bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma mannose level, a putative indicator of glycogenolysis, and glucose tolerance in Japanese individuals
Authors: Yoshimura Kumiko , Hirano Seiki , Takata Hiroshi , Funakoshi Shogo , Ohmi Satoko , Amano Eri , Nishi Yuichi , Inoue Mari , Fukuda Yoshiharu , Hayashi Hikari , Taguchi Tadao , Yamada Shuhei , Miwa Ichitomo , Terada Yoshio , Fujimoto Shimpei
Published: January 2017

Aims/Introduction

Mannose is a monosaccharide constituent of glycoproteins and glycolipids. Experiments in rats have shown previously that the plasma mannose level decreases after glucose load, but does not decrease in diabetic rats, and that hepatic glycogenolysis is a source of this plasma mannose; however, these results are not fully elucidated in humans. Plasma mannose levels before/after glucose loading in humans with various degrees of glucose intolerance were examined to analyze their association with clinical factors.

Materials and Methods

The 75‐g oral glucose tolerance test was carried out in Japanese individuals not taking diabetes medications. Participants were classified into normal glucose tolerance, impaired glucose metabolism and diabetes mellitus groups. Insulinogenic index as an index of insulin secretion, and Matsuda Index as an index of insulin sensitivity were calculated. Mannose was assayed by the established method using high‐performance liquid chromatography after labeling.

Results

After glucose load, the plasma mannose level decreased gradually in the normal glucose tolerance group, but did not decrease in the diabetes mellitus group. Plasma mannose changes during 120 min from baseline (M120‐M0) were significantly different among the three groups (normal glucose tolerance: −16.7 ± 1.7; impaired glucose metabolism: −9.0 ± 1.9; diabetes mellitus: −1.4 ± 1.8 μmol/L [n = 25 in each group], P < 0.0001). Plasma glucose 120 min after glucose loading (R2 = 0.412) or loge‐insulinogenic index, loge‐Matsuda Index and age (R2 = 0.230) were determinants of M120‐M0 in multiple regression analyses.

Conclusions

We clarified the relationship between plasma mannose level and glucose tolerance in humans. The present results are compatible with those using rats, in which mannose derived from glycogenolysis plays an important role in the alteration of mannose levels after glucose loading.
Accounting digital elevation uncertainty for flood consequence assessment
Authors: Bhuyian Md. N.M. , Kalyanapu A.
Published: January 2017

A digital elevation model (DEM) is commonly used as a substitute for surveyed topographic data. Selection of suitable DEM and optimum spatial resolution is, thus, a key for achieving expected accuracy within sufficient simulation time. This study compared DEMs from different sources (i.e. Shuttle Radar Topography Mission, Advanced Spaceborne Thermal Emission and Reflection Radiometer, National Elevation Dataset, and Light Detection and Ranging) with various spatial resolutions for a 35 km long stretch of the American River downstream of Folsom Dam in California. The study period was the 1997 ‘New Year's Flood’ used to estimate downstream flood consequences, especially in urban areas near Sacramento. The objective of this study was to quantify the comparative deviation of model accuracy for each specific set of topographic data. This study also looked into developing correlations between consequences and flood magnitude. The hydrodynamic model furnished input for flood damage assessment. The Hydrologic Engineering Center's Flood Impact Analysis (HEC‐FIA) was employed to estimate flood losses for each scenario. This analysis will assist decision‐makers in selecting the appropriate DEM for flood consequence assessment to get reasonable results within a convenient amount of time. It is also expected that this study will be useful for estimating consequences in absence of high‐quality terrain data, which will be especially helpful in remote study areas.
Wavefronts in the focus of a light microscope
Authors: Schrader M. , Hell S. W.
Published: January 2017

We report the visualization of the wavefronts of light in the focal region of an objective lens. The focused wavefronts are measured for the highest available numerical aperture, i.e, 1·4 oil immersion. The measurement is accomplished by scanning a scattering probe through the focal region of a lens illuminated by plane waves. The scattered light is coherently added to an external reference beam and focused into a point‐like detector. The registered signal allows the determination of the three‐dimensional shape of the wavefronts in the focal region and their evolution in time.
Privacy and RFID Technology: A Review of Regulatory Efforts
Authors: Turri Anna M. , Smith Ronn J. , Kopp Steven W.
Published: January 2017

Radio Frequency Identification (RFID) is rapidly becoming a common tool for manufacturers and retailers as they seek to manage supply chains and provide products and services to consumers. However, the widespread use ofRFIDtechnology also introduces consumer privacy concerns. This article reviews current regulatory efforts related toRFID, identifies gaps, calls for the enforcement of current guidelines, and provides suggestions for future research.
Controlled trial of Hartmann's solution versus 0.9% saline for diabetic ketoacidosis
Authors: Yung Michael , Letton Georgia , Keeley Steve
Published: January 2017

Aim

We aimed to determine whether using a balanced salt solution, Hartmann's solution (HS), in diabetic ketoacidosis (DKA) shortens the time to normalise acid–base status through the avoidance of hyperchloremic metabolic acidosis compared with 0.9% normal saline (NS).

Methods

We conducted a double‐blind, randomised controlled trial comparing HS to NS as the initial intravenous fluid in children with DKA. Patients were stratified by severity (pH < 7.1) and known or new diabetes. Electrolytes, venous blood gases and glucose were measured every 2 h until intravenous fluids were ceased. The primary outcome was the time for the plasma bicarbonate to reach 15 mmol/L. Secondary outcomes included time to normalise pH (7.3), time to receive subcutaneous (SC) insulin, change in sodium and insulin requirement.

Results

A total of 77 children were enrolled. The groups were similar at baseline. There was no difference in the time to reach a bicarbonate of 15 mmol/L: geometric mean (SD) 8.6 (2.3) h for NS versus 6.2 (4.7) h for HS, ratio 1.4 (95% confidence interval 0.8–2.5), and no difference in time to normalise pH: NS 8.5 (2.3) h versus HS group 7.5 (1.8) h, ratio 1.1 (0.8–1.6). Kaplan–Meier survival estimates showed shorter times for these end‐points in the severe subgroup: log‐rank test P = 0.0277 and 0.0024, respectively. There was no difference in time to SC insulin, NS: 15.2 (2.4) h versus HS 14.3 (1.6) h, ratio 1.1 (0.8–1.5). Patients treated with HS received significantly less total fluids/kg.

Conclusions

HS is an acceptable alternative to NS in DKA and may benefit those with severe DKA.
‘Dirty lesions’ on the neck and abdomen
Authors: Rosmaninho Aristóteles , Carvalho Sandrina
Published: January 2017

See Answer
Did you know Medicare does not usually include a dental benefit? Findings from a multisite investigation of oral health literacy
Authors: Macek Mark D. , Atchison Kathryn A. , Wells William , Haynes Don , Parker Ruth M. , Chen Haiyan
Published: January 2017

Objectives

Medicare does not usually include a dental benefit. Adults who are unaware of this fact risk unanticipated expenses after retirement. This report will explore the sociodemographic and oral health literacy determinants of this knowledge.

Methods

Data came from the Multi‐Site Oral Health Literacy Research Study, a survey of patients presenting to two university dental clinics. Sociodemographic descriptors included age, sex, race/ethnicity, education level, and dental insurance status. Oral health literacy was measured by the Rapid Estimate of Adult Literacy in Medicine and Dentistry (REALM‐D).

Results

Only 34 percent of respondents knew the correct answer to the Medicare question. Knowledge was significantly associated with age, race/ethnicity, education level (bivariate only), and REALM‐D score.

Conclusions

Policymakers and those assisting in Medicare enrollment should ensure information regarding dental coverage is communicated in ways that individuals of varying literacy, language, and culture understand what is necessary to make appropriate decisions.
Task‐Sharing Approaches to Improve Mental Health Care in Rural and Other Low‐Resource Settings: A Systematic Review
Authors: Hoeft Theresa J. , Fortney John C. , Patel Vikram , Unützer Jürgen
Published: January 2017

Purpose

Rural areas persistently face a shortage of mental health specialists. Task shifting, or task sharing, is an approach in global mental health that may help address unmet mental health needs in rural and other low‐resource areas. This review focuses on task‐shifting approaches and highlights future directions for research in this area.

Methods

Systematic review on task sharing of mental health care in rural areas of high‐income countries included: (1) PubMed, (2) gray literature for innovations not yet published in peer‐reviewed journals, and (3) outreach to experts for additional articles. We included English language articles published before August 31, 2013, on interventions sharing mental health care tasks across a team in rural settings. We excluded literature: (1) from low‐ and middle‐income countries, (2) involving direct transfer of care to another provider, and (3) describing clinical guidelines and shared decision‐making tools.

Findings

The review identified approaches to task sharing focused mainly on community health workers and primary care providers. Technology was identified as a way to leverage mental health specialists to support care across settings both within primary care and out in the community. The review also highlighted how provider education, supervision, and partnerships with local communities can support task sharing. Challenges, such as confidentiality, are often not addressed in the literature.

Conclusions

Approaches to task sharing may improve reach and effectiveness of mental health care in rural and other low‐resource settings, though important questions remain. We recommend promising research directions to address these questions.
Multiple anti‐predator mechanisms in the red‐spotted Argentina Frog (Amphibia: Hylidae)
Authors: Cajade R. , Hermida G. , Piñeiro J. M. , Regueira E. , Alcalde L. , Fusco L. S. , Marangoni F.
Published: January 2017

Anurans employ a wide variety of anti‐predator mechanisms to defend themselves. In casque‐headed hylids, defence is thought to be a complex combination of several anti‐predator mechanisms. However, the defence traits of only a few species are known; some hypotheses have yet to be addressed, whereas others, already tested in some species, need to be tested in additional taxa. The anti‐predator mechanism of the casque‐headed frog, Argenteohyla siemersi, is described here. It is a complex mechanism consisting of (1) behavioural and ecological traits, including secretive and semi‐phragmotic habits and posture; (2) morphological features, including cryptic and aposematic colourations, a skull covered with bony dermal spines and protuberances that are associated with two types of granular venom glands; and (3) physiological and chemical traits, such as a highly lethal skin secretion. Our results are compared with those of previous studies of defence mechanisms in casque‐headed frogs in an effort to understand the mechanisms and evaluate their potential phylogenetic signal in this group of anurans.
Hepatitis B virus long‐term impact of antiviral therapy nucleot(s)ide analogues (NUCs)
Authors: Grossi Glenda , Viganò Mauro , Loglio Alessandro , Lampertico Pietro
Published: January 2017

The goal of antiviral therapy is to improve the quality of life and survival of patients with chronic hepatitis B (CHB) by halting the progression to cirrhosis, end‐stage liver disease or hepatocellular carcinoma (HCC), thus preventing anticipated liver‐related death. Oral administration of potent and less resistance‐prone nucleot(s)ide analogues (NUCs), such as entecavir (ETV) and tenofovir disoproxil fumarate (TDF) has become the most popular treatment strategy worldwide because of their excellent efficacy and safety profile as well as easy management confirmed in both registration trials and in clinical practice studies. Long‐term administration of ETV or TDF suppresses HBV replication in >95% of patients, resulting in biochemical remission, histological improvement including the regression of cirrhosis and prevention or reversal of clinical decompensation but not the development of HCC, particularly in patients with cirrhosis. Moreover, NUCs can be administered to all patients including those with severe liver disease, the elderly and in those who do not respond, are unwilling to take or have contraindications to interferon. The need for long‐term, perhaps indefinite, treatment is the main limitation of NUCs therapy with the associated costs, unknown long‐term safety and the low rates of hepatitis B surface antigen (HBsAg) seroclearance, which is still the best stopping rule for NUCs‐treated patients with cirrhosis.
Management of cholestatic disease in 2017
Authors: de Vries Elsemieke , Beuers Ulrich
Published: January 2017

Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are the most frequent chronic cholestatic liver diseases and serve as model diseases to discuss the management of cholestasis in 2017 in the lecture that is summarized in this report. PBC and PSC are characterized by inflammation and fibrosis of small intrahepatic (PBC) or larger intra‐ and/or extrahepatic (PSC) bile ducts. Bile duct damage leads to cholestasis and can progress to liver fibrosis and even cirrhosis. Various genetic, environmental and endogenous factors may contribute to the development of chronic cholestatic liver diseases, but the exact pathogenesis of PBC and PSC has not been clarified. Ursodeoxycholic acid (UDCA) is the standard treatment of PBC and is used also for other cholestatic conditions including PSC, and it exerts anticholestatic effects at adequate doses. Novel anticholestatic therapeutic options for patients not adequately responding to UDCA are under development or have, like obeticholic acid, already been proven to have efficacy when combined with UDCA in the treatment of PBC. The future role of immunomodulating/immunosuppressive drug regimens must be critically reviewed.
Challenges in warranting access to prophylaxis and therapy for hepatitis B virus infection
Authors: Debarry Jennifer , Cornberg Markus , Manns Michael P.
Published: January 2017

Despite an available vaccine and efficient treatment for hepatitis B virus (HBV) infection, chronic HBV infection still remains a major global threat, and one of the top 20 causes of human mortality worldwide. One of the major challenges in controlling HBV infection is the high number of undiagnosed chronic carriers and the lack of access to prophylaxis and treatment in several parts of the world. We discuss relevant barriers that need to be overcome to achieve global control of HBV infection and make eradication possible. Most important, vaccination must be scaled‐up to lower the risk of vertical transmission and decrease the number of new infections, and comprehensive screening programs must be linked to care to obtain a better rate of diagnosis and treatment. This can probably only be achieved if sustainable funding is available. We therefore emphasize the importance of making the management of viral hepatitis a global health priority.
“Breastfeeding” but not at the breast: Mothers' descriptions of providing pumped human milk to their infants via other containers and caregivers
Authors: Felice Julia P. , Geraghty Sheela R. , Quaglieri Caroline W. , Yamada Rei , Wong Adriana J. , Rasmussen Kathleen M.
Published: January 2017

As pumping has become more prevalent among American women, pumped human milk (HM) is on the rise in their infants' diets in place of some or all feeding at the breast. We aimed to fill a gap in knowledge about mothers' motivations, practices and perceptions related to pumping, and about mothers' and other caregivers' motivations, practices, and perceptions related to feeding pumped HM. Results related to providing pumped HM are reported here, and results related to pumping are reported elsewhere. We conducted in‐depth, semi‐structured interviews among a diverse sample of mothers whose infants were fed pumped HM (n = 20), following each up to 1 year postpartum. Data were analyzed using thematic analysis with Atlas.ti. Nearly all mothers felt bottles were necessary to meet infant HM‐feeding goals. Nearly all pumped HM was fed by other caregivers because mothers typically preferred and prioritized feeding at the breast for convenience and maintaining their milk supply. Infants were bottle‐fed HM for several reasons that changed over time, such as mother's absence, latch difficulty, or desire to share the burden and bonding of feeding. Feeding practices differed between feeds from bottles versus at the breast; some infants were bottle‐fed on schedules but fed at the breast on demand. Mothers' methods for storing, transporting, and preparing HM varied substantially and included practices associated with loss of nutrients and microbial contamination. Mothers' reasons for bottle‐feeding HM may affect how much their infants are bottle‐fed. Consumption of pumped HM may not provide the same benefits to infants as feeding at the breast. These findings highlight important avenues for future research into the relationships between bottle‐feeding HM and infant health, growth, and developmental outcomes.
The LpxL acyltransferase is required for normal growth and penta‐acylation of lipid A in Burkholderia cenocepacia
Authors: Fathy Mohamed Yasmine , Hamad Mohamad , Ortega Ximena P. , Valvano Miguel A.
Published: January 2017

Lipid A anchors the lipopolysaccharide (LPS) to the outer membrane and is usually composed of a hexa‐acylated diglucosamine backbone. Burkholderia cenocepacia, an opportunistic pathogen, produces a mixture of tetra‐ and penta‐acylated lipid A. “Late” acyltransferases add secondary acyl chains to lipid A after the incorporation of four primary acyl chains to the diglucosamine backbone. Here, we report that B. cenocepacia has only one late acyltransferase, LpxL (BCAL0508), which adds a myristoyl chain to the 2′ position of lipid A resulting in penta‐acylated lipid A. We also identified PagL (BCAL0788), which acts as an outer membrane lipase by removing the primary β‐hydroxymyristate (3‐OH‐C14:0) chain at the 3 position, leading to tetra‐acylated lipid A. Unlike PagL, LpxL depletion caused reduced cell growth and defects in cell morphology, both of which were suppressed by overexpressing the LPS flippase MsbA (BCAL2408), suggesting that lipid A molecules lacking the fifth acyl chain contributed by LpxL are not good substrates for the flippase. We also show that intracellular B. cenocepacia within macrophages produced more penta‐acylated lipid A, suggesting lipid A penta‐acylation in B. cenocepacia is required not only for bacterial growth and morphology but also for adaptation to intracellular lifestyle.
Speaking of Possibilities: The Theistic Actualism of Anselm's Divine Locutio
Authors: McIntosh Jonathan Stewart
Published: January 2017

In his Monologion, Anselm represents God's knowledge of his creative possibilities, not in the intellectualist and Platonic terms of Augustine's divine ideas, but in the linguistic, poetic, and semi‐Stoic terms of a divine “utterance” or “expression” (locutio). Through his shift in theological metaphor, Anselm makes a subtle yet significant departure from the prevailing, “possibilist” model of divine possibility in western theology—according to which God's possibilities are known prior to and independently of any act or intention to create—towards a radically alternate, analogical and “actualist” appreciation of God as the sovereign speaker and inventor of his own possibilities.
Sport Mediation: Mediating High‐Performance Sports Disputes
Authors: Godin Paul Denis
Published: January 2017

Conflicts in high‐performance sports (HPS) are typically tense and emotionally charged experiences for the athletes, coaches, and sports organizations involved. Such disputes raise intriguing challenges for the mediators handling them. These disputes typically involve multiple parties who often have intensely competitive personalities negotiating a volatile mix of high‐stakes win/lose issues. Mediators typically confront numerous process challenges and must operate within the rigid policy parameters of the various governing organizations involved.

Mediation can successfully manage and resolve these challenging disputes, often in creative ways that repair and preserve the parties’ relationships. To be successful in this environment, however, mediators must adapt to and confront the unique dynamics of sports disputes described here.

In this article, I examine multiple case studies of mediations conducted through the Sport Dispute Resolution Centre of Canada (SDRCC) with the goal of identifying successful mediation strategies for HPS disputes. The centre, which has made mediation mandatory for almost all cases, had an overall settlement rate over a twelve‐year period of 46 percent, with rates as high as 94 percent for mediations voluntarily requested by the parties. Mediation has been used only sparingly elsewhere in the world for resolving HPS disputes to date, although, I argue, it is a successful tool that should be increasingly used both nationally and internationally. In recognition of mediation's potential role, the Court of Arbitration for Sport introduced updated mediation rules in 2016 and is moving to increase the use of mediation in international sports disputes.
Why Do We Respond to a Concession with Another Concession? Reciprocity and Compromise
Authors: Thuderoz Christian
Published: January 2017

All negotiation processes involve an exchange of concessions, and compromise is an agreement based on mutual concessions. Hence the questions investigated in this article: Why are concessions in negotiations always reciprocal? Why do negotiators follow this rule? And why do negotiators achieve these concessions through a process that we call compromise? Is there a connection between conceding and promising? In this article, I examine the structure of concession making and compromise through sociological, anthropological, and etymological lenses to better illuminate this critical negotiation component.
Maximalism and the Structure of Acts*
Authors: Brown Campbell
Published: January 2017

Suppose we believe that a property F is coextensive with moral permissibility. F may be, for example, the property of having the best consequences, if we are Consequentialists, or that of conforming to a universalisable maxim, if we are Kantians, and so on. This may raise the following problem. It is plausible that permissibility is “closed under implication”: any act that is implied by a permissible act must itself be permissible. Yet, in some cases, F might not be closed under implication. If that is so, then F cannot be coextensive with permissibility. Maximalism has been proposed as a solution to this problem. A “maximal” act is one not implied by any other act. Maximalism restricts the claim that F is coextensive with permissibility to maximal acts only. A non‐maximal act may be permissible without being F if it is implied by a maximal act that is F. The general aim of this paper is to investigate these issues by considering the formal structure of acts, or the “act‐implication” relation. Discussions of Maximalism have tended to assume implicitly that acts have structure of some sort, but there has been little careful attention given to this structure. I aim to show that, by thinking about structure, we can provide a stronger defence of Maximalism.
Effectiveness of interventions on physical activity in overweight or obese children: a systematic review and meta‐analysis including studies with objectively measured outcomes
Authors: Nooijen C. F. J. , Galanti M. R. , Engström K. , Möller J. , Forsell Y.
Published: January 2017

There is no consensus on interventions to be recommended in order to promote physical activity among overweight or obese children. The objective of this review was to assess the effects on objectively measured physical activity, of interventions promoting physical activity among overweight or obese children or adolescents, compared to no intervention or to interventions without a physical activity component. Publications up to December 2015 were located through electronic searches for randomized controlled trials resulting in inclusion of 33 studies. Standardized mean differences from baseline to post‐intervention and to long‐term follow‐up were determined for intervention and control groups and meta‐analysed using random effects models. The meta‐analysis showed that interventions had no effect on total physical activity of overweight and obese children, neither directly post‐intervention (−0.02 [−0.15, 0.11]) nor at long‐term follow‐up (0.07 [−0.27, 0.40]). Separate analyses by typology of intervention (with or without physical fitness, behavioural or environmental components) showed similar results (no effect). In conclusion, there is no evidence that currently available interventions are able to increase physical activity among overweight or obese children. This questions the contribution of physical activity to the treatment of overweight and obesity in children in the studied interventions and calls for other treatment strategies.
Primary and Secondary Stroke Prevention Using Left Atrial Appendage Closure with Watchman Devices in Atrial Fibrillation Patients
Authors: CHEN YANHONG , ZHANG YONGHUA , HUANG WEIPING , HUANG KEQIANG , XU BEI , SU XI
Published: January 2017

Background

Atrial fibrillation (AF) is associated with increased stroke risk resulting from cardiac embolism of the left atrial appendage (LAA). Stroke tends to recur in NVAF patients. Yet safety and feasibility of secondary stroke preventions with LAA closure (LAAC) have not been assessed in detail. This retrospective study was designed to compare the feasibility and safety of LAAC in primary and secondary stroke preventions, in a real‐world setting of Chinese patients.

Methods

From 2014 to 2015, non‐valvular AF patients with CHA2DS2‐VASc ≥1 were selected for percutaneous LAAC operations. Outcome observations of primary and secondary stroke preventions with Watchman devices were analyzed and compared.

Results

Overall, 122 patients were included. LAAC with Watchman devices were attempted in 115 patients, of whom 68 were for primary stroke prevention and 47 were for secondary prevention. Both the CHA2DS2‐VASc score and the HASBLED score were significantly higher in the secondary prevention group (4.09 ± 1.06 vs. 1.93 ± 1.09 for CHA2DS2‐VASc and 1.83 ± 1.03 vs. 1.26 ± 0.87 for HASBLED, P < 0.01). In both groups LAAC were achieved with high successful rate (98.53% in the primary prevention group and 100% in the secondary prevention group, P > 0.05) and low complication rates. The stroke rates were at a low level in both groups (1.47% in primary prevention group vs. 2.13% in secondary prevention group, P > 0.05).

Conclusions

In our initial single‐center experience, percutaneous LAA closure was a feasible and safe procedure for both primary and secondary stroke preventions in Chinese patients with nonvalvular AF.
Differential Effects of Abrupt Cycle Length Changes on the Refractoriness of Accessory Pathway, His‐Purkinje System, Atrial and Ventricular Myocardium in Wolff‐Parkinson‐White Syndrome
Authors: Shenasa Mohammad , Lacombe Pierre , Cardinal René , Pagé Pierre , Sadr-Ameli Mohammad-Ali
Published: January 2017

We compared the response of the accessory pathway (AP), the atrial myocardium, the His‐Purkinje system (HPS) and the ventricular myocardium during steady state (constant cycle length) and following an abrupt alteration in cycle length in 23 patients with Wolff‐Parkinson‐White syndrome. The durations of the anterograde and retrograde refractory periods were measured during constant drive cycle lengths of 600 and 400 ms (Method I) and during an abrupt change in cycle length of either short‐to‐long (400 to 600 ms) (Method II) or long‐to‐short (600 to 400 ms) (Method III) just before the extra stimulus. The mean durations of the anterograde effective refractory periods of the APs were 295 ± 43, 243 ± 39 and 273 ± 37 ms at 600, 400 and 400 to 600 ms cycle lengths, respectively. For the atrial effective refractory periods at the three cycles, they were 238 ± 18, 217 ± 11 and 241 ± 17 ms, respectively. During ventricular stimulation, the mean durations of the retrograde effective refractory periods of the APs were 263 ± 25, 245 ± 19 and 253 ± 21 ms at cycle lengths of 600, 400 and 400 to 600 ms, respectively. For the relative refractory periods of the HPS, they were 335 ± 29, 239 ± 23 and 367 ± 38 ms, respectively and, for the effective refractory periods of the ventricular myocardium, they were 227 ± 17, 206 ± 15 and 215 ± 18 ms, respectively. The retrograde effective refractory period of the HPS could be measured in only five patients at the three cycles (600, 400 and 400 to 600 ms) and the mean values were 265 ± 57, 225 ± 14 and 305 ± 27 ms, respectively. With Method III, AP and ventricular myocardium responded in a cumulative manner while HPS demonstrated paradoxical effect. Compared to Method I, changes with Methods II and III were statistically significant for all variables measured. During all three cycles, the retrograde effective refractory period of the HPS exceeded the effective refractory period of the AP; and the HPS demonstrated progressive conduction delay while the AP responded to no or minimal delays when the V1V2 intervals were similar. An abrupt cycle length change of the short‐to‐long type facilitated the induction of orthodromic tachycardia during ventricular pacing. The data suggest that in patients with Wolff‐Parkinson‐White syndrome the response of the AP to an abrupt cycle length alteration is similar to that of the ventricular myocardium, but not to those of the HPS or the atrial myocardium. These results have not been reported previously.
Prognostic Significance and Evolution of Late Ventricular Potentials in the First Year After Myocardial Infarction: A Prospective Study
Authors: Verzoni Alessandro , Romano Salvatore , Pozzoni Luigi , Tarricone Diego , Sangiorgio Stefano , Croce Luigi
Published: January 2017

We performed a prospective study of the high‐frequency components of the terminal portion of the QRS complex in 220 patients who survived acute myocardial infarction. Signal‐averaged electrocardiograms (SA‐ECGs) were performed before hospital discharge (16 ± 6 days) and then serially at regular intervals over the following year. SA‐ECGs were processed using a 40 Hz high‐pass bidirectional filter. Duration of “filtered” QRS (D‐normal value < 120 ms), duration of the low‐amplitude signals. (D40 ‐ n.v. < 39 ms) and last 40 ms voltage of the QRS complex (V40 ‐ n.v.> 20 µV) were measured. Late potentials (LPs) were defined as the presence of two or more abnormal values. In addition, 24‐hour Holter monitoring was performed in 208 patients and left ventricular ejection fraction (LVEF) was determined by scintigraphy in 111. Sixty‐two patients (group 1) had LPs, 158 had normal SA‐ECGs (group 2). Spontaneous normalization of SA‐ECGs occurred in 20% of patients after 6 months, although the mean values of D, D40 and V40 did not change significantly and the reproducibility was very good for all the indexes during all the follow‐up controls. Three patients had sudden death and three presented again with spontaneous, sustained ventricular tachycardia. Five of 62 (8%) group 1 patients had an arrhythmic event compared with one of 158 patients (0.6%) in group 2. The sensitivity of SA‐ECGs as a predictor of arrhythmic events was 83% with a specificity of 73%. Patients with subsequent arrhythmic events had longer filtered QRS (133 ± 19 vs 104 ± 16 ms; P < 0.001), longer duration of the low‐amplitude signals (54 ± 15 vs 33 ± 14 ms; P < 0.01), and lower voltages in the last 40 ms of the filtered QRS (11 ± 3 vs 36 ± 25 µV; P < 0.02) and, moreover, higher peak CK values and lower LVEF than those without such events. In conclusion, SA‐ECGs provide important prognostic information in identifying patients at risk of arrhythmic events after myocardial infarction although dynamic changes of LPs are observed during the first year after myocardial infarction.
Rapid Assessment of Rate and Antiarrhythmic Drug Effect on the Myocardium Using Asymmetric Biphasic Pulse Stimulation
Authors: Furukawa Tetsushi , Herscovici Harry , Desai Tushar , Sampsell Ronald , Nogami Akihiko , Moroe Kazuo , Rozanski John J. , Lister John W.
Published: January 2017

An asymmetric biphasic pulse which stimulates the heart and neutralizes the poststimulation polarization at the electrode‐myocardial interface permitting the recording of the evoked endocardial response (EER) up to approximately 1 ms poststimulation with the same electrode used for stimulation is described. Using this mode of cardiac stimulation in 20 dogs the effects on the EER of increasing heart rate and antiarrhythmic drugs, procainamide (PA) and N‐acetylpro‐cainamide (NAPA), were studied. EERs were recorded during bipolar and unipolar pacing rates of 120, 150, and 200/min before and during a five step PA or NAPA infusion which resulted in progressively increasing PA and NAPA plasma concentrations (Cps), 1.7 — 32.5 mg/l for PA and 8.1 — 116.1 mg/l for NAPA.

The effects of progressively increasing heart rates were: The T wave amplitude and QS area increased with increases in rate; during pacing at 120, 150, and 200/min, the T wave amplitudes were 7.6 ± 2.3, 8.2 ± 2.1, and 9.8 ± 2.5 mV and the QS areas were 905 ± 204, 995 ± 199, and 1101 ± 231 mVms. The QT interval and QST area decreased with increases in rate; during pacing at 120, 150, and 200/min, the QT intervals were 265 ± 61, 249 ± 57, and 226 ± 52 ms and the QST areas were 288 ± 198, 221 ± 154, and 154 ± 52 mVms. The effects of the antiarrhythmic drugs, PA and NAPA, on the EER were: PA prolonged both the QS duration and QT interval at low Cp (type Ia antiarrhythmic drug property); at a therapeutic PA Cp of 15.0 ± 0.2 mg/I and a heart rate of 120/min the percent increase of the QS duration was 12 ± 4% (P = 0.001) and that of the QT interval was 20 ± 6% (P < 0.001). The prolongation of the QS duration by PA was rate dependent, the faster the rate the greater the prolongation. NAPA prolonged the QT interval at low Cp, while the QS duration was not significantly effected at low or therapeutic Cps (type III antiarrhythmic drug property); at a therapeutic NAPA Cp of 15.9 ± 1.6 mg/l and a heart rate of 120/min the percent increase of the QS duration was 1± 1% (NS) and that of the QT interval was 13 ± 9% (P = 0.018). Our results show that the use of an asymmetric biphasic pulse allows for pacing and recording of an EER, QS and T waves, with a single electrode. This pacing and sensing system permits the rapid assessment of heart rate and antiarrhythmic drug effect on the myocardium.
Alternating Sequence of Retrograde Atrial Activation in Patients with Dual AV Nodal Physiology
Authors: Singer Igor , Siddoway Lyle A. , Guarnieri Thomas
Published: January 2017

Patients with dual AV nodal physiology have been demonstrated to have earliest retrograde activation sequence of the fast pathway in the lower septal right atrium and slow pathway in the proximal coronary sinus, and the posterior atrial septum. This case report describes a patient with dual AV nodal physiology demonstrating a dual sequence of retrograde activation with 2:1 block occurring in the fast pathway causing the conduction to proceed alternately via fast then slow pathway. This sequence was abolished by atropine allowing conduction to proceed via fast pathway. Surgical cure of patients with reentrant AV nodal tachycardia suggests the presence of two anatomically distinct AV nodal‐like path‐ways. This case report confirms this observation and further suggests preferential autonomic modulation of the fast pathway.
Coronary Revascularization and Implantation of the Automatic Cardioverter/Defibrillator: Reliability of Immediate Intraoperative Testing
Authors: Blakeman Bradford M. , Pifarre Roque , Scanlon Patrick J. , Wilber David J.
Published: January 2017

Concomitant coronary revascularization and implantation of the automatic cardioverter/defibrillator is an increasingly common procedure. To determine whether cardioversion/defibrillation thresholds measured after weaning patients from cardiopulmonary bypass are sufficint to justify immediate implantation of the pulse generator, we prospectively compared postpump values to those obtained 1 week later in five patients. R‐wave amplitudes during both sinus rhythm and ventricular tachycardia, lead impedance, defibrillation thresholds and cardioversion thresholds remained stable or improved from the postpump to the 1 week values. Five other patients had the generator implanted at the time of revascularization. Immediate postbypass cardioversion thresholds (mean 10 ± 8 joules) in theses ten patients did not significantly differ from those of 20 nonpump implantations (VT mean 7± joules; VF 15 ± 4 joules and defibrillation thresholds mean 17 ± 6 joules). These findings suggest that the residual effects of cardioplegia, core‐cooling and operative ischemia have no significant effects on intraoperative testing of implanted dfibrillators. This clinical experience supports the practice of immediate implantation of the pulse generator at the time of revascularization.
Lipoblastoma in children: Review of 12 cases
Authors: Susam‐Sen Hilal , Yalcin Bilgehan , Kutluk Tezer , Cahit Tanyel Feridun , Haliloglu Mithat , Orhan Diclehan , Aydin Burca , Kurucu Nilgun , Varan Ali , Akyuz Canan
Published: January 2017

Background

Lipoblastoma is a rare benign mesenchymal tumor of infancy and early childhood. Symptoms vary depending on localization, and signs of compression of adjacent organs may be seen.

Methods

A total of 12 children with pathologically proven lipoblastoma from 2000 to 2014 were reviewed retrospectively for their clinical features, treatment and follow up.

Results

There were seven boys and five girls between 7.5 months and 7.5 years of age. The most common symptom was painless rapid‐growing mass. The tumors were located in the neck, the abdomen, the groin, pelvis, axilla, glutea, labium majus, thigh and trunk. The largest tumor was in a retroperitoneal location and was 13 × 10 cm in size. Complete resection was performed in 10 patients. All of these patients were followed without any evidence of recurrence. Subtotal excision was performed in two patients. At a median follow up of 38 months (range, 1.8 months–10 years), all patients were disease free.

Conclusions

Lipoblastoma should be considered in the differential diagnosis of rapidly growing mass in patients <3 years of age. Total excision is the treatment of choice with preservation of vital organs. The prognosis is excellent despite large tumor size and local invasion. Recurrence rate is high in incompletely resected tumors. Regular follow up is important for early detection of recurrence.
What does “nothing over and above its parts” actually mean?
Authors: Smid Jeroen
Published: January 2017

Some philosophers say that a whole is “nothing over and above” its parts. Most also take general extensilonal mereology to be treating wholes as “nothing over and above” their parts. It is not always clear, however, what exactly is meant by the phrase “nothing over and above.” Nor is it obvious why the phrase is associated with mereology, and what purpose it serves there. In the words of Peter Van Inwagen (, 210): “This slippery phrase has had a lot of employment in philosophy, but what it means is never explained by its employers.” This paper sheds light on the various senses in which one might hold that a whole is “nothing over and above” its parts, and on how these senses are related both to each other and to mereology.
Neo‐Confucianism and Zhou Dunyi's Philosophy
Authors: Gallinaro Ludovica
Published: January 2017

Using a term coined by the contemporary Chinese philosopher Mou Zongsan, we could define Zhou Dunyi's thought in terms of ‘moral metaphysics’. Zhou Dunyi (1017–1073), a thinker who lived in Northern Song period (960–1127), developed a philosophy that shows an ontological link between the cosmic order of the universe and the human moral reality. His contribution consists of two short works, Penetrating the Book of Changes (Tongshu) and Discussion of the Supreme Polarity Diagram (Taijitu shuo). These works played a fundamental role in creating the metaphysical structure of the neo‐Confucian thought: Zhu Xi emphasized Zhou Dunyi's contribution to the neo‐Confucian philosophy and, more precisely, he pointed out how Zhou Dunyi's ideas helped to define the conceptual framework of neo‐Confucianism. Moreover, Zhu Xi legitimized Zhou Dunyi's role as the pioneer of the ‘Learning of the Way’, or the renewed neo‐Confucian tradition. This paper aims to provide an overview of Zhou Dunyi's crucial role in the field of neo‐Confucianism. At the same time, we stress the need for further analysis in order to fully understand the value of Zhou Dunyi's philosophy in the Song period intellectual context.
Building a Values‐Informed Mental Model for New Orleans Climate Risk Management
Authors: Bessette Douglas L. , Mayer Lauren A. , Cwik Bryan , Vezér Martin , Keller Klaus , Lempert Robert J. , Tuana Nancy
Published: January 2017

Individuals use values to frame their beliefs and simplify their understanding when confronted with complex and uncertain situations. The high complexity and deep uncertainty involved in climate risk management (CRM) lead to individuals’ values likely being coupled to and contributing to their understanding of specific climate risk factors and management strategies. Most mental model approaches, however, which are commonly used to inform our understanding of people's beliefs, ignore values. In response, we developed a “Values‐informed Mental Model” research approach, or ViMM, to elicit individuals’ values alongside their beliefs and determine which values people use to understand and assess specific climate risk factors and CRM strategies. Our results show that participants consistently used one of three values to frame their understanding of risk factors and CRM strategies in New Orleans: (1) fostering a healthy economy, wealth, and job creation, (2) protecting and promoting healthy ecosystems and biodiversity, and (3) preserving New Orleans’ unique culture, traditions, and historically significant neighborhoods. While the first value frame is common in analyses of CRM strategies, the latter two are often ignored, despite their mirroring commonly accepted pillars of sustainability. Other values like distributive justice and fairness were prioritized differently depending on the risk factor or strategy being discussed. These results suggest that the ViMM method could be a critical first step in CRM decision‐support processes and may encourage adoption of CRM strategies more in line with stakeholders’ values.
Cross‐Subsidies, and the Elasticity of Informality to Social Expenditures: The Case of Mexico's Seguro Popular
Authors: Alonso‐Ortiz Jorge , Leal Julio
Published: January 2017

How is the size of the informal sector affected when the distribution of social expenditures across formal and informal workers changes? How is it affected when the tax rate changes along with the generosity of these transfers? In our search model, taxes are levied on formal‐sector workers as a proportion of their wage. Transfers, in contrast, are lump‐sum and are received by both formal and informal workers. This implies that high‐wage formal workers subsidize low‐wage formal workers as well as informal workers. We calibrate the model to Mexico and perform counterfactuals. We find that the size of the informal sector is quite inelastic to changes in taxes and transfers. This is due to the presence of search frictions and to the cross‐subsidy in our model: for low‐wage formal jobs, a tax increase is roughly offset by an increase in benefits, leaving the unemployed approximately indifferent. Our results are consistent with the empirical evidence on the recent introduction of the “Seguro Popular” healthcare program.
More than a Question of Agency: Privatized Project Implementation, Accountabilities, and Global Environmental Governance
Authors: Rosenberg Jonathan
Published: January 2017

With limited success, international relations scholars have used principal‐agent theory (P‐A) to understand gaps in global governance. While P‐A may not provide robust explanations, it is still useful for mapping long chains of complex, boundary‐crossing relationships and locating the gaps that characterize global environmental governance (GEG). In this article, first I argue that we can get beyond merely locating and describing governance gaps, and start explaining them, by considering the problems of accountability that contribute to those gaps. Second, I argue that outsourced sustainable development projects, implemented by for‐profit contractors, provide an under‐studied and under‐theorized body of cases for examining the relationship between agency and accountability. Finally, I use the example of a United States Agency for International Development post‐hurricane recovery project in Grenada to suggest that when development assistance agencies privatize implementation they prioritize more economistic logics of accountability. As a result, they may enhance short‐term economic efficiency and even become more accountable to their principals. But they fail to connect the means and ends of GEG, despite firmly stated, official commitments to “taking the environment into account.”
Representing Legitimacy in Early Modern Russia
Authors: KOLLMANN NANCY SHIELDS
Published: January 2017

The article explores the ways in which the sixteenth‐century Illuminated Chronicle (Litsevoi letopisnyi svod) demonstrates the ideology of state legitimacy through its illustrations. Analyzing images of judicial punishment, it explores how artists worked within iconographic conventions to demonstrate a consistent image of legitimate, and illegitimate, uses of coercive power, using such devices as gesture, pose, regalia, and composition. As one of the few sources of somewhat secular art in Muscovy, these images provide a valuable source for political ideology.