bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of Autoantibodies to Tumour‐Associated Antigens in Sera of Patients with Systemic Autoimmunity Using a Novel Protein Microblot Array
Authors: Canzler U. , Bartsch H. , Ulitzsch S. , Kurien B. T. , Dorri Y. , Scofield R. H. , Grossmann K. , Lehmann W. , Pilarsky C. , Denz A. , Grützmann R. , Conrad K. , Schmitz M. , Rieber E. P. , Distler W. , Bachmann M. P.
Published: April 2009

It is well known that sera of patients with systemic autoimmunity contain autoantibodies to nuclear antigens. It is also known that patients with systemic autoimmunity have an increased risk for the development of tumours. Interestingly, tumour patients frequently develop autoantibodies and there is a growing list of potential tumour‐associated antigens. It is, however, not known whether or not patients with systemic autoimmunity also develop antibodies to tumour‐associated antigens. Here we describe the development of a novel multiprotein array allowing us to screen for autoantibodies to 30 different tumour‐associated antigens in parallel. Using this novel assay, we found that the frequency of autoantibodies to the selected tumour‐associated antigens is increased between 2‐ and 14‐fold in patients with systemic autoimmunity compared with an age‐matched control group.
Taking Complement to the Clinic – has the Time Finally Come?
Authors: Lachmann P. J. , Smith R. A. G.
Published: April 2009

Complement has been studied for over a century and its role in promoting the effector side of antibody‐mediated immune reactions and of inducing inflammation is well understood. Nevertheless, it has proved surprisingly difficult to translate this information into pharmaceutical agents that can be used to treat immunopathological and inflammatory disease. There are, however, now clear signs that this situation will change. New types of therapeutic agents to interfere with complement function are being developed and it has become apparent quite recently that some common and otherwise untreatable diseases such as age‐related macular degeneration are very largely due to mutations in the complement system that leads to a hyperinflammatory state. This has stimulated a renaissance of interest in the complement system as a therapeutic target and in this short review we discuss the possible ways of taking complement to the clinic, and the indications for which this may be carried out.
Experimental evidence that high levels of inbreeding depress sperm competitiveness
Authors: ZAJITSCHEK S. R. K. , LINDHOLM A. K. , EVANS J. P. , BROOKS R. C.
Published: April 2009

The effects of inbreeding on sperm quantity and quality are among the most dramatic examples of inbreeding depression. The extent to which inbreeding depression results in decreased fertilization success of a male’s sperm, however, remains largely unknown. This task is made more difficult by the fact that other factors, such as cryptic female choice, male sperm allocation and mating order, can also drive patterns of paternity. Here, we use artificial insemination to eliminate these extraneous sources of variation and to measure the effects of inbreeding on the competitiveness of a male’s sperm. We simultaneously inseminated female guppies (Poecilia reticulata) with equal amounts of sperm from an outbred (f = 0) male and either a highly (f = 0.59) or a moderately inbred (f = 0.25) male. Highly inbred males sired significantly fewer offspring than outbred males, but share of paternity did not differ between moderately inbred and outbred males. These findings therefore confirm that severe inbreeding can impair the competitiveness of sperm, but suggest that in the focal population inbreeding at order of a brother–sister mating does not reduce a male’s sperm competitiveness.
Characterization of Cylindrocarpon liriodendri Associated with Black Foot Disease of Grapevine in Iran
Authors: Mohammadi Hamid , Alaniz Sandra , Banihashemi Zia , Armengol Josep
Published: April 2009

Eight Cylindrocarpon isolates recovered from the trunk bases of 10‐year‐old grapevines showing decline symptoms from two vineyards in Bavanat (Fars province, south‐western Iran) were studied. Based on phenotypical characteristics, mating experiments and molecular data, they were identified as Cylindrocarpon liriodendri. Pathogenicity was confirmed with selected isolates inoculated into 8‐month‐old dormant rooted cuttings of grapevine rootstock cv. 110 Richter. This is the first report of C. liriodendri causing black foot disease of grapevines in Iran.
A Model‐based Assessment of the Impacts of Climate Variability on Fusarium Head Blight Seasonal Risk in Southern Brazil
Authors: Del Ponte Emerson M. , Fernandes José M. C. , Pavan Willingthon , Baethgen Walter E.
Published: April 2009

The frequency of Fusarium head blight (FHB) outbreaks increased considerably in many countries in the last two decades. We used a crop‐disease model to assess the impacts of climate variability over a 50‐year period at Passo Fundo, Rio Grande do Sul, Brazil. Thirty individual simulation runs of a wheat model were performed for each year by varying planting dates from 1 June to 30 June. For each simulation, an FHB risk index was estimated with the disease model using the heading date simulated by the crop model. A seasonal FHB risk index was estimated by averaging the 30 indices each year. Our simulation results showed that climate at Passo Fundo became favourable to FHB after the 1980s following a period of less favourable conditions for epidemics in the 1960s and 1970s. The risk for FHB was higher for the later planting dates in the most recent decades. Consideration of sea surface temperature (SST) anomalies (deviations from long‐term mean values) in the Tropical Pacific Ocean allowed the separation of groups of years with frequently low FHB risk (negative SST anomalies, La Niña like years) and years with frequently high FHB risks (positive SST anomalies – El Niño like years, and near‐normal SST – neutral years). Southern Atlantic SST anomalies were then included to separate years with different FHB risks in El Niño‐like years and Neutral years. However, the consideration of these anomalies did not result in an improvement. Our results suggest that increased spring rainfall linked to warm sea surface temperature in the Pacific after the 1980s was associated with higher frequency of FHB epidemics in southern Brazil.
Effect of outsourcing public sector audits on cost‐efficiency
Authors: Chong Kar‐Ming , Dolley Colin , Houghton Keith , Monroe Gary S.
Published: April 2009

This study compares the cost‐efficiency of ‘in‐house’ and outsourced to private sector audit supplier arrangements to deliver financial audits in the public sector by examining audit cost‐efficiency within the context of the public sector arrangement at one state in Australia (Western Australia). The results for 178 public agencies show that outsourced audits are, in general, more costly than in‐house audits, but this result is conditional on the type and size of public agency. Specifically, outsourced audits are more costly than in‐house audits for small statutory authority audits, whereas for specialist audits (i.e. hospitals) and large and complex statutory authority audits, the in‐house supply is equally efficient as the outsourced service.
Linking Social Development with the Capacity to Carry Debt: Towards an MDG‐Consistent Debt‐Sustainability Concept
Authors: Gunter Bernhard G. , Rahman Jesmin , Shi Haiyan
Published: April 2009

Owing to concerns among low‐income countries that the new debt sustainability framework of the Bretton Woods institutions may lock them into a so‐called ‘low debt‐low growth’ scenario, the United Nations has called for a more MDG‐consistent debt‐sustainability concept. This article shows that there is a robust relationship between achieving the Millennium Development Goals and having a higher capacity to carry debt. It then discusses options for modifying the current debt‐sustainability framework, and suggests that including progress made in achieving the MDGs in determining borrowing limits would be a first step towards adopting such a concept.
Generalised and Particularistic Thinking in Policy Analysis and Practice: The Case of Governance Reform in South Africa
Authors: Frödin Olle
Published: April 2009

This article is concerned with the relationship between generalised and particularistic knowledge in the context of policy‐making and policy analysis. It argues that it is problematic to assume that a reform model will generate similar outcomes across a wide variety of contexts. It presents a conceptual framework, including the concepts of transaction domain and domain consensus, that enables context‐sensitive analyses. The argument is exemplified by South Africa's introduction in the 1990s of an Integrated Development Planning model, based on British reform experience and various international public‐management models. With a case study of such planning in Lukhanji Municipality in the Eastern Cape Province, it illustrates how the conceptual framework may be used in policy research and analysis.
Beninese and Ethiopian Informal Insurance Groups: A Comparative Analysis
Authors: LeMay‐Boucher Philippe
Published: April 2009

Informal insurance groups have been created in many poor regions in response to a risky environment typical of developing countries. Drawing on original datasets from Benin and Ethiopia, this article provides empirical evidence describing the various forms these indigenous institutions take. While their principal role has been to provide indemnities for funeral expenses, they also cater for a wide range of shocks. The article finds striking resemblances in group structures and types of coverage offered, suggesting that households for whom the costs of formal insurance contracts are prohibitive tend to deal with risk in a comparable way. Dissimilarities may reflect different local household structures or the extent to which these groups are advertised and known to the public.
Health‐related stigma
Authors: Scambler Graham
Published: April 2009

The concept of stigma, denoting relations of shame, has a long ancestry and has from the earliest times been associated with deviations from the ‘normal’, including, in various times and places, deviations from normative prescriptions of acceptable states of being for self and others. This paper dwells on modern social formations and offers conceptual and theoretical pointers towards a more convincing contemporary sociology of health‐related stigma. It starts with an appreciation and critique of Goffman's benchmark sensitisation and traces his influence on the personal tragedy or deviance paradigm dominant in the medical sociology from the 1970s. To allow for the development of an argument, the focus here is on specific types of disorder – principally, epilepsy and HIV – rather than the research literature as a whole. Brief and critical consideration is given to attempts to operationalise or otherwise ‘measure’ health‐related stigma. The advocacy of a rival oppression paradigm by disability theorists from the 1980s, notably through re‐workings of the social model of disability, is addressed. It is suggested that we are now in a position to learn and move on from this paradigm ‘clash’. A re‐framing of notions of relations of stigma, signalling shame, and relations of deviance, signalling blame, is proposed. This framework, and the positing of a variable and changing dynamic between cultural norms of shame and blame – always embedded in social structures of class, command, gender, ethnicity and so on – is utilised to explore recent approaches to health stigma reduction programmes.
Transcritical Flow Over a Hole
Authors: Grimshaw R. H. J. , Zhang D.‐H. , Chow K. W.
Published: April 2009

Transcritical flow over a localized obstacle generates upstream and downstream nonlinear wavetrains. In the weakly nonlinear long‐wave regime, this flow has been modeled with the forced Korteweg‐de Vries (fKdV) equation, where numerical simulations and asymptotic solutions have demonstrated that the upstream and downstream nonlinear wavetrains have the structure of unsteady undular bores, connected by a locally steady solution over the obstacle. Further, it has been shown that when the obstacle is replaced by a step of semi‐infinite length, it is found that a positive step generates only an upstream‐propagating undular bore, and a negative step generates only a downstream‐propagating undular bore. This result suggests that for flow over a hole, that is a step down followed by a step up, the two wavetrains generated will interact over the hole. In this paper, this situation is explored by numerical simulations of the fKdV equation.
A Higher‐Order Internal Wave Model Accounting for Large Bathymetric Variations
Authors: De Zárate Ailín Ruiz , Vigo Daniel G. Alfaro , Nachbin André , Choi Wooyoung
Published: April 2009

A higher‐order strongly nonlinear model is derived to describe the evolution of large amplitude internal waves over arbitrary bathymetric variations in a two‐layer system where the upper layer is shallow while the lower layer is comparable to the characteristic wavelength. The new system of nonlinear evolution equations with variable coefficients is a generalization of the deep configuration model proposed by Choi and Camassa [1] and accounts for both a higher‐order approximation to pressure coupling between the two layers and the effects of rapidly varying bottom variation. Motivated by the work of Rosales and Papanicolaou [2], an averaging technique is applied to the system for weakly nonlinear long internal waves propagating over periodic bottom topography. It is shown that the system reduces to an effective Intermediate Long Wave (ILW) equation, in contrast to the Korteweg‐de Vries (KdV) equation derived for the surface wave case.
On the Geometry of the Instrumental Variable Estimator*
Authors: Mehlum Halvor
Published: April 2009

I derive the exact distribution of the exact determined instrumental variable estimator using a geometric approach. The approach provides a decomposition of the exact estimator. The results show that by geometric reasoning one may efficiently derive the distribution of the estimation error. The often striking non‐normal shape of the instrumental variable estimator, in the case of weak instruments and small samples, follows intuitively by the geometry of the problem. The method allows for intuitive interpretations of how the shape of the distribution is determined by instrument quality and endogeneity. The approach can also be used when deriving the exact distribution of any ratio of stochastic variables.
Technical choice, innovation, and British steam engineering, 1800–501
Authors: NUVOLARI ALESSANDRO , VERSPAGEN BART
Published: April 2009

The development of the high‐pressure expansive engine represented a watershed in the evolution of steam power technology, allowing the attainment of major fuel economies. In Britain, Cornish engineers took the lead in the exploration of this specific technological trajectory. Notwithstanding its superior fuel efficiency was immediately widely discussed, the high‐pressure expansive engine did not find widespread application in other steam‐using regions (in particular in Lancashire), where the Watt low‐pressure engine continued to be the favourite option. This article provides a reassessment of the factors accounting for the precocious adoption of the high‐pressure steam engine in Cornwall and for its delayed fortune in the rest of Britain.
Paediatric coma scales
Authors: Kirkham Fenella J , Newton Charles R J C , Whitehouse William
Published: April 2009

Traumatic and non‐traumatic coma is a common problem in paediatric practice with high mortality and morbidity. Early recognition of the potential for catastrophic deterioration in a variety of settings is essential and several coma scales have been developed for recording depth of consciousness that are widely used in clinical practice in adults and children. Prediction of outcome is probably less important, as this may be able to be modified by appropriate emergency treatment, and other clinical and neurophysiological criteria allow a greater degree of precision. The scales should be reliable, i.e. with little variation between observers and in test‐retest by one observer, since this promotes confidence in the assessments at different time points and by different examiners. This is particularly important when the patient is being assessed by personnel dealing with adults as well as children, discussed on the telephone, handed over at shift change, or transferred between units or hospitals. The British Paediatric Neurology Association has recommended one of the modified child's Glasgow coma scales (CGCS) for use in the UK. This review looks at the recent history of the development of coma scales and the rationale for recommending the CGCS.
Psychogenic and organic movement disorders in children
Authors: Ahmed M A S , Martinez Adelaida , Yee Ayeaye , Cahill Denise , Besag Frank M C
Published: April 2009

We report on 34 patients with abnormal body movements (AMs; 11 females, 23 males; mean age 10y 1mo, range 3y 6mo‐15y 11mo). Twenty‐three of the 34 patients had an organic movement disorder (OMD), five patients fulfilled the diagnostic criteria of documented psychogenic movement disorder (PMD), and six patients displayed probable or possible PMD. Diagnosis of children with OMD included essential tremor (n=7), Tourette syndrome (n=5), primary dystonia (n=2), chronic motor tics (n=2), viral cerebellar ataxia (n=2), drug‐induced ataxia (n=1), thyrotoxicosis related tremor (n=1), autosomal inherited dystonia (n=1), poststreptococcal chorea (n=1), and benign head tremor (n=1). Consistent findings among patients with PMD included disappearance of AMs when the patients thought they were not being observed and satisfactory recovery from the AMs after psychotherapy or suggestion. Reduction of the movements when the patient was distracted and variability of AMs during full relaxation, sleep, and stress were reported among patients with both PMD and OMD.
Development of the Gross Motor Function Classification System for cerebral palsy
Authors: Rosenbaum Peter L , Palisano Robert J , Bartlett Doreen J , Galuppi Barbara E , Russell Dianne J
Published: April 2009

The Gross Motor Function Classification System (GMFCS) for cerebral palsy has been widely used internationally for clinical, research, and administrative purposes. This paper recounts the ideas and work behind the creation of the GMFCS, reports on the lessons learned, and identifies some philosophical challenges inherent in trying to develop an ordered, valid, and consistent system to describe function in children and adolescents with developmental differences. It is hoped that these ideas will be useful to others who choose to expand the field with additional systems in other areas of childhood neurodisability.
Neuropeptide Y inhibits [Ca2+]i changes in rat retinal neurons through NPY Y1, Y4, and Y5 receptors
Authors: Álvaro Ana Rita , Rosmaninho‐Salgado Joana , Ambrósio António F. , Cavadas Cláudia
Published: April 2009

Neuropeptide Y (NPY) and NPY receptors are widely distributed in the CNS, including the retina, but the role of NPY in the retina is largely unknown. The aim of this study was to investigate whether NPY modulates intracellular calcium concentration ([Ca2+]i) changes in retinal neurons and identify the NPY receptors involved. As NPY decreased the [Ca2+]i amplitudes evoked by 30 mM KCl in only 50% of neurons analyzed, we divided them in two populations: NPY‐non‐responsive neurons (Δ2/Δ1 ≥ 0.80) and NPY‐responsive neurons (Δ2/Δ1 < 0.80), being the Δ2/Δ1 the ratio between the amplitude of [Ca2+]i increase evoked by the second (Δ2) and the first (Δ1) stimuli of KCl. The NPY Y1/Y5, Y4, and Y5 receptor agonists (100 nM), but not the Y2 receptor agonist (300 nM), inhibited the [Ca2+]i increase induced by KCl. In addition, the inhibitory effect of NPY on evoked‐[Ca2+]i changes was reduced in the presence of the Y1 or the Y5 receptor antagonists. In conclusion, NPY inhibits KCl‐evoked [Ca2+]i increase in retinal neurons through the activation of NPY Y1, Y4, and Y5 receptors. This effect may be viewed as a potential neuroprotective mechanism of NPY against retinal neurodegeneration.
Transcriptional response of the neuromuscular system to exercise training and potential implications for ALS
Authors: Ferraiuolo Laura , De Bono Joseph P. , Heath Paul R. , Holden Hazel , Kasher Paul , Channon Keith M. , Kirby Janine , Shaw Pamela J.
Published: April 2009

The transcriptional adaptive response of motoneurons and muscles to voluntary exercise has been investigated by using laser capture microdissection and microarray analysis. Our results show that motoneurons respond to physical activity by activating a complex transcriptional plan, with changes involved in neurotrophic factor signalling, electrophysiological changes and synaptic reorganization. Gastrocnemius muscle shows increases in transcripts responsible for neovascularization and new myogenesis. Both tissues show transcriptional changes involved in the growth and reinforcement of the neuromuscular junction. This study indicates that the neuromuscular system undergoes significant structural and functional alterations, aiming to optimize the transmission of both chemical and electrical stimuli, thus prompting axonal outgrowth and mechanisms similar to long‐term potentiation in hippocampal neurons. Understanding the response of these cells during exercise has potentially important implications for human neuromuscular disease, including amyotrophic lateral sclerosis, by highlighting candidate genes pivotal for the balance between the physiology and the pathology of the neuromuscular system in terms of the stress response to physical exercise.
How (not) to operationalise subnational political opportunity structures: A critique of Kestilä and Söderlund's study of regional elections
Authors: ARZHEIMER KAI , CARTER ELISABETH
Published: April 2009

Based on an aggregate analysis of the French regional elections of 2004, Kestilä and Söderlund, in their 2007 article, ‘Subnational Political Opportunity Structures and the Success of the Radical Right: Evidence from the March 2004 Regional Elections in France’, examine the impact of subnational political opportunity structures on the success of the radical right and argue that such an approach can control for a wider range of factors and provide more reliable results than cross‐national analyses. The present article disputes this claim on theoretical, conceptual and methodological grounds and demonstrates that their empirical findings are spurious.
An evaluation of the impact of a tracheostomy weaning protocol on extubation time
Authors: Clifford Collette , Spencer Alison
Published: April 2009

Background:  To avoid the possible complications of prolonged intubation, it is necessary and advisable to attempt weaning from the tracheostomy tube at the earliest opportunity. However, while weaning protocols have proven successful in reducing ventilation time of critical care patients, there is little evidence of their use and impact on tracheostomy tube weaning time.

Aims:  This pilot study sought to determine if the introduction of a new tracheostomy weaning protocol would reduce the time to extubation of the tracheostomy.

Method:  A quasi‐experimental design used two groups of patients. A retrospective control group of patients (n = 20) who had been weaned using standard practice were identified by a search of medical records. A prospective experimental group (n = 20) had care planned using a new tracheostomy weaning protocol. Data relating to time to extubation were collected on both groups who were all patients in an eight‐bedded Critical Care Unit of a District General Hospital. The same inclusion and exclusion criteria were applied to both groups.

Results:  The results revealed a reduction of 1·35 days from commencement of weaning to extubation in the prospective (experimental) group. This was not statistically significant (P = 0·181)

Conclusion:  Although the findings from the study were not statistically significant, they can be seen as clinically significant in terms of patient comfort and reduced dependency in care by a reduction of time with a tracheostomy. It is recommended that a larger scale study be carried out to determine if a tracheostomy weaning protocol does make an impact on length of time to extubation in wider care settings.
Feline Ilial Fractures: A Prospective Study of Dorsal Plating and Comparison with Lateral Plating
Authors: LANGLEY‐HOBBS SORREL J. , MEESON RICHARD L. , HAMILTON MICHAEL H. , RADKE HEIDI , LEE KARLA
Published: April 2009

Objective— To (1) report a technique for repair of feline ilial fractures using a dorsally applied bone plate and (2) compare outcome with cats treated by a lateral plate.

Study Design— Prospective study.

Animals— Cats (n=10) with iliac fractures.

Methods— Cats with ilial fractures (January 2005–December 2006) were treated by application of a dorsally applied bone plate. Immediate postoperative radiographs were compared with those taken 4–6 weeks later to assess screw loosening, screw purchase, and pelvic canal narrowing. Owners were contacted for medium‐term (>3 month) follow‐up. Data were compared with a report of outcome after lateral plating (LP) in 21 cats.

Results— Mean (± SD) screw purchase (89 ± 11 mm) was significantly greater (P<.01) with a dorsal plate compared with a lateral plate (33 ± 8 mm). Significantly more screws (P<.01) were used with a dorsal plate (median, 7) compared with a lateral plate (median, 6). Significantly less postoperative pelvic canal narrowing developed in the dorsal plating group between postoperative and 4–6‐week follow‐up radiography compared with the LP group (2% versus 15%, P<.01).

Conclusion— Dorsal plating of feline ilial fractures results in significantly less screw loosening and pelvic canal narrowing at 4–6 weeks after surgery compared with LP.

Clinical Relevance— Dorsal plating of feline iliac fractures may reduce complications associated with pelvic canal narrowing such as constipation and megacolon.
Sacroiliac Luxation in the Cat: Defining a Safe Corridor in the Dorsoventral Plane for Screw Insertion in Lag Fashion
Authors: SHALES CHRIS J. , WHITE LINDSAY , LANGLEY‐HOBBS SORREL J.
Published: April 2009

Objective—To define a safe corridor in the dorsoventral plane within the feline sacral body for placement of screws inserted in lag fashion for repair of sacroiliac luxation.

Study Design—Anatomic study.

Sample Population—Frozen cadaveric feline sacra.

Methods—Feline sacra (n=20) were used to perform a radiographic study to define a safe corridor to a depth of 66% of the sacral body width. Two drill start points (A and B) were evaluated. Dorsal exit from the safe corridor was considered unacceptable.

Results—Forty safe corridors were measured. The mean articular surface was 100±6.4° from horizontal. Mean maximum, optimum, and minimum safe corridor drill angles from drill point A were 107±6.8°, 97±6.9°, and 87±7.2°, respectively, from the articular surface. Mean maximum, optimum, and minimum angles from drill point B were 109±7.2°, 99±7.1°, and 89.5±7.2°, respectively. Point B increased the risk of ventral exit from the sacral body.

Conclusions—Point A and a drill angle of 90±4° for drilling of the feline sacral body is recommended. This margin for error risks ventral exit from the body in 23/40 (58%) of the sacra in this study. Reduction of the margin for error to ±2° would reduce the risk of ventral exit to 14/40 (35%) of the sacra in this study.

Clinical Relevance—Drilling at 90° to the feline sacral articular surface is recommended. Findings from this study present a strong case for use of angled drill guides.
Mexiletine in the Prevention of Sudden Cardiac Death: Experimental Evaluation and Clinical Implications
Authors: ZUANETTI GUILIO , VANOLI EMILIO , SCHWARTZ PETER J.
Published: April 2009

To investigate the anti arrhythmic efficacy of various agents in preventing sudden cardiac death triggered by transient acute myocardial ischemia, we designed two protocols, using adult cats, to induce coronary artery occlusion followed by sympathetic stimulation or reperfusion to produce arrhythmias. Mexiletine, reported in detail here, and other agents were then administered and their effectiveness measured. The experimental findings showed mexiletine to be ineffective; lidocaine and propafenone to be similarly ineffective; amiodarone and calcium channel blockers to be highly effective; and propranoiol and prazosin to be relatively effective. Extrapolating clinical implications from these experimental data may be limited by the facts that anesthesia was used during the surgical procedure, which can modify the cardiovascular responses to ischemia, and that we used animals with normal coronary arteries.
Telemetry of Programmed and Measured Data in Pacing System Evaluation and Follow‐up
Authors: CASTELLANET MARK J. , GARZA JUAN , SHANER STANLEY P. , MESSENGER JOHN C.
Published: April 2009

Telemetry of programmed and measured data is an important feature of many pacemakers currently used in clinical practice. The ability to receive non‐invasive data from the implanted device constitutes a major advantage for the long‐term follow‐up of the patients and of device performance. There are numerous types of data retrievable via telemetry: parameters of device characteristics (output, battery longevity, impedance, etc), event recorders or counters, event markers, and endocardial electrograms. Ideally, this information should be beneficial in the longitudinal surveilance of modern pacemakers.
Interest and Limitations of Phenotype Determination of Hydroxylation Ability in Patients Treated with Propafenone
Authors: LIBERSA C. , CARON J. , Bechtel P. , KACET S. , DAGANO J. , ROUEX R. , MARCHAND X. , DUPUIS B. , LEKIEFFRE J.
Published: April 2009

In order to confirm that variations in the plasma levels of propafenone in patients receiving the same daily dose are polyrnorphically distributed in relation to oxydative metabolism, the relationship between propafenone administration and debrisoquine metabolic phenotype was studied in two series of Caucasian patients with chronic supraventricular or ventricular arrhifthmias. In a first series of 16 Caucasian patients treated with propafenone, the poor metabolizer phenotype appeared to be more than 90%. In a second series of 13 Caucasian patients, two debrisoquine tests were performed: the first phenotype determination of debrisoquine hydroxylation ability was done without propafenone administration and the second determination when a steady state concentration of propafenone was reached. Of the 10 extensive metabolizers (determined without propafenone treatment), 7 patients became apparent poor metabolizers while considering the debrisoquine test during propafenone treatment with a general shift of the 13 studied patients to the upper values of log of the metabolic ratiodebrisoquine/4‐OH debrisoquine———‐suggesting deficiency in metabolizing debrisoquine. This study seems to indicate the presence of a common hydroxylation for propafenone and debrisoquine, which probably compete in the pathway. This metabolic competition should therefore be taken into consideration during phenotypic determination of hydroxylation ability.
Hemodynamic Effect of Propafenone and the Experience in Patients with Congestive Heart Failure
Authors: BAKER BONNIE J. , BRODSKY MICHAEL A. , DINH HA , ALLEN BYRON J. , COTTER BARBARA , LUCKETT CATHY , MURPHY MARVIN L.
Published: April 2009

The effects of propafenone on left ventricular function and hemodynamics are presented in this study. In one group of 13 patients who underwent electrophysiological testing and subsequent chronic oral therapy with propafenone, eight had left ventricular ejection fractions determined by nuclear study before and during therapy with the drug. Initial measurements ranged from 22% to 39% (mean 30%), while those on chronic therapy showed no statistical difference and ranged from 22% to 48% (mean 30%). In a separate dose titration study of 14 patients, left ventricular ejection fraction showed a modest but significant decrease (52%± 9% to 48%± 11%; p < 0.05). This change was more marked in patients with an initial low ejection fraction. Propafenone appears to be safe in these patients but should be administered with caution in patients with particularly low ejection fractions.
Decision Analysis for Choosing the Hemodynamically Optimum Pacemaker
Authors: GARBER GARY R. , POPP HANS , LEVINE PAUL A.
Published: April 2009

The current and future generation of pacemakers present a bewildering array of options for the implanting physician. The current economical and legal climate makes it imperative that the appropriate pacemaker is chosen. We developed an algorithm based on our experiences and published data for choosing the optimum pacing mode. This algorithm was programmed into a commercially available expert system shell on a PC platform. Determination was made through a question‐and‐answer session, with the system prompting the physician with questions and appropriate answer choices. Program output included “Recommended”, “Possible But Not Optimal”, and “Not Recommended” pacemakers. Only the general category of pacer type was suggested, not any particular manufacturer. Explanations and reasonings are also displayed during the consultation for educational purposes.

The system was then tested retrospectively on 30 consecutive pacemaker implantations. The number of times that the computer recommendation and pacer received agreed was 27. The number of times that the computer recommended a pacer type, but the patient received a different one was 3. The computer did not recommend incorrectly in any instance. There were three different implants: 1 patient was unable to receive suggested pacer for technical reasons; 2 patients had physicians that did not have programmers for the appropriate pacemaker. Based upon this retrospective analysis we conclude that a decision algorithm can be accurately applied to choose the appropriate pacemaker for implantations.
Late Potential Parameter and Noise Level Variability Caused by Bandpass Versus High‐Pass Filtering and Type of Signal Averaging Equipment Used
Authors: VACEK JAMES L. , SMITH SCOTT , DUNN MARVIN I.
Published: April 2009

Late potentials detected by signal averaged electrocardiography are predictive of ventricular arrhythmia induction and sudden cardiac death. Prior studies have used a variety of equipment and filtering parameters. The correlation between data from two commercially available signal averaging units and the effects of bandpass as opposed to high‐pass filtering were studied in 18 hospitalized patients. The addition of a low‐pass filter at 250 Hz to high‐pass filtering at 40 Hz caused no significant change in any time domain variable (total duration of the filtered QRS, root mean square voltage of the last 40 msec of the filtered QRS, and duration of low‐amplitude potentials < 40 μV). However, the data was significantly different (P < 0.01) when studies from the two machines were compared. We conclude that bandpass filtering does not affect time domain late potential variables in a clinically relevant fashion compared to high‐pass filtering alone. Significant data differences exist between the two different pieces of equipment. Therefore, caution should be exercised in extrapolating data obtained from each of the different machines.
Clinical Experience with Orthocor II Antitachycardia Pacing System for Recurrent Tachyarrhythmia Termination
Authors: OCCHETTA ERALDO , BOLOGNESE LEONARDO , MAGNANI ANDREA , FRANCALACCI GABRIELLA , ROGNONI GIORGIO , ROSSI PAOLO
Published: April 2009

Between June 1986 and December 1988, eight patients were treated with an Orthocor II 284 A antitachycardia pacemaker (Cordis Corp., Miami, FL, USA) forsupraventricular tachycardia (SVT) and ventricular tachycardia (VT) termination. Four patients had intra‐AV nodal reentrant tachycardias; 1 patient had AV reentrant tachycardia with an atrio‐nodal accessory bypass tract; 2 patients had AV reentrant tachycardias with concealed Kent bundle, and 1 patient had ventricular tachycardia. All patients had been treated with three or more drugs and were considered to be drug refractory. The programmed antitachycardia mechanism used for patients with SVT were: automatic overdrive in five patients and burst scanning in two patients. In the patient with VT, a critically timed double extrastimulus with fixed coupling interval was programmed. Follow‐up ranged from 2 to 30 months. The pacemaker proved to be effective in terminating tachycardias in all cases with SVT; in the patient with VT, the programmed antitachycardia mechanism was effective for a long time, but after an episode of sustained VT not interrupted by the pacemaker, the patient underwent automatic cardioverter/defibrillator (AICD) implantation. Additional antiarrhythmic therapy was required in 3 patients to control their maximum sinus rate, in 1 patient to reduce tachycardia episodes and to enable termination, and in 2 patients to prevent spontaneous atrial fibrillation. It is concluded that Orthocor II is a flexible and versatile antitachycardia pacemaker providing a safe and effective control of recurrent tachycardia in selected patients.
The ED of the Future: an Interdisciplinary Graduate Course in Healthcare Design
Authors: Cowan David , Yi‐Luen Do Ellen , Margolis Marilyn , Zimring Craig , Ackerman Jeremy
Published: April 2009

Six faculty members from Georgia Institute of Technology, Emory University School of Medicine, Emory Healthcare, and Perkins + Will created and taught a one‐semester course titled “The Emergency Department of the Future”. The goals of the course were to provide an environment for students to be exposed to the unique challenges of healthcare design, to experience and learn techniques for successful interdisciplinary design, and to create innovations with impact. Twenty graduate students representing five disciplines (architecture, health systems, human‐computer interaction, computer science, and systems engineering) participated in this class. The course included a series of didactic lectures covering a wide range of issues including architectural design of hospitals and emergency departments, observation techniques for working environments, electronic medical records, and patient‐centered care. Lecturers included emergency physicians, nurses, architects, human‐computer interaction researchers, and design specialists. Students developed problem statements along with prototype design solutions through these lectures, direct observation, and interaction with course faculty. The resulting projects include a mobile triage chair that takes vital signs, equipment sliders for easy functional transformation, an integrated lighting design, as well as patient assistants for self registration, communication, environmental control, and discharge support. The developed projects have generated ideas to improve emergency care that may be implementable commercial products as well as fundable projects for future research. The final presentation open house attracted over a hundred visitors from local and national healthcare facilities and industry. This presentation will highlight the structure and organization of the course as well as the resulting projects.
Beetle diversity in a matrix of old‐growth boreal forest: influence of habitat heterogeneity at multiple scales
Authors: Janssen Philippe , Fortin Daniel , Hébert Christian
Published: April 2009

The relative contribution of compositional and structural heterogeneity on biodiversity is currently ambiguous because field studies generally integrate these two sources of habitat heterogeneity into a single index. We established the relationship between species richness of ground‐dwelling and flying beetles and compositional and structural attributes of forest heterogeneity. The relationship was evaluated at two spatial scales: the scale of forest stand, corresponding to an 11.3 m radius, and the scale of landscape, corresponding to either a 400 or 800 m radius. Seventy stands were sampled in the matrix of old‐growth boreal forest of the North Shore region of Québec, Canada, during the summers of 2004 and 2005. A total of 133 ground‐dwelling beetle species (range: 4–42 species per site) were captured in the pitfall traps and 251 flying species (range 16–58 species per site) in flight‐interception traps. We found that the most relevant type of heterogeneity to explain variations in species richness and the significance of landscape scale information varied between groups of beetles. Compositional heterogeneity (i.e. the number of species of forest trees and shrubs) at the stand scale best predicted species richness in ground‐dwelling beetles. On the other hand, it was the combined influence of structural and compositional habitat heterogeneity at stand and landscape scales that best explained richness patterns in flying beetles. Our study outlines the significance of considering multiple types and spatial scales of habitat heterogeneity when describing patterns of species richness.
ORIGINAL ARTICLE: Modulation of Expression of Toll‐like receptors in the Human Endometrium
Authors: Lin Zhenyun , Xu Jian , Jin Xiuming , Zhang Xudong , Ge Fenfen
Published: April 2009

Problem  The purpose of the study was to investigate the different expressions of toll‐like receptors (TLRs) in the proliferative and the secretory phase of endometrial tissue.

Method of study  Eight infertile women were included in this study. The endometrial tissues of proliferative and secretory phase were obtained from each woman. The tissues were evaluated for the expression of mRNA for TLR1–10 by reverse transcribed polymerase chain reaction (RT‐PCR). The proteins of TLR2, 3, 4, and 9 were evaluated by Western blot. The mRNA and protein level of proliferative and secretory endometrial tissue from the same woman was compared. The data were analysed with SPSS15.0.

Results  TLR1–7, 9, and 10 mRNA were expressed throughout the menstrual cycle, but in the same woman, the expression of TLR2–6, 9, and 10 mRNA was higher during the secretory phase than that in the proliferative phase. The Western blot also showed that the protein expression of TLR2, 3, 4, and 9 was stronger in the secretory phase than that in the proliferative phase in the same woman.

Conclusion  The expression of TLRs is cycle dependent in human endometrial tissue. The expressions of TLRs were higher in the secretory phase than that in the proliferative phase: this indicated that TLRs may be regulated by sex hormones throughout the menstrual cycle.
The Role of Ground Water in Sub‐Saharan Africa
Authors: Braune Eberhard , Xu Yongxin
Published: April 2009

Although water resources managers speak of a water crisis in Africa, the management of ground water has to date not featured strongly in national and regional African water agendas. Examination of the physical environment of the continent and, in particular, the water resources in relation to the socioeconomic landscape and regional development challenges makes it clear that widely occurring, albeit largely low‐yielding, ground water resources will be crucial in the achievement of water security and development. Ground water is important primarily in domestic water and sanitation services, but also for other local productive needs like community gardens, stock watering, and brick‐making, all essential to secure a basic livelihood and thus to alleviate poverty. Despite the importance of small‐scale farming in Africa, there is little information on the present and potential role of ground water in agriculture. In contrast to its socioeconomic and ecological importance, ground water has remained a poorly understood and managed resource. Widespread contamination of ground water resources is occurring, and the important environmental services of ground water are neglected. There appear to be critical shortcomings in the organizational framework and the building of institutional capacity for ground water. Addressing this challenge will require a much clearer understanding and articulation of ground water's role and contribution to national and regional development objectives and an integrated management framework, with top‐down facilitation of local actions.
Ground Water Security and Drought in Africa: Linking Availability, Access, and Demand
Authors: Calow Roger C. , MacDonald Alan M. , Nicol Alan L. , Robins Nick S.
Published: April 2009

Drought in Africa has been extensively researched, particularly from meteorological, agricultural, and food security perspectives. However, the impact of drought on water security, particularly ground water dependent rural water supplies, has received much less attention. Policy responses have concentrated on food needs, and it has often been difficult to mobilize resources for water interventions, despite evidence that access to safe water is a serious and interrelated concern. Studies carried out in Ghana, Malawi, South Africa, and Ethiopia highlight how rural livelihoods are affected by seasonal stress and longer‐term drought. Declining access to food and water is a common and interrelated problem. Although ground water plays a vital role in buffering the effects of rainfall variability, water shortages and difficulties in accessing water that is available can affect domestic and productive water uses, with knock‐on effects on food consumption and production. Total depletion of available ground water resources is rarely the main concern. A more common scenario is a spiral of water insecurity as shallow water sources fail, additional demands are put on remaining sources, and mechanical failures increase. These problems can be planned for within normal development programs. Water security mapping can help identify vulnerable areas, and changes to monitoring systems can ensure early detection of problems. Above all, increasing the coverage of ground water–based rural water supplies, and ensuring that the design and siting of water points is informed by an understanding of hydrogeological conditions and user demand, can significantly increase the resilience of rural communities to climate variability.
A New Look at Husbands' and Wives' Time Allocation
Authors: ALENEZI MOHAMMAD , WALDEN MICHAEL L.
Published: April 2009

The impacts of economic and non‐economic factors on husbands’ and wives’ market work time and housework time are estimated using 13 years of data from the Panel Survey of Income Dynamics. Several limitations in earlier studies are addressed, and a unique feature of the study is the direct estimation of effects on time allocation from changes in the prices of market‐produced goods and input goods in household production. Many of the findings of earlier studies are reconfirmed, but new insights are also explored. Husbands and wives respond similarly in their time allocations to changes in input goods prices, but their responses are different to changes in market goods prices.