating force is evaluated experimentally with respect to the applied voltage. Subsequently, an active mount featuring the inertial actuator and a rubber element is devised and incorporated into a flexible beam structure for vibration control. A negative velocity feedback controller which does not require an accurate system model is then implemented experimentally through the digital signal processor and high-voltage amplifier. In order to demonstrate the effectiveness of the proposed control system, control responses such as beam acceleration and transmitted force are evaluated and presented in both time and frequency domains.