bluuebunny/crossref_metadata_2025 huggingface dataset:
Presence of Aggregatibacter actinomycetemcomitans in young individuals: a 16‐year clinical and microbiological follow‐up study
Authors: Höglund Åberg Carola , Sjödin Bengt , Lakio Laura , Pussinen Pirkko J. , Johansson Anders , Claesson Rolf
Published: August 2009

Aim: To look for clinical signs of periodontal disease in young adults who exhibited radiographic bone loss and detectable numbers of Aggregatibacter actinomycetemcomitans in their primary dentition.

Material and methods: Periodontal status and radiographic bone loss were examined in each of the subjects 16 years after the baseline observations. Techniques for anaerobic and selective culture, and checkerboard, were used to detect periodontitis‐associated bacterial species. The isolated A. actinomycetemcomitans strains were characterized by polymerase chain reaction.

Results: Signs of localized attachment loss were found in three out of the 13 examined subjects. A. actinomycetemcomitans was recovered from six of these subjects and two of these samples were from sites with deepened probing depths and attachment loss. Among the isolated A. actinomycetemcomitans strains, serotypes a–c and e, but not d or f, were found. None of the isolated strains belonged to the highly leucotoxic JP2 clone, and one strain lacked genes for the cytolethal distending toxin.

Conclusions: This study indicates that the presence of A. actinomycetemcomitans and early bone loss in the primary dentition does not necessarily predispose the individual to periodontal attachment loss in the permanent dentition.
The temporal course of mucoperiosteal flap revascularization at guided bone regeneration‐treated implant sites: a pilot study
Authors: Milstein Dan M. J. , Mathura Keshen R. , Lindeboom Jérôme A. H. , Ramsoekh Dewkoemar , Lindeboom Robert , Ince Can
Published: August 2009

Aims: To investigate post‐operative capillary density regeneration in healing mucoperiosteal flaps at guided bone regeneration‐treated implant sites.

Material and Methods: A non‐invasive post‐operative investigation was performed in 10 patients using orthogonal polarization spectral (OPS) imaging for assessment of capillary density during the course of mucoperiosteal flap wound healing for 6 weeks in patients receiving dental implants.

Results: The greatest increase in capillary regeneration occurred in the early wound‐healing phase, during weeks 1 and 2, and recovery to baseline was achieved between weeks 4 and 5. A comparison of adjacent OPS measurements indicated that differences between the time point immediately following administration of local anaesthesia and directly post‐operatively ( p=0.002), between a directly post‐operative time point and after 1 week (p=0.009), and between post‐operative weeks 1 and 2 (p=0.036) were statistically significant.

Conclusions: The early healing phase of mucoperiosteal flaps is characterized by rapid capillary regeneration. OPS imaging enabled the possibility to monitor and quantify the temporal development of mucoperiosteal flap revascularization following periodontal surgery.
Contribution of skin biometrology to the diagnosis of the Ehlers–Danlos syndrome in a prospective series of 41 patients
Authors: Catala‐Pétavy C. , Machet L. , Georgesco G. , Pétavy F. , Maruani A. , Vaillant L.
Published: August 2009

Background/purpose: The diagnosis of the Ehlers–Danlos syndrome (EDS) is primarily clinical. Clinical signs result from modifications of the rheological properties of the skin: thickness, extensibility and hydration. Our main objective was to demonstrate what skin biometry can contribute to the diagnosis and evaluation of the different types of EDS.

Methods: Forty‐one patients clinically diagnosed with EDS were paired by age and sex to 41 healthy subjects with no known dermatologic disease, in particular connective tissue diseases. We measured skin thickness, extensibility, hydration and sebum secretion by skin ultrasonography, use of a Cutometer®, a Corneometer® and a Sebumeter®.

Results: The skin is thinner in all three disease types (classical, hypermobility and vascular). It is more extensible only in the classical type, and more hydrated and fatty in the hypermobility type.

Conclusion: Non‐invasive measurement of skin thickness and elasticity are quantitative parameters that can be used to better diagnose EDS. Moreover, the sebaceous rate can help to diagnose the hypermobility type whereas the immediate retraction distinguishes the classical form from vascular and hypermobile types.
Measuring human skin buffering capacity: an in vitro model
Authors: Zhai Hongbo , Chan Heidi P. , Farahmand Sara , Maibach Howard I.
Published: August 2009

Background/purpose: It has been thought that skin possesses buffering capacity. This study measured the skin buffering capacity against two model solutions of acid and base at three concentrations with an in vitro system.

Methods: Ten microliters of model base (sodium hydroxide – NaOH) and acid (hydrochloric acid – HCl) solutions at concentrations of 0.025, 0.05, and 0.1 N was applied to human cadaver skin (3.18 μL/cm2) placed onto glass diffusion cells. Phosphate‐buffered saline (PBS) was used as a standard buffer solution. Deionized water served as the negative control, whereas untreated skin served as the blank control. Skin pH was read and recorded immediately following dosing (0 time), and at 10 and 30 min of post‐dosing. After the 30 min of dosing, each skin, except untreated skin (blank control), was then washed by applying 1 cm3 of deionized water. The pH on each washed skin was measured immediately following washing, and the pH measurement was repeated at 10 and 30 min of post‐washing. Six replicates were conducted.

Results: The pH values sharply significantly increased (P<0.05) immediately following dosing with NaOH at all concentrations (the highest concentration, caused the highest pH), and then decreased closely to baselines within 30 min post‐application but still remained at significantly (P<0.05) higher values when compared with the blank control (untreated skin). HCl (acid) significantly (P<0.05) decreased skin pH immediately following dosing with all concentrations (the highest concentration, caused the lowest pH) and then restored rapidly to baseline. There was no significant difference in post‐washing procedures on the skins that were pre‐treated with the acid (HCI) solutions. However, with all base solutions (NaOH) pre‐treated skin, pH values were significantly higher (P<0.05) at all time points post‐washing. Furthermore, both PBS and water controls significantly elevated (P<0.05) the pH values following washing.

Conclusion: Skin pH and its buffering capacity can be measured on human cadaver skin in vitro, which may partially replicate the response of in vivo skin. Dose–response was noted; i.e. the higher concentration caused larger changes in skin pH. In addition, the restoration of skin pH is relatively faster with acid when compared with base treatment. Clinical implications are offered.
Effects of 5′‐uridylic acid feeding on postprandial plasma concentrations of metabolites and metabolic hormones in pre‐weaning goats
Authors: OHTANI Yoshihisa , KOBAYASHI Yosuke , TAKAHASHI Tatsuyuki , HAGA Satoshi , TAKAGI Mutsuo , MASHIKO Takanori , KATOH Kazuo , OBARA Yoshiaki
Published: August 2009

5′‐Uridylic acid (UMP), which is present at high concentrations in cow's colostrum, has been shown to cause a reduction in increased plasma levels of insulin and glucose after ingestion of milk replacer in pre‐weaning calves. However, the precise mechanisms of UMP action have not been investigated, and its action has not been investigated in other pre‐weaning ruminants. In order to demonstrate whether UMP causes changes in postprandial metabolic and hormonal parameters in pre‐weaning goats, 11 Saanen kids were given milk replacer (twice a day) without (n = 5) or with (n = 6) UMP (1 g for each meal, 2 g/day for each head) for 14 days. Analysis of blood samples taken in the morning of day 14 demonstrated that the feeding of milk replacer with UMP abolished the significant changes in postprandial plasma glucose, NEFA, GH and insulin concentrations induced by feeding of milk replacer alone, and demonstrated a tendency to increase IGF‐I levels. However, there was no significant difference between the two groups at any sampling time. We conclude that UMP feeding with milk replacer showed a tendency to blunt the postprandial changes in levels of some plasma metabolites and hormones that are induced by replacer alone in pre‐weaning goats.
Extracellular signal‐regulated kinase (ERK) activation in chicken heterophils stimulated with phorbol 12‐myristate 13‐acetate (PMA), Formyl‐methionylleucyl‐phenylalanine (fMLP) and lipopolysaccharide (LPS)
Authors: GERILECHAOGETU  , HANIEH Hamza , ABE Asaki , KONDO Yasuhiro
Published: August 2009

The signaling pathways leading to the activation of extracellular signal‐regulated kinase (ERK) by phorbol 12‐myristate 13‐acetate (PMA), formyl‐methionylleucyl‐phenylalanine (fMLP) and lipopolysaccharide (LPS) in chicken heterophils were examined. To determine the mechanism of ERK's activation and its relation with the influx of calcium ions, heterophils were stimulated by PMA, fMLP and LPS. ERK was not activated by fMLP. LPS‐ and PMA‐stimulated activation of ERK, based on Western blotting with antibodies against the phosphorylated form of ERK, was attenuated by the pretreatment of cells with the intracellular calcium chelator BAPTA/AM (1,2‐bis (o‐aminophenoxy) ethane‐N,N,N′,N′‐tetraacetic acid) but not with the extracellular calcium chelator EGTA (glycol‐bis(2‐aminoethylether)‐N,N,N′,N′‐tetraacetic acid). Exposure of cells to the protein kinase C (PKC) inhibitor GF109203X inhibited the LPS‐ and PMA‐stimulated phosphorylation of ERK in a concentration‐dependent manner. The LPS‐stimulated phosphorylation was inhibited by pretreatment with the phospholipase C (PLC) inhibitor U73122 but not the phosphatidylinositol 3‐kinase (PI3K) inhibitor LY294002. These results indicate that the LPS‐induced phosphorylation of ERK in the chicken heterophils is mediated by PLC, PKC and intracellular calcium, and the PMA‐stimulated phosphorylation is dependent on intracellular calcium ion and PKC.
Phosphodiesterase Type 5 Inhibitors Facilitate Noncontact Erections in Male Rats: Site of Action in the Brain and Mechanism of Action
Authors: Sanna Fabrizio , Succu Salvatora , Boi Antonio , Melis Maria Rosaria , Argiolas Antonio
Published: August 2009

Introduction

Orally active phosphodiesterase type 5 inhibitors (PDE5i), used in the treatment of erectile dysfunction, facilitate the relaxation of cavernous smooth muscle tissues by reducing the degradation of cyclic guanosine monophosphate.

Aims

The aims of this article were to determine whether PDE5i facilitate penile erection and male sexual behavior by acting also on the central nervous system and to investigate their mechanism of action at central level.

Methods

PDE5i (sildenafil, vardenafil, and tadalafil) given intraperitoneally (i.p.) (5 mg/kg and 10 mg/kg), intracerebroventricularly (i.c.v.) (10 µg and 50 µg), or into the ventral tegmental area (VTA) (10 µg) were tested in the noncontact erection test in male Sprague-Dawley rats screened for their ability to display or not display this sexual response. Extracellular dopamine was measured in the dialysate obtained from the nucleus accumbens by intracerebral microdialysis on injection of PDE5i into the VTA.

Main Outcome Measures

Noncontact erections were counted after intraperitoneal, intracerebroventricular, or intra-VTA treatment with PDE5i. Extracellular dopamine was measured in the dialysate from the nucleus accumbens when sildenafil or vardenafil was given into the VTA.

Results

PDE5i induced a significant increase of noncontact erections in male rats displaying this sexual response following intraperitoneal or intracerebroventricular administration at the highest dose tested. However, both doses significantly increased noncontact erections in male rats not displaying this sexual response. Similar results were found when PDE5i were injected into the caudal VTA. Noncontact erections increased concomitantly to a rise in extracellular dopamine in the dialysate from the nucleus accumbens.

Conclusions

The results suggest that PDE5i may increase sexual arousal by acting in the central nervous system. This effect may be mediated (at least in part) by the activation of mesolimbic dopaminergic neurons.
Sexual Function in Male Patients Undergoing Treatment for Renal Failure: A Prospective View
Authors: Nassir Anmar
Published: August 2009

Introduction

Chronic renal failure in males causes wide-ranging disturbances including sexual dysfunction. The percentage and progression of sexual dysfunction in patients entering a dialysis program require further evaluation.

Aim

Our aim was to determine the ongoing effect of standard renal failure treatment on sexual function.

Methods

The sexual function was assessed prospectively, upon initiation of dialysis and every 10–12 months while on dialysis or after kidney transplantation. Participants were adult males with sexual partners.

Main Outcome Measure

The semiquantitative standard International Index of Erectile Function questionnaire was used initially as a baseline and compared with all subsequent follow-up measures.

Results

Fifty-two patients fulfilled the eligibility criteria and completed the questionnaire. Of the 52 subjects, 25 were on hemodialysis and 27 were on peritoneal dialysis. Only 17.3% of participants were potent upon entry into the study. Of the rest, 71% was classified as suffering from severe erectile dysfunction (ED). Sexual desire appeared less affected when compared with other domains. Of the study participants, 67% expressed an interest in treatment for ED, but only 12% had ever received any such therapy. Follow-up ranged from 10 months to 48 months. After excluding kidney-transplanted patients, ED scores on entry and at four subsequent reassessments were almost identical and showed no significant statistical differences. Patients showed significant improvement in ED score after kidney transplantation, with scores remaining high for 20–36 months of follow-up, compared with pre-transplantation.

Conclusions

This prospective study suggests that dialysis does not benefit sexual function, although a benefit was seen in a subset of men undergoing renal transplantation. We conclude that sexual function in men beginning dialysis should be assessed, and treatment for ED should be offered if appropriate.
ORIGINAL RESEARCH—PAIN: Sexual Functioning in Women with Chronic Pelvic Pain: The Role of Anxiety and Depression
Authors: ter Kuile Moniek M. , Weijenborg Philomeen T.M. , Spinhoven Philip
Published: August 2009

Introduction

Chronic pelvic pain (CPP) in women is a long lasting and often disabling condition. It seems reasonable to expect that as a result of the pain, extreme fatigue and/or emotional problems, women with CPP may report a variety of sexual problems.

Aim

The present study investigated differences in the report of sexual problems in women with CPP compared with healthy controls, and whether the association of CPP with sexual problems was moderated or mediated by somatic and psychological factors as manifested in women suffering from CPP.

Method

One hundred fifty-four women with CPP and 58 age-matched controls completed self-report measures for sexual functioning, pain, physical impairment, anxiety, depression, and sexual and physical abuse.

Main Outcome Measure

Golombok Rust Inventory of Sexual Satisfaction.

Results

Women with CPP reported higher levels of vaginistic complaints, sexual avoidance, nonsensuality and sexual dissatisfaction than healthy controls. Sexual problems were associated with anxiety, depression, and sexual abuse history but not with somatic factors as pain and physical impairment. Anxiety as well as depression, irrespective of the report of sexual abuse experiences, mediated the effect of CPP on sexual problems. Sexual abuse was a general predictor of sexual problems in both women with CPP and controls.

Conclusions

Anxiety and depression constitute important factors in the evaluation of sexual problems in women with CPP.
The Relevance of Sexual Responsiveness to Sexual Function in Male Stroke Patients
Authors: Duits Annelien , Van Oirschot Nicole , Van Oostenbrugge Robert Jan , Van Lankveld Jacques
Published: August 2009

Introduction

Stroke may have negative consequences for the patients’ quality of life, including sexual function. Whereas physical impairment will influence sexual positions and movement during sex, depression and medication may reduce sexual desire. So far, data on sexual dysfunction after stroke are scant. Although some support for physical as well as psychological explanations has been shown, further research to find the remedies for those patients with sexual problems after stroke is needed. The focus of the present study is on the identification of relevant psychological factors.

Aim

The aim of this study was to study the impact of anxiety, depression, and sexual responsiveness on sexual function in male stroke patients.

Methods

Nineteen male stroke patients completed a number of self-report measures to assess psychological and sexual factors.

Main Outcome Measures

Sexual function based on the International Index of Erectile Function, anxiety and depression based on the Symptom Checklist-90, and sexual responsiveness based on the Sexual Inhibition/Sexual Excitation Scale, including propensities for sexual excitation and sexual inhibition as a result of both performance failure and performance consequences, were assessed.

Results

Sexual excitation was positively related to sexual desire, whereas inhibition because of the threat of performance failure was negatively related to orgasmic function and sexual desire (P < 0.01). Patients with high levels of inhibition because of threat of performance failure were more likely to report low scores on overall sexual function than those with low levels.

Conclusions

Although the statistical power is rather low, the results show the relevance of sexual responsiveness to sexual function in male stroke patients. The present study can be considered as a first step toward building a theoretical framework of relevant psychological and physical factors, which is needed to develop adequate interventions for those patients with sexual problems after stroke.
Effects of Dialysis Purity on Uremic Dyslipidemia
Authors: Schiffl Helmut , Lang Susanne M
Published: August 2009

Dyslipidemia, a prominent feature of end‐stage renal disease, is considered a risk factor for premature atherosclerosis in hemodialysis (HD) patients. Dyslipidemia is related to loss of kidney function as well as use of low‐flux cellulosic dialyzer membranes, but the effects of dialysate purity are unknown. Forty‐eight incident HD patients started high‐flux polysulfone maintenance HD, either with conventional (potentially contaminated) or with on‐line produced ultrapure dialysate. The quality of the dialysis fluid (CFU/mL, endotoxin concentration), markers of inflammation (C‐reactive protein, Il‐6), and parameters of the lipid profile and oxidative stress (oxidized low‐density lipoprotein) were measured before initiation of HD, and after 6, 12 and 24 months on HD. Compared to baseline, treatment with conventional (mildly contaminated) dialysate significantly increased the uremic low‐grade systemic inflammatory response syndrome (SIRS), augmented uremic dyslipidemia (triglycerides by +21%, and high‐density lipoprotein (HDL) cholesterol by −10%) and enhanced oxidative stress. In contrast, the use of ultrapure dialysate significantly decreased uremia‐associated SIRS, dyslipidemia (triglycerides −7% and HDL cholesterol +11%) and oxidative stress. Ultrapure dialysis fluid improves potential parameters of cardiovascular risk by decreasing inflammatory reactions, improving uremic dyslipidemia and lowering oxidative stress.
Low‐Density Lipoprotein Apheresis Decreases Ferritin, Transferrin and Vitamin B12, Which May Cause Anemia in Serially Treated Patients
Authors: Bramlage Carsten P , Armstrong Victor W , Zapf Antonia , Bramlage Peter , Mueller Gerhard A , Koziolek Michael J
Published: August 2009

Clinical observations revealed an increased prevalence of iron deficiency anemia without chronic bleeding in patients treated with serial low‐density lipoprotein (LDL) apheresis. Since several different proteins are adsorbed by LDL apheresis beside pro‐atherogenic lipoproteins, we examined the modification of the full blood count, plasma iron, vitamin B12, folic acid, and hemolysis by LDL apheresis. Nineteen patients (55 (50–59) years, 4 female, 15 male) undergoing chronic LDL apheresis due to mixed dyslipidemia (N = 17), homozygous familiar hypercholesterolemia (N = 1) or isolated elevated lipoprotein(a) (N = 1) were included in this study. They were treated with direct adsorption of lipoproteins (DALI; N = 6), heparin‐induced LDL‐precipitation (HELP; N = 7) or double filtration plasmapheresis (DFPP; N = 6). The patients' full blood count, iron metabolism (plasma iron, ferritin, transferrin, transferrin saturation), vitamins involved in erythropoiesis (vitamin B12 and folic acid), and markers of hemolysis (haptoglobin and free hemoglobin) were analyzed directly before and after LDL apheresis. A single LDL apheresis session significantly decreased the levels (reduction in the median [25th–75th percentiles] of: ferritin 9.8 [1.3–18] %; P = 0.004), transferrin (12.1 [10.0–15.96] %; P = 0.0005), and vitamin B12 (17.8 [16.2–20.8] %; P = 0.0005). Thereby, transferrin and vitamin B12 were decreased in all (N = 19) and ferritin in 74% (N = 14) of the patients. Twelve out of 19 patients (63.2%) had mild anemia despite iron administration in 14 out of 19 patients (73.7%). LDL apheresis had no significant influence on full blood count, plasma iron, transferrin saturation, folic acid, or hemolysis. Similar changes were observed in all LDL apheresis methods used. LDL apheresis significantly decreases ferritin, transferrin, and vitamin B12, suggesting an influence of serial LDL apheresis on erythropoiesis.
Apheresis Technologies and Clinical Applications: The 2007 International Apheresis Registry
Authors: Malchesky Paul S , Koo Anna P , Skibinski Christine I , Hadsell Angela T , Rybicki Lisa A
Published: August 2009

The developments in apheresis technologies and techniques and their clinical applications worldwide are technologically, sociologically, and economically motivated. As in the past apheresis surveys, the statistics have highlighted both the differences by geographic region in clinical practice and in the type of technologies utilized. While a national view of apheresis is very important, an international view may be more representative overall of this therapeutic modality than national results that are highly dependent on the local economics and the available technologies. These regional differences have provided a basis for scientific and clinical assessment of these apheresis technologies and their clinical outcomes, and have impacted the marketing and business developments of new technologies worldwide. The results of the International Apheresis Registry for 2007 report data from 20 centers on five continents. The survey collected data exclusively via a secure internet website on 1735 patients for a total of 6787 treatments. As with our prior registry for 2005, information on stem cell infusions was gathered. Information collected included patients demographics, medical history, treatment diagnoses, treatment specifics (type, methodology, access type, anticoagulants, drugs, and equipment usage), side effects, clinical response, and payment provider. As in prior International Apheresis Registries for 1983, 2000, 2002, and 2005, the survey results highlight the regional differences in apheresis usage and treatment methodologies indicating that an international overview of apheresis may be more representative of the impact of this therapeutic modality.
Fractal Bubble cosmology: a concordant cosmological model?
Authors: Kwan Juliana , Francis Matthew J. , Lewis Geraint F.
Published: August 2009

The Fractal Bubble model has been proposed as a viable cosmology that does not require dark energy to account for cosmic acceleration, but rather attributes its observational signature to the formation of structure. In this Letter, it is demonstrated that, in contrast to previous findings, this model is not a good fit to cosmological supernovae data; there is significant tension in the best-fitting parameters obtained from different samples, whereas Λcold dark matter (ΛCDM) is able to fit all data sets consistently. Furthermore, the concordance between galaxy-clustering scales and data from the cosmic microwave background is not achieved with the most recent supernova compilations. The validity of the Fractal Bubble formalism as a sound cosmological model is further challenged as it is shown that previous studies of this model achieve concordance by requiring a value for the present-day Hubble constant that is derived from supernovae data containing an arbitrary distance normalization.
Cosmological and astrophysical constraints from the Lyman α forest flux probability distribution function
Authors: Viel Matteo , Bolton James S. , Haehnelt Martin G.
Published: August 2009

We use the probability distribution function (PDF) of the Lyman α forest flux at z= 2–3, measured from high-resolution UVES/VLT data, and hydrodynamical simulations to obtain constraints on cosmological parameters and the thermal state of the intergalactic medium (IGM) at z∼ 2–3. The observed flux PDF at z= 3 alone results in constraints on cosmological parameters in good agreement with those obtained from the Wilkinson Microwave Anisotropy Probe (WMAP) data, albeit with about a factor of 2 larger errors. The observed flux PDF is best fit with simulations with a matter fluctuation amplitude of σ8= 0.8–0.85 ± 0.07 and an inverted IGM temperature–density relation (γ∼ 0.5–0.75), consistent with our previous results obtained using a simpler analysis. These results appear to be robust to uncertainties in the quasar (quasi-stellar object) continuum placement. We further discuss constraints obtained by a combined analysis of the high-resolution flux PDF and the power spectrum measured from the Sloan Digital Sky Survey (SDSS) Lyman α forest data. The joint analysis confirms the suggestion of an inverted temperature–density relation, but prefers somewhat higher values (σ8∼ 0.9) of the matter fluctuation amplitude than the WMAP data and the best fit to the flux PDF alone. The joint analysis of the flux PDF and power spectrum (as well as an analysis of the power spectrum data alone) prefers rather large values for the temperature of the IGM, perhaps suggesting that we have identified a not yet accounted for systematic error in the SDSS flux power spectrum data or that the standard model describing the thermal state of the IGM at z∼ 2–3 is incomplete.
The hard TeV spectrum of 1ES 0229+200: new clues from Swift
Authors: Tavecchio F. , Ghisellini G. , Ghirlanda G. , Costamante L. , Franceschini A.
Published: August 2009

The BL Lac object 1ES 0229+200 (z= 0.14) has been detected by the High Energy Stereoscopic System (HESS) during observations taking place in 2005–2006. The TeV spectrum, when corrected for the absorption of gamma-ray photons through the interaction with the extragalactic background light, is extremely hard, even if the most conservative level for the background is considered. The case of 1ES 0229+200 is very similar to that of 1ES 1101−232, for which a possible explanation, in the framework of the standard one-zone synchrotron-self Compton (SSC) model, is that the high-energy emission is SSC radiation of electrons distributed as a power law with a large value of the minimum energy. In this scenario, the hard TeV spectrum is accompanied by a very hard synchrotron continuum below the soft X-ray band. We will show that recent Swift observations of 1ES 0229+200 in the critical UV X-ray band support this model, showing the presence of the expected spectral break and hard continuum between the UV and the X-ray bands.
Abstain or Rebel: Corruption Perceptions and Voting in East European Elections
Authors: KOSTADINOVA TATIANA
Published: August 2009

This paper argues that corruption, threatening democratic governance in the new democracies of Eastern Europe, is another influential determinant of voter turnout. I hypothesize that its impact is complex in that it generates distinct incentives for participation. A recursive model of voting specifies a direct effect where voters get mobilized to bring to power politicians of greater integrity, and an indirect effect in which perceptions of corruption corrode faith in the democratic process and consequently, depress voting. The analysis uses CSES survey data from eight post‐communist countries and the results provide empirical support for the theoretical model. The results also suggest that at least in 2001‐05, the two opposing incentives for voting balanced each other out, with a slight gain for the mobilization effect.

Este artículo argumenta que la amenaza de la corrupción dentro de los gobiernos democráticos de Europa del Este es un factor influyente en la participación de votantes. Planteo que su impacto es complejo puesto que genera incentivos contrapuestos para la participación. Un modelo de voto recursivo especifica un efecto directo donde los votantes se movilizan para llevar al poder a los políticos de mayor integridad, y un efecto indirecto en el cual las percepciones de corrupción corroen la fe en el proceso democrático y en consecuencia, reduce el voto. El análisis utiliza la investigación de datos del Estudio Comparativo de los Sistemas Electorales (CSES, por sus siglas en inglés) de ocho países post‐comunistas y los resultados proveen el respaldo empírico para el modelo teórico. Los resultados sugieren también que por lo menos en 2001‐05, los dos incentivos opuestos para el voto se equilibran mutuamente, con un ligero triunfo del efecto de la movilización.
Post‐Communist Mandates
Authors: LIPSMEYER CHRISTINE S.
Published: August 2009

The fulfillment of electoral mandates is a fundamental link between voters and their representatives. The absence of this link in newly democratizing countries may be a sign of poorly functioning democracies. This paper investigates this relationship in ten new democracies in Eastern Europe. I argue that governments are fulfilling their campaign promises, but they are doing so in a manner different from what has been found in established democracies. When testing my theory across economic reform, I find that the policies governments implement correspond with the dominant division between political parties. Unlike some previous research that finds new democracies do not follow through on their campaign promises, I conclude that governments are fulfilling their mandates.

El cumplimiento de los mandatos electorales es un vínculo fundamental entre los votantes y sus representantes. La ausencia de dicho vínculo en los países con nuevas democracias podría ser una señal del pobre funcionamiento de la misma. Este artículo investiga dicha relación en diez nuevas democracias de Europa del Este. Sostengo que los gobiernos están cumpliendo sus promesas de campaña, pero lo están haciendo de diferente manera a lo que puede ser observado en democracias establecidas. Cuando confronto mi teoría ante el periodo de reforma económica, encuentro que las políticas que el gobierno implementa corresponden a las divisiones dominantes entre los partidos políticos. A diferencia de trabajos de investigación previos que encuentran que las nuevas democracias no llevan a cabo las promesas de campaña, concluyo que los gobiernos están concretándolas durante sus mandatos.
Toward a More Useful Conceptualization of Populism: Types and Degrees of Populist Appeals in the Case of Slovakia
Authors: DEEGAN‐KRAUSE KEVIN , HAUGHTON TIM
Published: August 2009

Shifting our understanding of populism from a question of core identity to a description of party appeals allows for a neutralization of the term's negative connotations by allowing that all parties may use populist appeals to some extent. It is then possible to address a party's use of populist appeals by measuring its distinctly nonpopulist appeals, which are usually less bound up with normative judgments. Although the preliminary analysis of Slovakia shows a relatively close empirical fit among the theoretical elements in the existing literature, two categories of populist appeals are identified: the outward‐looking appeals that vary strongly with a party's relationship to power, and inward‐looking appeals that remain more stable over time. Use of these by politicians may offer clues to the origination, attractiveness, and longevity of populist and nonpopulist appeals.

Cambiar nuestro entendimiento del populismo desde la cuestión de identidad a una que se enfoca en los llamados partidistas nos permite neutralizar la connotación negativa del término populismo puesto que nos lleva a reconocer que todos los partidos recurren a los llamados populistas en una medida u otra. Es entonces posible establecer el uso de los atractivos del populismo por parte del partido al medir sus atractivos no‐populistas, los cuales usualmente están menos vinculados con opiniones normativas. Aunque el análisis preliminar de Eslovaquia demuestra un ajuste empírico perfecto relativamente cerrado entre los elementos teóricos en la literatura existente, dos categorías de las características populistas son identificadas: los atractivos observados en el exterior que varían fuertemente con la relación del partido con el poder y los atractivos observados en el interior que permanecen mucho más estables a través del tiempo. El uso de éstos por los políticos puede ofrecer claves para el origen, atractivo, y longevidad de los atractivos populistas y no‐populistas.
Patent Law Reform in Uganda: Addressing Priorities and Strategies
Authors: Tabaro Edgar
Published: August 2009

The Republic of Uganda is presently engaged, as many other developing countries, in reform of its intellectual property laws. The process raises a number of questions as to whether it addresses priorities besides the legal framework. What has prompted the reforms and what systems of innovation does the country have so as to harness the power of patents in enhancing Uganda's technological capacity? The article also challenges the philosophy and orthodoxy that underpins the basis for patent protection in facilitating the transfer of technology to developing countries and stimulating innovations. In particular, it is argued that patent legislation reform can be meaningful if it is met with marching reforms outside the ambit of the law.
A Systematic Review of Caregiver Burden following Stroke
Authors: Rigby H. , Gubitz G. , Phillips S.
Published: August 2009

Caregiver burden following stroke is increasingly recognised as a significant health care concern. A growing number of studies have evaluated the patient, caregiver, and social support factors that contribute to increased caregiver burden. We conducted a systematic review of this literature to guide future research. A search of the MEDLINE, PsyclNFO, CINAHL, and EMBASE databases (up to July 2008) and reference sections of published studies using a structured search strategy yielded 24 relevant articles. Studies were included if they evaluated predictors and/or correlates of caregiver burden in the setting of stroke. The prevalence of caregiver burden was 25–54% and remained elevated for an indefinite period following stroke. In studies that evaluated independent baseline predictors of subsequent caregiver burden, none of the factors reported were consistent across studies. In studies that assessed concurrent factors independently contributing to caregiver burden in the poststroke period, patient characteristics and social support factors were inconsistently reported. Several studies identified caregiver mental health and the amount of time and effort required of the caregiver as significant determinants of caregiver burden. Our findings highlight the need for more research to identify caregivers in need of support and guide the development and implementation of appropriate interventions to offset caregiver burden.
Stent-Protected Angioplasty in Asymptomatic Carotid Artery Stenosis vs. Endarterectomy: SPACE2 – a Three-Arm Randomised-Controlled Clinical Trial
Authors: Reiff T. , Stingele R. , Eckstein H. H. , Fraedrich G. , Jansen O. , Mudra H. , Mansmann U. , Hacke W. , Ringleb P.
Published: August 2009

Moderate to severe (≥70%) asymptomatic stenosis of the extracranial carotid artery leads to an increased rate of stroke of approximately 11% in 5 years. Patients with asymptomatic carotid stenosis, however, are also at a higher risk of nonstroke vascular events. The estimated annual risks of such events in patients with asymptomatic stenosis are 7% for a coronary ischaemic event and 4–7% for overall mortality. The superiority of carotid endarterectomy compared with medical treatment in symptomatic carotid disease is established, provided that the surgical procedure can be performed with a perioperative morbidity and mortality of <6%. The advantage of carotid endarterectomy for asymptomatic patients is less established. An alternative treatment, carotid artery stenting, has been developed. This treatment is used frequently in both symptomatic and asymptomatic patients. In the last decade, major advantages in medical primary prevention of cerebrovascular and cardiovascular disease have been accomplished. The control groups in the large trials for asymptomatic carotid artery disease (ACAS and ACST) originate from more than a decade ago and, for the most part, have not received a medical primary prevention strategy that would now be considered the standard according to current national and international guidelines. For this reason, a three-arm trial (SPACE2; http://www.space-2.de ) with a hierarchical design and a recruitment target of 3640 patients is chosen. Firstly, a superior trial of intervention (carotid artery stenting or carotid endarterectomy) vs. state-of-the-art conservative treatment is designed. In case of superiority of the interventions, a noninferiority end-point will be tested between carotid artery stenting and carotid endarterectomy. This trial is registered at Current Controlled Trials ISRCTN 78592017.
The Modified National Institutes of Health Stroke Scale: its Time has Come
Authors: Meyer B. C. , Lyden P. D.
Published: August 2009

The National Institutes of Health Stroke Scale (NIHSS) is a well known, reliable and valid stroke deficit scale. The NIHSS is simple, quick, and has shown significant reliability in diverse groups, settings, and languages. The NIHSS also contains items with poor reliability and redundancy. Recent investigations (include assessing a new training DVD, analyzing web-based or videotape certifications, and testing foreign language versions) have further detailed reliability issues. Items recurrently shown to have poor reliability include Level of Consciousness, Facial Palsy, Limb Ataxia, and Dysarthria. The modified NIHSS (mNIHSS) minimizes redundancy and eliminates poorly reliable items. The mNIHSS shows greater reliability in multiple settings and cohorts, including scores abstracted from records, when used via telemedicine, and when used in clinical trials. In a validation of the mNIHSS against the NIHSS, the number of elements with excellent agreement increased from 54% to 71%, while poor agreement decreased from 12% to 5%. Overall, 45% of NIHSS items had less than excellent reliability vs. only 29% for the mNIHSS. The mNIHSS is not the ideal stroke scale, but it is a significant improvement over the NIHSS. The mNIHSS has shown reliability at bedside, with record abstraction, with telemedicine, and in clinical trials. Since the mNIHSS is more reliable, it may allow for improved practitioner communication, improved medical care, and refinement of trial enrollments. The mNIHSS should now serve as the primary stroke clinical deficit scale for clinical and research aims. When it comes to the mNIHSS, its time has come!
Taking action to close the research/practice divide
Authors: Alde Pamela , Cheek Julianne , Ballantyne Alison
Published: August 2009

In this paper we focus at the level of individual project to explore aspects of the nexus between research and practice. Using a research project that sought to explore and understand care transitions for older people as the vehicle for our discussion, we examine how the process by which a research project itself is thought about, conceptualized, developed and conducted influences knowledge translation and ways to get research into practice, and conversely practice into research. Processes and strategies we engaged in throughout this research project to promote the transfer of knowledge both among and between researchers, practitioners and the wider practice community are highlighted.
Connecting what we do with what we know: building a community of research and practice
Authors: Cheek Julianne , Corlis Megan , Radoslovich Helen
Published: August 2009

How to think about, develop, maintain and optimize connections between research and practice remains a vexed and contested area in the increasingly complex multidisciplinary and inter‐professional practice that constitutes contemporary healthcare and service delivery. A body of literature challenging linear and passive notions of research uptake has emerged which views research uptake as a dynamic, contextualized and active process. This paper explores the development of a successful and exciting community of research and practice involving a university and an aged care organization in Australia. The community of research and practice is premised on dynamic, contextual and active interaction between research and practice; where the categories of research and practice are not mutually exclusive or static; and where community is more than just a structure to facilitate collaborative research projects. It is proposed that the idea of a community of research and practice is a useful one in terms of seeking to better understand and provide strategies for knowledge translation between researchers and practitioners and those who are both.
How Well Does a Shortened Time Interval Characterize Results of a Full Ambulatory Blood Pressure Monitoring Session?
Authors: Ernst Michael E. , Weber Cynthia A. , Dawson Jeffrey D. , O'Connor Michelle A. , Lin Wenjiao , Carter Barry L. , Bergus George R.
Published: August 2009

Ambulatory blood pressure monitoring (ABPM) is useful in evaluating cardiovascular risk but requires significant time. The authors examined how closely shortened time intervals correlate with the systolic blood pressure (BP) determined from a full 24‐hour ABPM session in 1004 ABPM recordings. After excluding the first hour, Pearson correlations performed for the mean systolic BP of the subsequent 3‐, 5‐, and 7‐hour periods (4, 6, and 8 hours total) with the entire, and remainder of the session, demonstrated greatest improvement in correlation when the session is increased from 4 to 6 hours. Bland‐Altman analysis of the 6‐hour time period revealed a mean difference of 5.41 mm Hg compared with the full session mean. The authors conclude that 6‐hour ABPM can approximate the overall mean BP obtained from full 24‐hour ABPM. However, shortened sessions do not characterize the influence of circadian variation on the 24‐hour mean BP and may overestimate the 24‐hour BP levels.
Abdominal Obesity Is Associated With Potassium Depletion and Changes in Glucose Homeostasis During Diuretic Therapy
Authors: Mariosa Lydia Sebba Souza , Ribeiro‐Filho Fernando Flexa , Batista Marcelo Costa , Hirota Andréa Harumi , Borges Rodolfo Leão , Ribeiro Artur Beltrame , Zanella Maria Teresa
Published: August 2009

The activation of the renin‐angiotensin system (RAS) is an important mechanism that contributes to hypertension in obese individuals. Thiazide diuretics also activate the RAS in response to volume contraction and can lead to a decrease in serum potassium values and glucose metabolism abnormalities. To evaluate the impact of abdominal obesity on potassium depletion and glucose homeostasis in hypertensive patients receiving thiazide therapy, the authors studied 329 hypertensive patients without known diabetes or impaired renal function. Patients were stratified into 2 major groups according to whether they used thiazide diuretic therapy, and each group was further divided in 2 subgroups according to the presence of abdominal obesity. The authors demonstrated that obese patients receiving diuretic therapy had lower plasma potassium levels and higher glucose values compared with nonobese patients receiving diuretic therapy. In conclusion, abdominal obesity predisposes to potassium depletion during diuretic therapy in association with effects on glucose homeostasis.
Renin‐Angiotensin System Polymorphisms and Risk of Hypertension: Influence of Environmental Factors
Authors: Forman John P. , Fisher Naomi D. L. , Pollak Martin R. , Cox David G. , Tonna Stephan , Curhan Gary C.
Published: August 2009

Renin‐angiotensin system (RAS) polymorphisms have been studied as candidate risk factors for hypertension with inconsistent results, possibly due to heterogeneity among various environmental factors. We analyzed the association between RAS candidate gene polymorphisms and risk of hypertension among 2722 women and also explored whether these associations varied according to menopausal status, body mass index, and dietary factors. In a main‐effects analysis of all 2722 women adjusted for age and race, homozygosity for the AT1R A1166C polymorphism was associated with hypertension (odds ratio, 1.35; 95% confidence interval [CI], 1.03–1.78). We also found that a novel nonsense polymorphism in the aminopeptidase‐A gene was associated with hypertension among postmenopausal women (hazard ratio, 1.54; 95% CI, 1.01–2.37), women with inadequate calcium intake (hazard ratio, 2.47; 95% CI, 1.29–4.72) and, marginally, women with inadequate vitamin D intake. In addition, angiotensin‐converting enzyme and AT1R A1166C polymorphisms were associated or marginally associated with incident hypertension among postmenopausal women and those with inadequate calcium and vitamin D intakes. These data suggest that demographic and dietary factors may influence the associations between RAS polymorphisms and hypertension and could explain heterogeneity in prior studies.
The Silent Epidemic of Thiazide‐Induced Hyponatremia
Authors: Mann Samuel J.
Published: August 2009

Hyponatremia is a recognized complication of treatment with thiazide diuretics, particularly in patients older than 70 years. Severe and symptomatic hyponatremia requires urgent management, usually requiring infusion of normal or hypertonic saline. Milder, asymptomatic, thiazide‐induced hyponatremia requires steps to manage the hyponatremia as well as to prevent its future recurrence. This is a particular problem in patients who despite a history of thiazide‐induced hyponatremia might require a diuretic in the management of their hypertension. In this review, the acute management of symptomatic and asymptomatic thiazide‐induced hyponatremia is reviewed. Emphasis is also placed on the chronic management of patients who have experienced mild hyponatremia, in whom decisions about treatment with diuretic and nondiuretic antihypertensive agents must be made to satisfy the twin goals of controlling hypertension and avoiding recurrent hyponatremia.
Hypertension in Women—Part II
Authors: Pemu Priscilla Igho , Ofili Elizabeth
Published: August 2009

In Part I, we reviewed the pathophysiology of hypertension in women. This section focuses on the treatment of hypertension in special circumstances and special populations: pregnancy, preeclampsia, and lactation; hypertension in black women; and hypertension in the elderly.