bluuebunny/crossref_metadata_2025 huggingface dataset:
Commentary: Binding Early Offers versus Caps for Medical Malpractice Claims?
Authors: O'CONNELL JEFFREY
Published: May 2007

Like damages caps, early offer reform promises reduction in the costs of medical liability cases. In contrast to damages caps, early offer reform offers advantages to both claimant and defendant. Under early offer, the defendant would have the option to offer an injured patient periodic payments for the patient's net economic losses as they accrue, but not payments for noneconomic losses (pain and suffering). If an early offer were made and accepted, that would settle the claim. This commentary1 explains how an early offer reform might work and summarizes data from a recent closed claim study of medical malpractice cases in Texas and Florida. The data show widespread opportunities for successful early offers and provide evidence that substantial per case savings would result.
Development of a Policy‐Relevant Child Maltreatment Research Strategy
Authors: MACMILLAN HARRIET L. , JAMIESON ELLEN , WATHEN C. NADINE , BOYLE MICHAEL H. , WALSH CHRISTINE A. , OMURA JOHN , WALKER JASON M. , LODENQUAI GREGORY
Published: May 2007

Child maltreatment is associated with a huge burden of suffering, yet there are serious gaps in knowledge about its epidemiology and approaches to intervention. This article describes the development of a proposed national research framework in child maltreatment, as requested by the Department of Justice, Canada, based on (1) a review of the literature, (2) consultation with experts, and (3) application of evaluation criteria for considering research priorities. The article identifies gaps in knowledge about child maltreatment in Canada and proposes a research agenda to make evidence‐based policy decisions more likely. Although this work was driven by gaps in Canada's knowledge about child maltreatment, the international scope of the review and consultation process could make the findings useful to broader research and policy audiences.
Dermoscopy is a suitable method for the observation of the pregnancy‐related changes in melanocytic nevi
Authors: Aktürk AS , Bilen N , Bayrämgürler D , Demirsoy EO , Erdogan S , Kiran R
Published: May 2007

Background  It is a common opinion that expansion and darkening in melanocytic nevi may occur during pregnancy. The main problem is that whether it is a usual finding, or it is a condition that requires suspicion about melanoma.

Objectives  It was aimed to find the changes that might occur in the sizes and structures of melanocytic nevi during pregnancy.

Methods  Ninety‐seven nevi of the 56 pregnant women in the first trimester were evaluated in the study. The localization and size of the nevi were recorded on a standard body diagram. After clinical examination, dermoscopic analyses were applied. Pattern analyses were done, and total dermoscopy scores (TDS) were calculated by applying ABCD scoring system. All subjects were seen again during the third trimester.

Results  There was a statistically significant difference between the mean diameters of nevi in the first and third trimester (P = 0.001). Of nevi whose diameters increased, 10 (50.00%) were localized on the front of body, 6 (30.00%) on the face and neck, 3 (15.00%) on the legs, and 1 (5.00%) on the back. The enlargement in diameters was more significant on the front of the body, but there was no statistically significant difference. Compared according to the pattern analysis, new dot formation was observed only on the structure of six nevi during the last trimester. Four of them were localized on the front of the body. There was statistically significant increase in mean TDS in comparison between the first and third trimesters (P = 0008).

Conclusions  During the pregnancy, widening in diameters and structure changes of nevi may be seen especially on the front of the body. We also think that these findings might be connected with expansion of the skin during pregnancy. Dermoscopic controls are the first choice of method to analyse the nevi since the patient may not recognize these changes.
Premature atherosclerosis in patients with xanthelasma
Authors: Noël B
Published: May 2007

Background  Only about half the patients with xanthelasma are hyperlipidemic. The clinical significance of xanthelasma as a marker of cardiovascular disease is not yet well defined.

Objective  To determine the risk of cardiovascular disease in patients with normolipidemic and hyperlipidemic xanthelasma.

Methods  Carotid ultrasonography (7 MHz using B‐mode images, Advanced Technology Laboratories) was used to detect carotid plaques and measure the intima‐media thickness (IMT) of the common carotid arteries. Seventeen patients with normolipidemic and hyperlipidemic xanthelasma were examined and compared with 21 age‐matched normal subjects.

Results  The risk of cardiovascular disease was significantly increased in patients with xanthelasma. Carotid plaques were more frequent in patients with xanthelasma than in controls (64.7% and 23.8%, respectively; P = 0.020), and IMT was significantly higher (mean ± SD: 1.1 ± 0.1 and 0.6 ± 0.2 mm, respectively; P < 0.001). The difference of carotid IMT between normolipidemic xanthelasma and hyperlipidemic xanthelasma was not statistically different (mean ± SD: 1.1 ± 0.1 and 1.1 ± 0.2 mm, respectively; P = 0.577).

Conclusion  Premature carotid atherosclerosis is observed in patients with normolipidemic and hyperlipidemic xanthelasma. Patients with xanthelasma should be considered to have an increased risk of cardiovascular disease independently to the level of plasma lipids. A larger number of patients is, however, needed to confirm this preliminary study.
Brush cells in the human duodenojejunal junction: an ultrastructural study
Authors: Morroni Manrico , Cangiotti Angela Maria , Cinti Saverio
Published: May 2007

Brush cells have been identified in the respiratory and gastrointestinal tract mucosa of many mammalian species. In humans they are found in the respiratory tract and the gastrointestinal apparatus, in both the stomach and the gallbladder. The function of brush cells is unknown, and most morphological data have been obtained in rodents. To extend our knowledge of human brush cells, we performed an ultrastructural investigation of human small intestine brush cells. Six brush cells identified in five out of more than 300 small intestine biopsies performed for gastrointestinal tract disorders were examined by transmission electron microscopy. Five brush cells were located on the surface epithelium and one in a crypt. The five surface brush cells were characterized by a narrow apical pole from which emerged microvilli that were longer and thicker than those of enterocytes. The filamentous core extended far into the cell body without forming the terminal web. Caveolae were abundant. Filaments were in the form of microfilaments and intermediate filaments. Cytoplasmic projections containing filaments were found on the basolateral surface of brush cells. In a single cell, axons containing vesicles and dense core granules were in close contact both with the basal and the lateral surface of the cell. The crypt brush cell appeared less mature. We concluded that human small intestine brush cells share a similar ultrastructural biology with those of other mammals. They are polarized and well‐differentiated cells endowed with a distinctive cytoskeleton. The observation of nerve fibres closely associated with brush cells, never previously described in humans, lends support to the hypothesis of a receptor role for these cells.
Variation in community intervention programmes and consequences for children and families: the example of Sure Start Local Programmes
Authors: Melhuish Edward , Belsky Jay , Anning Angela , Ball Mog , Barnes Jacqueline , Romaniuk Helena , Leyland Alastair , Research Team The NESS
Published: May 2007

Background:  An area‐based initiative, Sure Start Local Programmes (SSLPs), was established by the UK government to reduce social exclusion through improving the well‐being of children aged 0–3 years and their families in disadvantaged communities; a true community intervention in that all children under four and their families in specified areas served as targets of universal services. A national evaluation examined the links between variation in programme implementation and effectiveness.

Methods:  Data gathered from multiple sources produced measures of implementation in terms of proficiency, services and staffing. Measures of programme impact on child/parenting outcomes derived from multilevel models, controlling for child, family and area characteristics, were identified to demonstrate programme effectiveness.

Results:  Some modest linkage between programme implementation (e.g., proficiency, empowerment of parents and staff, identification of users) and effectiveness for child and parenting outcomes.

Conclusions:  Overall proficiency and specific aspects of implementation may influence effectiveness, which should guide the design of other child, family and community services.
Transitional Spaces: Mapping Physical Change
Authors: Sprake Juliet , Thomas Helen
Published: May 2007

Museums and buildings are both considered immutable by the majority of people who use them. A small team from Goldsmiths College, the V&A+RIBA Architecture Partnership and Pimlico School set out to challenge this preconception. The Victoria & Albert museum was taken as a case study to investigate how buildings are a physical manifestation of an institute, and how their physical presence records the way the museum has to respond to outside criteria, from government funding strategies to cultural trends.

This article puts forward the argument that a museum building as a subject is a constantly changing environment, through which young learners can develop their historical imagination and critical abilities. It describes the process and findings from a project carried out with students from Pimlico School, who were asked to find and respond to evidence in the fabric of the V&A museum buildings of the substantial physical changes that it is currently undergoing. By choosing specific sites, the students put together a series of PDA‐based threads to describe and archive different narratives about the museum at the moment of their mapping. These are made for future visitors to see, hear and compare the museum environment they are experiencing with the one that the students recorded.
Conditions for Learning: Partnerships for Engaging Secondary Pupils with Contemporary Art
Authors: Burgess Lesley , Addison Nicholas
Published: May 2007

This article examines the findings of the London Cluster research, ‘Critical Minds’, in which the Institute of Education, University of London (IoE) worked in collaboration with Whitechapel Chapel Art Gallery (the lead London gallery), Bow Arts, Chisenhale Gallery and Space ‐The Triangle, and four east London comprehensive schools. By collaborating with art departments and by focusing on learning within the gallery context, the research team questioned whether the perceived constraints of traditional art and design pedagogy can be overcome by changing the conditions in which learning takes place. The following analysis focuses on these conditions as outlined in the research report's recommendations.
Cardiovascular Outcomes Using Doxazosin vs. Chlorthalidone for the Treatment of Hypertension in Older Adults With and Without Glucose Disorders: A Report From the ALLHAT Study
Authors: Barzilay Joshua I. , Davis Barry R. , Bettencourt Judy , Margolis Karen L. , Goff David C. , Black Henry , Habib Gabriel , Ellsworth Allan , Force Rex W. , Wiegmann Thomas , Ciocon Jerry O. , Basile Jan N.
Published: May 2007

Insulin resistance underlies most glucose disorders in adults and is associated with an increased risk of cardiovascular disease. Alpha blockers decrease insulin resistance, whereas diuretics increase insulin resistance.

The authors studied the effects of these two classes of hypertension medications (doxazosin, an α blocker, and chlorthalidone, a diuretic) on cardiovascular disease outcomes in adults aged >55 years with hypertension and glucose disorders who were participants in the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (8749 had known diabetes mellitus and 1690 had a newly diagnosed glucose disorder [fasting glucose ≥110 mg/dL]). There was no difference in either group between the chlorthalidone‐ and doxazosin‐based treatments with regard to fatal or nonfatal myocardial infarction or all‐cause mortality. There was, however, a difference for combined cardiovascular disease (myocardial infarction, revascularization procedures, angina, stroke, heart failure, and peripheral arterial disease) in favor of the diuretic. This difference was due primarily to an increased heart failure risk in those treated with doxazosin (relative risk, 1.85; 95% confidence interval, 1.56–2.19) in the known diabetes mellitus group and a relative risk of 1.63 (95% confidence interval, 1.05–2.55) in those with a newly diagnosed glucose disorder despite lower glucose levels on follow‐up in those treated with α blockers. The authors conclude that treatment of hypertension with doxazosin in adults with glucose disorders incurs the same risk of coronary heart disease as treatment with chlorthalidone; however, treatment with doxazosin increases the risk of combined cardiovascular disease and heart failure despite lower glucose levels.
The JNC 7 Approach Compared to Conventional Treatment in Diabetic Patients With Hypertension: A Double‐Blind Trial of Initial Monotherapy vs. Combination Therapy
Authors: Fox Jonathan C. , Leight Kellie , Sutradhar Santosh C. , Demopoulos Laura A. , Gleim Gilbert W. , Lewin Andrew J. , Bakris George L.
Published: May 2007

The JNC 7 states that persons with blood pressure (BP) more than 20/10 mm Hg above goal should be started on combination drug therapy. This criterion includes patients with BP >160/100 mm Hg and diabetics with hypertension. The goal BP for persons with diabetes mellitus is <130/80 mm Hg. A randomized, double‐blind trial force titrated initial combination therapy utilizing an angiotensin receptor blocker (ARB) combination (losartan/hydrochlorothiazide [LOS/HCTZ]) compared with an angiotensin‐converting enzyme (ACE) inhibitor (ramipril), for 8 weeks, and tested the hypothesis that combination therapy is more likely to achieve goal BP vs. monotherapy. At 4 weeks, 30.5% of LOS/HCTZ and 14.4% of ramipril recipients achieved goal diastolic BP (p<0.001). More participants achieved goal systolic BP in the ARB/HCTZ group at 4 weeks (29.8% vs. 14.4%; p<0.001). At 4 weeks, mean diastolic BP had decreased 10.2±7.4 mm Hg in the LOS/HCTZ group compared with 6.4±6.8 mm Hg in the ramipril group (p<0.001), and systolic BP had fallen 15.4±13.1 mm Hg in the ARB/HCTZ compared with 9.2±10.2 mm Hg in the ACE‐inhibitor group (p<0.001). Significant differences favoring the combination were also noted at 8 weeks. Drug‐related adverse experiences were 10.3% for the combination compared with 12.7% for the monotherapy group. Initial combination therapy with an ARB/HCTZ was more effective than ACE‐inhibitor monotherapy in achieving BP goals in participants with diabetes with no significant differences in the incidence of adverse experiences. These observations confirm other studies of combination therapies, such as β blocker/diuretic, ACE inhibitor/diuretic, or ACE inhibitor/calcium channel blocker. The use of two medications will achieve goal BP in more patients than monotherapy. This observation is important in treatment of high‐risk patients with diabetes.
Obesity and High Blood Pressure: A Clinical Phenotype for the Insulin Resistance Syndrome in African Americans
Authors: Campbell Kimberly L. , Kushner Harvey , Falkner Bonita
Published: May 2007

The high prevalence of insulin resistance syndrome in African Americans predisposes this population to higher morbidity and mortality from cardiovascular disease. To test the hypothesis that the combination of obesity and high blood pressure (BP) represents the physical phenotype of insulin resistance syndrome, 337 African‐American men and women aged 32±4 years were examined and classified into four groups (nonobese‐normal BP, nonobese‐high BP, obese‐normal BP, obese‐high BP), according to presence or absence of obesity and high BP. Mean values of glucose, insulin, lipids, urinary albumin excretion, and clamp‐derived insulin sensitivity were determined for each group. Prevalence of prediabetes (24.4%), diabetes (19.2%), and insulin resistance syndrome (87.2%) were highest in the obese‐high BP group (p<0.001). Mean triglycerides, urinary albumin excretion, fasting glucose, fasting insulin, and insulin resistance were highest in the obese‐high BP group (p<0.001). Subjects with both obesity and high BP showed greater expression of lipid and glucose abnormalities, higher urinary albumin excretion, and greater prevalence of prediabetes, undetected type 2 diabetes, and insulin resistance syndrome.
Improving Outcomes in the Post‐Myocardial Infarction Setting
Authors: Yancy Clyde W.
Published: May 2007

Heart disease is the leading cause of death in the United States, with African‐American men having the highest rate of cardiovascular mortality in the US population. Although the clustering of multiple cardiovascular risk factors is particularly apparent in this group, a key reason for the higher rate of cardiovascular mortality among African‐American men compared with other ethnic groups may be related to underdiagnosis and undertreatment. Studies have shown that minority persons with myocardial infarction are less likely than nonminorities to be diagnosed, to receive appropriate drug therapy, or to undergo bypass surgery. However, there are no data that suggest established treatments and secondary prevention strategies are less effective in African Americans. Appropriate therapy for secondary prevention—including thrombolysis, antiplatelet strategies, angiotensin‐converting enzyme inhibition, β blockade, and lipid‐lowering therapies—results in significant reductions in mortality for all patients.
Left Ventricular Geometric Patterns After 1 Year of Antihypertensive Treatment
Authors: Luque Manuel , Martell Nieves , Egocheaga Isabel , Fernandez‐Pinilla Carmen , Zamorano Jose , Almeria Carlos , Fernandez‐Cruz Arturo , Ferrario Carlos M.
Published: May 2007

Left ventricular hypertrophy increases the risk for cardiovascular target organ damage, myocardial infarction, and stroke. The authors assessed the patterns of ventricular adaptation in 107 essential hypertensives whose treatment had been withdrawn and its modification after 1 year of hypertension treatment. Blood pressure decreased from 158+17/96+12 mm Hg to 137+15/83+10 mm Hg (mean + SD; p<0.001); 45% of the patients (49 of 107) had their blood pressure controlled below 140 mm Hg and 90 mm Hg. Although a significant decrease of left ventricular mass index was found in the study, the percentage of patients with normal left ventricular geometry at the completion of the study increased by only 9% (27% to 36%, p>0.05). Left ventricular mass geometry improved in 31% of the patients, remained unaffected in 51%, and worsened in 18%. The data suggest that even while suboptimal antihypertensive treatment reduces left ventricular mass index, either left ventricular hypertrophy or concentric remodeling remains present in a significant number of patients at the end of a 1‐year treatment period. The authors conclude that these patients should be considered as a subgroup at high risk and should be treated more aggressively.
Aortic Dissection
Authors: Prisant L. Michael , Nalamolu V. R. Prasad
Published: May 2007

Aortic root enlargement is generally asymptomatic, with few clinical clues, but may be observed as an incidental finding on a chest x‐ray, echocardiogram, or contrast‐enhanced computerized tomogram of the chest. Aortic dissection is one of the most feared complications of hypertension. A history of hypertension is commonly present, but the systolic blood pressure in type A dissection (proximal to the left subclavian artery) has been found to be less than 150 mm Hg in 64% of patients. However, 71% of type B dissections (distal to the left subclavian artery) present with a systolic blood pressure 150 mm Hg or higher (International Registry of Acute Aortic Dissection). Most frequently, onset of symptoms is in the daytime, especially between 6 a.m. and noon. Severe sharp chest pain that is abrupt in onset is the most likely presentation. Migrating pain is uncommon. Although a pulse deficit with decreased or absent carotid, brachial, or femoral pulses occurs in only 30% of patients, three or more deficits predict an in‐house mortality of about 60%. A chest x‐ray finding of a widened mediastinum is present in 62.6% of type A and 56% of type B dissections. Contrast‐enhanced computerized tomography or transesophageal echocardiography is the most commonly performed procedure for diagnosis. In‐house mortality has been found to be 32.5% in type A dissections and 13% in type B dissections.
Early Initiation of β Blockade in Heart Failure: Issues and Evidence
Authors: Williams Randall E.
Published: May 2007

Despite clinical trials demonstrating that inhibitors of the renin‐angiotensin and sympathetic nervous systems can reduce the mortality and morbidity risk associated with heart failure, these drugs have remained underutilized in general clinical practice. In particular, many patients with heart failure due to left ventricular systolic dysfunction fail to receive β blockers, although this class of drugs, as well as other antihypertensive agents such as angiotensinconverting enzyme inhibitors or angiotensin receptor blockers, are recommended as part of routine heart failure therapy by national expert consensus guidelines. In‐hospital initiation of β‐blocker therapy may improve long‐term utilization by physicians and compliance by patients through obviating many of the misperceived dangers associated with β blockade. The following review of the clinical trial data from the Randomized Evaluation of Strategies for Left Ventricular Dysfunction (RESOLVD) trial, the Metoprolol Controlled‐Release Randomized Intervention Trial in Heart Failure (MERIT‐HF), the Cardiac Insufficiency Bisoprolol Study II (CIBIS‐II), the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial, and the Initiation Management Predischarge Process for Assessment of Carvedilol Therapy for Heart Failure (IMPACT‐HF) trial on the efficacy, safety, and tolerability of β blockers indicates that early initiation can be safely achieved and can improve patient outcomes.
The Role of Calcium Antagonists in Stroke Prevention
Authors: Elliott William J. , Bandari Armin
Published: May 2007

Lowering elevated blood pressure significantly reduces the risk of stroke, but whether any specific type of antihypertensive medication is better for this purpose, independent of blood pressure‐lowering effects, is controversial. Compared with placebo or no treatment, the point estimate for stroke reduction is the largest with calcium antagonists; all such studies used dihydropyridine compounds. When all clinical trials published through December 2004 are combined in meta‐analysis, stroke is not significantly reduced when an initial dihydropyridine or nondihydropyridine calcium antagonist is compared with an initial diuretic or P blocker, but when the two subclasses are combined, stroke reduction (9%) is significant. The risk of heart failure, however, is significantly increased (by 29%) with the initial calcium antagonist. These estimates may change as newer trials are reported.
Quality of Life and Antihypertensive Drug Therapy
Authors: Handler Joel
Published: May 2007

Quality of life on antihypertensive therapy is an important consideration because clinicians are asked to initiate drug therapy and follow mostly asymptomatic patients for long periods of time on agents that are fairly equivalent in both blood‐pressure‐lowering capacity and the reduction of adverse clinical events. There is, however, evidence to show that hypertension is not always an asymptomatic condition; therefore, the reduction of blood pressure makes people not previously knowledgeable of their hypertensive state feel better. Labeling a patient hypertensive May have negative quality‐of‐life consequences. Clinicians need to be well informed regarding side‐effect profiles as well as anxiety conditions that May lead to subjective complaints that are blamed on medication. Additionally, medication information given to patients May have an important effect on adverse effect reporting. Specific intolerance profiles to the thiazides, angiotensin‐converting enzyme inhibitors, β blockers, calcium channel blockers, and angiotensin receptor blockers are discussed in this review. Medication compliance requires a multi‐tiered strategy. Low‐dose thiazide is well tolerated.
Angiotensin‐Converting Enzyme Inhibitors' Side Effects—Physiologic and Non‐Physiologic Considerations
Authors: Sica Domenic A.
Published: May 2007

Angiotensin‐converting enzyme (ACE) inhibitors are increasingly recognized as having an important role in the treatment of hypertension and/or end‐organ disease. The sheer number of ACE inhibitors in the United States—now numbering 10 different chemical entities—has created a sense of comfort with these compounds, which is particularly evident when these compounds are used in the patient with essential hypertension; conversely, when comorbid conditions are present in the ACE inhibitor‐treated patient, circumstances change and physician vigilance becomes more of a necessity. ACE inhibitor therapy in patients with either cardiac and/or renal disease is as much an art as it is a science, and even in the most skilled hands can prove a challenging undertaking. This review discusses the physiologic and non‐physiologic basis for side effects with ACE inhibition.
Pathophysiologic, Diagnostic, and Therapeutic Aspects of the Metabolic Syndrome
Authors: Giles Thomas D. , Sander Gary E.
Published: May 2007

The metabolic syndrome, characterized by increases in waist circumference, blood pressure, and triglyceride concentrations combined with reduced high‐density lipoprotein and evidence of glucose intolerance, results from the interaction of visceral or central obesity with insulin resistance. This syndrome presents a clinical situation of systemic inflammation and increased cardiovascular risk. Blood pressure, even if only in the “prehypertensive” range, plays an important role in increasing the risk of cardiovascular disease. Recognition and treatment of each individual component of the metabolic syndrome is critical in reducing cardiovascular risk. Treatment should begin with lifestyle changes, including diet, exercise, and weight reduction. Antihypertensive therapy should be directed toward reduction of blood pressure to levels as close to optimal (<120/80 mm Hg) as feasible, and treatment protocols that do not cause worsening of glucose intolerance should be selected. Therapy for dyslipidemia should be directed at reducing triglycerides and increasing high‐density lipoprotein. Glucose‐lowering agents may be indicated, and drugs such as metformin and thiazolidinediones, which reduce insulin resistance, should form the basis of therapy. Carefully chosen therapy will effectively improve cardiovascular outcomes.
Circadian Blood Pressure and Heart Rate Changes in Patients in a Persistent Vegetative State After Traumatic Brain Injury
Authors: Pattoneri Paolo , Tirabassi Giovanni , Pelà Giovanna , Astorri Ettore , Mazzucchi Anna , Borghetti Alberico
Published: May 2007

Alteration of autonomic nervous system regulation is known to be present in the persistent vegetative state after traumatic brain injury, termed the dysautonomic syndrome. This study assessed the circadian blood pressure and heart rate pattern and variability in the persistent vegetative state through noninvasive 24‐hour ambulatory blood pressure monitoring. The study was performed in 20 subjects: 10 patients (six men and four women; mean age, 29.5±9.9 years; range, 19–39 years) in a vegetative state (mean, 27.3±5.6 days after trauma) and 10 healthy subjects as controls (six men and four women; mean age, 28±5.7 years; range, 29–37 years). The patients showed a blood pressure nondipper pattern; 24‐hour, daytime, and nighttime values of blood pressure and heart rate were significantly higher in patients than in controls. The day‐night difference in heart rate and blood pressure was also significantly lower in patients. Finally, SD and variation coefficients were significantly lower in patients. The results show changes in the variability and
circadian blood pressure and heart rate patterns in persistent vegetative state patients with dysautonomic syndrome, as an expression of the sympathetic‐parasympathetic activity imbalance in the control of vasomotor tone.
Na/K Pump Current in Guinea Pig Cardiac Myocytes and the Effect of Na Leak
Authors: DOBRETSOV MAXIM , STIMERS JOSEPH R.
Published: May 2007

Na/K Pump Current. Introduction: Steady‐State Na/K pump current (Ip) in adult guinea pig ventricular myocytes was studied to determine the effect on the Na/K pump of transmembrane Na leak, membrane potential, and pipette Na concentration.

Methods and Results: Using conventional whole cell, patch clamp techniques, Ip was identified as either K0‐sensitive or ouabain‐sensitive current when most other membrane currents were inhibited. Control experiments showed that there were no K0‐sensitive currents other than Ip under the conditions of our experiments. Ip was found to be similar to that reported by others being voltage dependent between −130 and 0 mV and having a half maximal activation hy Nai of 28 mM. Ouabain sensitivity was also measured, and it was found that there were two binding sites with the high affinity site comprising 5% to 10% of the total and having an apparent affinity 1000‐fold higher than the low affinity site. Apparent affinity of both sites was shifted about 10‐fold (higher affinity) by increasing Nai from 10 to 85 mM. When internally perfused with 0 Na solution, Na leak through the membrane was found to be linearly related to Na/K pump activity. In contrast to prior suggestions, Ip was not correlated with series resistance when there was a large transmembrane Na gradient.

Conclusion: These data suggest that, under conditions of high transmembrane Na gradient, Na leak through the membrane plays a significant role in determining Na/K pump activity.
Morphological Descriptions of New and Little‐Known Benthic Ciliates from Ganghwa Tidal Flat, Korea
Authors: GONG JUN , CHOI JOONG KI , ROBERTS DAVID McL. , KIM SUN YOUNG , MIN GI SIK
Published: May 2007

ABSTRACT. Ciliates are highly diverse in the benthos where there are rare species to be unrevealed and described. By isolating species during successive and diversified cultivations, we discovered several new and interesting taxa from the top layer sediment of a muddy site in the Ganghwa tidal flat. These include three new species Spirodysteria ganghwaensis n. sp., Uronemella parafilificum n. sp., Zosterodasys minuta n. sp., and one poorly known form Loxophyllum chaetonotumBorror 1965. The morphology of live cells and infraciliature of these four species are described based on living observations, protargol impregnations, and morphometrics. Diagnoses and improved definitions are also provided. The newly established genus Spirodysteria n. g. differs from Dysteria mainly in its spirally twisted body shape. Spirodysteria kahli (Tucolesco 1962) n. comb. (formerly Dysteria kahliTucolesco 1962) has been included in this new genus.
Pericardial Lipoma: An Autopsy Case and Review of the Literature
Authors: Durak Dilek , Eren Bülent
Published: May 2007

Postmortem examination performed on a 70‐year‐old man revealed a thinly encapsulated, ovoid, large mass in the right hemithorax. The tumor was attached with its pedicle to the atrioventral pericardium and adjoined the diaphragm with compression of the right lower lobe of the lung. There was no adhesion between the tumor and the surrounding organs. Light microscopy showed a lipoma consisting of mature adipose tissue, and no malignancy was found.
CONFIGURING HISTORICAL FACTS THROUGH HISTORICAL FICTION: AGENCY, ART‐IN‐FACT, AND IMAGINATION AS STEPPING STONES BETWEEN THEN AND NOW
Authors: Den Heyer Kent , Fidyk Alexandra
Published: May 2007

Abstract The historical fiction novel straddles the factual and the fictive recreation of past motivations that animate historical events. Through reading a work of historical fiction, Ursula Hegi’s novel Stones from the River, Kent den Heyer and Alexandra Fidyk offer a theoretical consideration of the following questions and their classroom implications: What is the role of historical fiction in enabling the imaginative grappling with historical fact? Or, in what ways does historical fiction enable us to come to terms with the ethical imperatives of learning from the past? What role does agency play in historical imagination? These are questions of ethics. They are, therefore, also questions of education.
THE CONFLICT BETWEEN INTERPERSONAL RELATIONS AND ABSTRACT SYSTEMS IN EDUCATION
Authors: Endres Benjamin
Published: May 2007

Abstract In this essay, Benjamin Endres examines how teaching is caught between the ideals of formal, systemic institutions, on the one hand, and the ideals of more intimate or personal relations, on the other. Endres uses Anthony Giddens’s account of “abstract systems” and “pure” relations to suggest that the tension that teachers face is not only the result of opposing ideologies or philosophies of teaching, but it is the product of conflicting undercurrents in modern social and economic life. Although there is no simple solution to the ambiguous and contested status of teaching, Endres points to two examples of how the interpersonal dimensions of teaching may gain recognition and support by the institutional system of schooling: research on the effects of class size and legal guarantees for individualized educational plans in the area of special education. He concludes by emphasizing the particular challenge of cultivating interpersonal relations for the most disadvantaged students.
HUMAN CAPITAL AND THE LABOR OF LEARNING: A CASE OF MISTAKEN IDENTITY
Authors: Sidorkin Alexander M
Published: May 2007

Abstract In this essay, Alexander Sidorkin offers a conceptual critique of the human capital theory that makes erroneous assumptions about the nature of student work and the private cost of schooling. Specifically, human capital theorists underestimate the private cost of schooling by taking low‐level manual labor as the basis for estimating students’ forgone earnings. This does not take into consideration the nature of students’ labor of learning. In the essay, Sidorkin describes student work as a form of labor, not an investment activity, and considers the implications such an understanding of student work has for school reform.
Degradation of nuclear DNA by DNase II‐like acid DNase in cortical fiber cells of mouse eye lens
Authors: Nakahara Masaki , Nagasaka Akiomi , Koike Masato , Uchida Kaori , Kawane Kohki , Uchiyama Yasuo , Nagata Shigekazu
Published: May 2007

The eye lens is composed of fiber cells that differentiate from epithelial cells on its anterior surface. In concert with this differentiation, a set of proteins essential for lens function is synthesized, and the cellular organelles are degraded. DNase II‐like acid DNase, also called DNase IIβ, is specifically expressed in the lens, and degrades the DNA in the lens fiber cells. Here we report that DNase II‐like acid DNase is synthesized as a precursor with a signal sequence, and is localized to lysosomes. DNase II‐like acid DNase mRNA was found in cortical fiber cells but not epithelial cells, indicating that its expression is induced during the differentiation of epithelial cells into fiber cells. Immunohistochemical and immunocytochemical analyses indicated that DNase II‐like acid DNase was colocalized with Lamp‐1 in the lysosomes of fiber cells in a relatively narrow region bordering the organelle‐free zone, and was often found in degenerating nuclei. A comparison by microarray analysis of the gene expression profiles between epithelial and cortical fiber cells of young mouse lens indicated that some genes for lysosomal enzymes (cathepsins and lipases) were strongly expressed in the fiber cells. These results suggest that the lysosomal system plays a role in the degradation of cellular organelles during lens cell differentiation.
LEADERSHIP AND SEX‐SIMILARITY: A COMPARISON IN A MILITARY SETTING
Authors: VECCHIO ROBERT P. , BRAZIL DONNA M.
Published: May 2007

In a study of the possible impact of leader and follower sex‐similarity on leadership criteria, survey responses of 1,974 military cadets in 167 squads were analyzed at the completion of a month‐long field training exercise. Analyses (which included a series of hierarchical linear models that explicitly accounted for the nested character of squad membership relative to a leader) yielded results that indicated that same‐sex leader–subordinate pairings had more positive working relationships than different‐sex pairings. However, leader ratings of subordinate performance did not yield clear evidence of such an effect. In addition, increases in the proportion of female members in a squad were not associated with differences in squad‐level cohesion, while being associated with decreases in squad‐level leader–member exchange (LMX). Subordinate reports of participation in decision making, although correlated positively with LMX, were not significantly different as a function of leader–subordinate sex‐similarity. Implications are derived for managing demographic diversity in order to enhance within‐unit functioning.
FIELD MEASURES OF STRENGTH AND FITNESS PREDICT FIREFIGHTER PERFORMANCE ON PHYSICALLY DEMANDING TASKS
Authors: HENDERSON NORMAN D. , BERRY MICHAEL W. , MATIC TOMISLOV
Published: May 2007

Recruits from 9 consecutive fire academy classes were assessed on a battery of strength and endurance measures at Weeks 1, 7, and 14 of training. Regression analyses using Week 1 measures indicated that strength variables were the primary predictors of performance on physically demanding firefighting tasks assessed at the completion of training. Incremental validity was obtained with the addition of aerobic capacity, which produced more accurate performance distinctions among recruits with high strength levels. Results showed predictive validity and linearity throughout the upper range of strength and endurance levels, but evidence of an increased drop‐off in performance for recruits with strength levels below the male 25th percentile. Structural equation modeling, a more powerful and comprehensive approach to validation than traditional regression, provided strong support for the construct validity of general strength and endurance as predictors of firefighter performance on physically demanding fire suppression and rescue tasks.
Cutting More from Cut Forests: Edge Effects on Foraging and Herbivory of Leaf‐Cutting Ants in Brazil
Authors: Urbas Pille , Araújo Manoel V. , Leal Inara R. , Wirth Rainer
Published: May 2007

Edge‐mediated changes in species composition are known to result in modified species interactions. Because of the crucial trophic position of herbivores and their far‐reaching impact on plant communities, it is important to understand how edge influences herbivory. In the present paper, we investigated whether and how leaf‐cutting ant foraging is altered in the forest edge, as this habitat is characterized by an increased proportion of pioneer species. We assessed basic foraging data as well as the herbivory rate (i.e., the proportion of the leaf material harvested by a colony in relation to the available leaf area in the foraging area) of Atta cephalotes colonies at the edge versus interior sites of a large remnant of the Atlantic forest in Northeast Brazil. Our results indicated clear edge effects on leaf‐cutting ants: equally sized A. cephalotes colonies located at the forest edge removed about twice as much leaf area from their foraging grounds than interior colonies (14.3 vs. 7.8%/col/yr). This greater colony‐level impact within the forest edge zone was a consequence of markedly reduced foraging areas (0.9 vs. 2.3 ha/col/yr) and moderately lower leaf area index in this habitat, whereas harvest rates were the same. Our results suggest that forest edges induce increased leaf‐cutting ant herbivory, probably via the release of resource limitation. Together with the increase of leaf‐cutting ant populations along forest edges, this may amplify environmental changes induced by habitat fragmentation.
Asteroseismic signatures of stellar magnetic activity cycles
Authors: Metcalfe T. S. , Dziembowski W. A. , Judge P. G. , Snow M.
Published: May 2007

Observations of stellar activity cycles provide an opportunity to study magnetic dynamos under many different physical conditions. Space-based asteroseismology missions will soon yield useful constraints on the interior conditions that nurture such magnetic cycles, and will be sensitive enough to detect shifts in the oscillation frequencies due to the magnetic variations. We derive a method for predicting these shifts from changes in the Mg ii activity index by scaling from solar data. We demonstrate this technique on the solar-type subgiant β Hyi, using archival International Ultraviolet Explorer spectra and two epochs of ground-based asteroseismic observations. We find qualitative evidence of the expected frequency shifts and predict the optimal timing for future asteroseismic observations of this star.
SALT CONCENTRATION, TYPE OF PHOSPHATE AND FILM SEALANT EFFECTS ON MEAT ADHESION TO PACKAGING FILMS
Authors: KENDRICK C.A. , ACTON J.C.
Published: May 2007

Packaging film adhesion strength at the meat‐film interface was measured on a vacuum‐packaged, cook‐in‐the‐film prepared turkey product using an approximate 90° peeling angle from the plane of the meat surface. Adhesion increased (P<0.05) as added NaCl increased from 0.75% to 2.0% (w/w) but not with further increase to 2.5%. Sodium phosphates at 0.4% (w/w) increased (P<0.05) adhesion strength as follows: pyrophosphate > tripolyphosphate > monophosphate > no phosphate = hexametaphosphate. Film sealants of nylon blend and Surlyn® produced more (P<0.05) adhesion to meat surfaces than linear low densiq polyethylene‐Surlyn® blend, linear low density polyethylene‐ethyl vinyl acetate or ethylene‐propylene copolymer. Nylon blend sealant had the most surface adhesion (171.2 g/cm) and surface energy (56.2 dynes/cm) whereas ethylene‐propylene copolymer yielded the lowest measures (6.3 g/cm and 31.7 dynes/cm, respectively). Film‐to‐meat adhesion responded to NaCl concentration and type of phosphate in the sume manner as water and meat‐to‐meat binding respond during meat processing.
SODIUM LEVULINATE AND SODIUM LACTATE EFFECTS ON MICROBIAL GROWTH AND STABILITY OF FRESH PORK AND TURKEY SAUSAGES1
Authors: VASAVADA MIHIR , CARPENTER CHARLES E. , CORNFORTH DAREN P. , GHORPADE VISWAS
Published: May 2007

This study compared the effects of 1.4% or 2.7% sodium levulinate or sodium lactate on aerobic plate count (APC), color, pH, and TBA values of fresh pork and turkey sausage. Both sodium lactate and levulinate inhibited growth of aerobic microorganisms during storage compared to controls. Antimicrobial effects of sodium lactate were dose‐dependent, where as 2.7% lactate was significantly more antimicrobial than 1.4% lactate. This was not the case for sodium levulinate where 1.4% sodium levulinate was as inhibitory to microbial growth as 2.7% sodium levulinate. Additionally. 1.4% sodium levulinate was as inhibitory to microbial growth CIS the higher level (2.7%) of sodium lactate. TBA values, color and pH were not affected by either sodium lactate or levulinate. In conclusion, sodium levulinate may have potential as an antimicrobial agent in fresh sausage if it can be obtained at a reasonable cost on a commercial basis.
EVALUATION OF COOKING METHODS ON VARIOUS BEEF STEAKS1
Authors: HERRING J. L. , ROGERS R. W.
Published: May 2007

The purpose of this study was to evaluate sensory attributes and physical differences among steaks from two different cooking methods. Beef steaks (n=516) were cooked either with a conventional electric broiler oven (EB) or a gas infrared oven broiler unit (IR). Three 1.27 cm diameter cores were removed from each steak for Warner‐Bratzler shear determinations. Three 2.54 em cubes were removed for texture profile analysis. The remaining meat was evaluated by a trained sensory panel for scoring tenderness and juiciness. The average time required to cook the steaks with IR was 4 min 56 s less (P<0.05) than with EB, a reduction of 25%. Based on sensory data. sirloin tip steaks and rib steaks were more tender and juicy (P<0.05) when cooked with IR, however sensory attributes of round steaks and top butt steaks were not (P>O.OS) affected.
Advanced practice nurse attitudes toward sex offender patients
Authors: Rash Elizabeth , Winton Mark A
Published: May 2007

Purpose: To determine advanced practice nurses’ (APNs’) attitudes and behaviors toward patients in their practices who are registered sex offenders.

Data sources: An online survey of 300 APN members of a local APN organization asking respondents to identify the behavioral actions they were likely to agree or disagree with when faced with a scenario of realizing that a sex offender was a patient in their practice. Sixty‐nine respondents submitted completed surveys.

Conclusions: There was an ambiguity of behavioral responses and no consensus among APNs on how to respond to the issue of a sex offender patient in a healthcare practice. There was also a lack of awareness of whether sex offenders were patients in their practice.

Implications for practice: The modest number of respondents and their demographic homogeneity limit the ability to draw any conclusions or generalizations from this study. While awareness of a known sex offender in a practice is unlikely to alter direct patient care, it may have an impact on office policies and procedures and should be a consideration of all involved staff, including providers, ancillary team members, and administrative personnel.
Separation of early afterdepolarizations from arrhythmogenic substrate in the isolated perfused hypokalaemic murine heart through modifiers of calcium homeostasis
Authors: Killeen M. J. , Gurung I. S. , Thomas G. , Stokoe K. S. , Grace A. A. , Huang C. L.‐H.
Published: May 2007

Aims: We resolved roles for early afterdepolarizations (EADs) and transmural gradients of repolarization in arrhythmogenesis in Langendorff‐perfused hypokalaemic murine hearts paced from the right ventricular epicardium.

Methods: Left ventricular epicardial and endocardial monophasic action potentials (MAPs) and arrhythmogenic tendency were compared in the presence and absence of the L‐type Ca2+channel blocker nifedipine (10 nm–1 μm) and the calmodulin kinase type II inhibitor KN‐93 (2 μm).

Results: All the hypokalaemic hearts studied showed prolonged epicardial and endocardial MAPs, decreased epicardial‐endocardial APD90difference, EADs, triggered beats and ventricular tachycardia (VT) (n = 6). In allspontaneously beatinghearts, 100 (but not 10) nmnifedipine reduced both the incidence of EADs and triggered beats from 66.9 ± 15.7% to 28.3 ± 8.7% and episodes of VT from 10.8 ± 6.3% to 1.2 ± 0.7% of MAPs (n = 6 hearts,P < 0.05); 1 μmnifedipine abolishedallthese phenomena (n = 6). In contrast programmed electrical stimulation (PES) still triggered VT in six of six hearts with 0, 10 and 100 nmbut not 1 μmnifedipine. 1 μmnifedipine selectively reduced epicardial (from 66.1 ± 3.4 to 46.2 ± 2.5 ms) but not endocardial APD90, thereby restoring ΔAPD90from −5.9 ± 2.5 to 15.5 ± 3.2 ms, close to normokalaemic values. KN‐93 similarly reduced EADs, triggered beats and VT in spontaneously beating hearts to 29.6 ± 8.9% and 1.7 ± 1.1% respectively (n = 6) yet permitted PES‐induced VT (n = 6), in the presence of a persistently negative ΔAPD90.

Conclusions: These findings empirically implicatebothEADs and triggered beatsalongsidearrhythmogenic substrate of ΔAPD90in VT pathogenesis at the whole heart level.