bluuebunny/crossref_metadata_2025 huggingface dataset:
The introduction of integrated out‐of‐hours arrangements in England: a discrete choice experiment of public preferences for alternative models of care
Authors: Gerard Karen , Lattimer Val , Surridge Heidi , George Steve , Turnbull Joanne , Burgess Abigail , Lathlean Judith , Smith Helen
Published: January 2006

Objective  To establish which generic attributes of general practice out‐of‐hours health services are important to the public.

Methods  A discrete choice experiment postal survey conducted in three English general practitioner (GP) co‐operatives. A total of 871 individuals aged 20–70 years registered with a GP. Outcomes were preferences for, and trade‐offs between: time to making initial contact, time waiting for advice/treatment, informed of expected waiting time, type of contact, professional providing advice, chance contact relieves anxiety, and utility estimates for valuing current models of care.

Results  Response rate was 37%. Respondents valued out‐of‐hours contact for services for reducing anxiety but this was not the only attribute of importance. They had preferences for the way in which services were organized and valued information about expected waiting time, supporting findings from elsewhere. Participants were most willing to make trade‐offs between waiting time and professional person. Of the predicted utility for three models of care utility was higher for fully integrated call management.

Conclusions  Greater utility might be achieved if existing services are re‐configured more in line with the government's fully integrated call management model. Because the attributes were described in generic terms, the findings can be applied more generally to the plethora of models that exist (and many that might exist in the future). The approach used is important for achieving greater public involvement in how health services develop. Few experiments have elicited public preferences for health services in the UK to date. This study showed valid preferences were expressed but there were problems obtaining representative views from the public.
Enhanced sympathetic control of renal function in rats congenic for the hypertension‐related region on chromosome 1
Authors: Wang Tao , Kobayashi Yuta , Nabika Toru , Takabatake Toshikazu
Published: January 2006

1. Recent studies suggest that a quantitative trait locus (QTL) for blood pressure (BP) on rat chromosome 1 is associated with exaggerated sympathetic nervous activity. The aim of the present study was to examine whether this QTL can affect BP by altering sympathetic control of renal function.

2. Male stroke‐prone spontaneously hypertensive rats of Izumo origin (SHRSP/Izm), Wistar‐Kyoto rats (WKY/Izm) and rats from a WKY/Izm congenic strain that contains an SHRSP/Izm chromosomal segment between D1Wox29 and D1Arb21 (WKYpch1.0) were used. Clearance and micropuncture experiments were performed in anaesthetized rats after acute unilateral renal denervation (DN).

3. Mean BP in sham‐operated WKYpch1.0 was significantly higher than that in WKY/Izm. The DN procedure elicited a greater reduction in renal noradrenaline levels in SHRSP/Izm and WKYpch1.0 than in WKY/Izm.

4. In both SHRSP/Izm and WKYpch1.0, DN decreased renal vascular resistance and filtration fraction, whereas it increased renal blood flow and urinary and fractional excretion of sodium. Unilateral renal denervation did not affect these parameters in WKY/Izm.

5. Unilateral renal denervation decreased the tubuloglomerular feedback (TGF) responsiveness only in SHRSP/Izm, whereas it increased the non‐perfused early proximal flow rate in SHRSP/Izm and WKYpch1.0.

6. The results of the present study indicate that the renal sympathetic nervous system exerts enhanced tonic control of the renal vasculature and tubular function in SHRSP/Izm and WKYpch1.0, but not in WKY/Izm. Neural impact on the TGF response in WKYpch1.0 is indiscernible. Thus, a gene or genes in the QTL may influence BP, at least in part, through renal vasoconstriction and sodium retention mediated by the enhanced activity of the renal sympathetic nerves.
Increased responsiveness to 5‐hydroxytryptamine after antigenic challenge is inhibited by nifedipine and niflumic acid in rat trachea in vitro*
Authors: Moura Carlos Tiago Martins , Bezerra Fernanda Carvalho , De Moraes Isabelle Maciel , Magalhães Pedro Jorge Caldas , Capaz Francisco Ruy
Published: January 2006

1. Antigenic challenge often induces hyperreactivity in asthmatic airway, although the precise mechanism(s) underlying this increased responsiveness is not entirely known.

2. Tracheae obtained from ovalbumin (OVA)‐sensitized saline‐ or OVA‐challenged rats were placed in 10 mL bath chambers for isometric recording of 5‐hydroxytryptamine (5‐HT)‐induced contractions.

3. 5‐Hydroxytryptamine induced a stronger contraction compared with control in antigen‐challenged trachea under normal or Ca2+‐free conditions.

4. In tracheae pretreated with the L‐type Ca2+ channel blocker nifedipine (10−6 mol/L) or the Ca2+‐activated Cl– channel blocker niflumic acid (10−4 mol/L), this hyperresponsiveness was not developed in either normal or Ca2+‐free medium.

5. The increased contractile response to 5‐HT in allergic rat isolated trachea may be related to a greater ionic (Ca2+ and Cl–) channel involvement.
The biomechanics of restricted movement in adult obesity
Authors: Wearing S. C. , Hennig E. M. , Byrne N. M. , Steele J. R. , Hills A. P.
Published: January 2006

In spite of significant advances in the knowledge and understanding of the multi‐factorial nature of obesity, many questions regarding the specific consequences of the disease remain unanswered. In particular, there is a relative dearth of information pertaining to the functional limitations imposed by overweight and obesity. The limited number of studies to date have mainly focused on the effect of obesity on the temporospatial characteristics of walking, plantar foot pressures, muscular strength and, to a lesser extent, postural balance. Collectively, these studies have implied that the functional limitations imposed by the additional loading of the locomotor system in obesity result in aberrant mechanics and the potential for musculoskeletal injury. Despite the greater prevalence of musculoskeletal disorders in the obese, there has been surprisingly little empirical investigation pertaining to the biomechanics of activities of daily living or into the mechanical and neuromuscular factors that may predispose the obese to injury. A better appreciation of the implications of increased levels of body adiposity on the movement capabilities of the obese would afford a greater opportunity to provide meaningful support in preventing, treating and managing the condition and its sequelae. Moreover, there is an urgent need to establish the physical consequences of continued repetitive loading of major structures of the body, particularly of the lower limbs in the obese, during the diverse range of activities of daily living.
Poverty and the extent of child obesity in Canada, Norway and the United States
Authors: Phipps S. A. , Burton P. S. , Osberg L. S. , Lethbridge L. N.
Published: January 2006

The goal of this paper is to compare the extent of child obesity in Canada, Norway and the United States. As child poverty is an important correlate of child obesity, we wish to examine the potential role of international differences in child poverty in explaining international differences in the extent of child obesity. We use three representative microdata surveys containing parental reports of child height and weight collected in the mid‐1990s in Canada, Norway and the US. We calculate both the prevalence and proportional severity of child obesity for 6–11‐year‐old children in each country, and represent the ‘extent’ of obesity diagrammatically. Differences in patterns of child poverty are similarly depicted. Obesity extent is also compared for poor and non‐poor children in Canada and the US. Finally, child obesity in the three countries is compared using only non‐poor children where we find that the extent of child obesity is much lower in Norway than in Canada or the US. The pattern apparent for obesity is remarkably similar to that found for child poverty. In Canada and especially in the US, we find a much greater extent of obesity for poor than non‐poor children. However, when we compare only non‐poor children in the three countries, although the magnitude of difference is smaller, it remains clear that Norwegian children are much less likely to be obese. Policy and research directed towards reducing the extent of child obesity in both Canada and the US should pay particular attention to issues of child poverty.
A New Parametric Family for Modelling Cumulative Incidence Functions: Application to Breast Cancer Data
Authors: Jeong Jong-Hyeon
Published: January 2006

Competing risks situations can be encountered in many research areas such as medicine, social science and engineering. The main stream of analyses of those competing risks data has been nonparametric or semiparametric in the statistical literature. We propose a new parametric family to parameterize the cumulative incidence function completely. The new distribution is sufficiently flexible to fit various shapes of hazard patterns in survival data and increases the efficiency of the cumulative incidence estimates over the distribution-free approaches. A simple two-sample parametric test statistic is also proposed to compare the cumulative incidence functions between two groups at a given time point. The new parametric approach is illustrated by using breast cancer data sets from the National Surgical Adjuvant Breast and Bowel Project.
Characterization of highly polymorphic nuclear microsatellite loci in Juniperus communis L.
Authors: MICHALCZYK I. M. , SEBASTIANI F. , BUONAMICI A. , CREMER E. , MENGEL C. , ZIEGENHAGEN B. , VENDRAMIN G. G.
Published: January 2006

We developed five nuclear microsatellite markers in Juniperus communis L. using an enriched library method. Samples from 28 juniper individuals were collected in Spain, Germany and Slovakia and were analysed at the five loci. A high level of allelic diversity with values ranging from nine to 23 alleles was found. These highly polymorphic markers will be used in ongoing population genetic studies to evaluate the genetic resources and to contribute to the maintenance of genetic diversity of juniper in Middle Europe.
CO1 phylogenies in diploblasts and the ‘Barcoding of Life’— are we sequencing a suboptimal partition?
Authors: ERPENBECK D. , HOOPER J. N. A. , WÖRHEIDE G.
Published: January 2006

Partitions of the cytochrome oxidase subunit 1 (CO1) gene, especially the 5′ end, are frequently recruited to infer lower level phylogenies in animals. In diploblasts, mitochondrial genes were found to evolve in a slower rate than their bilaterian counterparts. Therefore, diploblast CO1 gene trees repeatedly remained unresolved, which also raises doubts on the suitability of CO1 for DNA barcoding in these animals. The complete mitochondrial genome sequences from Anthozoa and recently from Porifera allow us to compare the resolution power of the 5′ partition, which has also been proposed as the standard marker for DNA barcoding, with a less frequently used partition further downstream. We report on the finding of significantly different substitution patterns of the downstream partition opposed to the 5′ partition. We discuss the consequences and potential in the light of diploblast phylogenetic reconstruction and DNA barcoding.
Encephalocraniocutaneous Lipomatosis: Clinical Spectrum of Systemic Involvement
Authors: Sofiatti Alexandre , Cirto Ana Gabriela , Arnone Marcelo , Romiti Ricardo , Santi Claudia , Leite Claudia , Sotto Mirian
Published: January 2006

Abstract:  Encephalocraniocutaneous lipomatosis is a rare neurocutaneous syndrome with involvement of ectomesodermal tissues. Unilateral lipomatous hamartomas of the scalp and eyes are the hallmarks of this disorder. Associated findings are extremely variable, ranging from minor abnormalities to severe, debilitating disease. We report two unrelated Brazilian patients with encephalocraniocutaneous lipomatosis, one presenting with the full‐blown spectrum of cutaneous, ocular, and central nervous system manifestations, and the other with minor extracutaneous manifestations after a 5‐year follow‐up period.
Transient Aquagenic Palmar Hyperwrinkling: The First Instance Reported in a Young Boy
Authors: Neri Iria , Bianchi Federica , Patrizi Annalisa
Published: January 2006

Abstract:  Transient reactive papulotranslucent acrokeratoderma is a rare palmoplantar keratoderma seen predominantly in adolescent and young adult women. Clinically it is characterized by translucent white papules generally involving the palmar surfaces after exposure to water. The typical “hands‐in‐the‐bucket” sign, which is not clearly visible until the hand is submerged in water, is indispensable for the diagnosis. Histologic examination shows a mild orthokeratotic hyperkeratosis and dilated eccrine ducts. We propose the term “transient aquagenic palmar hyperwrinkling” to describe this condition. Until now, a total of 12 patients have been reported in the literature, all female, with an age of onset from 9 to 33 years. We present the first reported instance of this condition in a young boy.
Juvenile Xanthogranuloma of the Finger
Authors: Hughes Duncan B. , Hanasono Matthew M. , Nolan William B.
Published: January 2006

Abstract:  We present an unusual instance of juvenile xanthogranuloma occurring in the hand. A 23‐month‐old girl had a mass on the radial aspect of the right third finger at the distal interphalangeal joint that extended to the collateral ligament. The lesion was histologically diagnosed as a juvenile xanthogranuloma after resection of the mass. Juvenile xanthogranuloma is uncommon in the hand, and only three patients with this condition occurring in the digits have been reported in the English language literature. The clinical presentation, diagnosis, and treatment are discussed.
Differences in the Features of Aspiration Pneumonia According to Site of Acquisition: Community or Continuing Care Facility
Authors: Reza Shariatzadeh M. , Huang Jane Q. , Marrie Thomas J.
Published: January 2006

OBJECTIVES: To determine the prevalence of aspiration pneumonia and to compare the features and risk factors for this entity in patients from continuing care facilities (CCFs) and the community who were admitted to the hospital with pneumonia.

DESIGN: Prospective population‐based study.

SETTING: Six hospitals in Capital Health Region (Edmonton), Alberta, Canada.

PARTICIPANTS: One thousand nine hundred forty‐six adults admitted with pneumonia. Patients were stratified by their residence as community or CCF.

MEASUREMENTS: Aspiration pneumonia prevalence; risk factors; and outcomes such as mortality, length of stay, and intensive care unit admission rates.

RESULTS: Ten percent of those with community‐acquired pneumonia (CAP) had aspirated, compared with 30% of those with CCF‐acquired pneumonia. Those with community‐acquired aspiration pneumonia (CAAP) and those with CCF‐acquired aspiration pneumonia (CCF‐AP) were younger, more likely to go to ICU, and more likely to require mechanical ventilation and had a longer length of stay and a higher mortality rate than nonaspirators. The risk factors for aspiration differed; for those with CAAP, impaired consciousness due to alcohol, drugs, or hepatic failure predominated, whereas 72% of those with CCF‐AP had neurological disease that resulted in dysphagia. Eighty percent were treated with antibiotics effective against anaerobic bacteria.

CONCLUSION: Aspiration pneumonia is common in patients with both CAP and CCF‐acquired pneumonia. The risk factors differ, and there is a high mortality rate. Neurological disease dominates as the predisposing factor toward aspiration pneumonia in people in CCFs.
Hyponatremia and Arginine Vasopressin Dysregulation: Mechanisms, Clinical Consequences, and Management
Authors: Miller Myron
Published: January 2006

Hyponatremia, the most common electrolyte disorder, occurs frequently in older people and in hospitalized patients. Physiological changes of aging that interact with diseases and drugs commonly present in older people put this population at greater risk for hyponatremia. It can accompany central nervous system disorders, pulmonary and renal disease, cancer, congestive heart failure, and liver cirrhosis, as well as many commonly used drugs. Delayed recognition can lead to symptomatic hyponatremia with consequent cerebral edema and possibly irreversible neurological damage. Symptoms and signs of hyponatremia may be subtle or not attributed to hyponatremia. Most cases are of the euvolemic type, in which extracellular fluid volume is normal and is often due to the syndrome of inappropriate secretion of antidiuretic hormone. Hyponatremia can also occur in association with hypervolemia or hypovolemia. Common to all of these circumstances is increased secretion of arginine vasopressin (AVP). Understanding of the pathophysiological basis of hyponatremia and of brain compensatory mechanisms is critical to safe treatment. Fluid restriction or infusion of hypertonic saline can improve symptoms and normalize serum sodium levels but does not address excess AVP, which in most cases is the underlying cause of the disorder. A major new approach to treatment of hyponatremia is the development of aquaretics: AVP‐receptor antagonists that provide a targeted therapeutic approach to correcting the many kinds of hyponatremia caused by excess AVP levels.
Is a Dual‐Sensor Pacemaker Appropriate in Patients with Sino‐Atrial Disease? Results from the DUSISLOG Study
Authors: PADELETTI LUIGI , PIERAGNOLI PAOLO , DI BIASE LUIGI , COLELLA ANDREA , LANDOLINA MAURIZIO , MORO EUGENIO , ORAZI SERAFINO , VICENTINI ALFREDO , MAGLIA GIAMPIERO , PENSABENE ORAZIO , RACITI GIOVANNI , BAROLD S. SERGE
Published: January 2006

Background: Rate‐responsive pacemakers (PMs) are often supplied with accelerometer (XL) and minute ventilation (MV) sensors to provide a physiologic rate response according to patient needs. No information is available about the real benefit of dual‐sensor rate‐responsive pacing on the daily life of patients.

Methods: DUSISLOG (Dual Sensor vs Single Sensor comparison using patient activity LOGbook) is a two‐arm prospective, randomized, multicenter study that enrolled 105 patients who received a rate‐responsive PM (Insignia
®, Guidant Corp.). After 1 month of DDD pacing at 60 ppm lower rate, a single sensor (XL or MV, randomized) was activated for 3 months at the manufacturer's suggested nominal settings, followed by a 3‐month period with dual sensors optimized with automatic response. During the last month of each period, the following data concerning patient physical activity were retrieved from PM diagnostics (Activity Log): mean percentage of physical activity, mean intensity of activity. Quality of life (QoL) scores and 6‐minute walk test (WT) were also recorded.

Results: Single‐sensor rate‐responsive pacing resulted in symptomatic benefit equally with XL and MV sensors while no additional benefit was found using dual sensor. In a subgroup analysis, patients (17%) with marked chronotropic incompetence and with 0% atrial sensing received benefits from single sensor with an additional advantage from sensor (QoL: +21 ± 14% P < 0.05; WT: +17 ± 7% P < 0.02).

Conclusion: In most patients with rate‐responsive devices, a single sensor is sufficient to achieve a satisfactory rate response. A dual sensor combination and optimization provides an additional benefit only in a selected population with an advanced atrial chronotropic disease.
Skin surface topography grading is a valid measure of skin photoaging
Authors: Battistutta Diana , Pandeya Nirmala , Strutton Geoffrey M. , Fourtanier Anny , Tison Sylvie , Green Adèle C.
Published: January 2006

Background: The technique of grading the surface topography of sun‐exposed skin using silicone impressions of the skin surface is a simple, non‐invasive method for measuring skin damage because of sun exposure, but it has never been validated in a community setting.

Objective: To investigate the repeatability and validity of using standardly‐graded skin impressions as a means of assessing skin photoaging.

Patients/Methods: A random sample of 195 adults aged 18–79 years and living in Nambour, Australia (latitude, 26° South) had a silicone impression taken of the back of the left hand and a 2 mm punch biopsy of the skin at the same site. Silicone impressions were graded twice independently and histological photoaging was determined by two pathologists.

Results: Grading of silicone impressions of skin surface topography was highly repeatable (weighted κ>0.8). Compared with those with low skin impression grades (least degeneration), people with high grades were three times more likely to show a high degree of dermal elastosis on skin histology (odds ratio 3.1, 95% confidence interval 1.6, 5.7) after adjusting for age, sex, skin colour, tanning ability, occupational exposure, smoking and height‐adjusted weight. Other photoaging changes in the stratum corneum and dermis were also strongly correlated with high grades of damage on skin impressions.

Conclusion: Grading silicone impressions of skin surface topography is a highly reliable and a valid measure of photoaging and enables prediction of dermal elastosis in a population setting.
A Standard Protocol for Liana Censuses1
Authors: Gerwing Jeffrey J. , Schnitzer Stefan A. , Burnham Robyn J. , Bongers Frans , Chave Jérôme , DeWalt Saara J. , Ewango Corneille E. N. , Foster Robin , Kenfack David , Martínez‐Ramos Miguel , Parren Marc , Parthasarathy N. , Pérez‐Salicrup Diego R. , Putz Francis E. , Thomas Duncan W.
Published: January 2006

A recent increase in published studies of lianas has been paralleled by a proliferation of protocols for censusing lianas. This article seeks to increase uniformity in liana inventories by providing specific recommendations for the determination of which taxa to include, the location of diameter measurement points on individual stems, the setting of minimum stem diameter cutoffs, the treatment of multiple‐stemmed and rooted clonal groups, and the measurement of noncylindrical stems. Use of more uniform liana censusing protocols may facilitate comparison of independently collected data sets and further our understanding of global patterns in liana abundance, diversity, biomass, and dynamics.
Macrophage-Mediated Inhibitory Effect ofZingiber officinaleRosc, A Traditional Oriental Herbal Medicine, on the Growth of Influenza A/Aichi/2/68 Virus
Authors: Imanishi Nobuko , Andoh Tsugunobu , Mantani Naoki , Sakai Shinya , Terasawa Katsutoshi , Shimada Yutaka , Sato Miyuki , Katada Yuko , Ueda Kyouka , Ochiai Hiroshi
Published: January 2006

The inhibitory effect of Zingiber officinale Rosc (ZOR), an Oriental traditional herbal medicine, on the growth of influenza A/Aichi/2/68 (Aichi) virus was investigated in Madin-Darby canine kidney (MDCK) cells. Direct addition of ZOR (0.1 ~ 100 μ g/ml ) to the infected cells did not have any inhibitory effect. However, the ZOR-induced conditioned medium (ZOR-CM) of RAW cells, a murine macrophage (Mφ) cell line, exhibited an apparent inhibitory effect on MDCK cells without cytotoxicity. In accordance with the time-dependent inhibitory effect of ZOR-CM, it has been demonstrated that tumor necrosis factor (TNF)-α was gradually accumulated in ZOR-CM by the induction of TNF-α mRNA expression in ZOR-stimulated RAW cells. Conversely, the inhibitory effect of ZOR-CM was reduced significantly by the removal of TNF-α after the formation of an immune complex with anti-TNF-α monoclonal antibody. These data suggested that ZOR itself has no inhibitory effect on the growth of influenza virus, but could exert its effect via macrophage activation leading to production of TNF-α.
EXCESS CONDUCTIVITY IN THE MEAN FIELD AND PARACOHERENCE REGIMES OF (La1.6Y0.4)Ba2Ca0.8Cu4.8Oz SUPERCONDUCTORS
Authors: NAYAK P. K. , RAVI S.
Published: January 2006

The temperature variations of electrical resistivity have been measured on pure and 5 wt% Ag doped ( La 1.6 Y 0.4) Ba 2 Ca 0.8 Cu 4.8 O z superconductors. These data were analyzed in terms of fluctuation-induced excess conductivity in the mean field regime by using the Aslamazov–Larkin (AL), Lawrence–Doniach (LD) and Maki–Thompson (MT) models. The fluctuations in the amplitude of order parameter are found to be two dimensional in nature in the mean field region. The estimated values of the average phase breaking time τϕ (100 K) are found to be 3.9×10-16 s and 4.6×10-16 s for pure and Ag doped samples respectively. The resistivity data were also analyzed in terms of excess conductivity due to phase fluctuations of the order parameter in the paracoherence region. The critical exponent is found to be mostly comparable to that of the 3D XY ferromagnet in the vicinity of zero resistivity temperature and the diluted Heisenberg model at a higher temperature.
Therapeutic Inertia Is an Impediment to Achieving the Healthy People 2010 Blood Pressure Control Goals
Authors: Okonofua Eni C. , Simpson Kit N. , Jesri Ammar , Rehman Shakaib U. , Durkalski Valerie L. , Egan Brent M.
Published: January 2006

Therapeutic inertia (TI), defined as the providers’ failure to increase therapy when treatment goals are unmet, contributes to the high prevalence of uncontrolled hypertension (≥140/90 mm Hg), but the quantitative impact is unknown. To address this gap, a retrospective cohort study was conducted on 7253 hypertensives that had ≥4 visits and ≥1 elevated blood pressure (BP) in 2003. A 1-year TI score was calculated for each patient as the difference between expected and observed medication change rates with higher scores reflecting greater TI. Antihypertensive therapy was increased on 13.1% of visits with uncontrolled BP. Systolic BP decreased in patients in the lowest quintile of the TI score but increased in those in the highest quintile (−6.8±0.5 versus +1.8±0.6 mm Hg;
P
<0.001). Individuals in the lowest TI quintile were &33 times more likely to have their BP controlled at the last visit than those in highest quintile (odds ratio, 32.7; 95% CI, 25.1 to 42.6;
P
<0.0001). By multivariable analysis, TI accounted for &19% of the variance in BP control. If TI scores were decreased &50%, that is, increasing medication dosages on &30% of visits, BP control would increase from the observed 45.1% to a projected 65.9% in 1 year. This study confirms the high rate of TI in uncontrolled hypertensive subjects. TI has a major impact on BP control in hypertensive subjects receiving regular care. Reducing TI is critical in attaining the Healthy People 2010 goal of controlling hypertension in 50% of all patients.
A Longitudinal Study of Hypertension Risk Factors and Their Relation to Cardiovascular Disease
Authors: Wang Wenyu , Lee Elisa T. , Fabsitz Richard R. , Devereux Richard , Best Lyle , Welty Thomas K. , Howard Barbara V.
Published: January 2006

This study estimated hypertension incidence and explored hypertension risk factors and their association with cardiovascular disease. Data collected from 4549 American Indian participants in the 3 exams of the Strong Heart Study were used. Hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or current use of antihypertensive medication. Generalized linear models were used to identify the risk factors for hypertension and the correlates of blood pressures. Cox proportional models with time-dependent covariates and the mixed models were used to explore the association of hypertension with cardiovascular disease. There was no sex difference in hypertension. After adjustment for other risk factors, the risks of developing hypertension among subgroups in each characterized group were as follows: prehypertensive versus normotensive, 3.21 times; macroalbuminuria and microalbuminuria versus normal, 3.47 and 1.72; diabetic versus nondiabetic, 1.56; overweight and obese versus normal weight, 1.30 and 1.51; and current alcohol drinking versus not, 1.22. Moreover, systolic blood pressure was significantly and positively associated with age, obesity, and albuminuria and negatively with smoking. After adjusting all other risk factors, those pretreated, untreated, controlled, and uncontrolled hypertensive participants had &1.74, 1.81, 2.19, and 2.77 times higher risks of developing cardiovascular disease compared with normotensive participants, respectively. In 45- to 74-year-old American Indians, the risk of developing hypertension was rising. Prehypertensive participants had 3.2/1.74 times higher risk of developing hypertension/cardiovascular disease than normotensive participants. Age, diabetes, and macro/microalbuminuria were independently significant risk factors of both hypertension and cardiovascular disease.
Endogenous NO Regulates Plasminogen Activator Inhibitor-1 During Angiotensin-Converting Enzyme Inhibition
Authors: Brown Nancy J. , Muldowney James A.S. , Vaughan Douglas E.
Published: January 2006

To test the hypothesis that NO contributes to effects of angiotensin-converting enzyme inhibitors on fibrinolysis, fibrinolytic balance was assessed in 17 normal subjects during placebo and after randomized, double-blind 4-week treatment with the NO precursor
l
-arginine (3 g TID), ramipril (10 mg QD), or
l
-arginine+ramipril. Neither
l
-arginine nor ramipril alone affected basal plasminogen activator inhibitor-1 or tissue-type plasminogen activator (t-PA) antigen in these salt-replete subjects in whom plasma renin activity was suppressed (mean±SD 0.7±0.5 ng angiotensin I/mL per hour). In contrast,
l
-arginine+ramipril reduced morning plasminogen activator inhibitor-1 antigen (10.8±9.5 ng/mL) and the molar ratio of plasminogen activator inhibitor-1:t-PA (2.3±1.6) compared with placebo (13.5±10.8 ng/mL,
P
=0.006; ratio 2.9±2.1,
P
=0.015) or ramipril alone (15.2±13.2 ng/mL,
P
=0.009; ratio 3.7±3.3,
P
=0.005).
l
-arginine and ramipril synergistically increased
d
-dimers (23.1±31.5, 29.7±50.0, 35.1±50.0, and 57.1±144.8 ng/mL during placebo,
l
-arginine, ramipril, and
l
-arginine+ramipril, respectively;
P
<0.05 for
l
-arginine+ramipril versus any other group). During ramipril, the NO synthase inhibitor
l
-
N
G
-nitro-arginine-methyl-ester (2 mg/kg) significantly increased plasminogen activator inhibitor-antigen after 2 hours (from 9.4±8.6 ng/mL during vehicle to 13.5±11.0 ng/mL during
l
-
N
G
-nitro-arginine-methyl-ester;
P
=0.020), consistent with an effect on expression but rapidly increased t-PA activity (from 0.4±0.3 to 0.5±0.4 IU/mL;
P
=0.031), consistent with an effect on release. Both effects of
l
-
N
G
-nitro-arginine-methyl-ester were reversed by
l
-arginine. During angiotensin-converting enzyme inhibition, endogenous NO decreases plasminogen activator inhibitor-1 antigen and improves fibrinolytic balance in normotensive salt-replete subjects.
Imatinib Attenuates End-Organ Damage in Hypertensive Homozygous TGR(mRen2)27 Rats
Authors: Schellings Mark W.M. , Baumann Marcus , van Leeuwen Rick E.W. , Duisters Rudy F.J.J. , Janssen Suzanne H.P. , Schroen Blanche , Peutz-Kootstra Carine J. , Heymans Stephane , Pinto Yigal M.
Published: January 2006

Imatinib specifically inhibits receptor tyrosine kinase signaling and is clinically used to treat leukemia. Receptor tyrosine kinases not only mediate tumor growth but also initiate adverse signaling in heart failure. We investigated whether imatinib, by inhibiting the platelet-derived growth factor receptor-β (PDGFRβ), prevents cardiac and renal damage in TGR(mRen2)27 (Ren2) rats. Eight-week-old male homozygous Ren2 and Sprague Dawley rats were treated either with imatinib (30 mg/kg; STI-571) or placebo for 8 weeks (Ren2 n=12 for each group; Sprague Dawley n=6 for each group). Imatinib did not affect blood pressure or left ventricular (LV) hypertrophy in both groups. Imatinib attenuated the decline in fractional shortening (imatinib versus Ren2 placebo 45±4.5% versus 32±3%; n=7–11;
P
<0.05) and in diastolic function in Ren2 rats (baseline diastolic dP/dt corrected for systolic blood pressure Ren2 imatinib versus Ren2 placebo 38.6±0.67 versus 35.3±0.41 [1 · s
−1
]; n=7–11;
P
<0.05). This was associated with decreased cardiac fibrosis and decreased activation of PDGFRβ and extracellular signal-regulated kinase 1/2. Renal microvascular hypertrophy and perivascular fibrosis in Ren2 rats were significantly decreased by imatinib. In vitro, imatinib blocked angiotensin II-induced activation of the PDGFRβ and significantly decreased fibroblast proliferation and collagen production. In conclusion, imatinib did not affect LV hypertrophy but attenuated the decline in cardiac function and reduced renal microvascular damage associated with reduced activation of the PDGFRβ. The simultaneous improvement in both heart and kidneys suggests that inhibition of the PDGFRβ has broad protective effects that may provide novel avenues for a blood pressure-independent protection against end-organ damage.
Dietary Approaches to Prevent and Treat Hypertension
Authors: Appel Lawrence J. , Brands Michael W. , Daniels Stephen R. , Karanja Njeri , Elmer Patricia J. , Sacks Frank M.
Published: January 2006

A substantial body of evidence strongly supports the concept that multiple dietary factors affect blood pressure (BP). Well-established dietary modifications that lower BP are reduced salt intake, weight loss, and moderation of alcohol consumption (among those who drink). Over the past decade, increased potassium intake and consumption of dietary patterns based on the “DASH diet” have emerged as effective strategies that also lower BP. Of substantial public health relevance are findings related to blacks and older individuals. Specifically, blacks are especially sensitive to the BP-lowering effects of reduced salt intake, increased potassium intake, and the DASH diet. Furthermore, it is well documented that older individuals, a group at high risk for BP-related cardiovascular and renal diseases, can make and sustain dietary changes. The risk of cardiovascular disease increases progressively throughout the range of BP, beginning at 115/75 mm Hg. In view of the continuing epidemic of BP-related diseases and the increasing prevalence of hypertension, efforts to reduce BP in both nonhypertensive and hypertensive individuals are warranted. In nonhypertensive individuals, dietary changes can lower BP and prevent hypertension. In uncomplicated stage I hypertension (systolic BP of 140 to 159 mm Hg or diastolic BP of 90 to 99 mm Hg), dietary changes serve as initial treatment before drug therapy. In those hypertensive patients already on drug therapy, lifestyle modifications, particularly a reduced salt intake, can further lower BP. The current challenge to healthcare providers, researchers, government officials, and the general public is developing and implementing effective clinical and public health strategies that lead to sustained dietary changes among individuals and more broadly among whole populations.
Predictors of Ischemic Stroke in the Territory of a Symptomatic Intracranial Arterial Stenosis
Authors: Kasner Scott E. , Chimowitz Marc I. , Lynn Michael J. , Howlett-Smith Harriet , Stern Barney J. , Hertzberg Vicki S. , Frankel Michael R. , Levine Steven R. , Chaturvedi Seemant , Benesch Curtis G. , Sila Cathy A. , Jovin Tudor G. , Romano Jose G. , Cloft Harry J.
Published: January 2006

Background—

Antithrombotic therapy for intracranial arterial stenosis was recently evaluated in the Warfarin versus Aspirin for Symptomatic Intracranial Disease (WASID) trial. A prespecified aim of WASID was to identify patients at highest risk for stroke in the territory of the stenotic artery who would be the target group for a subsequent trial comparing intracranial stenting with medical therapy.

Methods and Results—

WASID was a randomized, double-blinded, multicenter trial involving 569 patients with transient ischemic attack or ischemic stroke due to 50% to 99% stenosis of a major intracranial artery. Median time from qualifying event to randomization was 17 days, and mean follow-up was 1.8 years. Multivariable Cox proportional hazards models were used to identify factors associated with subsequent ischemic stroke in the territory of the stenotic artery. Subsequent ischemic stroke occurred in 106 patients (19.0%); 77 (73%) of these strokes were in the territory of the stenotic artery. Risk of stroke in the territory of the stenotic artery was highest with severe stenosis ≥70% (hazard ratio 2.03; 95% confidence interval 1.29 to 3.22;
P
=0.0025) and in patients enrolled early (≤17 days) after the qualifying event (hazard ratio 1.69; 95% confidence interval 1.06 to 2.72;
P
=0.028). Women were also at increased risk, although this was of borderline significance (hazard ratio 1.59; 95% confidence interval 1.00 to 2.55;
P
=0.051). Location of stenosis, type of qualifying event, and prior use of antithrombotic medications were not associated with increased risk.

Conclusions—

Among patients with symptomatic intracranial stenosis, the risk of subsequent stroke in the territory of the stenotic artery is greatest with stenosis ≥70%, after recent symptoms, and in women.
Standard Chemotherapy Compared With High-Dose Chemoradiotherapy for Multiple Myeloma: Final Results of Phase III US Intergroup Trial S9321
Authors: Barlogie Bart , Kyle Robert A. , Anderson Kenneth C. , Greipp Philip R. , Lazarus Hillard M. , Hurd David D. , McCoy Jason , Moore Dennis F. , Dakhil Shaker R. , Lanier Keith S. , Chapman Robert A. , Cromer Jeana N. , Salmon Sydney E. , Durie Brian , Crowley John C.
Published: January 2006

Purpose

Results of a prospective randomized trial conducted by the Intergroupe Francais du Myélome (IFM 90) indicated that autologous hematopoietic cell–supported high-dose therapy (HDT) effected higher complete response rates and extended progression-free survial (PFS) and overall survival (OS) compared with standard-dose therapies (SDT) for patients with multiple myeloma (MM).

Patients and Methods

In 1993, three North American cooperative groups launched a prospective randomized trial (S9321) comparing HDT (melphalan [MEL] 140 mg/m2 plus total-body irradiation 12 Gy) with SDT using the vincristine, carmustine, MEL, cyclophosphamide, and prednisone regimen. Responders on both arms (≥ 75%) were randomly assigned to interferon (IFN) or no maintenance treatment.

Results

With a median follow-up time of 76 months, no differences were observed in response rates between the two study arms (HDT, n = 261 patients; SDT, n = 255 patients). Similarly, PFS and OS durations did not differ between the HDT and SDT arms, with 7-year estimates of PFS of 17% and 16%, respectively, and OS of 37% and 42%, respectively. Of 242 patients achieving at least 75% tumor reduction, no difference was observed in PFS or OS among the 121 patients randomly assigned to IFN and the 121 patients randomly assigned to no maintenance therapy. Among 157 patients relapsing on SDT, 87 received a salvage autotransplantation; their median survival time of 30 months was only slightly better than the survival time of the remaining patients who were managed with further SDT (23 months; P = .13).

Conclusion

The HDT and SDT regimens used in S9321 yielded comparable response rates and PFS and OS durations. IFN maintenance therapy did not benefit patients who achieved ≥ 75% tumor reduction on either arm.
The role of the Brr5/Ysh1 C-terminal domain and its homolog Syc1 in mRNA 3′-end processing in Saccharomyces cerevisiae
Authors: ZHELKOVSKY ALEXANDER , TACAHASHI YOKO , NASSER TOMMY , HE XIAOYUAN , STERZER ULRIKE , JENSEN TORBEN HEICK , DOMDEY HORST , MOORE CLAIRE
Published: January 2006

The cleavage/polyadenylation factor (CPF) of Saccharomyces cerevisiae is thought to provide the catalytic activities of the mRNA 3′-end processing machinery, which include endonucleolytic cleavage at the poly(A) site, followed by synthesis of an adenosine polymer onto the new 3′-end by the CPF subunit Pap1. Because of similarity to other nucleases in the metallo-β-lactamase family, the Brr5/Ysh1 subunit has been proposed to be the endonuclease. The C-terminal domain of Brr5 lies outside of β-lactamase homology, and its function has not been elucidated. We show here that this region of Brr5 is necessary for cell viability and mRNA 3′-end processing. It is highly homologous to another CPF subunit, Syc1. Syc1 is not essential, but its removal improves the growth of other processing mutants at restrictive temperatures and restores in vitro processing activity to cleavage/ polyadenylation-defective brr5-1 extract. Our findings suggest that Syc1, by mimicking the essential Brr5 C-terminus, serves as a negative regulator of mRNA 3′-end formation.
Factors affecting fracture healing after intramedullary nailing of the tibial diaphysis for closed and grade I open fractures
Authors: Drosos G. I. , Bishay M. , Karnezis I. A. , Alegakis A. K.
Published: January 2006

As there is little information on the factors that influence fracture union following intramedullary nailing of the tibia we retrospectively investigated patient-, injury- and treatment-related factors in 161 patients with closed or grade I open fractures of the tibial diaphysis. The patients were reviewed until clinical and radiological evidence of union at a mean of 13.3 months (4 to 60). Multivariate statistical analysis using a Cox proportional hazards model showed that the risk of failure of union increased by 2.38 times for highly comminuted fractures, by 3.14 times when nail dynamisation was applied, and by 1.65 times when the locking screws failed. In fractures with no or only minimal comminution the risk of nonunion increased if the post-reduction gap was ≥ 3 mm.
The angle-bore acetabular component and dislocation after revision of a failed total hip replacement
Authors: Wroblewski B. M. , Siney P. D. , Fleming P. A.
Published: January 2006

We reviewed 1039 revision total hip replacements where an angle-bore acetabular component was used. After a mean follow-up of nine years (0 to 20.6), the incidence of revision for dislocation was 2.1% (22 revisions), a success rate of 97.9%. In 974 revisions, where the indication was other than dislocation, the success rate was 98.5%. Of the 65 revisions for dislocation, 58 (89.2%) were successful after the first revision and a further five after the second revision, an overall success of 96.9%. Two patients elected to have their implants removed. Dislocation after revision of failed total hip replacement is a complex issue. There is often no single cause and no simple solution. The angle-bore acetabular component, in combination with a 22.225-mm diameter femoral head, offers a high level of success.
Imageless navigation for insertion of the acetabular component in total hip arthroplasty
Authors: Kalteis T. , Handel M. , Bäthis H. , Perlick L. , Tingart M. , Grifka J.
Published: January 2006

In a prospective randomised clinical study acetabular components were implanted either freehand (n = 30) or using CT-based (n = 30) or imageless navigation (n = 30). The position of the component was determined post-operatively on CT scans of the pelvis.

Following conventional freehand placement of the acetabular component, only 14 of the 30 were within the safe zone as defined by Lewinnek et al (40° inclination sd 10°; 15° anteversion sd 10°). After computer-assisted navigation 25 of 30 acetabular components (CT-based) and 28 of 30 components (imageless) were positioned within this limit (overall p < 0.001). No significant differences were observed between CT-based and imageless navigation (p = 0.23); both showed a significant reduction in variation of the position of the acetabular component compared with conventional freehand arthroplasty (p < 0.001). The duration of the operation was increased by eight minutes with imageless and by 17 minutes with CT-based navigation.

Imageless navigation proved as reliable as that using CT in positioning the acetabular component.
Solution-based routes to transition-metal oxide one-dimensional nanostructures
Authors: Wang Xun , Li Yadong
Published: January 2006

One-dimensional (1D) nanostructures have drawn continuous research attention because of their unique electrical, optical, and magnetic properties different from that of bulk and nanoparticles, as well as their potential applications in mesoscopic research and nanodevices. The main challenge in this area is how to precisely control the sizes, dimensionalities, compositions, and crystal structures in nanoscale, which may serve as a powerful tool for the tailoring of physical/chemical properties of materials in a controllable way. Here, we review the advances in the solution-based routes to prepare 1D nanostructures. Particularly, three systems of MnO2, rare-earth compounds, and silicates have been chosen to show the synthetic strategy under hydrothermal conditions. As the main theme, a rolling mechanism has been given special attention to present a relative general understanding of the growth of various transition-metal oxide (TMO) 1D nanostructures under solution conditions.
2nd IUPAC Symposium on Trace Elements in Food: An introduction
Authors: Berg Torsten
Published: January 2006

The 2nd IUPAC Symposium on Trace Elements in Food (TEF-2) presented contributions within a wide range of issues, from trace element bioavailability, toxicological and nutritional aspects of trace elements, to trace elements in fortified foods and in food supplements, discussed from both a speciation and a legislation point of view.
Selenium in agriculture, food, and nutrition
Authors: Sager M.
Published: January 2006

In the case of Se, the concentration range between essentiality and toxicity for terrestric animals and humans is rather narrow, while aquatic organisms are much less affected, and no essentiality to green plants and aquatic macrophytes has been established yet. This review focuses on the situation in Europe, where Se levels are generally low. Apart from industrial and mining activities, the main Se sources are the burning of coal and selenite additions to animal feedstuffs. Reduction processes in sediments, soils, and feedstuffs to yield elemental Se act as sinks for available Se forms. In soils and crops, Se levels get enhanced from recycling of manure, dung, and sewage sludge, which is beneficial for Europe. New data from Austria have been added to the detailed discussions. In human nutrition, Se is supplied via pork, liver and kidneys, seafood, and cereals, but main sources as well as blood Se levels vary between different countries and nutritional habits. Food processing, like boiling, baking, or grilling, results in Se losses.