bluuebunny/crossref_metadata_2025 huggingface dataset:
PLACE PROMOTION, ECONOMIC LOCATION AND THE CONSUMPTION OF CITY IMAGE
Authors: YOUNG CRAIG , LEVER JONATHAN
Published: March 2008

As European and American cities suffer the effects of declining manufacturing bases place promotion strategies have become increasingly important to attract new investment. These involve the creation of a new image of cities. However, very little is known about how effective the marketed image is. The role of the image of Manchester (UK) promoted by the Central Manchester Development Corporation (CMDC) in office relocation is evaluated. An analysis of the experience of office managers as consumers of this image reveals considerable diversity of perception. The results suggest the need for further research into the nature and effectiveness of place images.
THE ASIAN PACIFIC RIM IN THE GLOBAL GAME
Authors: SINGH MAHINDAR SANTOKH
Published: March 2008

The socio‐political and economic processes of regionalization are varied. This article attempts at understanding the how and in which directions the Pacific Rim, especially the Asian Pacific Region, has been able to create a dynamic environment that has increased its significance, competitiveness and contribution to the global game of contemporary capitalism. The article proposes a new scheme of analysis that focuses on the financial capital and intellectual capital‐led regional integration processes operating in the information era. It draws on local, historical and geographical time‐space specifications of major stakeholders to support the arguments on how places added value.
VIETNAM AND THE ‘THIRD WAY’: THE NATURE OF SOCIO‐ECONOMIC TRANSITION
Authors: FAHEY STEPHANIE
Published: March 2008

A major dilemma for the Vietnamese state during transition from a command to market economy is how to manage the emergence of market forces within an existing Marxist ideology. The quandary for commentators is whether a hybrid form of the socialist market or the ‘third way’ is a viable goal. Underpinning the analysis of socio‐economic change in former socialist countries is some understanding of the processes by which the transition occurs. Questions of process are the major focus of the increasing volume of literature on transition in Vietnam. In this article questions of process are also addressed but the analysis is extended to a discussion of what the outcome of transition will be. It is clear in Eastern Europe and the former USSR that economic and political institutions which supported socialism disintegrated with a ‘big bang’ and that these countries are in the process of rebuilding themselves according to the principles of the capitalist market. It is argued that in Vietnam as in China, the process of transition has been one of ‘gradualism’ beginning with micro‐economic followed by macro‐economic reforms but with limited political reform. The intention of both Vietnamese and Chinese policy‐makers is not to create a capitalist market but a socialist‐oriented market in which the Communist Party leadership remains in place and that public ownership of the means of production is a declared priority. In this article historical, cultural, social as well as economic evidence is drawn upon to argue that persistence of a hybrid socio‐economic structure in Vietnam is possible.
THE IMPACT OF TOYOTA ON DERBYSHIRE'S LOCAL ECONOMY AND LABOUR MARKET
Authors: FOLEY PAUL , HUTCHINSON JO , HERBANE BRAHIM , TAIT GILLIAN
Published: March 2008

Many localities are aware of the need to attract inward investment. This article examines the impact of Toyota's £700 million investment in Derbyshire. It investigates its direct and indirect employment effects. The article attempts to go beyond the predominantly quantitative approach adopted in previous studies by examining the characteristics of the new jobs at Toyota, and those who secure them. In addition, the nature of supplier likages and multiplier effects is investigated to analyse secondary effects. Whilst approximately 3, 000 jobs will be directly created by Toyota, there may be some disruptive effects in the local labour market. Furthermore, the potential for employment through supplier linkages and multiplier effects has not yet been maximised, although it is possible that these may materialise in the longer term. Discussion of these factors clearly highlights the fact mat the attraction of inward investment is only the first stage in the process of significant job creation.
NAMING AND PLACING THE OTHER: POWER AND THE URBAN LANDSCAPE IN ZANZIBAR
Authors: MYERS GARTH ANDREW
Published: March 2008

Place names mark the spatiality of power relationships, but toponymy has yet to be reexamined in light of human geography's recent philosophical and theoretical emphasis on power and language. This essay utilizes the example of Zanzibar's Ng'ambo neighborhoods, literally the city's ‘Other Side’, in order to show how toponymy and boundary‐making embody a complex spatial discourse on power. Rather than simply reflecting the impress of state or elite ideologies, the toponymic tapestry of the Other Side and the micro‐geographies of boundary‐making that accompany it indicate die presence of many interwoven layers of power in the landscape. Toponymy and the accompanying emplacement process can thus be rich sources for analysis of the ‘capillary’ nature of power.
THE REVIVAL OF FRANCE'S PORT CITIES
Authors: BAUDOUIN THIERRY , COLLIN MICHELE
Published: March 2008

Port cities the world over have been subjected to huge and rapid transformations by events in the international arena, and France is no exception. This situation has triggered a readjustment of the balance of power within French port cities, the pace and scope of which is insufficient compared to the scale of the exogenous changes. This imbalance is probably die most striking aspect of die process of adaptation to changing conditions visible in France's port cities today. We will begin by analysing die challenges, at the end of die Fordist era, to die French government's strategic choices, i.e., die development of the nation's ports with a domestic and industrial bias. This period was then followed by a policy of European integration, with a fundamentally continental emphasis. We will go on to outline die beginnings of a renaissance of France's port cities due firstly to die initiatives of die local audiorities, and die renewed interest they have shown in their ports and their economic potential, and secondly to die new relationship forged between die State and private sectors in die domain of port activity.
ITALIAN PORTS AND THE WIND OF CHANGE
Authors: RIDOLFI GIOVANNI
Published: March 2008

In Italy, sea routes have always been of great importance both for inter‐island and trade links. Italian ports handle 67% of the total volume of imports and 41% of exports. Italy's economy is therefore heavily dependent on sea transport and effective port activities. Nevertheless, the contribution of maritime commerce to the general transport system has not been adequate because the lack of a decisive policy for the sector has put a brake on the development of sea transport and ports. Good prospects however have emerged from new government undertakings to organise the whole maritime‐port‐transport sector into some sort of order. This will involve, in harmony with the EU, the criteria of interdependence and functional integration of the different modalities of transport, which will contribute towards improving inland accessibilty between the less developed south and the developed north regions, and also external accessibility, that is the access to the neighbouring countries of the advanced transalpine North and of the emerging trans‐Mediterranean South.
Genetic diversity of the subterranean Gansu zokor in a semi‐natural landscape
Authors: Lin G. H. , Cai Z. Y. , Zhang T. Z. , Su J. P. , Thirgood S. J.
Published: March 2008

We studied the relationship between genetic diversity of the subterranean Gansu zokor Myospalax cansus and habitat variability in the Loess Plateau, Qinghai Province, China. We used a combination of geographic information systems and molecular techniques to assess the impact of habitat composition and human activities on the genetic diversity of zokor populations in this semi‐natural landscape. Although they occurred relatively infrequently in the landscape, woodland and high‐coverage grassland habitats were the main positive contributors to the genetic diversity of zokor populations. Rural residential land, plain agricultural land and low‐coverage grassland had a negative effect on genetic diversity. Hilly agricultural land and middle‐coverage grassland had little impact on zokor genetic diversity. There were also interactions between some habitat types, that is, habitat types with relatively better quality together promoted conservation of genetic diversity, while the interaction between (among) bad habitat types made situations worse. Finally, habitat diversity, measured as patch richness and Shannon's diversity index, was positively correlated with the genetic diversity. These results demonstrated that: (1) different habitat types had different effects on the genetic diversity of zokor populations and (2) habitat quality and habitat heterogeneity were important in maintaining genetic diversity. Habitat composition was closely related to land use thus emphasizing the importance of human activities on the genetic diversity of subterranean rodent populations in this semi‐natural landscape. Although the Gansu zokor was considered to be a pest species in the Loess Plateau, our study provides insights for the management and conservation of other subterranean rodent species.
Reproductive dynamics of a tropical freshwater crocodilian: Morelet's crocodile in northern Belize
Authors: Platt S. G. , Rainwater T. R. , Thorbjarnarson J. B. , McMurry S. T.
Published: March 2008

Morelet's crocodile Crocodylus moreletii has not been well‐studied and many aspects of its life history are unknown. In particular there is a notable paucity of information on nesting and reproductive ecology. We studied the nesting ecology of Morelet's crocodile in northern Belize from 1992 through 1995. Nesting occurs at the onset of the wet season in mid‐June and continues through mid‐July (mean oviposition date =1 July±10 days). Eggs hatch from mid‐August through mid‐ to late September. Nesting effort at our primary study site remained relatively constant during 1992, 1993 and 1995, but nearly doubled in 1994; this appeared to reflect a regional trend. Natural and man‐made islands are heavily used as nesting sites. Nesting success in 1993 and 1994 was consistently higher on natural islands when compared with man‐made islands or shoreline sites. Nest losses were primarily due to flooding and raccoon Procyon lotor predation. Losses from predation were greatest in 1994 when unseasonably low water levels facilitated predator access to nests. Females probably reach sexual maturity in 7–8 years after attaining a total length of 150 cm. Mean clutch size (25.0±7.6; range=9–42; n=73) did not differ among years. Mean clutch size, egg width (EW), egg length, egg mass (EM) and clutch mass were positively correlated with female snout–vent length (SVL). Mean EW was the best predictor of female SVL. A partial correlation analysis of egg and clutch attributes found that independent of female SVL, EM increases with increasing clutch size.
Variation of group size among African buffalo herds in a forest‐savanna mosaic landscape
Authors: Korte L. M.
Published: March 2008

Documenting within species group size variation is important to completely understand social organization within species and to interpret variation among species. Here, I investigated group size of African buffalo Syncerus caffer over 2 years in a heterogeneous landscape. African buffalo use closed continuous forest and vast open savannas, and anecdotal observations suggest that habitat type influences their social structure. While the Cape buffalo Syncerus caffer caffer is well studied, few data exist for the forest‐dwelling Syncerus caffer nanus. I observed forest buffalo at Lopé National Park, Gabon, and examined variation of group size. Eighteen forest buffalo herds used the study area with an estimated population of 342 individuals (∼5 buffalo km−2). The mean group size for the 18 herds was 12 ± 2 (range of means=3–24), considerably smaller than Cape buffalo herds. For eight radiocollared forest buffalo, the mean group size was stable, varying little with time of day, across seasons, or between savanna and marsh habitat. However, herd size varied widely across herds, from fewer than 10 individuals in the smallest herds to more than 20 buffalo in the largest. Large herd size is associated with home ranges that contain substantial areas of open habitat, and thus more food resources than forested habitats.
Are gram‐positive bacteria capable of electron transfer across their cell wall without an externally available electron shuttle?
Authors: EHRLICH H. L.
Published: March 2008

The extensive contributions by Terry Beveridge to our understanding of the differences in cell wall organization with respect to structure, chemistry and compartmentalization between gram‐positive and gram‐negative bacteria are summarized. These contributions greatly aided in conceptualization of recent discoveries concerning electron export and import across cell walls of some gram‐negative bacteria. Although electron export and import across the cell wall by any gram‐positive has not been documented so far, Beveridge's observations and concepts concerning cell walls of gram‐positive bacteria suggest potential mechanisms by which such electron transfer may occur.
Measuring immigration and philopatry in seabirds; recruitment to Black‐legged Kittiwake colonies
Authors: COULSON J. C. , COULSON B. A.
Published: March 2008

The degree of philopatry in two new Black‐legged KittiwakeRissa tridactylacolonies in northeast England was studied for 36 and 16 successive years, respectively. There was a tendency in both colonies for the number of recruits to the breeding group to increase with the age (and size) of the colony, but by an average of only one additional recruit each year. In the two new colonies, it was 7 and 9 years respectively before the first young birds bred in their natal colony. By that time, over 100 immigrants had recruited and bred in each colony. Thereafter, new philopatric birds were recorded annually. But these formed only an average of 23% of the recruits during 36 years (1955–90) at North Shields, and 4.2% over 16 years (1991–2006) at Coquet Island. In every year at both colonies the number of new immigrants exceeded the number of philopatric recruits. Males formed 82% of philopatric birds. The low degree of philopatry in the Kittiwake will result in appreciable gene flow between colonies and this is consistent with little geographic variation in the species. Each immigrant has to make a choice of which colony to enter, but the criteria for this selection are not understood. It is argued that many measures of philopatry in birds are biased towards high values because of the greater ease in identifying philopatric individuals. The generalization that there is a high degree of philopatry in colonial seabird species is not justified, as there is considerable variation between species, and possibly between colonies. More estimates based on unbiased data are needed.
International Accounting Standards and Accounting Quality
Authors: BARTH MARY E. , LANDSMAN WAYNE R. , LANG MARK H.
Published: March 2008

We examine whether application of International Accounting Standards (IAS) is associated with higher accounting quality. The application of IAS reflects combined effects of features of the financial reporting system, including standards, their interpretation, enforcement, and litigation. We find that firms applying IAS from 21 countries generally evidence less earnings management, more timely loss recognition, and more value relevance of accounting amounts than do matched sample firms applying non‐U.S. domestic standards. Differences in accounting quality between the two groups of firms in the period before the IAS firms adopt IAS do not account for the postadoption differences. Firms applying IAS generally evidence an improvement in accounting quality between the pre‐ and postadoption periods. Although we cannot be sure our findings are attributable to the change in the financial reporting system rather than to changes in firms' incentives and the economic environment, we include research design features to mitigate effects of both.
Autonomous initialisation of exterior orientation parameters using a collinearity search‐based solution
Authors: Seedahmed Gamal H.
Published: March 2008

As is well known, a collinearity‐based solution for the exterior orientation parameters (EOPs) has to deal with their initial approximation. Although this problem has been thoroughly investigated, contemporary literature continues to report it as a major obstacle. To this end, this paper proposes a general and innovative solution for the EOP approximation problem. This solution is formulated as a computational search for the best hypothesis for the approximate values of the EOPs that explains the known correspondence between the observed image coordinates and their counterparts in object space. In particular, the three ranges of the 3D rotation angles are discretised in a coarse‐to‐fine strategy to generate different hypotheses for their values. These hypotheses are combined to form angular triplets that could serve as candidate solutions for the 3D rotation angles. Then, each angular triplet is substituted in a ‘‘linear version’’ of the collinearity equations to solve directly for a candidate hypothesis of the 3D camera position. Together, the two candidate solutions form a hypothesis for the solution vector of the EOPs. Then each hypothesis of the EOPs performs a back‐projection of the object space coordinates, via the collinearity equations, to compute a hypothesis for the image coordinates. The EOP hypothesis that gives the minimum Euclidean distance, or l2 norm, between the observed and the computed image coordinates, is selected as the best global solution for the approximate values of the EOPs.
Remifentanil‐assisted local anaesthesia: Application to continence surgery
Authors: HAYLEN Bernard T. , KATZ Steven , CHETTY Naven
Published: March 2008

Remifentanil, an ultrarapid‐acting opioid, as an intravenous infusion, generally in combination with a sedative/amnesic (for example midazolam) and local anaesthesia can provide an effective assisted local anaesthetic technique (Remi‐ALA) for tension‐free vaginal tapes or equivalent continence procedures in urogynaecology. Excellent analgesia for the local anaesthetic injections and tape insertion is provided as well as optimal patient cooperation for clinicians who wish to perform cough testing after tape insertion. Dose‐related respiratory depression and, less commonly, bradycardia are possible side‐effects, potentially more likely in older women (particularly over 70 years).
Cytokine polymorphisms in women with recurrent pregnancy loss: Meta‐analysis
Authors: BOMBELL Sarah , McGUIRE William
Published: March 2008

Background:  Inflammatory cytokine cascades have been implicated in the pathogenesis of recurrent pregnancy loss (RPL). Polymorphisms in cytokine genes may affect the risk of RPL, but genetic association studies are often limited by small sample sizes. Meta‐analysis of all available studies can increase the precision of these estimates.

Aims:  To assess and synthesise the available data from association studies of inflammatory cytokine polymorphisms with RPL.

Methods:  Systematic review and random effects meta‐analysis of genetic association studies.

Results: Sixteen reports of genetic association studies of cytokine polymorphisms with RPL were identified. Meta‐analyses did not identify any significant associations with tumour necrosis factor (–308A, or –238A), interferon‐gamma (+874T), interleukin (IL)‐1β (–511T), IL‐6 (–174G), or IL‐10 (–1082A, or –819T, or –592A). Significant associations were found with IL‐1B (–31T) (two studies: pooled odds ratio (OR) 2.12 (95% confidence interval (CI) 1.04 to 4.33)) and IL‐6 (–634G) (one study: OR 0.22 (95% CI 0.09 to 0.57)).

Conclusions:  The available data are not consistent with more than modest associations between these candidate cytokine polymorphisms and RPL. Data from future association studies may be added to the meta‐analyses to obtain more precise estimates of effect sizes.
Prevalence of endometrial cancer and hyperplasia in non‐symptomatic overweight and obese women
Authors: VIOLA Alexandre S. , GOUVEIA Daniela , ANDRADE Liliana , ALDRIGHI Jose M. , VIOLA Carolina F. M. , BAHAMONDES Luis
Published: March 2008

Background:   Obesity is a public health problem and it is necessary to identify if non‐symptomatic obese women must be submitted to endometrial evaluation.

Aims:   To determine the prevalence of endometrial hyperplasia and cancer in non‐symptomatic overweight or obese women.

Methods:   A cross‐sectional study was carried out in 193 women submitted to an endometrial biopsy using a Pipelle de Cornier. The findings were classified as normal, hyperplasia or cancer, and the results were compared to body mass index (BMI; kg/m2). For the purpose of statistical analysis, women were divided into two groups: women of reproductive age and postmenopausal women, and according to BMI as overweight or obese.

Results:   The prevalence of endometrial cancer and hyperplasia was 1.0% and 5.8% in women of reproductive age and 3.0% and 12.1% in postmenopausal women, respectively. According to logistic regression, being in the postmenopause increased the risk of endometrial hyperplasia and cancer to 1.19 (95% confidence interval (CI): 0.36–3.90), while being postmenopausal and severely obese increased the odds ratio (OR) to 1.58 (95%CI: 0.30–8.23) and being postmenopausal and morbidly obese increased the OR to 2.72 (95%CI: 0.65–11.5). No increase in risk was found in women of reproductive age who were either overweight or obese.

Discussion:   Our results show that non‐symptomatic, severe or morbidly obese postmenopausal women have a high risk of developing endometrial hyperplasia or cancer; however, no such risk was found for women of reproductive age.
Magnetic Suspension of the Rotor of a Ventricular Assist Device of Mixed Flow Type
Authors: Horikawa Oswaldo , De Andrade Aron José Pazin , Da Silva Isaías , Bock Eduardo Guy Perpetuo
Published: March 2008

Abstract:  This work presents results of preliminary studies concerning application of magnetic bearing in a ventricular assist device (VAD) being developed by Dante Pazzanese Institute of Cardiology—IDPC (São Paulo, Brazil). The VAD‐IDPC has a novel architecture that distinguishes from other known VADs. In this, the rotor has a conical geometry with spiral impellers, showing characteristics that are intermediate between a centrifugal VAD and an axial VAD. The effectiveness of this new type of blood pumping principle was showed by tests and by using it in heart surgery for external blood circulation. However, the developed VAD uses a combination of ball bearings and mechanical seals, limiting the life for some 10 h, making impossible its long‐term use or its use as an implantable VAD. As a part of development of an implantable VAD, this work aims at the replacement of ball bearings by a magnetic bearing. The most important magnetic bearing principles are studied and the magnetic bearing developed by Escola Politécnica of São Paulo University (EPUSP‐MB) is elected because of its very simple architecture. Besides presenting the principle of the EPUSP‐MB, this work presents one possible alternative for applying the EPUSP‐MB in the IDPC‐VAD.
A New Technique to Control Brushless Motor for Blood Pump Application
Authors: Fonseca Jeison , Andrade Aron , Nicolosi Denys E.C. , Biscegli José F. , Legendre Daniel , Bock Eduardo , Lucchi Júlio César
Published: March 2008

Abstract:  This article presents a back‐electromotive force (BEMF)‐based technique of detection for sensorless brushless direct current motor (BLDCM) drivers. The BLDCM has been chosen as the energy converter in rotary or pulsatile blood pumps that use electrical motors for pumping. However, in order to operate properly, the BLDCM driver needs to know the shaft position. Usually, that information is obtained through a set of Hall sensors assembled close to the rotor and connected to the electronic controller by wires. Sometimes, a large distance between the motor and controller makes the system susceptible to interference on the sensor signal because of winding current switching. Thus, the goal of the sensorless technique presented in this study is to avoid this problem. First, the operation of BLDCM was evaluated on the electronic simulator PSpice. Then, a BEMF detector circuitry was assembled in our laboratories. For the tests, a sensor‐dependent system was assembled where the direct comparison between the Hall sensors signals and the detected signals was performed. The obtained results showed that the output sensorless detector signals are very similar to the Hall signals at speeds of more than 2500 rpm. Therefore, the sensorless technique is recommended as a responsible or redundant system to be used in rotary blood pumps.
Genetic Influence on Dysmorphogenesis in Embryos From Different Rat Strains Exposed to Ethanolin Vivoandin Vitro
Authors: Wentzel Parri , Eriksson Ulf J.
Published: March 2008

Background: The aim was to investigate the susceptibility of embryos from 2 rat strains (U and H) to a 48 hours ethanol exposure in early pregnancy, both in vivo and in vitro.

Methods: The embryos were studied on gestational days 9 to 11. We used 1 ethanol dose in vivo (6 g/kg × 2), 3 different ethanol concentrations in vitro (88 mM, 132 mM, 176 mM) and also attempted to diminish the teratogenic effect in vitro by supplying the antioxidant N–acetylcysteine (NAC, 0.5 mM) to the culture medium.

Results: The U embryos were more damaged by ethanol than the H embryos, both in vivo and in vitro.NAC addition diminished, but failed to completely normalize, the embryonic maldevelopment. Ethanol increased the Bax/Bcl‐2 ratio in the U embryos both in vivo and in vitro, but not in the H embryos. Furthermore, ethanol caused increased Caspase‐3 immunostaining in U embryos, but not in H embryos. Ethanol exposure in vivo did not alter CuZnSOD and MnSOD mRNA levels in U and H embryos. In vitro, however, the ethanol‐exposed U embryos increased their CuZnSOD and MnSOD mRNA levels, whereas the CuZnSOD mRNA was unchanged and MnSOD mRNA decreased in the H embryos, in neither strain did NAC exert any effect. The U embryos increased catalase gene expression in response to ethanol in vivo,but decreased catalase mRNA levels in vitro, changes normalized by NAC. The H embryos did not alter catalase mRNA levels in vivo, but increased gene expression in vitro, with no NAC effect. Ethanol affected the gene expression of the other ROS scavenging enzymes and the developmental genes studied – Bmp‐4, Ret, Shh, Pax‐6 – similarly in the 2 strains.

Conclusions: The findings support a role for genetic predisposition, oxidative stress, and apoptosis in ethanol teratogenicity, and suggest that the teratogenic predisposition of the more susceptible U rats may reside, at least in part, in the regulation of the ROS scavenging enzymes in the U embryos.
Off‐Label Use of Drugs in Pain Medicine and Palliative Care: An Algorithm for the Assessment of its Safe and Legal Prescription
Authors: Verhagen Constans C. A. H. H. V. M. , Niezink Anne G. H. , Engels Yvonne Y , Hekster Yechiel Y. A. , Doornebal Joan J. , Vissers Kris C. P.
Published: March 2008

▪ Abstract  Off‐label medication use is common practice, particularly in difficult to treat patients who have already tried commonly accepted medication unsuccessfully. Health authorities try to regulate this practice to protect the patient's safety and to prevent over consumption of new and more expensive drugs. Justified off‐label drug use requires a thorough assessment. Physicians, in cooperation with formulary committees, need tools to structure this assessment. The evaluation algorithm for off‐label prescription we present here, to be used after identification of a planned off‐label application, consists of four steps. Step 1 indicates the extent of the problem and the need for further investigation. Step 2 is the decisional process evaluating the necessity of off‐label use in identified prescriptions and confirmation as to what extent it needs further investigation. In step 3, the scientific knowledge to support the proposed off‐label use is gathered in a short or extensive evaluation trajectory. The short trajectory consists of assembling the information approved in other countries or in accepted guidelines and textbooks, whereas the extensive trajectory is necessary when the indication, route, or formulation is not approved nationally or internationally. Assessment needs to be based on a literature research on the clinical and pharmacological information of the product. Step 4 is the acceptance or rejection of the off‐label use of the drug for the indication at hand. Those four steps need to be carefully documented. Treatment outcome will then be closely monitored, documented, and made available to professionals, thus allowing for regular update of recommendations. This algorithm can help formulary committees to develop a strategy for evaluating off‐label prescriptions in well‐defined conditions, and help healthcare providers to develop protocols and guidelines. ▪
Neurally Mediated Susceptibility in Individuals with Brugada‐Type ECG Pattern
Authors: LETSAS KONSTANTINOS P. , EFREMIDIS MICHALIS , GAVRIELATOS GERASIMOS , FILIPPATOS GERASIMOS S. , SIDERIS ANTONIOS , KARDARAS FOTIOS
Published: March 2008

Background:

Neurally mediated syncope and Brugada syndrome (BS) share common pathophysiologic mechanisms related to autonomic nervous system modulations, and particularly with increased vagal tone. This study aimed to investigate the incidence of neurally mediated susceptibility in individuals with Brugada‐type electrocardiogram (ECG) pattern.

Methods and Results:

Eight asymptomatic male individuals (mean age 41.6 ± 10.6 years) with spontaneous or procainamide‐induced type 1 ECG pattern of BS and structurally normal hearts underwent a drug‐free head‐up tilt test. Twenty‐five healthy male subjects (mean age 37.4 ± 14.1 years) with normal ECG and without structural heart disease were included in the study, and served as comparative controls. A positive tilt test response was observed in three out of eight subjects with the Brugada‐type ECG pattern (37%) and in three out of 25 controls (12%) (P = 0.018).

Conclusions:

This study demonstrates a high incidence of neurally mediated susceptibility in asymptomatic individuals with Brugada‐type ECG pattern. Severe diagnostic and therapeutic dilemmas may rise from this coexistence. A positive tilt test in subjects with Brugada‐type ECG displaying a history of syncope may mislead the physician to a false sense of security. Further studies are required to validate our findings and possibly evaluate the role of tilt test in risk stratification of patients with BS.
Acute Sleep Deprivation is Associated with Increased Electrocardiographic P‐Wave Dispersion in Healthy Young Men and Women
Authors: SARI IBRAHIM , DAVUTOGLU VEDAT , OZBALA BURCU , OZER ORHAN , BALTACI YASEMIN , YAVUZ SEMA , AKSOY MEHMET
Published: March 2008

Background: Sleep deprivation (SD) is associated with worse cardiovascular outcome including mortality. Prolonged P‐wave duration and P‐wave dispersion (Pd) are known to represent inhomogeneous conduction of sinus impulses and are known to be electrophysiologic predictors of atrial fibrillation. Pd in normal subjects has been reported to be influenced by the autonomic tone. Because autonomic tone is affected by sleep and sleep duration, we evaluated the effect of acute SD on P‐wave duration and Pd in healthy young adults and whether the effect was gender selective.

Methods

: We obtained electrocardiograms of 37 healthy young volunteers (age: 28.45 ± 7.97; 11 women) after a night of regular sleep and repeated after a night with sleep debt. We measured minimum and maximum P‐wave durations (Pmin, Pmax) and Pd in milliseconds.

Results

: Average sleep time of the subjects were 7.7 ± 0.8 hours during regular sleep and 1.7 ± 1.6 hours during a night of sleep debt (P < 0.001). Subjects had significantly lower values of Pmin in milliseconds after a night of sleep debt when compared to regular sleep (65.13 ± 8.03 vs 74.86 ± 10.95; P < 0.001), whereas they had significantly higher values of Pmax and Pd (102.16 ± 9.46 vs 95.13 ± 11.21; P < 0.001 and 37.02 ± 8.11 vs 20.27 ± 11.42; P < 0.001, respectively). In Pearson's correlation analysis Pmin was positively and Pmax and Pd were negatively correlated with sleep time (P < 0.001, r = 0.465; P = 0.003, r =−0.336 and P < 0.001, r =–0.698 respectively). Effect of SD on P‐wave duration and Pd was similar for both men and women.

Conclusions

: In conclusion, prolongation of Pmax and Pd in acute SD suggests that acute SD might contribute to development and/or recurrence of atrial fibrillation.
Application of Combined Morphological–Molecular Approaches to the Identification of Planktonic Protists from Environmental Samples
Authors: DUFF ROBERT JOEL , BALL HOPE , LAVRENTYEV PETER J.
Published: March 2008

ABSTRACT. The value of molecular databases for unicellular eukaryotic identification and phylogenetic reconstruction is predicated on the availability of sequences and accuracy of taxonomic identifications that accompany those sequences. Biased representation of sequences is due in part to the differing ability to isolate and culture various groups of protists. Techniques that allow for parallel single‐cell morphological and molecular identifications have been reported for a few groups of unicellular protists. We have sought to explore how those techniques can be adapted to work across a greater phylogenetic diversity of taxa. Twelve morphologically diverse and abundant members of limnetic microplankton, including ciliates, dinoflagellates, cryptophytes, stramenopiles, and synurophytes, were targeted for analysis. These cells were captured directly from environmental samples, identified, and prepared for sequence analyses using variations of single‐cell extraction techniques depending on their size, mobility, and the absence or presence of the cell wall. The application of these techniques yielded a strong congruence between the morphological and molecular identifications of the targeted taxa. Challenges to the single‐cell approach in some groups are discussed. The general ability to obtain DNA sequences and morphological descriptions from individual cells should open new avenues to studying either rare or difficult to culture taxa, even directly at the point of collection (e.g. remote locations or shipboard).
Recovery of Growth of Hyphochytrium catenoides after Exposure to Environmental Stress
Authors: GLEASON FRANK H. , LETCHER PETER M. , EVERSHED NICK , MCGEE PETER A.
Published: March 2008

ABSTRACT. The survival of an isolate of Hyphochytrium catenoides collected from soil in the Blue Mountains in eastern New South Wales, Australia, was tested under extreme conditions in the laboratory. This isolate recovered growth after being subjected to drying on filter paper, to heat while desiccated, to hypersalinity, to strict anaerobic conditions, to freezing temperatures, and to a short period in solutions at pH 2.8–11.2. The capacity to survive under these conditions in the laboratory suggests adaptation to fluctuating conditions in the soil. The partial DNA sequence of the 28S ribosomal RNA gene in the isolate from New South Wales was 98% similar to that in an isolate from Arizona with a similar morphology.
Substance Use in Emergency Medicine Training Programs
Authors: McBeth Brian D. , Ankel Felix K. , Ling Louis J. , Asplin Brent R. , Mason Emily J. , Flottemesch Thomas J. , McNamara Robert M.
Published: March 2008

Objectives:  To explore the prevalence of substance use among emergency medicine (EM) residents and compare to a prior study conducted in 1992.

Methods:  A voluntary, anonymous survey was distributed in February 2006 to EM residents nationally in the context of the national in‐service examination. Data regarding 13 substances, demographics, and perceptions of personal patterns of substance use were collected.

Results:  A total of 133 of 134 residencies distributed the surveys (99%). The response rate was 56% of the total EM residents who took the in‐service examination (2,397/4,281). The reported prevalence of most illicit drug use, including cocaine, heroin, amphetamines, and other opioids, among EM residents are low. Although residents reporting past marijuana use has declined (52.3% in 1992 to 45.0% in 2006; p < 0.001), past‐year use (8.8%–11.8%; p < 0.001) and past‐month use (2.5%–4.0%; p < 0.001) have increased. Alcohol use appears to be increasing, including an increase in reported daily drinkers from 3.3% to 4.9% (p < 0.001) and an increase in number of residents who indicate that their consumption of alcohol has increased during residency (from 4% to 12.6%; p < 0.001).

Conclusions:  Self‐reported use of most street drugs remains uncommon among EM residents. Marijuana and alcohol use, however, do appear to be increasing. Educators should be aware of these trends, and this may allow them to target resources for impaired and at‐risk residents.
An Alternative Hemostatic Dressing: Comparison of CELOX, HemCon, and QuikClot
Authors: Kozen Buddy G. , Kircher Sara J. , Henao Jose , Godinez Fermin S. , Johnson Andrew S.
Published: March 2008

Objectives:  Uncontrolled hemorrhage remains a leading cause of traumatic death. Several topical adjunct agents have been shown to be effective in controlling hemorrhage, and two, chitosan wafer dressing (HemCon [HC]) and zeolite powder dressing (QuikClot [QC]), are being utilized regularly on the battlefield. However, recent literature reviews have concluded that no ideal topical agent exists. The authors compared a new chitosan granule dressing (CELOX [CX]) to HC, QC and standard dressing in a lethal hemorrhagic groin injury.

Methods:  A complex groin injury with transection of the femoral vessels and 3 minutes of uncontrolled hemorrhage was created in 48 swine. The animals were then randomized to four treatment groups (12 animals each). Group 1 included standard gauze dressing (SD); Group 2, CX; Group 3, HC; and Group 4, QC. Each agent was applied with 5 minutes of manual pressure followed by a standard field compression dressing. Hetastarch (500 mL) was infused over 30 minutes. Hemodynamic parameters were recorded over 180 minutes. Primary endpoints included rebleed and death.

Results:  CX reduced rebleeding to 0% (p < 0.001), HC to 33% (95% CI = 19.7% to 46.3%, p = 0.038), and QC to 8% (95% CI = 3.3% to 15.7%, p = 0.001), compared to 83% (95% CI = 72.4% to 93.6%) for SD. CX improved survival to 100% compared to SD at 50% (95% CI = 35.9% to 64.2%, p = 0.018). Survival for HC (67%) (95% CI = 53.7% to 80.3%) and QC (92%; 95% CI = 84.3% to 99.7%) did not differ from SD.

Conclusions:  In this porcine model of uncontrolled hemorrhage, CX improved hemorrhage control and survival. CELOX is a viable alternative for the treatment of severe hemorrhage.
Comparison of Nebulized Epinephrine to Albuterol in Bronchiolitis
Authors: Walsh Paul , Caldwell John , McQuillan Kemedy K. , Friese Steven , Robbins Dale , Rothenberg Stephen J.
Published: March 2008

Objectives: To compare the effect of nebulized racemic epinephrine to nebulized racemic albuterol on successful discharge from the emergency department (ED).

Methods: Children up to their 18th month of life presenting to two teaching hospital EDs with a clinical diagnosis of bronchiolitis who were ill enough to warrant treatment but did not need immediate intubation were eligible for this double‐blind randomized controlled trial (RCT). Patients received either three doses of racemic albuterol or one dose of racemic epinephrine plus two saline nebulizers. Disposition was decided 2 hours after the first nebulizer. Successful discharge was defined as not requiring additional bronchodilators in the ED after study drug administration and not subsequently admitted within 72 hours. Adjusted relative risks (aRR) were estimated using the modified Poisson regression with successful discharge as the dependent variable and study drug and severity of illness as exposures. Secondary analysis was performed for patients aged less than 12 months and first presentation.

Results: The authors analyzed 703 patients; 352 patients were given albuterol and 351 epinephrine. A total of 173 in the albuterol group and 160 in the epinephrine group were successfully discharged (crude RR = 1.08, 95% confidence interval [CI] = 0.92 to 1.26). When adjusted for severity of illness, patients who received albuterol were significantly more likely than patients receiving epinephrine to be successfully discharged (aRR = 1.18, 95% CI = 1.02 to 1.36). This was also true among those with first presentation and in those less than 12 months of age.

Conclusions: In children up to the 18th month of life, ED treatment of bronchiolitis with nebulized racemic albuterol led to more successful discharges than nebulized epinephrine.
Mucosal tissue transglutaminase expression in celiac disease
Authors: Villanacci Vincenzo , Not Tarcisio , Sblattero Daniele , Gaiotto Tiziano , Chirdo Fernando , Galletti Anna , Bassotti Gabrio
Published: March 2008

Tissue transglutaminase (tTG) plays an important role in celiac disease pathogenesis and antibodies to tTG are a diagnostic marker of gluten‐sensitive enteropathy. The aim of this study was to investigate the localization of tTG in the duodenal mucosa in control tissues and in different histological stages of celiac disease by using a commercial and a novel set of anti‐tTG monoclonal antibodies, to see whether this assessment can be useful for diagnostic purpose. The distribution of tTG was firstly evaluated in 18 untreated celiac patients by using a commercial monoclonal antibody (CUB7402) against tissue transglutaminase enzyme and directed against the loop‐core region of the enzyme. Thereafter, in further 30 untreated celiac patients we employed three newly characterized anti‐tTG monoclonal antibodies produced against recombinant human‐tTG. The epitopes recognized are located in three distinct domains of the protein corresponding to the core, C1 and C2 protein structure. Eleven age‐ and sex‐matched patients with chronic duodenitis acted as controls. All subjects underwent upper endoscopy to obtain biopsy samples from the duodenum. Overall, we found that (i) tTG is equally expressed in CD at different stages of disease; (ii) tTG is expressed, at similar level, in CD and controls with duodenitis. Assessment of tTG level in biopsy samples by immunohistochemical methods is not useful in the clinical diagnostic work‐up of CD.
Anatomical retinal reattachment after scleral buckling with and without retinopexy: a pilot study
Authors: Mahdizadeh Morteza , Masoumpour Masoumeh , Ashraf Hossein
Published: March 2008

Purpose:  To compare the anatomical results of scleral buckling with and without retinopexy and to assess the effect of retinopexy on the scleral buckling outcome.

Methods:  This randomized clinical trial was performed on 55 patients. Twenty‐two eyes were treated with scleral buckling (segmental or encircling) with or without drainage of subretinal fluid without any type of retinopexy (group 1); 33 patients received transscleral retinal cryopexy around retinal break(s) in addition to the former procedure. The two groups were matched regarding age, sex, myopia, aphakia, stage of proliferative vitroretinopathy (PVR) and number, type and location of the break(s).

Results:  In the non‐retinopexy group, 19 patients (86%) had complete retinal reattachment and one patient had partial reattachment after 34–48 months of follow‐up. One patient did not develop attachment because of missed break out of the buckle, and one had no attachment at all because of PVR. Overall success rate was 91% (20 of 22) in this group. In the retinal cryopexy group, 26 patients (79%) had complete retinal reattachment and two had partial reattachment during 35–56 months of follow‐up. In two patients, no attachment was achieved because of missed break out of the buckle; three patients developed redetachment after 1 and 3 months because of PVR. Overall success rate was 85% (28 of 33). The anatomical results in these two groups were the same statistically.

Conclusion:  With the permanent scleral buckling technique, retinal cryopexy adds no benefit to the success rate of anatomical retinal reattachment.
Quantitative real‐time RT‐PCR in sentinel lymph nodes from melanoma patients
Authors: RIBER‐HANSEN RIKKE , ABRAHAMSEN HELENE NORTVIG , SORENSEN BOE SANDAHL , HAMILTON‐DUTOIT STEPHEN JACQUES , STEINICHE TORBEN
Published: March 2008

Quantitative real‐time reverse transcriptase polymerase chain reaction (qRT‐PCR) for specific melanoma markers is more sensitive than histology for detecting cells of melanocytic origin in sentinel lymph nodes (SLNs) in cutaneous melanoma. The clinical significance of a positive qRT‐PCR analysis is unclear. We performed qRT‐PCR for the presence of MART‐1 and tyrosinase in SLNs from 93 melanoma patients, and then followed these patients clinically (median follow‐up time 43.5 months). We found a significant correlation between disease progression and presence of MART‐1 mRNA in SLNs (p=0.02), but no correlation with the amount of MART‐1 mRNA as measured by qRT‐PCR. No correlation between histology and recurrence was detected, recurrence rates being low in both histology‐negative (12%) and ‐positive (15%) patients. We found a significant difference in disease recurrence between patients positive by both histology and RT‐PCR and patients negative by both methods (15% vs 0%, p=0.02). However, a significant difference in disease recurrence was also found when comparing patients negative by both methods with patients positive by RT‐PCR but negative by histology (0% vs 19%, p=0.009). This suggests that the presence of submicroscopic metastases may influence prognosis, indicating that RT‐PCR detection of melanocytic cells in SLNs may be an important diagnostic marker.