bluuebunny/crossref_metadata_2025 huggingface dataset:
The Neurobiological Underpinnings of Coping With Pain
Authors: Edwards Robert R. , Campbell Claudia , Jamison Robert N. , Wiech Katja
Published: September 2009

The biopsychosocial model treats pain as resulting from a complex interaction of biological, psychological, and social factors. Individual differences in approaches to coping with pain-related symptoms are important determinants of pain-related outcomes, and are often classified under the “psychological” category within the biopsychosocial model. However, engagement in various cognitive, affective, and behavioral pain-coping strategies appears to exert biological effects, which we review here. Pain-coping activities such as catastrophizing, distracting oneself from pain sensations, or reappraisal of pain may exert effects on activity in a variety of pain-processing and pain-modulatory circuits within the brain, as well affect the functioning of neuromuscular, immune, and neuroendocrine systems. The interface between pain-related neurobiology and the use of specific pain-coping techniques represents an important avenue for future pain research.
The Thermometer of Social Relations
Authors: IJzerman Hans , Semin Gün R.
Published: September 2009

“Holding warm feelings toward someone” and “giving someone the cold shoulder” indicate different levels of social proximity. In this article, we show effects of temperature that go beyond these metaphors people live by. In three experiments, warmer conditions, compared with colder conditions, induced (a) greater social proximity, (b) use of more concrete language, and (c) a more relational focus. Different temperature conditions were created by either handing participants warm or cold beverages (Experiment 1) or placing them in comfortable warm or cold ambient conditions (Experiments 2 and 3). These studies corroborate recent findings in the field of grounded cognition revealing that concrete experiences ground abstract concepts with which they are coexperienced. Our studies show a systemic interdependence among language, perception, and social proximity: Environmentally induced conditions shape not only language use, but also the perception and construal of social relationships.
Technological Backwardness in Agriculture: Is it Due to Lack of R&D, Human Capital, and Openness to International Trade?
Authors: Cermeño Rodolfo , Vázquez Sirenia
Published: September 2009

This paper investigates the relationship between the agricultural technological level and R&D expenditures, human capital, and openness to international trade using cross‐country information for a sample of 104 countries and various subsamples over the period 1961–91. The unobservable technological level is modeled as a dynamic process in the context of a general translog production function. The results suggest that the technological gap between developed and less developed countries in agriculture increased considerably over this period of time. Overall, the technological levels are directly related to R&D expenditures, human capital, and openness, although this relationship is not robust across different groups of countries.
‘I could be dead for two weeks and my boss would never know’: telework and the politics of representation
Authors: Whittle Andrea , Mueller Frank
Published: September 2009

This article presents data from a qualitative study of teleworking consultants in a European firm. We examine the ‘gap’ between the utopian visions produced by the consultants for the benefit of clients and the tales of isolation, disconnection, disaffection and cynicism we observed when clients were not present. The study highlights the power and politics involved in the diffusion of popular images of technology‐enabled flexibility.
Systemic and Idiosyncratic Risk in EU‐15 Sovereign Yield Spreads after Seven Years of Monetary Union
Authors: Gómez‐Puig Marta
Published: September 2009

The market capitalisation of international bond markets is much larger than that of international equity markets. However, compared to the large body of literature on international equity market linkages, there are far fewer empirical studies of bond systemic risk or international bond market co‐movements. The extent of international bond market linkages merits investigation, as it may have important implications for the cost of financing fiscal deficit, monetary policymaking independence, modelling and forecasting long‐term interest rates, and bond portfolio diversification. In this paper, we investigate the relative influence of systemic and idiosyncratic risk factors on yield spreads over 10‐year German government securities during the seven years after the beginning of Monetary Integration. We estimate both panel regressions for the two groups of EU‐15 countries (EMU and non‐EMU) and specific‐country regressions for the nine countries in the EMU group and the three countries in the non‐EMU group. All estimations include both domestic (differences in market liquidity and credit risk) and international risk factors. The results present clear evidence that it was mostly idiosyncratic rather than systemic risk factors that drove the evolution of 10‐year yield spread differentials over Germany in all EMU countries during the seven years after the beginning of Monetary Integration. Conversely, in the case of non‐EMU countries, adjusted yield spreads (corrected from the foreign exchange factor) are influenced more by systemic risk factors. The fact that these countries do not share a common Monetary Policy might explain these results, which may show that government bonds from EMU countries have a better safe‐haven status that those of non‐EMU countries.
Discordant responses on starting highly active antiretroviral therapy: suboptimal CD4 increases despite early viral suppression in the UK Collaborative HIV Cohort (UK CHIC) Study*
Authors: Gilson R , Man S‐L , Copas A , Rider A , Forsyth S , Hill T , Bansi L , Porter K , Gazzard B , Orkin C , Pillay D , Schwenk A , Johnson M , Easterbook P , Walsh J , Fisher M , Leen C , Anderson J , Sabin CA ,   on behalf of the UK Collaborative HIV Cohort Study Group
Published: September 2009

Objectives

Patients starting highly active antiretroviral therapy (HAART) may have a suboptimal CD4 increase despite rapid virological suppression. The frequency and the significance for patient care of this discordant response are uncertain. This study was designed to determine the incidence of a discordant response at two time‐points, soon after 6 months and at 12 months, and to determine the relationship with clinical outcomes.

Methods

Data obtained in the UK Collaborative HIV Cohort Study were analysed. A total of 2584 treatment‐naïve patients starting HAART with HIV viral load (VL)>1000 HIV‐1 RNA copies/mL at baseline and <50 copies/mL within 6 months were included in the analysis. Patients were classified at either 6–10 (midpoint 8) months or 10–14 (midpoint 12) months as having a discordant (CD4 count increase <100 cells/μL from baseline) or concordant response (CD4 count increase ≥100 cells/μL).

Results

Discordant responses occurred in 32.1% of patients at 8 months and in 24.2% at 12 months; 35% of those discordant at 8 months were concordant at 12 months. A discordant response was associated with older age, lower baseline VL, and (at 12 months) higher baseline CD4 cell count. In a multivariate analysis it was associated with an increased risk of death, more strongly at 12 months [incidence rate ratio (IRR) 3.35, 95% confidence interval (CI) 1.73–6.47, P<0.001] than at 8 months (IRR 2.08, 95% CI 1.19–3.64, P=0.010), but not with new AIDS events.

Conclusions

Discordant responders have a worse outcome, but assessment at 12 months may be preferred, given the number of ‘slow’ responders. Management strategies to improve outcomes for discordant responders need to be investigated.
Prevalence of etravirine mutations and impact on response to treatment in routine clinical care: the Swiss HIV Cohort Study (SHCS)
Authors: Scherrer AU , Hasse B , Von Wyl V , Yerly S , Böni J , Bürgisser P , Klimkait T , Bucher HC , Ledergerber B , Günthard HF
Published: September 2009

Objectives

Etravirine (ETV) is a novel nonnucleoside reverse transcriptase inhibitor (NNRTI) with reduced cross‐resistance to first‐generation NNRTIs, which has been primarily studied in randomized clinical trials and not in routine clinical settings.

Methods

ETV resistance‐associated mutations (RAMs) were investigated by analysing 6072 genotypic tests. The antiviral activity of ETV was predicted using different interpretation systems: International AIDS Society‐USA (IAS‐USA), Stanford, Rega and Agence Nationale de Recherches sur le Sida et les hépatites virales (ANRS).

Results

The prevalence of ETV RAMs was higher in NNRTI‐exposed patients [44.9%, 95% confidence interval (CI) 41.0–48.9%] than in treatment‐naïve patients (9.6%, 95% CI 8.5–10.7%). ETV RAMs in treatment‐naïve patients mainly represent polymorphism, as prevalence estimates in genotypic tests for treatment‐naïve patients with documented recent (<1 year) infection, who had acquired HIV before the introduction of NNRTIs, were almost identical (9.8%, 95% CI 3.3–21.4). Discontinuation of NNRTI treatment led to a marked drop in the detection of ETV RAMs, from 51.7% (95% CI 40.8–62.6%) to 34.5% (95% CI 24.6–45.4%, P=0.032). Differences in prevalence among subtypes were found for V90I and V179T (P<0.001). Estimates of restricted virological response to ETV varied among algorithms in patients with exposure to efavirenz (EFV)/nevirapine (NVP), ranging from 3.8% (95% CI 2.5–5.6%) for ANRS to 56.2% (95% CI 52.2–60.1%) for Stanford. The predicted activity of ETV decreased as the sensitivity of potential optimized background regimens decreased. The presence of major IAS‐USA mutations (L100I, K101E/H/P and Y181C/I/V) reduced the treatment response at week 24.

Conclusions

Most ETV RAMs in drug‐naïve patients are polymorphisms rather than transmitted RAMs. Uncertainty regarding predictions of antiviral activity for ETV in NNRTI‐treated patients remains high. The lowest activity was predicted for patients harbouring extensive multidrug‐resistant viruses, thus limiting ETV use in those who are most in need.
The Wood for the Trees: Ordinary Environmental Injustice and the Everyday Right to Urban Nature
Authors: WHITEHEAD MARK
Published: September 2009

This article explores the potential for a more ordinary sense of urban environmental justice. While great progress has been made over the last 30 years in connecting environmental politics to the everyday concerns of urban residents, this article claims that the urbanization of environmentalism has produced a very narrow sense of what everyday forms of justice may be. Drawing on a Lefebvrian‐inspired interpretation of everyday life, this article exposes a residual set of ordinary socio‐ecological injustices that persist in urban space. While rarely addressed in either environmental politics or urban policy, this article claims that these expressions of ordinary injustice have a significant impact on the capabilities of disadvantaged urban communities to live out a full life. Drawing on the case of the Black Country Urban Forest in the English West Midlands — the largest urban woodland project in the UK — analysis considers how the spatial location and scalar constitution of the project appear to draw attention to the spaces of ordinary environmental neglect in cities. Further analysis shows, however, that the desire to address simultaneously questions of social and ecological injustice, which is typical in such large‐scale urban greening initiatives, can actually compromise the ability of such schemes to resolve ordinary forms of urban injustice.

Cet article s’intéresse à la possibilité de donner un sens plus ordinaire à la justice environnementale urbaine. Ces trente dernières années ont vu un progrès énorme dans l’association de la politique environnementale aux préoccupations quotidiennes des habitants des villes. Toutefois, l’urbanisation de l’environnementalisme s’est traduite par un sens très étroit de ce que peuvent être les formes de justice au quotidien. Se basant sur une interprétation de la vie quotidienne inspirée de Lefebvre, l’article expose un ensemble persistant d’injustices socio‐écologiques ordinaires dans l’espace urbain. Rarement traitées en politique environnementale comme en politique publique urbaine, ces expressions de l’injustice ordinaire ont pourtant un impact important sur les capacités des communautés urbaines défavorisées à vivre pleinement. À partir du cas anglais de la Black Country Urban Forest dans les West Midlands (le plus vaste projet de terrain boisé urbain au Royaume‐Uni), l’analyse s’attache à la façon dont la localisation spatiale et le dimensionnement du projet semblent attirer l’attention sur les espaces d’abandon de l’environnement ordinaire au sein des villes. Une analyse plus poussée montre toutefois que la volonté de traiter simultanément des questions d’injustice sociale et écologique, volonté typique de telles initiatives écologiques urbaines à grande échelle, peut en fait compromettre l’aptitude de ces programmes à résoudre les formes ordinaires d’injustice urbaine.
Comparative evaluation of different substrates for the in vitro determination of sunscreen photostability: spectrophotometric and HPLC analyses
Authors: Scalia S. , Mezzena M. , Bianchi A.
Published: September 2009

Synopsis

Polymethylmethacrylate (PMMA) plates and TransporeTM tapes were compared as substrates for the in vitro evaluation of photostability of commercial sunscreen products. The sun care preparations were applied respectively on TransporeTM tapes and PMMA plates and their sun protection factors (SPF) and UVA protection parameters [UVA/UVB ratio, critical wavelength, UVA protection factor (UVA‐PF)] were measured by transmission spectroscopy, before and after irradiation with simulated sunlight. No significant differences were observed in the UV protection parameters measured on TransporeTM tapes or PMMA plates, before exposure to the solar simulator. Conversely, after irradiation, the SPF values of the sun care products exhibited marked variations between the two substrates, the decrease in SPF being greater on PMMA plates (31.3–63.1%) than on TransporeTM tapes (10.4–23.8%). Differences between the two substrates were detected also for the UVA protection parameters, although they were significant only for the UVA‐PF. The tested samples were assayed also by high‐performance liquid chromatography (HPLC) to assess the extent of photodegradation of the UV filters present in the examined formulations. The results showed that for the PMMA plates, the light‐induced decrease in SPF, as determined by spectrophotometry, fitted well with the percentage loss of ethyl hexyl methoxycinnamate (the only photounstable UVB filter present) measured by HPLC. Moreover, for the PMMA substrate, the UVA‐PF percentage reduction was consistent with the percentage degradation of butyl methoxydibenzoylmethane (the only photounstable UVA filter present) determined by HPLC. On the other hand, poor correlation between spectrophotometric and HPLC analyses was observed on TransporeTM tapes. Therefore, PMMA plates are more reliable than TransporeTM tapes as substrates for in vitro photodegradation tests of sunscreen products by transmission spectroscopy.
History, Community Milieu, and Christian‐Muslim Differentials in Contraceptive Use in Sub‐Saharan Africa
Authors: Agadjanian Victor , Yabiku Scott T. , Fawcett Lubayna
Published: September 2009

In the globalization discourse, Christianity and Islam are often construed as representing two traditions that are conflicted and incompatible. This study engages the “clash of civilizations” discourse by examining Muslim‐Christian differentials in the use of modern contraception in Nigeria, where Christians have a much higher contraceptive prevalence, and Tanzania, where Muslims are somewhat more likely to use contraception. Employing data from six nationally representative surveys conducted in the two countries between 1990 and 2004 and multilevel logistic regression, we find that the effects of religion remain strong but operate largely through the community religious milieu. Contraceptive use tends to be highest in religiously mixed areas, but the “optimal” religious makeup differs between the two nations, reflecting the historically shaped configurations of their religious expressions and politics.
Financial Restatements, Cost of Debt and Information Spillover: Evidence From the Secondary Loan Market
Authors: Park Jong Chool , Wu Qiang
Published: September 2009

Abstract:  In this paper, we investigate the effect of financial restatements on the debt market. Specifically, we focus on the secondary loan market, which has become one of the largest capital markets in the US, and ask the following: (1) whether financial restatements increase restating firm's cost of debt financing and (2) whether the information about restatements arrives at the secondary loan market earlier than at the stock market? Using 176 restatement data, we find significant negative abnormal loan returns and increased bid‐ask spreads around restatement announcements. Furthermore, this negative loan market reaction is more pronounced when the restatement is initiated by either the SEC or auditors, and when the primary reason for restatement is related to revenue recognition issues. Additionally, we find restatement information arrives at the secondary loan market earlier than at the equity market, and that such private information quickly flows into the equity market. We also show that stock prices begin to decline approximately 30 days prior to the restatement announcements for firms with traded loans. However, we do not find such informational leakage for firms without traded loans. Collectively, the results of this paper suggest: (1) increased cost of debt financing after restatements and (2) superior informational efficiency of the secondary loan market to the stock market.
Through the eye of the needle: a review of isotope approaches to quantify microbial processes mediating soil carbon balance
Authors: Paterson Eric , Midwood Andrew J. , Millard Peter
Published: September 2009

For soils in carbon balance, losses of soil carbon from biological activity are balanced by organic inputs from vegetation. Perturbations, such as climate or land use change, have the potential to disrupt this balance and alter soil–atmosphere carbon exchanges. As the quantification of soil organic matter stocks is an insensitive means of detecting changes, certainly over short timescales, there is a need to apply methods that facilitate a quantitative understanding of the biological processes underlying soil carbon balance. We outline the processes by which plant carbon enters the soil and critically evaluate isotopic methods to quantify them. Then, we consider the balancing CO2 flux from soil and detail the importance of partitioning the sources of this flux into those from recent plant assimilate and those from native soil organic matter. Finally, we consider the interactions between the inputs of carbon to soil and the losses from soil mediated by biological activity. We emphasize the key functional role of the microbiota in the concurrent processing of carbon from recent plant inputs and native soil organic matter. We conclude that quantitative isotope labelling and partitioning methods, coupled to those for the quantification of microbial community substrate use, offer the potential to resolve the functioning of the microbial control point of soil carbon balance in unprecedented detail.

Contents

Summary
19

I.
Introduction
20

II.
Inputs
20

III.
Outputs
24

IV.
Interactions between carbon inputs and outputs from soil
27

V.
Conclusions
29

Acknowledgements
29

References
30
Do early intervention programmes improve cognitive and motor outcomes for preterm infants after discharge? A systematic review
Authors: ORTON JANE , SPITTLE ALICIA , DOYLE LEX , ANDERSON PETER , BOYD ROSLYN
Published: September 2009

Aim  The aim of this study was to review the effects of early developmental intervention after discharge from hospital on motor and cognitive development in preterm infants.

Method  Randomized controlled trials (RCTs) or quasi‐RCTs of early developmental intervention programmes for preterm infants in which motor or cognitive outcomes were reported and in which the intervention commenced before or after discharge were included. A systematic review and meta‐analysis of studies grouped by intervention, age of outcome, and study quality was undertaken. Databases searched (up to January 2009) included the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, PsycINFO, and Embase.

Results  Eighteen studies met the inclusion criteria (2686 patients randomized), but only 11 studies had data suitable for meta‐analysis. Early developmental intervention improved cognitive outcomes at infant age (developmental quotient: standardized mean difference [SMD] 0.42, 95% confidence interval [CI] 0.33–0.52; p<0.001), and at preschool age (IQ: SMD 0.46, 95% CI 0.33–0.59; p<0.001). However, the benefit was not sustained at school age (IQ: SMD 0.02, 95% CI –0.10 to 0.14; p=0.71). Early intervention had little effect on motor outcome at infant or school age, and there was no study reporting motor outcome at preschool age.

Interpretation  Current evidence suggests that the benefits of developmental intervention postdischarge are restricted to short‐term gains in cognitive outcome.
Die‐off of Escherichia coli in intact and disrupted cowpats
Authors: Muirhead R. W. , Littlejohn R. P.
Published: September 2009

Diffuse pollution from grazed pastures is recognised as an important source of faecal microbial contamination of surface waters, and farmers urgently require mitigation options to reduce this impact of their farming activities. An obvious mitigation strategy is to reduce the size of the reservoir of faecal material in pastures during critical periods when overland flow is most likely. This work tested the hypothesis that smearing fresh cowpats to increase their surface area would increase exposure to solar radiation and increase desiccation, which in turn would accelerate the die‐off of Escherichia coli in the faecal material. The total solids content and E. coli concentration in intact and disrupted cowpats were monitored during the four seasons. The total solids content was significantly (P < 0.001) higher in the disrupted cowpats compared to the intact cowpats. This indicates that increased desiccation of the faecal material was successful. However, there was no significant difference (P > 0.05) in E. coli concentrations in the disrupted and intact cowpats. The physical disruption of cowpats did not therefore accelerate the die‐off of E. coli in the faecal material. The disrupted cowpats did appear to decompose faster than the intact cowpats. Mitigation options to reduce faecal micro‐organism losses in overland flow from grazed pastures will now need to focus on other methods to reduce the build up of reservoirs of faecal material on farm.
Impact of Family Structure on Stimulant Use among Children with Attention‐Deficit/Hyperactivity Disorder
Authors: Rabbani Atonu , Alexander G. Caleb
Published: September 2009

Objective. To examine the impact of family structure on pharmacologic stimulant use among children with attention‐deficit/hyperactivity disorder (ADHD).

Data Source. Nationally representative, population‐based sample of the National Health Interview Survey from 1997 to 2003 linked with drug event files from the Medical Expenditure Panel Survey from 1998 to 2005.

Study Design. Stepwise multivariate logistic regression was used to examine the likelihood of stimulant use for each individual during 2 years of observation after adjustment for sociodemographic, health, and family characteristics. Stratified analyses were also conducted to examine whether family characteristics had different impacts within single‐mother and dual‐parent households.

Principal Findings. Stimulant use varied based on children's sociodemographic and health characteristics. In multivariate analyses, associations between children's household structure, parental education, and stimulant use appeared to be mediated by children's access to care and health status. However, in full multivariate models, there remained a robust positive association between family size and stimulant use.

Conclusions. These findings highlight the influence that nonclinical factors such as family size may have in mediating the use of pharmacologic therapies for children.
Variation in Emergency Department Wait Times for Children by Race/Ethnicity and Payment Source
Authors: Park Christine Y. , Lee Mary Alice , Epstein Andrew J.
Published: September 2009

Objective. To quantify the variation in emergency department (ED) wait times by patient race/ethnicity and payment source, and to divide the overall association into between‐ and within‐hospital components.

Data Source. 2005 and 2006 National Hospital Ambulatory Medical Care Surveys.

Study Design. Linear regression was used to analyze the independent associations between race/ethnicity, payment source, and ED wait times in a pooled cross‐sectional design. A hybrid fixed effects specification was used to measure the between‐ and within‐hospital components.

Data Extraction Methods. Data were limited to children under 16 years presenting at EDs.

Principal Results. Unadjusted and adjusted ED wait times were significantly longer for non‐Hispanic black and Hispanic children than for non‐Hispanic white children. Children in EDs with higher shares of non‐Hispanic black and Hispanic children waited longer. Moreover, Hispanic children waited 10.4 percent longer than non‐Hispanic white children when treated at the same hospital. ED wait times for children did not vary significantly by payment source.

Conclusions. There are sizable racial/ethnic differences in children's ED wait times that can be attributed to both the racial/ethnic mix of children in EDs and to differential treatment by race/ethnicity inside the ED.
Treatment of feline mammary tumours using chemotherapy, surgery and a COX‐2 inhibitor drug (meloxicam): a retrospective study of 23 cases (2002–2007)*
Authors: Borrego J. F. , Cartagena J. C. , Engel J.
Published: September 2009

The efficacy of a treatment combination of a COX‐2 inhibitor (meloxicam), chemotherapy and surgery in 23 cats with histologically confirmed mammary gland adenocarcinoma was evaluated. All of the cases underwent an aggressive surgery with concurrent doxorubicin‐based chemotherapy. Meloxicam was given orally starting the day after surgery and was continued indefinitely. Serum renal parameters were measured every 3–5 months. Three cats developed azotemia, whereas in four other renal parameters increased but remained within normal limit. The Kaplan–Meier median survival time was 460 days. The Kaplan–Meier median disease free interval was 269 days. The survival times are similar to other studies, not supporting the use of this treatment combination. Prospective studies with a higher number of cases are warranted to investigate the utility of this multimodality protocol for the treatment of feline mammary tumours.
Hepatocyte growth factor protects against Fas‐mediated liver apoptosis in transgenic mice
Authors: Suzuki Hideyuki , Toyoda Mitsuo , Horiguchi Norio , Kakizaki Satoru , Ohyama Tatsuya , Takizawa Daichi , Ichikawa Takeshi , Sato Ken , Takagi Hitoshi , Mori Masatomo
Published: September 2009

Background: Apoptosis via the Fas/Fas ligand signalling system plays an important role in the development of various liver diseases. The administration of an agonistic anti‐Fas antibody to mice causes massive hepatic apoptosis and fulminant hepatic failure. Several growth factors including hepatocyte growth factor (HGF) have been found to prevent apoptosis.

Methods: In this study, we demonstrated the overexpression of HGF to have a protective effect on Fas‐mediated hepatic apoptosis using a transgenic mice (Tg mice) model.

Results: In HGF Tg mice, the elevation of alanine aminotransferase was dramatically inhibited at 12 and 24 h after the administration of 0.15 mg/kg anti‐Fas antibody. HGF Tg mice showed a significantly lower number of apoptotic hepatocytes at 12 h compared with wild‐type (WT) mice. Furthermore, 85% (six of seven) HGF Tg mice were able to survive after the administration of 0.3 mg/kg anti‐Fas antibody, while none of the WT mice survived. The Bcl‐xL expression was increased in HGF Tg mice, while there was no difference in the expression of Bax, Bid, Mcl‐1 and bcl‐2 between WT mice and HGF Tg mice. In addition, the HGF Tg mice showed more Akt phosphorylation than the WT mice both before and after the anti‐Fas antibody injection.

Conclusions: Taken together, our findings suggest that HGF protects against Fas‐mediated liver apoptosis in vivo, and the upregulation of Bcl‐xL via Akt activation may also play a role in the protective effects of HGF.
Pulmonary dysfunction and hepatopulmonary syndrome in cirrhosis and portal hypertension
Authors: Møller Søren , Krag Aleksander , Madsen Jan L. , Henriksen Jens H. , Bendtsen Flemming
Published: September 2009

Background: Pulmonary dysfunction including the hepatopulmonary syndrome (HPS) is an important complication to cirrhosis and portal hypertension. However, the precise relation to liver dysfunction and the prevalence of HPS are unclear.

Aims: We therefore aimed to assess (i) the prevalence of HPS in consecutive alcoholic cirrhotic patients, (ii) the degree of pulmonary dysfunction in relation to liver function and (iii) the response of a 100% oxygen test on cardiopulmonary and peripheral oxygenation.

Methods: Fifty patients with cirrhosis and 12 matched healthy controls were entered in this study. All underwent haemodynamic and pulmonary investigations [lung diffusing capacity for carbon monoxide (DLCO), contrast‐enhanced echocardiography and detection of extrapulmonary shunt fraction]. A 100% oxygen test was performed with the assessment of arterial oxygen tension (PaO2), the alveolar‐arterial oxygen gradient (AaPO2) and peripheral transcutaneous oxygen tension (tcPO2).

Results: The prevalence of HPS was 10%. PaO2 and DLCO were reduced in 32 and 72% and AaPO2, was increased in 60% of the patients respectively. DLCO correlated with indicators of liver dysfunction (galactose elimination capacity, P<0.01, indocyanine green clearance, P<0.001), portal hypertension (post‐sinusoidal resistance, P<0.01) and central hypovolaemia (central and arterial blood volume, P<0.01). After 100% oxygen inhalation, the changes in PaO2, AaPO2, tcPO2 and heart rate were abnormal in the patients compared with controls (P<0.02).

Conclusions: Pulmonary dysfunction in alcoholic cirrhosis is common and relates to different aspects of liver dysfunction, whereas the prevalence of HPS is low. The haemodynamic response to oxygen inhalation is clearly impaired and HPS and pulmonary dysfunction seem to be caused by different pathophysiological mechanisms.
Lateglacial older and younger coversand in northwest Europe: chronology and relation to climate and vegetation
Authors: KOLSTRUP ELSE
Published: September 2009

Kolstrup, E. 2007 (January): Lateglacial older and younger coversand in northwest Europe: chronology and relation to climate and vegetation. Boreas, Vol. 36, pp. 65–75. Oslo. ISSN 0300–9483.

Dutch, Belgian, German and Danish Lateglacial localities with both coversand and well‐dated organic deposits are used to relate older and younger coversand development to changes in climate and vegetation. The number of well‐dated coversand sequences in northwest Europe is low, but it appears that the transition from older to younger coversand was asynchronous and spanned Bølling sensu stricto to late Allerød, so there is no clear single cause for the change in grain‐size composition of the sediment. Aeolian activity took place during all parts of the Lateglacial and seems to have continued well into the Holocene. The effect of changing temperatures is mainly reflected indirectly as periods with denser vegetation, especially forest, that led to reduced coversand net‐accumulation. The outline proposes that the lithostratigraphic position of a peat layer cannot be used as an Allerød marker because even a well‐developed peat layer within coversands may differ in age from one area to the next. The combined coversand and vegetation development shows that local conditions were important for the accumulation and preservation of sediments.
Palaeogeographic reconstruction of proglacial lakes in Estonia
Authors: ROSENTAU ALAR , VASSILJEV JÜRI , SAARSE LEILI , MIIDEL AVO
Published: September 2009

This paper describes a Geographical Information System (GIS)‐based palaeogeographic reconstruction of the development of proglacial lakes formed during deglaciation in Estonia, and examines their common features and relations with the Baltic Ice Lake. Ice marginal positions, interpolated proglacial lake water levels and a digital terrain model were used to reconstruct the spatial distribution and bathymetry of the proglacial lakes. Our results suggest that the proglacial lakes formed a bay of the Baltic Ice Lake after the halt at the Pandivere‐Neva ice margin about 13.3 cal. kyr BP Shoreline reconstruction suggests that two major proglacial lake systems, one in eastern and the other in western Estonia, were connected via a strait and thus had identical water levels. The water budget calculations show that the strait was able to transfer a water volume several times greater than the melting glacier could produce. As this strait compensated for the water level difference between the two lake parts, the subsequent further merging in north Estonia did not result in catastrophic drainage, as has been proposed.
Dynamics of the Late Weichselian ice sheet on Svalbard inferred from high‐resolution sea‐floor morphology
Authors: OTTESEN DAG , DOWDESWELL JULIAN A. , LANDVIK JON Y. , MIENERT JUERGEN
Published: September 2009

High‐resolution bathymetric mapping of the fjords and continental shelf around the Svalbard archipelago shows an extensive pattern of large‐ and medium‐scale submarine landforms formed by differences in ice‐flow regimes. Mega‐scale glacial lineations, lateral moraines, transverse ridges and glaciotectonic features are superimposed on the large‐scale fjord, shelf and cross‐shelf trough morphology of the margin. From these landforms we have inferred the flow and dynamics of the last ice sheet on Svalbard. Major fjords and their adjacent cross‐shelf troughs have been identified as the main routes for ice streams draining the ice sheet. On the west coast of Svalbard major pathways existed along Bellsund, Isfjorden and Kongsfjorden. Along the northern Svalbard margin most of the ice drained through the Woodfjorden cross‐shelf trough and Wijdefjorden‐Hinlopen strait. Extensive areas with trough‐parallel glacial lineations in the cross‐shelf troughs suggest fast ice flow by palaeo‐ice streams. Lateral ice‐stream moraines, several tens of kilometres in length, have been mapped along the margins of some of the cross‐shelf troughs, identifying the border zone between fast ice flow and stagnant or slow‐flowing ice on intervening banks. Several general implications can be drawn from the interpretation of the glacier‐derived submarine landforms around Svalbard. Firstly, the Late Weichselian ice sheet was partitioned into fast‐flowing ice streams separated by slower moving ice. Secondly, our submarine morphological evidence supports earlier sedimentological, stratigraphical and chronological studies in implying that a large ice sheet reached the shelf edge around almost all of western and northern Svalbard in the Late Weichselian. The idea of a relatively restricted ice sheet over Svalbard, with ice‐free conditions in some areas of the west coast at the Last Glacial Maximum, is therefore unlikely to be correct. Thirdly, the ice sheet appears to have retreated more rapidly from the cross‐shelf troughs and outer fjords, although sometimes this occurred in a punctuated pattern indicated by grounding‐zone wedges, and more slowly from the intervening shallower banks. In addition, a grounding zone for the ice sheet has been mapped at the shelf edge 10–20 km off the northwest coast of Svalbard, suggesting that ice did not reach the adjacent Yermak Plateau during the Late Weichselian.
Lacosamide: What Can be Expected from the Next New Antiepileptic Drug?
Authors: Abou-Khalil Bassel W.
Published: September 2009

Adjunctive Lacosamide for Partial-Onset Seizures: Efficacy and Safety Results from a Randomized Controlled Trial. Halasz P, Kalviainen R, Mazurkiewicz-Beldzińska M, Rosenow F, Doty P, Hebert D, Sullivan T; SP755 Study Group. Epilepsia 2009;50(3):443–453. PURPOSE: To evaluate the efficacy and safety of lacosamide (200 and 400 mg/day) when added to one to three concomitant antiepileptic drugs (AEDs) in patients with uncontrolled partial-onset seizures. METHODS: This multicenter, double-blind, placebo-controlled trial randomized patients (age 16–70 years) with partial-onset seizures with or without secondary generalization to placebo, lacosamide 200, or lacosamide 400 mg/day. The trial consisted of an 8-week baseline, a 4-week titration, and a 12-week maintenance period. RESULTS: Four hundred eighty-five patients were randomized and received trial medication. Among these, 87% were taking two or more concomitant AEDs. Median percent reduction in seizure frequency per 28 days from baseline to maintenance period (intent-to-treat, ITT) was 20.5% for placebo, 35.3% for lacosamide 200 mg/day ( p = 0.02), and 36.4% for 400 mg/day ( p = 0.03). In the per protocol population, the reductions were 35.3% for lacosamide 200 mg/day ( p = 0.04) and 44.9% for 400 mg/day ( p = 0.01) compared to placebo (25.4%). The 50% responder rate for lacosamide 400 mg/day (40.5%) was significant ( p = 0.01) over placebo (25.8%), but was not for 200 mg/day (35.0%). In the per protocol population, the 50% responder rate for lacosamide 400 mg/day (46.3%) was significant ( p < 0.01) compared with the placebo responder rate (27.5%). Dose-related adverse events (AEs) included dizziness, nausea, and vomiting. Clinically relevant changes in the mean plasma concentrations of commonly used AEDs were not observed. DISCUSSION: Results of this trial demonstrated the efficacy and tolerability of adjunctive lacosamide 200 and 400 mg/day and support that lacosamide may be an advantageous option for the treatment of partial-onset seizures in patients with epilepsy.
Breathing New Life into the Fight against Sudden Death in Epilepsy
Authors: Hirsch Lawrence J.
Published: September 2009

Ictal Hypoxemia in Localization-Related Epilepsy: Analysis of Incidence, Severity and Risk Factors. Bateman LM, Li CS, Seyal M. Brain 2008;131(Pt 12):3239–3245. Ictal hypoxemia has been reported in small series of cases and may contribute to sudden unexpected death in epilepsy (SUDEP). We sought to determine the incidence and severity of ictal hypoxemia in patients with localization-related epilepsy undergoing in-patient video-EEG telemetry. We examined whether seizure-associated oxygen desaturation was a consequence of hypoventilation and whether factors such as seizure localization and lateralization, seizure duration, contralateral spread of seizures, patient position at seizure onset and body mass index influenced ictal-related hypoxemia. A total of 304 seizures with accompanying oxygen saturation data were recorded in 56 consecutive patients with intractable localization-related epilepsy; 51 of 304 seizures progressed to generalized convulsions. Pulse oximetry showed oxygen desaturations below 90% in 101 (33.2%) of all seizures with or without secondary generalization, with 31 (10.2%) seizures accompanied by desaturations below 80% and 11 (3.6%) seizures below 70%. The mean duration of desaturation below 90% was 69.2 ± 65.2 s (47; 6–327). The mean oxygen saturation nadir following secondary generalization was 75.4% ± 11.4% (77%; 42–100%). Desaturations below 90% were significantly correlated with seizure localization [ p = 0.005; odds ratio (OR) of temporal versus extratemporal = 5.202; 95% CI = (1.665, 16.257)], seizure lateralization [ p = 0.001; OR of right versus left = 2.098; 95% CI = (1.078, 4.085)], contralateral spread of seizures [ p = 0.028; OR of contralateral spread versus no spread = 2.591; 95% CI = (1.112, 6.039)] and gender [ p = 0.048; OR of female versus male = 0.422; 95% CI = (0.179, 0.994)]. In the subset of 253 partial seizures without secondary generalized convulsions, 34.8% of seizures had desaturations below 90%, 31.8% had desaturations below 80% and 12.5% had desaturations below 70%. The degree of desaturation was significantly correlated with seizure duration ( p = 0.001) and with electrographic evidence of seizure spread to the contralateral hemisphere ( p = 0.003). Central apnoeas or hypopnoeas occurred with 50% of 100 seizures. Mixed or obstructive apnoeas occurred with 9% of these seizures. End-tidal carbon dioxide (ETCO2) was recorded in seven patients (19 seizures). The mean increase in ETCO2 from preictal baseline was 18.6 ± 17.7 mm Hg (13.2; 2.8–77.8). In these 19 seizures, all oxygen desaturations below 85% were accompanied by an increase in ETCO2. Ictal hypoxemia occurs often in patients with localization-related epilepsy and may be pronounced and prolonged; even with seizures that do not progress to generalized convulsions. Oxygen desaturations are accompanied by increases in ETCO2, supporting the assumption that ictal oxygen desaturation is a consequence of hypoventilation. Ictal hypoxemia and hypercapnia may contribute to SUDEP.
Pilocarpine-Induced Seizures Revisited: What Does the Model Mimic?
Authors: Vezzani Annamaria
Published: September 2009

Antagonism of Peripheral Inflammation Reduces the Severity of Status Epilepticus. Marchi N, Fan Q, Ghosh C, Fazio V, Bertolini F, Betto G, Batra A, Carlton E, Najm I, Granata T, Janigro D. Neurobiol Dis 2009;33(2):171–181. Status epilepticus (SE) is one of the most serious manifestations of epilepsy. Systemic inflammation and damage of blood-brain barrier (BBB) are etiologic cofactors in the pathogenesis of pilocarpine SE while acute osmotic disruption of the BBB is sufficient to elicit seizures. Whether an inflammatory-vascular-BBB mechanism could apply to the lithium–pilocarpine model is unknown. LiCl facilitated seizures induced by low-dose pilocarpine by activation of circulating T-lymphocytes and mononuclear cells. Serum IL-1β levels increased and BBB damage occurred concurrently to increased theta EEG activity. These events occurred prior to SE induced by cholinergic exposure. SE was elicited by lithium and pilocarpine irrespective of their sequence of administration supporting a common pathogenetic mechanism. Since IL-1 β is an etiologic trigger for BBB breakdown and its serum elevation occurs before onset of SE early after LiCl and pilocarpine injections, we tested the hypothesis that intravenous administration of IL-1 receptor antagonists (IL-1ra) may prevent pilocarpine-induced seizures. Animals pre-treated with IL-1ra exhibited significant reduction of SE onset and of BBB damage. Our data support the concept of targeting systemic inflammation and BBB for the prevention of status epilepticus.
A Rare Connection: Fasciculoventricular Pathway in PRKAG2 Disease
Authors: GOVINDAN MALINI , WARD DAVID , BEHR ELIJAH
Published: September 2009

Fasciculoventricular Pathway in PRKAG2 Disease.  Mutations in the PRKAG2 gene that regulates the gamma 2 subunit of the AMP‐dependent protein kinase A have been associated with the development of AV accessory pathways, cardiac hypertrophy, and conduction system abnormalities. The accessory pathways described in PRKAG2 disease have mostly been AV bypass tracts, as mutations in the PRKAG2 gene disrupt the normal AV junction development. There have also been a few reports of nodoventricular tracts associated with PRKAG2 mutations, as these tracts also involve the AV junction. We describe a case of a fasciculoventricular pathway with PRKAG2 mutation suggesting a more widespread involvement of the PRKAG2 gene in the development of the cardiac conduction system. (J Cardiovasc Electrophysiol, Vol. 21, pp. 329–332, March 2010)
New Endpoint for Ablation of Ventricular Tachycardia: Change in QRS Morphology with Pacing at Protected Isthmus as Index of Isthmus Block
Authors: BALA RUPA , DHRUVAKUMAR SANDHYA , LATIF SHUAIB A. , MARCHLINSKI FRANCIS E.
Published: September 2009

New Endpoint for Ablation of Ventricular Tachycardia. 
Introduction: Endpoints confirming block in the critical isthmus in sinus rhythm and with pace mapping have not been established.

Methods and Results: A 44‐year‐old man with a history of Tetralogy of Fallot presented with recurrent ventricular tachycardia (VT). Entrainment mapping was consistent with a macroreentrant circuit rotating in a clockwise fashion under the pulmonic valve. After termination of the VT in a critical isthmus located on the conal free wall, a pace map proximal to the site of successful ablation was consistent with a change in QRS morphology. This change in QRS morphology suggested critical isthmus block and successful ablation, which was confirmed by noninducibility with programmed stimulation.

Conclusion: Evidence of conduction block can be used as an additional endpoint for successful ablation of VT. (J Cardiovasc Electrophysiol, Vol. 21, pp. 320–324, March 2010)
Implementation of Real Time Three‐Dimensional Transesophageal Echocardiography in Percutaneous Mitral Balloon Valvuloplasty and Structural Heart Disease Interventions
Authors: Eng Marvin H. , Salcedo Ernesto E. , Quaife Robert A. , Carroll John D.
Published: September 2009

Percutaneous interventions for structural heart disease are performed in a dynamic and complex environment that necessitates multiple imaging modalities to achieve procedural success. Structural interventions are routinely guided by two‐dimensional (2D) modalities such as x‐ray fluoroscopy, transesophageal echocardiography (TEE), and intracardiac echocardiography. Real time imaging with three‐dimensional (3D) echocardiography is a novel method of guidance to facilitate complex structural interventions with the promise of greater safety and efficacy. Real time 3D TEE (RT3D‐TEE) affords the capability of imaging catheters and devices, the interventional objective, and adjacent structures simultaneously. We present an overview of RT3D‐TEE and explore its functionality in structural heart interventions by using percutaneous mitral balloon valvuloplasty as a model.
Quadricuspid Aortic Valve with Ruptured Sinus of Valsalva Aneurysm to the Right Atrium
Authors: Aggarwal Suneil Kumar , Lingan Anand , Reddy Kiran Kumar , Swamy Mallindra , Iyer V. Ramnath , Srivatsa S. Sanjay
Published: September 2009

A 32‐year‐old man with a sudden onset of chest pain and progressive dyspnea was found to have a ruptured sinus of Valsalva aneurysm to the right atrium with an associated quadricuspid aortic valve. Echocardiographic and angiographic images are presented, with real time transthoracic 3D echo. The patient was successfully operated.
Left Ventricular Apical Thin Point Viewed with Two‐Dimensional Echocardiography
Authors: Baosheng Guo , Jun Yang , Xiaona Yu , Bing Han , Ying Zhang , Shuxi Gao , Zhaoxia Luan , Ying Li , Weidong Ren , Shoujun Liu
Published: September 2009

The aim of this study was to evaluate the usefulness of two‐dimensional echocardiography in observing the left ventricular apical thin point (LVATP) and to view the change in thickness and width of the LVATP during the cardiac cycle. Transthoracic echocardiography was performed in 32 healthy adult volunteers to observe the LVATP in an apical three‐chamber view. The width and thickness of the LVATP were measured at the end‐diastole as well as at the end‐systole. With two‐dimensional echocardiography, the LVATP could be clearly shown. The width of the LVATP at the end‐diastole and end‐systole was 3.3 mm ± 1.4 mm versus 0.9 mm±0.4 mm, P < 0.001; the thickness of the LVATP at the end‐diastole and end‐systole was 1.7 mm ± 0.6 mm versus 1.8 mm ± 0.8 mm, P > 0.05. The LVATP can be viewed with two‐dimensional echocardiography; the LVATP changes significantly in width during the cardiac cycle, whereas the thickness of the LVATP changes insignificantly.