bluuebunny/crossref_metadata_2025 huggingface dataset:
Duodenal surveillance improves the prognosis after duodenal cancer in familial adenomatous polyposis
Authors: Bülow S. , Christensen I. J. , Højen H. , Björk J. , Elmberg M. , Järvinen H. , Lepistö A. , Nieuwenhuis M. , Vasen H.
Published: October 2011

Aim  Duodenal adenomatosis in familial adenomatous polyposis results in a cancer risk that increases with age. Endoscopic surveillance has been recommended, but the effect has not yet been documented. The aim of this study was to present the results of long‐term duodenal surveillance and to evaluate the risk of cancer development.

Method  Follow up of patients in a previous study with gastroduodenoscopy in 1990–2010. Statistical analysis included the χ2 test, actuarial method and Kaplan–Meier analysis.

Results  Among 304 patients, 261 (86%) had more than one endoscopy. The median follow up was 14 (interquartile range, 9–17) years. The cumulative lifetime risk of duodenal adenomatosis was 88% (95% CI, 84–93), and of Spigelman stage IV was 35% (95% CI, 25–45). The Spigelman stage improved in 32 (12%) patients, remained unchanged in 88 (34%) and worsened in 116 (44%). Twenty (7%) patients had duodenal cancer at a median age of 56 (range, 44–82) years. The cumulative cancer incidence was 18% at 75 years of age (95% CI, 8–28) and increased with increasing Spigelman stage at the index endoscopy to 33% in Spigelman stage IV (P < 0.0001). The median overall survival was 6.4 years (95% CI, 1.7 to not estimated): 8 years after a screen‐detected cancer vs 0.8 years (95% CI, 0.03–1.7) after a symptomatic cancer (P < 0.0001). The location of the mutation in the APC gene did not influence the risk of developing Spigelman stage IV (P = 0.46) or duodenal cancer (P = 0.83).

Conclusion  The risk of duodenal cancer in familial adenomatous polyposis is considerable, and regular surveillance and cancer prophylactic surgery result in a significantly improved prognosis.
Dose response for travoprost®in the glaucomatous beagle
Authors: MacKay Edward O. , McLaughlin Marsha , Plummer Caryn E. , Ben‐Shlomo Anna , Gelatt Kirk N.
Published: October 2011

Objective To evaluate the changes in intraocular pressure (IOP) and pupil size in 12 Beagles with inherited glaucoma after instillations of 0.033, 0.0033, 0.001, 0.00033, and 0.0001% travoprost (Travatan®‐Alcon Laboratories, Inc., Ft Worth, TX, USA) in multiple single‐dose studies.

Procedures Intraocular pressure and pupil diameter (PD) measurements were obtained at 9 am, 12 pm, 3 pm, and 9 amthe following day (24 h) in two groups of six glaucoma dogs. After 7 days, the vehicle or concentration was repeated in the contralateral eye of the same animals.

Results Concentrations of 0.00033, 0.001, and 0.0033% travoprost significantly lowered IOP and PD, but the 0.0001% concentration provided limited IOP changes, although PD changes were still significant. This suggests travoprost is effective in the dog to lower IOP and reduce pupil size at concentrations starting between 0.0001 and 0.00033%.

Conclusions The dose response for travoprost in the glaucomatous Beagle indicates this model is highly sensitive to this group of drugs, even at concentrations as low as 0.00033% (1/12 the commercially available concentration).
Penetrating ocular gunshot injury in a Labrador Retriever
Authors: Sansom Jane , Labruyère Julien
Published: October 2011

A 3½‐year‐old, female (spayed) working black Labrador Retriever was referred to the Unit of Comparative Ophthalmology at the Animal Health Trust after a penetrating lead gunshot injury to the right eye. Clinical examination revealed penetrating injuries to the right cornea, left lateral canthus, and left forelimb. Radiography revealed the presence of multiple metallic foreign bodies in the head and one in the left forelimb. B‐mode ocular ultrasonography confirmed the presence of an intraocular metallic foreign body within the posterior tunics of the right eye. Medical treatment of the right eye over a period of 1 month resulted in a comfortable, visual eye. Long‐term follow‐up over 4½ years revealed a slow deterioration in vision because of progressive lens opacification and the presence of a localized area of chorioretinopathy.
Insulin resistance and pathological brain ageing
Authors: Cholerton B. , Baker L. D. , Craft S.
Published: October 2011

Diabet. Med. 28, 1463–1475 (2011)

Sir Harold Himsworth’s prescient observations 75 years ago have recently been expanded to include a clear relationship between insulin resistance and central nervous system function. Insulin is a master regulator of corporeal ageing in all known species, determining the rate and expression of ageing in multiple body systems. Thus, it is not surprising that insulin also plays an important role in brain ageing and cognitive decline that is associated with pathological brain ageing. Brain ageing is accompanied by reduced insulin effectiveness, either by an inadequate cellular response to insulin or by insulin deficiency attributable to reduced insulin transport across the blood–brain barrier. Age‐associated brain insulin abnormalities may contribute to cognitive decline in ageing, as have been documented in older adults with Type 2 diabetes mellitus and hypertension. With more extreme pathology, brain insulin resistance may be associated with neurogenerative diseases such as Alzheimer’s disease, and the condition which precedes Alzheimer’s disease, known as amnestic mild cognitive impairment. In the following review, we discuss the mechanisms through which insulin resistance may induce or potentiate pathological brain ageing and thereby create a neurobiological environment that promotes neurodegeneration and associated cognitive decline. This topic is timely, given that insulin resistance‐associated conditions such as diabetes and obesity have reached epidemic proportions. The prevalence of such chronic conditions, in combination with a rapidly ageing population, may result in a corresponding increase in the prevalence of Alzheimer’s disease and other cognitive disorders. Fortunately, insulin resistance‐associated conditions are amenable to both pharmacologic and lifestyle interventions that may reduce the deleterious impact of insulin resistance on the ageing brain.
Predicting continued use of online teacher professional development and the influence of social presence and sociability
Authors: Smith Jo Ann , Sivo Stephen A.
Published: October 2011

This study examined how a well‐established Technology Acceptance Model (TAM) could predict teachers' intentions to continue using e‐learning for professional development based on perceived ease of use and usefulness. Although studies have shown social interactions are important to teachers, no study has analyzed the mediating influence of social presence and sociability within e‐learning professional development. Therefore, the original TAM was expanded to encompass user perceptions of social presence and sociability. Structural equation modeling was used to measure the mediating affects on their intention to continue using e‐learning for their professional development. The results indicate that the expanded hypothesized model was a good predictor of continuance intention. Perceived ease of use, perceived usefulness and social presence were found to be significant determinants of teachers' intent to continue using e‐learning to meet their future professional development needs. The results have implications for educational leaders, designers and facilitators who want to promote teacher online professional development and embed e‐learning conditions that will be readily embraced by classroom teachers.
Watching, creating and achieving: Creative technologies as a conduit for learning in the early years
Authors: McDonald Susan , Howell Jennifer
Published: October 2011

This paper describes the use of robotics in an Early Years classroom as a tool to aid the development of technological skills in a creative environment rich with literacy and numeracy opportunities. The pilot project illustrates how a three‐phase process can result in the development of: (1) emergent literacy and numeracy, (2) digital access for disadvantaged Early Years learners and (3) basic engineering concepts. The pilot study was conducted with a class of 16 students aged between 5 years and 6 months to 7 years, over a 6‐week period. During this period, the students were introduced to and engaged in the creation of robots and simple machines via the use of a commercial robotics package. The pilot was designed around three distinct phases: modelling, exploring and evaluating. These phases provided scaffolding for the students to engage with the technology and for the class teacher to develop her own skills. The use of this particular robotics package is unique to Australia, unique to Early Years, and links hands‐on, fine‐motor development with 21st century learning. The researchers and authors of this paper are currently based at the Australian Catholic University and are involved with projects involving creative, digital technologies, children in the early years of formal schooling, emerging literacy and numeracy for diverse Early Years learners and the development of Science, Technology, Engineering and Mathematics (STEM) subjects.
Formation in the Classroom
Authors: Glennon Fred , Jacobsen Douglas , Jacobsen Rhonda Hustedt , Thatamanil John J. , Porterfield Amanda , Moore Mary Elizabeth
Published: October 2011

What is the relationship between the academic knowledge of the guild and the formation of students in the classroom? This Forum gathers four essays originally presented at a Special Topics Session at the 2009 conference of the American Academy of Religion (Atlanta, Georgia), with a brief introductory essay by Fred Glennon explaining the genesis of the panel. Douglas Jacobsen and Rhonda Hustedt Jacobsen clarify some of the issues at stake in undergraduate liberal arts classrooms by distinguishing between four dimensions of what they refer to as “the (in)formation teaching matrix: institutional context, course content, faculty roles, and student outcomes. John Thatamanil argues that all learning necessarily presupposes formation. Amanda Porterfield argues against using the word “formation” because it complicates and undermines her teaching goals to historicize religion and narratives about it through open‐ended inquiry. And, finally, Mary Elizabeth Moore explores the interactive processes linking formation, information, reformation, and transformation.
The prevalence of neuromyelitis optica in South East Wales
Authors: Cossburn M. , Tackley G. , Baker K. , Ingram G. , Burtonwood M. , Malik G. , Pickersgill T. , te Water Naudé J. , Robertson N.
Published: October 2011

Background and purpose:  Neuromyeltis optica (NMO) is a neuroinflammatory disorder considered rare in Caucasian populations. However, accurate population‐based epidemiological data for NMO and NMO spectrum disorder (NMO‐SD) from Western populations employing validated diagnostic criteria remain limited. We sought therefore to estimate the prevalence and clinical features of NMO in a north European Caucasian population in South East Wales.

Methods:  Patients were identified by a comprehensive, multistage ascertainment strategy employing a regional neuroinflammatory disease register, hospital diagnostic databases personal physician referrals and regional requests for anti‐aquaporin‐4 antibodies (anti‐AQP4).

Results:  Fourteen Caucasian patients (11 patients with NMO and three with NMO‐SD) were identified in a population of 712 572 (19.6/million; 95% CIs: 12.2–29.7). There was an excess of females (female:male 12:2), 11/14 were anti‐AQP4 positive and 5/14 had disease onset under the age of 20 years.

Conclusion:  This study suggests that NMO and related spectrum disorders are at least as frequent in Northern European populations as in non‐Caucasian populations and that the demographic profile of prevalent patients differs from clinic‐based cohorts.
Reassessing received wisdom in ALS – pain is common when studied systematically
Authors: Wicks P.
Published: October 2011

Click here to view the accompanying paper in this issue.
Stroke mechanism in patients with non‐valvular atrial fibrillation according to the CHADS2 and CHA2DS2‐VASc scores
Authors: Cha M.‐J. , Kim Y. D. , Nam H. S. , Kim J. , Lee D. H. , Heo J. H.
Published: October 2011

Background and purpose:  The CHADS2 and CHA2DS2‐VASc scores are useful to stratify embolic risks in patients with non‐valvular atrial fibrillation (NVAF) and to identify patients eligible for anticoagulation. Although the risk of stoke increases in patients with higher CHADS2 or CHA2DS2‐VASc scores, it is uncertain why the stroke rate increases in them. Concomitant potential cardiac sources of embolism (PCSE) may be more frequent in patients with higher CHADS2 or CHA2DS2‐VASc scores because stroke risks increase when concomitant PCSE is present in Atrial fibrillation (AF). On the other hand, atherothrombosis may be the cause when considering that most components of the CHADS2 and CHA2DS2‐VASc scores are risk factors for atherosclerosis.

Methods:  Amongst 5493 stroke patients who were prospectively registered with the stroke registry for 11 years, 860 consecutive patients with NVAF were included for this study. We investigated the mechanisms of stroke according to the CHADS2/CHA2DS2‐VASc score in stroke patients with NVAF.

Results:  Amongst 860 patients, concomitant PCSE were found in 334 patients (38.8%). The number of PCSE increased as the CHADS2/CHA2DS2‐VASc score increased (P < 0.001). Of individual PCSE, akinetic left ventricular segment, hypokinetic left ventricular segment and myocardial infarction <4 weeks were associated with the CHADS2/CHA2DS2‐VASc score. The presence of possible atherothrombotic mechanism, in addition to AF, was suggested in 27.3%. The proportion of patients with concomitant presence of possible atherothrombosis was increased as the CHADS2/CHA2DS2‐VASc score increased (P < 0.001).

Conclusions:  Increased frequency of concomitant PCSE and that of the atherothrombotic mechanism may explain the high risk of stroke in patients with higher CHADS2/CHA2DS2‐VASc score.
Adalimumab for psoriasis in Greece: clinical experience in a tertiary referral centre
Authors: Fotiadou C. , Lazaridou E. , Sotiriou E. , Ioannides D.
Published: October 2011

Background  Adalimumab, a fully human, anti‐TNFα monoclonal antibody has been shown to be effective for moderate‐to‐severe psoriasis in clinical trial setting. However, only a limited number of studies reflect everyday clinical experience with this drug.

Objectives  To provide evidence on the efficacy, dose optimization and safety of adalimumab based on everyday clinical experience in a tertiary referral centre for psoriasis, in Greece.

Methods  We retrospectively reviewed the records of all patients with moderate‐to‐severe psoriasis who received adalimumab, in our referral centre, between January 2008 and October 2010.

Results  In total, 52 patients were treated with adalimumab for a mean period of 14 months (range 4–30 months). Mean baseline Psoriasis Area and Severity Index (PASI) was 16.7 (range 9–40.3). At 4, 6, 12 and 18 months, PASI75 was attained by 68%, 82%, 89% and 88% of patients respectively. Nineteen of 52 patients (36%) reached a PASI100 at a mean time of 10 months (range 4–18 months). The dose interval between the injections of adalimumab was increased from 2 to 3 weeks for 14 patients (27%) who achieved and sustained a PASI100 after the first year of treatment, without any relapse. The overall rate of adverse events reached 38%, but treatment was discontinued only in two cases (4%).

Conclusions  Our study demonstrates that adalimumab is effective and safe in patients with moderate‐to‐severe psoriasis in short‐ and long‐term setting. At the same time, it points out novel and interesting issues for further investigation.
Carbon pools and soil biochemical properties in manure‐based organic farming systems of semi‐arid New Mexico
Authors: Jacinthe P.‐A. , Shukla M. K. , Ikemura Y.
Published: October 2011

The economic benefits of organic agriculture and its wide adoption are well documented, but the impact of that practice on soil C dynamics in irrigated croplands of semi‐arid regions is less well understood. In manure‐based organic production systems, land applications of animal wastes not only provide nutrients but could also contribute to soil carbon sequestration. A study was conducted in irrigated cotton (Gossypium arboreum L) agro‐ecosystems of New Mexico (USA) under conventional (CONV; 100 kg N/ha as urea and NH4NO3) and organic farming practices (OF for 3–9 yr; 50 Mg dry manure/ha) to assess the effect of OF on soil C stocks (organic, inorganic) and biochemical indices [microbial biomass C (MBC); respiration; metabolic quotient (qCO2)]. In the plough layer (0–30 cm), soil organic carbon (SOC) stocks tended to be higher (although not statistically) under OF (35.9 Mg C/ha) than CONV (33.5 Mg C/ha). However, when the entire 100‐cm soil profile was considered, the total SOC under CONV exceeded that under OF by 39.8 Mg C/ha, but this may be influenced by other factors. Accounting for 52% of the total C stock, inorganic C was significantly higher under CONV than OF and was positively correlated with soil respiration and the H/C ratio of soil organic matter. While OF duration had no consistent effect on soil biochemical properties, MBC was significantly higher (1.5 times) and the qCO2 (3–6 times) was lower in the organically fertilized soils than under CONV. These results suggest the development, under OF, of a soil microbial community that is larger and processes added C substrates more efficiently compared with the community present in CONV practices.
A web‐based approach to improve collation and communication of complex soil‐landscape data with examples relating to agricultural production, environmental degradation and mineral exploration
Authors: Baker A. , Fitzpatrick R.
Published: October 2011

This paper provides examples of how to use web‐based techniques to organize and communicate large quantities of complex and varied soil and landscape data. It describes a straightforward method for creating an interactive, web‐based data site that can be used to facilitate more rapid and effective communication between project staff (scientists and managers) and clients (farmers and land managers). This can facilitate teleconferences between team members and be used to communicate information and ideas. Consequently, it reduces costs associated with travel and makes it easier to interpret data during collection. The web‐based data site can be used to deliver easily understood final reports to clients that may have limited background knowledge in a particular area. Additionally, it provides a sufficiently logical and intuitive user interface for use by a wide range of end‐users including farmers, land managers, policy makers and the general public. This approach has been used successfully to provide a framework to coordinate and report on the large quantities of complex data generated during the following three diverse projects: (i) a study of base metal exploration methods in an area impacted by mining and land clearance in the Mount Lofty Ranges in South Australia, (ii) acid drainage issues impacting on agricultural production in the Wheatbelt of Western Australia and (iii) inland acid sulphate soils impacting on land degradation and water quality in wetlands adjacent to the River Murray in the Riverland region of South Australia.
BANK OUTPUT MEASUREMENT IN THE EURO AREA: A MODIFIED APPROACH
Authors: COLANGELO ANTONIO , INKLAAR ROBERT
Published: October 2011

Banks do not charge explicit fees for many of the services they provide, bundling the service payment with the offered interest rates. This output therefore has to be imputed using estimates of the opportunity cost of funds. We argue that rather than using the single short‐term, low‐risk interest rate as in current official statistics, reference rates should match the risk characteristics of loans and deposits. This would lower euro area imputed bank output by, on average, 28–54 percent compared with the current methodology, implying that euro area GDP (at current prices) is overstated by 0.11–0.18 percent. This adjustment also leads to more plausible shares in value added of income from fixed capital in the banking industry.
Poverty Reduction and Economic Structure: Comparative Path Analysis for Mozambique and Vietnam
Authors: Arndt Channing , Garcia Andres , Tarp Finn , Thurlow James
Published: October 2011

While economic growth generally reduces income poverty, there are pronounced differences in the strength of this relationship across countries. Typical explanations for this variation include measurement errors in growth–poverty accounting and different compositions of economic growth. We explore the additional influence of economic structure in determining a country's growth–poverty relationship and performance. Using structural path analysis, we compare the experiences of Mozambique and Vietnam—two countries with similar levels and compositions of economic growth but divergent poverty outcomes. We find that the structure of the Vietnamese economy more naturally lends itself to generating broad‐based growth. A given agricultural demand expansion in Mozambique will, ceteris paribus, achieve much less rural income growth than in Vietnam. Inadequate education, trade and transport systems are found to be more severe structural constraints to poverty reduction in Mozambique than in Vietnam. Investing in these areas can significantly enhance the effectiveness of Mozambican growth to reduce poverty.
The Importance of Illness Perception in End‐Stage Renal Disease: Associations with Psychosocial and Clinical Outcomes
Authors: Chilcot Joseph
Published: October 2011

Illness perceptions refer to organized beliefs surrounding the symptoms, consequences, time course, controllability, and causes of an illness. Illness perceptions have been shown to predict a range of psychosocial and clinical outcomes in patients with ESRD including depression, nonadherence, and even survival. Accordingly, personal illness beliefs are novel yet potentially modifiable prognostic factors. Studies are required to assert whether illness perception‐based interventions deliver the promise of improved subjective and clinical well‐being in patients with ESRD.
Necrolytic Acral Erythema in an Adolescent
Authors: Ridder Kelly , Vessels Cassey , Kennedy Kristy , Patel Tejesh , Scott Riddell , Shimek Christina , Randall M. Barry , Skinner Robert B.
Published: October 2011

Abstract:  In 1996 el Darouti and Abu el Ela described seven Egyptian patients with similar cutaneous lesions and proposed necrolytic acral erythema (NAE) as a distinct entity of the necrolytic erythema family. Since then, NAE has emerged as a cutaneous manifestation of hepatitis C virus infection and taken its place in the literature as a marker for systemic disease. NAE initially presents with burning, pruritic eruptions of circumscribed, erythematous papules with flaccid vesiculation on the acral surfaces universally affecting the dorsum of the feet. The presenting papules of acute NAE evolve over time into confluent, velvety, hyperkeratotic plaques with decreased central erythema but a characteristic dark erythematous rim and adherent scale. Although mostly misdiagnosed as psoriasis or inflammatory dermatitis, NAE can be definitively placed among the necrolytic erythema family as a distinct entity based on clinical and histopathologic characteristics. We report a case of necrolytic acral erythema in a 17‐year‐old followed by a review of the literature.
Efficacy of Ω‐3 Polyunsaturated Fatty Acids for the Treatment of Refractory Hydroa Vacciniforme
Authors: DURBEC FRÉDÉRIQUE , REGUIAÏ ZIAD , LÉONARD FABIENNE , PLUOT MICHEL , BERNARD PHILIPPE
Published: October 2011

Abstract:  Hydroa vacciniforme (HV) is a rare photodermatosis. Several therapies, with sometimes severe side effects, have been used in isolated cases. We report a case of refractory HV successfully treated with dietary fish oil rich in ω‐3 polyunsaturated fatty acids.
Childhood Epidermolysis Bullosa Acquisita: Report of a Chinese Case
Authors: Yang Baoqi , Wang Chong , Wang Na , Pan Futang , Chen Shengli , Zhou Guizhi , Yu Meiling , Zhang Furen
Published: October 2011

Abstract:  Epidermolysis bullosa acquisita (EBA) is a rare, acquired, subepidermal blistering disease characterized by autoantibodies directed against type VII collagen, the major component of anchoring fibrils. We report a 5‐year‐old Chinese boy who presented with extensive lesions consisting of disseminated pruritic vesicles and tense blisters. The diagnosis of EBA was confirmed by histopathology, immunofluorescence, and immunoblotting analysis. The disease was controlled with a combination of prednisone and dapsone.
Evidence‐Based Evaluation and Management of Chronic Urticaria in Children
Authors: Zitelli Kristine B. , Cordoro Kelly M.
Published: October 2011

Abstract:  Urticaria affects nearly 25% of the population at some time in their lives. In a subset of children, urticaria will develop into a chronic condition that can greatly affect quality of life. Although numerous causes and triggers are proposed for chronic urticaria (CU) in children, ranging from infections, allergens, and medications to physical factors and autoimmune disease, the exact etiology is not always identifiable. Accordingly, a large subset of cases are designated “chronic idiopathic urticaria.” Because of the clinical complexities of CU, as well as the confusing literature on this topic, we have developed a conceptual framework based on the cumulative evidence to assist with the categorization, clinical evaluation, and treatment of CU in children.
Effect of Chlorhexidine on Denture Biofilm Accumulation
Authors: Machado de Andrade Ingrid , Cruz Patricia C. , Silva‐Lovato Cláudia H. , de Souza Raphael F. , Cristina Monteiro Souza‐Gugelmin Maria , de Freitas Oliveira Paranhos Helena
Published: October 2011

Purpose: Adequate denture hygiene can prevent and treat infection in edentulous patients, who are frequently elderly and have difficulty brushing their teeth. This study evaluated the efficacy of complete denture biofilm removal using a chlorhexidine solution in two concentrations: 0.12% and 2.0%.

Materials and Methods: Sixty complete denture wearers participated in a trial for 21 days after receiving brushing instructions. They were distributed into three groups, according to the tested solution and regimen (n = 20): (G1) Control (daily overnight soaking in water); (G2) daily immersion at home in 0.12% chlorhexidine for 20 minutes after dinner; and (G3) a single immersion in 2.0% chlorhexidine for 5 minutes at the end of the experimental period, performed by a professional. Biofilm coverage area (%) was quantified on the internal surface of maxillary dentures at baseline and after 21 days. Afterward, the differences between initial and posttreatment results were compared by means of the Kruskal‐Wallis test (α= 0.05).

Results: Median values for biofilm coverage area after treatment were: (G1) 36.0%; (G2) 5.3%; and (G3) 1.4%. Differences were significant (KW = 35.25; p < 0.001), although G2 and G3 presented similar efficacy in terms of biofilm removal.

Conclusions: Both chlorhexidine‐based treatments had a similar ability to remove denture biofilm. Immersion in 0.12% or 2.0% chlorhexidine solutions can be used as an auxiliary method for cleaning complete dentures.
Focal Left Atrial Tachycardias Not Associated with Prior Catheter Ablation for Atrial Fibrillation: Clinical and Electrophysiological Characteristics
Authors: BIVIANO ANGELO B. , BAIN WILLIAM , WHANG WILLIAM , LEITNER JOSHUA , DIZON JOSÉ , HICKEY KATHLEEN , GARAN HASAN
Published: October 2011

Background:
 The clinical features and electrophysiological characteristics of patients with focal left atrial tachycardias (LATs) are not well characterized. This study reports the experience of a single center in catheter mapping and radiofrequency ablation of focal LAT not associated with prior atrial fibrillation (AF) ablation, including in cardiac sarcoidosis and transplant patients.

Methods:
 Patients with focal LAT without a history of AF ablation were included in this retrospective analysis.

Results:
 A total of 24 focal LATs were documented in 20 patients. Two patients were subsequently diagnosed with cardiac sarcoidosis. Two patients were status post a thoracic transplant. The mean initial cycle length of the focal LATs was 347.4 ± 96.2 ms (range 190–510 ms). Patients with a pulmonary vein (PV) ostium focus (n = 6) demonstrated a shorter cycle length than patients with other LA foci (259.2 ± 56.4 ms vs 371.9 ± 91.1 ms, P = 0.02), as well as a trend for a history of AF (67% vs 21%, P = NS). Catheter ablation was immediately successful for 19 of 22 focal LATs.

Conclusions:
 Focal LATs not associated with prior AF ablation can originate in a variety of LA locations and clinical settings. Focal LAT arising in the PV ostia is associated with a history of AF and demonstrates a faster tachycardia rate. We also report focal LAT in cardiac sarcoidosis patients and in the donor heart of an orthotopic heart transplant recipient. Radiofrequency ablation is a successful treatment for focal LAT not associated with prior ablation, including those refractory to medical therapy. (PACE 2012; 35:17–27)
Vascular Endothelial Dysfunction in Patients with Newly Diagnosed Type 2 Diabetes and Effects of 2‐year and 5‐year Multifactorial Intervention
Authors: Tian Jing , Wen Yanling , Yan Li , Cheng Hua , Yang Haiyun , Wang Jingfeng , Kozman Hani , Villarreal Daniel , Liu Kan
Published: October 2011

Objectives: Investigate short‐ and long‐term effect of multifactorial intervention on endothelial dysfunction in patients with newly diagnosed type 2 diabetes. Background: Whether multifactorial intervention reduces cardiovascular risk in type 2 diabetes is largely controversial, partially because of lack of reliable method for endothelial dysfunction detection. Using high‐resolution ultrasonographical flow‐mediated vasodilatation (FMD), we completed a 5‐year randomized prospective intervention trial in patients with newly diagnosed type 2 diabetes. We have studied the effect of multifactorial intervention therapy on their endothelial dysfunction. Methods: One hundred eight patients with newly diagnosed type 2 diabetes, and 83 healthy subjects received measurement of brachial artery FMD and endothelium‐independent dilatation (EID). Diabetic patients were assigned into four groups, treated with: (A) hypoglycemic and antihypertensive agents, (B) hypoglycemic, antihypertensive and lipid‐lowering agents, (C) hypoglycemic, antihypertensive and lipid‐lowering agents, and vitamin E, and (D) hypoglycemic, antihypertensive and lipid‐lowering agents, and compound salvia tablets. Both FMD and EID were remeasured after 24‐ and 60‐month treatment. Results: FMD in diabetic patients was significantly lower than those in healthy subjects. After 24‐month treatment, there was no FMD change. However, FMD improved significantly after 60‐month treatment. The differences between 24‐ and 60‐month are also significant. EID did not change significantly after both 24‐ and 60‐month treatments. Conclusions: (1) FMD‐detectable endothelial dysfunction exists in newly diagnosed type 2 diabetic patients. (2) Reverse of endothelial function occurs only after long‐term (60‐month) multifactorial intervention. (3) FMD could potentially help early identification, stratification, and treatment of endothelial dysfunction in type 2 diabetic patients. (Echocardiography 2011;28:1133‐1140)
Assessment of Right Ventricular Function Using Echocardiographic Speckle Tracking of the Tricuspid Annular Motion: Comparison with Cardiac Magnetic Resonance
Authors: Ahmad Homaa , Mor‐Avi Victor , Lang Roberto M. , Nesser Hans‐Joachim , Weinert Lynn , Tsang Wendy , Steringer‐Mascherbauer Regina , Niel Johannes , Salgo Ivan S. , Sugeng Lissa
Published: October 2011

Background: Assessment of right ventricular (RV) function is difficult due to the complex shape of this chamber. Tricuspid annular plane systolic excursion (TAPSE) measured with M‐mode echocardiography is frequently used as an index of RV function. However, its accuracy may be limited by ultrasound beam misalignment. We hypothesized that two‐dimensional (2D) speckle tracking echocardiography (STE) could provide more accurate estimates of RV function. Accordingly, STE was used to quantify tricuspid annular displacement (TAD), from which RV longitudinal shortening fraction (LSF) was calculated. These STE derived indices were compared side‐by‐side with M‐mode TAPSE measurements against cardiac magnetic resonance (CMR) derived RV ejection fraction (EF). Methods: Echocardiography (Philips iE33, four‐chamber view) and CMR (Siemens, 1.5 T) were performed on the same day in 63 patients with a wide range of RV EF (23–70% by CMR). TAPSE was measured using M‐mode echocardiography. TAD and RV LSF were obtained using STE analysis (QLAB CMQ, Philips). TAPSE, TAD and RV LSF values were compared with RV EF obtained from CMR short axis stacks. Results: STE analysis required <15 seconds and was able to track tricuspid annular motion in all patients as verified visually. Correlation between RV EF and TAD (0.61 free‐wall, 0.65 septal) was similar to that with M‐mode TAPSE (0.63). However, STE‐derived RV LSF showed a higher correlation with CMR EF (r = 0.78). Conclusion: RV LSF measurement by STE is fast and easy to obtain and provides more accurate evaluation of RV EF than the traditional M‐mode TAPSE technique, when compared to CMR reference. (Echocardiography 2012;29:19‐24)
Building local nodes in a global sector: Clustering within the aeronautics industry in Montreal
Authors: Hassen Tarek Ben , Klein Juan‐Luis , Tremblay Diane‐Gabrielle
Published: October 2011

This article analyzes the mechanisms through which metropolitan governance is established in Montreal's aeronautics sector, one of the most important and innovative industries in the region. The article also examines the role of lead firms, socio‐economic actors, and public agencies from a territorial point of view. It is established that on the one hand the existence of a small number of prime producers at the local level facilitates productive linkages among businesses through subcontracting, and on the other hand, the intensive participation of intermediate socio‐economic agencies and organizations ensures a metropolitan anchoring of the sector and creates a strong territorial identity among the players.
Growth and Spectroscopic Characteristics of Er‐Doped CeF3–CaF2 Disordered Crystals
Authors: Wang Qingguo , Su Liangbi , Zheng Lihe , Li Hongjun , Tang Huili , Guo Xin , Jiang Dapeng , Xu Jun
Published: October 2011

Er‐Doped and Yb,Er‐Doped CeF3–CaF2 disordered crystals were grown by temperature gradient technique (TGT) method. The UV–VIS–NIR absorption spectra, near‐infrared emission spectra, and the lifetime of 4I13/2 level were measured. The infrared to visible upconversion emission of Er3+ was investigated in the grown crystals. The concentration distribution of doped ions was analyzed using ICP measurements. The efficiency of energy transfer from Yb3+ (2F5/2) to Er3+ (4I11/2) was about 88%. The experimental luminescence lifetime of the ~1.5 μm emission for CeF3–CaF2:Yb,Er crystal was 3.84 ms, and its quantum efficiency was 79%.
Effect of Yttria Content on the Zirconia Unit Cell Parameters
Authors: Krogstad Jessica A. , Lepple Maren , Gao Yan , Lipkin Don M. , Levi Carlos G.
Published: October 2011

The relationship between yttria concentration and the unit cell parameters in partially and fully stabilized zirconia has been reassessed, motivated by the need to improve the accuracy of phase analysis upon decomposition of t′‐based thermal barrier coatings. Compositions ranging from 6 to 18 mol% YO1.5 were synthesized and examined by means of high‐resolution X‐ray diffraction. Lattice parameters were determined using the Rietveld refinement method, a whole‐pattern fitting procedure. The revised empirical relationships fall within the range of those published previously. However, efforts to achieve superior homogeneity of the materials, as well as accuracy of the composition and lattice parameters, provide increased confidence in the reliability of these correlations for use in future studies. Additional insight into the potential sources for scatter previously reported for the transition region (~12–14 mol% YO1.5), where tetragonal and cubic phases have been observed to coexist, is also provided. Implications on the current understanding of stabilization mechanisms in zirconia are discussed.
Fabrication of Superfine Leucite‐Reinforced Dental Material by Hydrothermal Precursor and Low‐Temperature Frit
Authors: Yao Lan , Peng Cheng , Wu Jianqing
Published: October 2011

A superfine leucite‐reinforced dental material was prepared by heat‐treating the mixture of hydrothermally derived leucite precursor and low‐temperature frit at 750°C. XRD and DSC results indicate that the low‐temperature frit can lower leucite crystallization temperature from 1027°C to 694°C. High‐temperature X‐ray diffraction of the dental porcelain demonstrates that there exists a temperature range in which leucite crystals are in the equilibrium of forming, ripening, and dissolving, and the size and content of leucite remain almost unchanged in the range. The average size of leucite in the dental porcelain prepared by the mixture of low‐temperature frit and the material is about 115 nm, which would benefit PFM's strength.
Determination of the True Young's Modulus of Pb(Zr0.52Ti0.48)O3 Films by Nanoindentation: Effects of Film Orientation and Substrate
Authors: Liu Dan , Zhou Bo , Yoon Sang H. , Kim Seon‐Bae , Ahn Hosang , Prorok Barton C. , Kim Seung‐Hyun , Kim Dong‐Joo
Published: October 2011

PZT films were deposited by the sol‐gel method on platinized silicon substrates with silicon nitride and silicon oxide structural layer materials. The crystalline orientations of the PZT films were controlled by both a chelating agent and pyrolysis temperature. A nanoindentation CSM (continuous stiffness measurement) technique was utilized to characterize the Young's moduli of these PZT films. It was found that the measured moduli of PZT films on the two types of substrates showed similar orientation dependence (E001 > E111>E(110,111)) but distinct values, which indicated a clear substrate effect. By using a new model of film indentation, we were able to decouple the effects of film orientation and structural layer type on the Young's modulus.
New Borothermal Reduction Route to Synthesize Submicrometric ZrB2 Powders with Low Oxygen Content
Authors: Guo Wei‐Ming , Zhang Guo‐Jun
Published: October 2011

The ZrB2 powders with submicrometric particle size and low oxygen content were synthesized by a new borothermal reduction route using ZrO2 and excess boron as raw materials. The conventional process only contained the borothermal reduction of ZrO2 with boron at 1550°C. By exploring the mechanism of ZrB2 particle coarsening during conventional process, a new borothermal reduction route was proposed. This route included the borothermal reduction of ZrO2 with boron at 1000°C, washing by hot water, and the removal of residual boron oxides at 1550°C, namely, two‐step reduction plus intermediate water‐washing (RWR). Using conventional process, the particle size and oxygen content of ZrB2 powder were about 2–3 μm and 0.68 wt%, respectively. Based on the new route, the particle size and oxygen content of ZrB2 powder were about 0.4–0.7 μm and 0.40 wt%, respectively.
Relative Contribution of Perception/Cognition and Language on Spatial Categorization
Authors: Choi Soonja , Hattrup Kate
Published: October 2011

This study investigated the relative contribution of perception/cognition and language‐specific semantics in nonverbal categorization of spatial relations. English and Korean speakers completed a video‐based similarity judgment task involving containment, support, tight fit, and loose fit. Both perception/cognition and language served as resources for categorization, and allocation between the two depended on the target relation and the features contrasted in the choices. Whereas perceptual/cognitive salience for containment and tight‐fit features guided categorization in many contexts, language‐specific semantics influenced categorization where the two features competed for similarity judgment and when the target relation was tight support, a domain where spatial relations are perceptually diverse. In the latter contexts, each group categorized more in line with semantics of their language, that is, containment/support for English and tight/loose fit for Korean. We conclude that language guides spatial categorization when perception/cognition alone is not sufficient. In this way, language is an integral part of our cognitive domain of space.
Floral resources enhance aphid suppression by a hoverfly
Authors: Hogg Brian N. , Nelson Erik H. , Mills Nicholas J. , Daane Kent M.
Published: October 2011

The reduction in floral diversity that often accompanies agricultural intensification may compromise the effectiveness of many natural enemies. Field studies examining the effects of floral resources on natural enemy fitness have been rare, however, particularly for predators such as hoverflies. Making the link between the presence of floral resources and the suppression of herbivores in crop fields has proved difficult. We investigated the effects of the floral resource plant sweet alyssum, Lobularia maritima (L.) Desv. (Brassicaceae), on aphid suppression by the hoverfly Eupeodes fumipennis (Thomson) (Diptera: Syrphidae) in California lettuce fields. The presence of alyssum in field cages significantly enhanced hoverfly egg production, resulting in more hoverfly larvae and fewer aphids (Hemiptera: Aphididae). Hoverfly survival was unaffected by alyssum, indicating that the indirect effect of alyssum on aphids was mediated primarily through the reproductive component of hoverfly fitness. Alyssum and other plant species are used to enhance resources for natural enemies in agricultural landscapes, and the results of this study provide some of the clearest evidence to date that increasing floral resource availability can enhance pest suppression and crop quality through elevated natural enemy fitness.
Prognostic impact of DNMT3A mutations in patients with intermediate cytogenetic risk profile acute myeloid leukemia
Authors: Marková Jana , Michková Petra , Burčková Kateřina , Březinová Jana , Michalová Kyra , Dohnalová Alena , Maaloufová Jacqueline Soukupová , Soukup Petr , Vítek Antonín , Cetkovský Petr , Schwarz Jiří
Published: October 2011

Objectives: Recently, mutations in DNMT3A gene have been described in about 25% acute myeloid leukemia (AML) cases, preferentially in monocytic AML. They were found to predict worse overall survival (OS) of mutated patients. Patients and methods: RT‐PCR followed by direct sequencing was used to test the presence of DNMT3A mutations in 226 AML patients with an intermediate‐risk (IR) cytogenetics. Results: Sixty‐seven patients of 226 (29.6%) carried a mutation in the DNMT3A gene. Occurrence of DNMT3A mutations was associated with female sex (P = 0.027) and with the presence of FLT3/ITD (P = 0.003), but not with particular FAB subtypes. Patients with DNMT3A mutation had higher initial WBC counts than those without it (P = 0.064) only because of higher incidence of FLT3/ITD within these cases. There was no difference between mutated and wild‐type groups in reaching complete remission (CR) (P = 0.380). OS was not affected by DNMT3A mutation (P = 0.251), but OS of patients who reached CR was longer in DNMT3A negative cases (P = 0.025). Patients with DNMT3A mutation had a higher relapse rate (P = 0.007). Patients carrying both the DNMT3A mutation and FLT3/ITD relapsed more often than either patients with single DNMT3A mutation (P = 0.044) or patients with FLT3/ITD only (P = 0.058). DNMT3A mutations were associated with higher relapse rate even within the FLT3/ITD‐negative group (P = 0.072). After reaching CR, these two genetic factors were independent predictors of relapse at multivariate analysis (P < 0.001). Only three of 30 ‘double‐mutated’ (FLT3/ITD+, DNMT3A+) patients are still alive, all of them having undergone hematopoietic stem cell transplant. Conclusions: We have confirmed the high incidence of DNMT3A mutations in patients with AML with IR cytogenetics. Patients with DNMT3A mutations relapse more often and have inferior OS when only patients achieving CR are analyzed. ‘Double‐mutated’ patients have a very poor prognosis.
Chronic kidney disease stage 5 as the prognostic complement of International Staging System for multiple myeloma
Authors: Hsiao Liang‐Tsai , Yang Ching‐Fen , Yang Sheng‐Hsiang , Gau Jyh‐Pyng , Yu Yuan‐Bin , Hong Ying‐Chung , Liu Chun‐Yu , Liu Jin‐Hwang , Chen Po‐Min , Chiou Tzeon‐Jye , Tzeng Cheng‐Hwai
Published: October 2011

Background:  Reversal of renal impairment (RI) in patients with multiple myeloma (MM) has been evaluated using the estimated glomerular filtration rate (eGFRMDRD) formula developed by the Modification of Diet in Renal Disease study group. However, the prognostic impact of eGFRMDRD at diagnosis of MM is not well studied, particularly its use in conjunction with the International Staging System (ISS).

Methods:  Newly diagnosed patients with MM were enrolled between 1996 and 2007. Data on clinical features, laboratory tests, and overall survival were compared in terms of corresponding eGFRMDRD.

Results:  A total of 387 patients with MM (median age, 71 yr) were enrolled. At diagnosis, 56% had ISS stage III disease; the median values of serum creatinine (SCr) and eGFRMDRD were 1.4 mg/dL and 38.2 mL/min/1.73 m2, respectively. Thirty‐four percent of patients had SCr of ≥2.0 mg/dL, and 81.2% had chronic kidney disease stages 3–5 (CKD 3–5). Higher CKD stages were significantly more common in men, older patients (≥65 yr), and those with Durie–Salmon and ISS stage III, light‐chain diseases, anemia, thrombocytopenia, hypercalcemia, elevated serum β2 microglobulin, or lactate dehydrogenase. In the Cox regression model, CKD 4–5 or CKD 5 alone was independently associated with poor survival. A diagnosis of CKD 5 was shown to be useful in identifying the subgroup of ISS‐III patients at high risk – those with a median overall survival of 7.2 months.

Conclusions:  Our study demonstrates the prognostic impact of eGFRMDRD in patients with MM and CKD 5 as the ISS‐independent surrogate predictor of poorest prognosis.
Therapeutic management for post‐traumatic treatment of the anterior dental region: a case report with long‐term follow up
Authors: Savi Andrea , Turillazzi Oliviero , Pizzi Silvia , Bonanini Mauro , Manfredi Maddalena
Published: October 2011

Abstract –  The treatment plan represents the final step in every diagnostic procedure and is the result of a series of assessments based on information gathered from a detailed clinical history. This clinical case reports the replacement of two central incisors that were lost because of a trauma. The advantages and disadvantages of the two treatment options (i.e. implantology or prosthetic restoration) were carefully evaluated in relation to the case in hand. Patient compliance and aesthetic requirements had been also considered. In this case, a conventional prosthetic restoration was performed using a metal‐ceramic bridge, utilising full crowns between the right and left maxillary lateral incisors associated with minimal canine preparation. By this strategy, the treatment plan allows for a future implant restoration, should this become necessary.