bluuebunny/crossref_metadata_2025 huggingface dataset:
Benchmarking the Urology Practice
Authors: Brower Paul A.
Published: December 2008

The medical practice today is relentlessly challenged by medical progress, by rising costs, and by the mounting pressures of the managed care environment. It should be the approach of every medical practice manager and practitioner to seek out and measure up to the best standards so as to optimize patient care and business outcomes. This requires the resolute pursuit of good models, brought about by the fostering of key collaborative relationships that are both practical and strategic. Integral to this process is benchmarking: the way by which information is obtained from both internal and external sources to determine and set the standards for performance. Benchmarking is an invaluable strategic tool.
Regulation of Peroxisome Proliferator‐Activated Receptors by E6‐Associated Protein
Authors: Gopinathan Lakshmi , Hannon Daniel B. , Smith Russell W. , Peters Jeffrey M. , Vanden Heuvel John P.
Published: December 2008

Peroxisome proliferator‐activated receptors (PPARs) are nuclear receptors (NRs) that regulate genes involved in lipid and glucose metabolism. PPAR activity is regulated by interactions with cofactors and of interest are cofactors with ubiquitin ligase activity. The E6‐associated protein (E6‐AP) is an E3 ubiquitin ligase that affects the activity of other NRs, although its effects on PPARs have not been examined. E6‐AP inhibited the ligand‐independent transcriptional activity of PPARα and PPARβ, with marginal effects on PPARγ, and decreased basal mRNA levels of PPARα target genes. Inhibition of PPARα activity required the ubiquitin ligase function of E6‐AP, but occurred in a proteasome‐independent manner. PPARα interacted with E6‐AP, and in mice treated with PPARα agonist clofibrate, mRNA and protein levels of E6‐AP were increased in wildtype, but not in PPARα null mice, indicating a PPARα‐dependent regulation. These studies suggest coordinate regulation of E6‐AP and PPARα, and contribute to our understanding of the role of PPARs in cellular metabolism.
The karyotype of Alouattapigra (Primates: Platyrrhini): mitotic and meiotic analyses
Authors: Steinberg E.R. , Cortés-Ortiz L. , Nieves M. , Bolzán A.D. , García-Orduña F. , Hermida-Lagunes J. , Canales-Espinosa D. , Mudry M.D.
Published: December 2008

We describe for the first time the karyotype of the black howler monkey, Alouatta pigra. Conventional staining, G- and C-banding, and fluorescence in situ hybridization (FISH) with a peptide nucleic acid (PNA) pantelomeric probe were performed. Eight free ranging adult individuals, four males and four females, within the natural distribution of the species presented a diploid karyotype with 2n = 58. Mitotic analyses showed an autosomal complement composed of 6 submetacentric, 3 metacentric, and 19 acrocentric chromosome pairs for females, and 6 submetacentric, 3 metacentric, and 18 acrocentric pairs for males. Meiotic analyses in males revealed 27 autosomal bivalents and a quadrivalent composed of a submetacentric X1 and acrocentric X2, Y1, and Y2. The G-banded karyotype allowed us to identify pair #17 as the autosomal pair involved in the rearrangement and the morphology of the quadrivalent components. C-banding technique in metaphase I corroborated the structure of the quadrivalent showing four C+ centromeres. FISH analysis showed telomeric signals at the terminal regions of all chromosomes. No interstitial signals were detected. DNA sequence data were in accordance with those previously published for this species.
SNP detection and comparative linkage mapping of 66 bone-related genes in the pig
Authors: Onteru S.K. , Fan B. , Rothschild M.F.
Published: December 2008

Osteoporosis is a multigenic complex disorder. Though the mouse and rat are used as experimental models for human osteoporosis, the pig bone remodeling cycle is histologically more similar to human than the rat or mouse. Moreover, livestock genomics have many advantages over model organisms and human studies for complex trait dissection. Hence, in the present work 66 bone-related genes were newly genetically mapped on pig chromosomes. Comparative chromosomal patterns of bone-related genes in the pig, human, mouse and rat provide clues that the chromosomal organization of bone-related genes in pigs is more similar to human than that of the mouse and rat. Therefore, the pig can be considered as one of the better models for studying the molecular genetics of bone-related disorders.
Chromosome reduction in Eleocharis maculosa (Cyperaceae)
Authors: Maximiano da Silva C.R. , González-Elizondo M.S. , Laforga Vanzela A.L.
Published: December 2008

Chromosome numbers in Cyperaceae lower than the typical basic number x = 5 have been described for only three species: Rhynchospora tenuis (n = 2), Fimbristylis umbellaris (n = 3) and Eleocharis subarticulata (n = 3). Eleocharis maculosa is recorded here as the fourth species of Cyperaceae that has a chromosome number lower than 2n = 10, with 2n = 8, 7 and 6. The karyotype differentiation in E. maculosa was studied using conventional staining (mitosis and meiosis), FISH with 45S and 5S rDNA and telomere probes. The results allow us to determine which chromosomes of the chromosome race with 2n = 10 fused to form the remaining reduced numbers, as well as to understand how the symploidy and translocation mechanisms were important in karyotype differentiation and the formation of chromosome races in Eleocharis.
Experimental Agents Which Inhibit Hepatocarcinogenesis
Authors: Yoon Jung-Hwan , Lee Hyo-Suk
Published: December 2008

Hepatocellular carcinoma (HCC) is characteristically hypervascular, and therefore many antiangiogenic therapies are under clinical investigation. However, their therapeutic efficacies are still limited. While inhibition of angiogenesis results in tumor hypoxia and cell death, this may also activate a variety of hypoxia-induced cell growth and survival signals, which may promote HCC progression. Therefore, the simultaneous blockage of these signals may be essential in maximizing the efficiency of antiangiogenic therapies. Information regarding some of our experimental agents targeting these HCC signals is presented in this manuscript.
Sonazoid-Enhanced Ultrasonography for Diagnosis of Hepatic Malignancies: Comparison with Contrast-Enhanced CT
Authors: Hatanaka Kinuyo , Kudo Masatoshi , Minami Yasunori , Maekawa Kiyoshi
Published: December 2008

Objective: The purpose of this study was to assess the usefulness of Sonazoid-enhanced ultrasonography (US) in the diagnosis of hepatic malignancies in comparison with contrast-enhanced CT findings. Methods: A total of 74 patients with 113 hepatic tumors having or highly suspected of having malignancies were enrolled. These hepatic nodules were diagnosed by typical findings of imaging such as contrast-enhanced CT, dynamic MRI or Sonazoid-enhanced US, tumor markers and histological examinations after surgical resection or biopsy. Results: 108 nodules were diagnosed as malignant tumors (hepatocellular carcinoma: n = 90; metastasis: n = 16; intrahepatic cholangiocarcinoma: n = 2) and the remaining five tumors were diagnosed as benign tumors (dysplastic nodules: n = 5). Sonazoid-enhanced US correctly depicted the presence or absence of tumors in 74 patients, with a sensitivity of 95.4%, an accuracy of 94.7%, and a positive predictive rate of 99%. Contrast-enhanced CT depicted the malignancies with a sensitivity of 85.2%, an accuracy of 82.3%, and a positive predictive rate of 95.8%. There were significant differences between Sonazoid-enhanced US and contrast-enhanced CT for sensitivity and accuracy (both p < 0.05). Conclusion: Sonazoid-enhanced US has a higher sensitivity and accuracy for the diagnosis of hepatic malignancies than contrast-enhanced CT.
Magnetic Resonance Imaging of Hepatocellular Carcinoma
Authors: Kanematsu Masayuki , Kondo Hiroshi , Goshima Satoshi , Tsuge Yusuke , Watanabe Haruo
Published: December 2008

In hepatocellular carcinomas (HCCs), T1 shortening occurs due to internal protein, fat, copper, iron, hypercellularity, or a combination thereof. T1-weighted magnetic resonance imaging (MRI) is obtained with a non-fat-suppressed phase shift [in- (4 ms) and opposed- (2 ms) phase] gradient-echo sequence. Internal fat deposition is often (36%) seen in well-differentiated HCCs between 1.1 and 1.5 cm in size. T2-weighted MRI is crucial in differentiating HCCs from premalignant or borderline lesions in cirrhosis and serves as a tie breaker for small early-enhancing lesions. Gadolinium-enhanced MRI has advantages over contrast-enhanced CT: greater contrast enhancement, smaller volume of contrast, and less frequent adverse reactions. Double hepatic arterial-phase imaging has been performed in many centers, allowing less frequent off-timing arterial-phase imaging and improved temporary resolution. Hypervascular HCCs often show ‘corona’ enhancement in the late hepatic arterial phase, which makes it possible to distinguish small HCCs from enhancing pseudolesions. Liposoluble gadolinium chelate (e.g., Gd-EOB-DTPA) behaving both as an extracellular and hepatobiliary agent is very useful in the diagnosis. Diffusion-weighted imaging has become a routine imaging tool thanks to the parallel imaging technique. However, diffusion-weighted imaging may not significantly improve detection, characterization, or estimation of tumor grade for HCCs, and it should still be supplementary. In summary, we believe MRI outperforms CT in the diagnosis of HCCs.
Hepatocellular Carcinoma 2009 and Beyond: from the Surveillance to Molecular Targeted Therapy
Authors: Kudo Masatoshi
Published: December 2008

Hepatocellular carcinoma (HCC) is a malignant tumor which is becoming more prevalent worldwide. Patients at high risk of developing HCC, namely hepatitis B- and C-related liver cirrhosis patients, should be entered into surveillance programs, which should be performed using both ultrasonography and 3 tumor markers (AFP, PIVKA-II, AFP-L3). The surveillance interval needs to be shortened for patients at higher risk of HCC. Therefore, super-high-risk patients should be screened at 3- to 4-month intervals based on their risk of developing HCC. Sonazoid-enhanced US is extremely useful to characterize hepatic tumors when compared with multidetector-row computed tomography (MDCT). Moreover, Sonazoid-enhanced US with defect reperfusion imaging is a breakthrough approach in the treatment of HCC. This technique will markedly change the therapeutic strategy for liver cancer. Furthermore, diagnostic capability using the new imaging technique Gd-EOB-DTPA MRI is promising. A reduced uptake (low intensity) in the hepatobiliary phase of Gd-EOB-DTPA MRI strongly suggests HCC (including early-stage HCC) or a high-grade dysplastic nodule with high malignant potential. Empirically, intrahepatic arterial infusion chemotherapy using implanted reservoir port is known to be effective for advanced HCC with vascular invasion; however, no randomized study exists to prove its efficacy. Further controlled study is necessary to establish this treatment option as a standard of care in a treatment algorithm for HCC. In contrast, sorafenib was established as the first choice of treatment as a standard of care in advanced HCC patients with preserved liver function and vascular invasion/extrahepatic spread. Furthermore, global clinical trials are now ongoing using sorafenib as an adjuvant setting after resection, ablation or TACE. Efficacy of combined use of sorafenib with TACE or intra-arterial infusion chemotherapy is not clear. In order to clarify this issue a randomized clinical trial for intermediate and advanced HCC comparing sorafenib alone versus sorafenib combined with maintenance TACE/intra-arterial infusion chemotherapy and/or intra-arterial infusion chemotherapy is scheduled to be initiated in Japan in 2009. If positive results are obtained by these trials, its impact on treatment strategy for HCC will be drastically changed.
Wound Healing Is Not Impaired in Rats Undergoing Perioperative Treatment with the Antineoplastic Agent Taurolidine
Authors: Braumann C. , Guenther N. , Pohlenz J. , Pfirrmann R.W. , Menenakos C.
Published: December 2008

Background/Aim: The aim of this study was to determine whether an intravenous or an intraperitoneal application of the antineoplastic agent taurolidine (TRD) impairs wound healing in the absence of tumor load in rats. Methods: Eighty rats were randomized into eight groups (n = 10). Median laparotomy was performed in all animals. Three groups were treated by intravenous injection and three groups by local administration using a central port catheter system. For each group, 1 ml was applied: isotone sodium chloride solution (control groups), 1% TRD, 2% TRD, and 3% TRD. Fascia and skin were closed using a standardized running suture technique with 4-0 Vicryl®. Wounds were evaluated once a day. Animals were treated every 8 h for 7 days (ports were then removed) and wounds were evaluated at day 28. Macroscopic and histopathologic examinations of scar tissue biopsies (hemalaun-eosin stain) were performed at the end of the experiment. Results: No animal died. No relevant impairment of wound healing was observed independent of the different treatment strategies. Conclusion: Our results suggest that wound healing does not seem to be impaired by TRD in rats.
New Practical Course for Laparoscopy Training: Anatomizing the Orange
Authors: Wang H. , Yang B. , Xu C. , Sun Y.
Published: December 2008

Purpose: The aim of this study was to evaluate whether anatomizing the orange reliably improves laparoscopic skills and can therefore be used as a course in laparoscopic surgical training. Materials and Methods: 12 trainees were required to practice baseline laparoscopic skills for 10 days and were then randomized into groups: 6 people who anatomized the orange for 1 h daily for 5 days and 6 in a control group who continued to practice the baseline laparoscopic skills. The trainees were tested on completing porcine laparoscopic nephrectomy. Operative performance was measured using a global assessment scale of surgical skill. Results: The total score of global rating scale was 23.4 ± 4.1 for the group who anatomized the orange and 18.3 ± 2.7 for the control group (p < 0.05). Operative performance significantly improved in the group anatomizing the orange. Conclusion: Anatomizing the orange resulted in improving laparoscopic skills and can be incorporated into the laparoscopic training course. This could be beneficial for those who wish to develop the advanced skills required for various laparoscopic surgery procedures.
Positive Adnexal or Uterine Serosal Involvement in Stage IIIC Endometrial Cancer Is an Adverse Factor for Recurrence
Authors: Hétu Valérie , Petignat Patrick , Wu Yucan , Drouin Pierre , Sauthier Philippe , Provencher Diane , Gauthier Philippe
Published: December 2008

Objectives: Clinical and pathological significance of stage IIIC endometrial cancer is unclear. Our study was designed to determine the risk of recurrence among patients with stage IIIC endometrial cancer according to different pathological findings. Methods: We retrospectively reviewed all patients with FIGO IIIC endometrial carcinoma (n = 48) treated in our institution between 1996 and 2005. Patients without comprehensive surgical staging were excluded. Patients were classified into two groups: with adnexae and/or uterine serosal metastasis (group A, n = 18) and without metastasis (group B, n = 20). Cox proportional hazards model was used for multiple regression analysis. Results: Mean age was 64 years (range 46–90). Eighteen patients received adjuvant chemotherapy and pelvic radiotherapy, 17 received pelvic radiotherapy alone, and 11 received chemotherapy or hormonotherapy. At a median follow-up of 26.7 months, 12 had recurrence of the disease. Serosal and/or adnexal involvement was a negative independent prognostic factor for disease-free survival [relative risk = 3.75 (1.01–13.9); p = 0.04], whereas histological type, grade, depth of invasion and age at diagnosis had no influence. Conclusion: Patients with stage IIIC endometrial cancer and metastasis to adnexae and/or serosa have a higher risk of recurrence than those with node metastasis alone. Optimal adjuvant therapy for these groups remains unclear.
Evaluation of Crofelemer in the Treatment of Diarrhea-Predominant Irritable Bowel Syndrome Patients
Authors: Mangel Allen W. , Chaturvedi Pravin
Published: December 2008

Background: Crofelemer improves bowel function in several conditions characterized by states of prominent secretory diarrhea. Aim: This double-blind, randomized, placebo-controlled trial evaluated the effects of 3 dose levels of crofelemer in patients with diarrhea-predominant irritable bowel syndrome (D-IBS). Methods: Male and female patients were randomly assigned to receive crofelemer 125, 250 or 500 mg or placebo twice daily for 12 weeks. The primary efficacy measure was a responder for improvement in stool consistency. In addition, abdominal pain- and discomfort-free days, pain and discomfort scores as well as other bowel function parameters (such as stool frequency and consistency, urgency, bloating) were evaluated. Results: Two hundred and forty-two D-IBS patients were randomized. Crofelemer did not produce significant improvement in stool consistency (primary endpoint), stool frequency, urgency or adequate relief. However, female D-IBS patients showed improvement in the proportion of pain- and discomfort-free days during treatment with 500 mg crofelemer: month 1 (crofelemer vs. placebo: 17.7 vs. 10.2%, p = 0.098); month 2 (23.5 vs. 13.3%, p = 0.076); month 3 (26.1 vs. 10.6%, p = 0.0076). No benefit was seen in male D-IBS patients. Crofelemer was well tolerated. Conclusions: Crofelelmer did not produce benefit on bowel function; an increase in the number of pain- and discomfort-free days in female D-IBS patients was seen. Further studies with crofelemer are warranted to evaluate it as a potential visceral analgesic.
Differential Involvement of Ca2+ and Actin Filament in Leukocyte Shape Change
Authors: Schratl Petra , Heinemann Akos
Published: December 2008

At the sites of inflammation, leukocytes are confronted with mediators which induce different cellular responses like chemotaxis, degranulation and respiratory burst. Morphologically, these responses are accompanied by changes in the cells’ shape. In this study, we investigated the involvement of the actin cytoskeleton and Ca2+ in the shape change responses of human eosinophils and neutrophils to chemoattractants and correlated the obtained findings to degranulation and respiratory burst using flow cytometry. Shape change was recorded as an increase in forward scatter. Degranulation was measured as the cell surface upregulation of the granule-associated marker CD63. Respiratory burst was determined fluorimetrically as the oxidation of dihydrorhodamine 123. The involvement of actin filaments and phospholipase C (PLC) was investigated with the actin inhibitor cytochalasin B and the selective PLC inhibitor U-73122, respectively. The data that we obtained demonstrated that granulocytes exhibit 2 distinct types of shape change responses when stimulated with chemoattractants: (i) one type is induced by chemokines like eotaxin and interleukin 8, which are poor degranulators, and also by classical chemoattractants, C5a and formyl-methionyl-leucyl-phenylalanine; this shape change depends on the activation of PLC and functional actin filaments, but does not require Ca2+ influx from outside; (ii) the second type of shape change is not stimulated by chemokines, but can be seen with classical chemoattractants which are also potent inducers of degranulation and respiratory burst. This type of shape change does not require any functional actin filaments, but appears to be a consequence of degranulation and depends essentially on the activation of PLC and Ca2+ influx from the extracellular space.
Transparency of Information on Eye Diseases on the Internet
Authors: Lüchtenberg Marc , Ohrloff Christian , Schalnus Rainer
Published: December 2008

Background: Transparency is an indicator of trustworthiness and quality of health information about eye diseases on the Internet. Methods: 20 websites that contained information about eye diseases aimed at the general public were evaluated. A modified Afgis (Aktionsforum Gesundheitsinformationssystem/action forum health information system) project transparency checklist was used. Results: On average, 6.15 ± 1.68 criteria were fulfilled. All websites maintained separation between advertising and editorial content. Between 80 and 90% of the websites studied contained complete information about the provider, aims and target audience, and feedback from users. The criteria for privacy were met by 70% of websites, 40% met those for currency of content and data, 35% those for methods of quality assurance, 15% those for financing and sponsoring and 0% met the requirements for authors and sources of information. Conclusion: Visually impaired people benefit from transparency, because this facilitates accessibility to web-based health information. Hence, websites containing health information related to eye diseases should meet the demands of transparency.
Prevalence of Possible Idiopathic Normal-Pressure Hydrocephalus in Japan: The Osaki-Tajiri Project
Authors: Tanaka Naofumi , Yamaguchi Satoshi , Ishikawa Hiroyasu , Ishii Hiroshi , Meguro Kenichi
Published: December 2008

Background: Several studies have reported that the prevalence of idiopathic normal-pressure hydrocephalus (iNPH) was between 0 and 5%. However, the precise prevalence in a community-based elderly population remains unclear. We investigated the prevalence of possible iNPH retrospectively using an age- and gender-stratified random sample database. Methods: Five hundred and sixty-seven participants were randomly selected from among the 1,654 members of the population aged 65 years and older in Tajiri, Japan, and 497 underwent MRI. We classified participants as having possible iNPH if they had: (1) ventricular enlargement, as shown by an Evans index of ≥0.3, with closing sulci at the high convexity with dilation of the sylvian fissure on MRI, (2) at least one of the iNPH clinical triad (gait disturbance, urinary incontinence and cognitive impairment), and (3) no identifiable potential secondary cause of hydrocephalus. Results: We found 7 participants who met the criteria mentioned above. Cognitive impairments were the most common symptoms (n = 6) followed by gait disturbances (n = 3); however, urinary incontinence was not observed. No full clinical triad was present in the patients and only 3 participants had 2 of the triad. Conclusions: We considered the prevalence of possible iNPH in elderly adults to be 1.4% (95% confidence interval = 0.6–2.9%).
Clinical and Immunological Follow-Up of Pemphigus Patients on Adjuvant Treatment with Immunoadsorption or Rituximab
Authors: Pfütze Martin , Eming Rüdiger , Kneisel Andrea , Kuhlmann Uwe , Hoyer Joachim , Hertl Michael
Published: December 2008

Background: Pemphigus vulgaris (PV) is a life-threatening autoimmune blistering skin disease which is associated with pathogenic IgG autoantibodies against desmogleins (Dsg) 1 and 3. Novel therapeutic strategies such as immunoadsorption (IA) or the anti-CD20 antibody rituximab (Rtx) hold promise to be effective in severe or recalcitrant PV. Patients and Methods: In the present retrospective study, 6 patients with extensive cutaneous PV were subjected to adjuvant IA treatment while 5 patients with severe mucosal PV received adjuvant Rtx treatment. Results: Within 6 months, IA and Rtx induced excellent clinical responses which were associated with a significant reduction of prednisolone doses and a decrease in anti-Dsg-specific IgG. Over a 12-month period, 3 IA-treated patients required additional adjuvant drugs while all of the PV patients on Rtx had no or only minimal residual symptoms. Conclusion: The relative therapeutic (long-term) efficacy of IA and Rtx in cutaneous versus mucosal PV needs to be evaluated in a prospective study.
Effect of Basic Fibroblast Growth Factor in Transgenic Mice: Corneal Epithelial Healing Process after Excimer Laser Photoablation
Authors: Meduri Alessandro , Scalinci Sergio Zaccaria , Morara Mariachiara , Ceruti Piero , Grenga Pier Luigi , Zigiotti Gian Luigi , Scorolli Lucia
Published: December 2008

Purpose: To evaluate the role of preparedbasic fibroblast growth factor (bFGF) eyedrops in corneal epithelial healing of transgenic mice after excimer laser photoablation. Materials and Methods: In our prospective case series, 60 eyes of 30 mice had uneventful bilateral excimer laser photoablation. In each mouse, 1 eye received the standard topical postoperative therapy with tobramicin, diclofenac and dexamethasone eyedrops, plusbFGF eyedrops 5 μg/10 μl PBS 3 times a day for 1 week, or until corneal reepithelialization was complete. The fellow eye served as the control and received the standard postoperative therapy plus placebo. The mice were monitored daily, commencing the day after surgery and for 7 days, in order to evaluate the corneal reepithelialization rate by using a video slitlamp camera with a cobalt blue light. The mean diameter of the corneal wounds was measured. Videotaped images were recorded and analyzed by computer planimetry. Results: All the eyes treated withbFGF eyedrops healed completely before day 5 after surgery, with a mean reepithelialization time of 90 ± 12 h (standard deviation); the mean reepithelialization time was 124 ± 10 h in those eyes receiving placebo. There were no statistically significant differences between the 2 groups in corneal haze presentation during the follow-up, perhaps because the time period was too brief (7 days). However, corneal clarity on slitlamp biomicroscopy was greater in the study group than in the control group. No side effects or toxic effects were documented. Conclusions: These data suggest that the bFGF significantly accelerates epithelial healing after excimer photoablation. A further clinical study should be performed to prove the results obtained in this study as well as the long-term efficacy of bFGF to prevent corneal haze.
Preserving Oxygenation during Walking in Severe Chronic Obstructive Pulmonary Disease: Noninvasive Ventilation versus Oxygen Therapy
Authors: Dreher M. , Doncheva E. , Schwoerer A. , Walterspacher S. , Sonntag F. , Kabitz H.J. , Windisch W.
Published: December 2008

Background: Physical activity is known to cause significant deoxygenation in patients with severe chronic obstructive pulmonary disease (COPD). Although noninvasive positive pressure ventilation (NPPV) has been shown to improve oxygenation and physical activity in these patients, no practical approach for the application of NPPV during walking has yet been established. Objective: To elucidate the most effective approach to preserving oxygenation during walking in patients with severe COPD receiving long-term NPPV. Methods: Three 12-min walking tests were performed in a randomized cross-over design on 3 consecutive days, comparing the usual and double dosages of oxygen versus NPPV plus the usual dosage of oxygen. The ventilator and oxygen tank were placed in a backpack. Results: Eleven patients (FEV1 26 ± 9% predicted) completed the study, while 8 patients refused to walk with NPPV, due to the weight of the ventilatory device (7.3 kg with NPPV vs. 3.1 kg without). PaO2 changes during walking differed [p = 0.01, repeated-measures (RM)-ANOVA], whereas dyspnea was unchanged. The difference in PaO2 change was 14.0 ± 16.6 mm Hg (unadjusted p = 0.0036, critical level = 0.017, RM-ANOVA) in favor of NPPV compared to the usual dosage of oxygen. Changes in FEV1, tidal volume and inspiratory impedance were in favor of NPPV-aided exercise (all p < 0.05, RM-ANOVA). Walking distance was reduced under NPPV (555 ± 227 m) compared to the usual (619 ± 210 m) and double (622 ± 215 m) dosages of oxygen (p = 0.024, RM-ANOVA). Conclusions: NPPV plus supplemental oxygen, but not oxygen alone, preserves oxygenation during walking in patients with severe COPD. However, dyspnea and walking distance were not improved due to the burden of carrying the heavy ventilatory equipment in a backpack.
Induced Sputum in Interstitial Lung Diseases: Novel Insights in the Diagnosis, Evaluation and Research
Authors: Economidou Foteini , Samara Katerina D. , Antoniou Katerina M. , Siafakas Nikolaos M.
Published: December 2008

The search for noninvasive procedures of retrieving cells and soluble material from the lung has gained momentum over the past few years. Induced sputum (IS) by inhalation of hypertonic saline solution is a noninvasive technique used to collect cellular and soluble material from lung airways. During the past decade, this method has been widely used to assess airway inflammation in asthma and chronic obstructive disease, since it produces reliable results and compares favorably to other invasive techniques, such as biopsy and bronchoalveolar lavage fluid. However, recent attention has been paid to its efficacy in the evaluation of interstitial lung diseases. Recent research in this area clearly showed that IS analysis could give extensive information regarding the inflammation in pulmonary sarcoidosis, such as the lymphocytic cell count, the CD4+/CD8+ ratio and the Th1 immunologic response. The CD4+/CD8+ ratio recovered from lymphocytes from IS is as useful as the same value retrieved from examination of lymphocytes recovered from bronchoalveolar lavage fluid for clinical use. The above findings suggest that integrating IS procedure in the diagnosis, evaluation, follow-up and research in patients with pulmonary sarcoidosis is necessary. Besides sarcoidosis, the review of the current literature in other interstitial lung diseases showed that IS could provide us with useful information regarding inflammatory molecules, but cannot fully replace more invasive techniques. This review analyzes the applications of IS in the assessment of fibrotic and granulomatous diseases such as sarcoidosis and extrinsic allergic alveolitis, idiopathic pulmonary fibrosis, connective tissue disorders, occupational lung diseases and other systemic diseases.
Effects of Ageing on Adaptation during Vibratory Stimulation of the Calf and Neck Muscles
Authors: Patel M. , Fransson P.A. , Magnusson M.
Published: December 2008

Background: The ability to adapt and habituate based on prior experiences is important for human movement control, fall prevention and for the ability to enhance performance during various human activities. However, little is known about the ability for the elderly to adapt to balance perturbations in the lateral direction. Objective: To determine whether adaptation, i.e., the ability to adjust postural control to handle balance perturbations better over time, differed in the elderly subjects compared with young subjects in the anteroposterior and lateral directions, and whether the site of the balance perturbation or the presence or absence of vision affected the response. Methods: Postural stability was measured as anteroposterior and lateral torque variance in a young group (n = 18 (9 female and 9 male), average age = 29.1 years) and an elderly group (n = 16 (5 female and 11 male), average age = 71.5 years) with eyes open and closed during balance perturbations from calf and neck vibrations. After a 30-s period of quiet stance, these vibrations were repeated over a period of 200 s, so the adaptive responses could be analyzed by splitting the data into 50-s periods. Results: The adaptive responses in the anteroposterior and lateral directions were different. Adaptation in the anteroposterior direction occurred to an almost equal extent in the elderly and young, whereas adaptation in the lateral direction was markedly larger in the elderly in all tests except for neck vibration with eyes closed. Age, vision and vibration site were all influential factors for recorded body movements, but no significant combined effects were found. Conclusion: Balance perturbation instigates an adaptive response in the elderly in both the anteroposterior and lateral directions. However, during perturbation, age and vision are both very influential factors for the stability, thus associating the previously documented age-related decline in visual functioning with a higher risk of falls in this age range.
Abrupt Transitions and Hysteresis in Thermohaline Laboratory Models
Authors: Whitehead J. A.
Published: December 2008

As a driving parameter is slowly altered, thermohaline ocean circulation models show either a smooth evolution of a mode of flow or an abrupt transition of temperature and salinity fields from one mode to another. An abrupt transition might occur at one value or over a range of the driving parameter. The latter has hysteresis because the mode in this range depends on the history of the driving parameter. Although assorted ocean circulation models exhibit abrupt transitions, such transitions have not been directly observed in the ocean. Therefore, laboratory experiments have been conducted to seek and observe actual (physical) abrupt thermohaline transitions. An experiment closely duplicating Stommel’s box model possessed abrupt transitions in temperature and salinity with distinct hysteresis. Two subsequent experiments with more latitude for internal circulation in the containers possessed abrupt transitions over a much smaller range of hysteresis. Therefore, a new experiment with even more latitude for internal circulation was designed and conducted. A large tank of constantly renewed freshwater at room temperature had a smaller cavity in the bottom heated from below with saltwater steadily pumped in. The cavity had either a salt mode, consisting of the cavity filled with heated salty water with an interface at the cavity top, or a temperature mode, in which the heat and saltwater were removed from the cavity by convection. There was no measurable hysteresis between the two modes. Possible reasons for such small hysteresis are discussed.
Seasonal Ensemble Forecasts: Are Recalibrated Single Models Better than Multimodels?
Authors: Weigel Andreas P. , Liniger Mark A. , Appenzeller Christof
Published: December 2008

Multimodel ensemble combination (MMEC) has become an accepted technique to improve probabilistic forecasts from short- to long-range time scales. MMEC techniques typically widen ensemble spread, thus improving the dispersion characteristics and the reliability of the forecasts. This raises the question as to whether the same effect could be achieved in a potentially cheaper way by rescaling single model ensemble forecasts a posteriori such that they become reliable. In this study a climate conserving recalibration (CCR) technique is derived and compared with MMEC. With a simple stochastic toy model it is shown that both CCR and MMEC successfully improve forecast reliability. The difference between these two methods is that CCR conserves resolution but inevitably dilutes the potentially predictable signal while MMEC is in the ideal case able to fully retain the predictable signal and to improve resolution. Therefore, MMEC is conceptually to be preferred, particularly since the effect of CCR depends on the length of the data record and on distributional assumptions. In reality, however, multimodels consist only of a finite number of participating single models, and the model errors are often correlated. Under such conditions, and depending on the skill metric applied, CCR-corrected single models can on average have comparable skill as multimodel ensembles, particularly when the potential model predictability is low. Using seasonal near-surface temperature and precipitation forecasts of three models of the Development of a European Multimodel Ensemble System for Seasonal-to-Interannual Prediction (DEMETER) dataset, it is shown that the conclusions drawn from the toy-model experiments hold equally in a real multimodel ensemble prediction system. All in all, it is not possible to make a general statement on whether CCR or MMEC is the better method. Rather it seems that optimum forecasts can be obtained by a combination of both methods, but only if first MMEC and then CCR is applied. The opposite order—first CCR, then MMEC—is shown to be of only little effect, at least in the context of seasonal forecasts.
Impact of the Intraseasonal Variability of the Western North Pacific Large-Scale Circulation on Tropical Cyclone Tracks
Authors: Chen Tsing-Chang , Wang Shih-Yu , Yen Ming-Cheng , Clark Adam J.
Published: December 2008

The life cycle of the Southeast Asian–western North Pacific monsoon circulation is established by the northward migrations of the monsoon trough and the western Pacific subtropical anticyclone, and is reflected by the intraseasonal variations of monsoon westerlies and trade easterlies in the form of an east–west seesaw oscillation. In this paper, an effort is made to disclose the influence of this monsoon circulation on tropical cyclone tracks during its different phases using composite charts of large-scale circulation for certain types of tracks.

A majority of straight-moving (recurving) tropical cyclones appear during weak (strong) monsoon westerlies and strong (weak) trade easterlies. The monsoon conditions associated with straight-moving tropical cyclones are linked to the intensified subtropical anticyclone, while that associated with recurving tropical cyclones is coupled with the deepened monsoon trough. The relationship between genesis locations and track characteristics is evolved from the intraseasonal variation of the monsoon circulation reflected by the east–west oscillation of monsoon westerlies and trade easterlies. Composite circulation differences between the flows associated with the two types of tropical cyclone tracks show a vertically uniform short wave train along the North Pacific rim, as portrayed by the Pacific–Japan oscillation. During the extreme phases of the monsoon life cycle, the anomalous circulation pattern east of Taiwan resembles this anomalous short wave train.

A vorticity budget analysis of the strong monsoon condition reveals a vorticity tendency dipole with a positive zone to the north and a negative zone to the south of the deepened monsoon trough. This meridional juxtaposition of vorticity tendency propagates the monsoon trough northward. The interaction of a tropical cyclone with the monsoon trough intensifies the north–south juxtaposition of the vorticity tendency and deflects the tropical cyclone northward. In contrast, during weak monsoon conditions, the interaction between a tropical cyclone and the subtropical high results in a northwestward motion steered by the intensified trade easterlies. The accurate prediction of the monsoon trough and the subtropical anticyclone variations coupled with the monsoon life cycle may help to improve the forecasting of tropical cyclone tracks.
Effects of Talker Variability on Perceptual Learning of Dialects
Authors: Clopper Cynthia G. , Pisoni David B.
Published: December 2008

Two groups of listeners learned to categorize a set of unfamiliar talkers by dialect region using sentences selected from the TIMIT speech corpus. One group learned to categorize a single talker from each of six American English dialect regions. A second group learned to categorize three talkers from each dialect region. Following training, both groups were asked to categorize new talkers using the same categorization task. While the single-talker group was more accurate during initial training and test phases when familiar talkers produced the sentences, the three-talker group performed better on the generalization task with unfamiliar talkers. This cross-over effect in dialect categorization suggests that while talker variation during initial perceptual learning leads to more difficult learning of specific exemplars, exposure to intertalker variability facilitates robust perceptual learning and promotes better categorization performance of unfamiliar talkers. The results suggest that listeners encode and use acoustic-phonetic variability in speech to reliably perceive the dialect of unfamiliar talkers.
The Perception of Syllable Affiliation of Singleton Stops in Repetitive Speech
Authors: de Jong Kenneth J. , Lim Byung-jin , Nagao Kyoko
Published: December 2008

Stetson (1951) noted that repeating singleton coda consonants at fast speech rates makes them be perceived as onset consonants affiliated with a following vowel. The current study documents the perception of rate-induced resyllabification, as well as what temporal properties give rise to the perception of syllable affiliation. Stimuli were extracted from a previous study of repeated stop + vowel and vowel + stop syllables (de Jong, 2001a, 2001b). Forced-choice identification tasks show that slow repetitions are clearly distinguished. As speakers increase rate, they reach a point after which listeners disagree as to the affiliation of the stop. This pattern is found for voiced and voiceless consonants using different stimulus extraction techniques. Acoustic models of the identifications indicate that the sudden shift in syllabification occurs with the loss of an acoustic hiatus between successive syllables. Acoustic models of the fast rate identifications indicate various other qualities, such as consonant voicing, affect the probability that the consonants will be perceived as onsets. These results indicate a model of syllabic affiliation where specific juncture-marking aspects of the signal dominate parsing, and in their absence other differences provide additional, weaker cues to syllabic affiliation.
Nasality in Taiwanese
Authors: Pan Ho-hsien
Published: December 2008

This study used perceptual and articulatory data to investigate a language specific phonemic inventory, and allophonic rules for homorganic initial voiced stops versus homorganic nasal stops, and oral versus nasal vowels in Taiwanese. Four experiments were conducted: concept formation, gating, and two airflow studies. Results of a first nasal airflow study on syllable initial voiced stops and nasal stops showed that initial voiced stops were nasalized when preceded by a nasal consonant across a word boundary. Results of a concept formation experiment indicated that Taiwanese listeners grouped homorganic voiced stops and nasal stops into the same category. A gating experiment showed that subjects were insensitive to the phonetic differences between homorganic voiced stops and nasal stops. The presence or absence of nasality within the vowel nucleus was the crucial cue to the identification of oral and nasal syllables. A second nasal airflow study on vowel nuclei demonstrated that oral vowels were nasalized at their onset and offset when preceded or followed by a nasal consonant respectively. The distinction between oral and nasal vowels was maintained at the center of the vowel nuclei. By classifying homorganic initial voiced stops and nasal stops into the same category, Taiwanese speakers were able to ignore the phonetic difference between them and relied on the distinction between nasal vowel versus oral and nasalized vowel to distinguish between nasal versus oral syllables. Taiwanese speakers produced a clear distinction between oral and nasal vowels to retain the crucial role that oral versus nasal contrasts on vowel nuclei played during perception experiments. This study offers phonetic evidence to answer the controversial nasality issue in Taiwanese. Furthermore, a link was found between perception and extent of application of allophonic rules during production.
How Children and Adults Produce and Perceive Uncertainty in Audiovisual Speech
Authors: Krahmer Emiel , Swerts Marc
Published: December 2008

We describe two experiments on signaling and detecting uncertainty in audiovisual speech by adults and children. In the first study, utterances from adult speakers and child speakers (aged 7—8) were elicited and annotated with a set of six audiovisual features. It was found that when adult speakers were uncertain they were more likely to produce fillers, delays, high intonation, eyebrow movements, and “funny faces.” The basic picture for the child speakers was somewhat similar, in that the presence of certain audiovisual cues correlated with uncertainty, but the differences were relatively small and less often significant. In the second study both adult and child judges watched responses from adult and child speakers selected from the first study to find out whether they were able to correctly estimate a speakers' level of uncertainty. It was found that both child and adult judges gave more accurate scores for answers from adult speakers than from child speakers and that child judges overall provided less accurate scores than adult judges.
Disambiguation of Homonyms in Real-Time Japanese Sentence Processing: Case-Markings and Thematic Constraint
Authors: Tokimoto Shingo
Published: December 2008

This paper experimentally examines the effects of the case-markings and the constraint on the assignments and the receptions of thematic roles in Japanese sentence processing. A self-paced reading experiment was carried out with syntactically well-controlled Japanese sentences including homonyms locally ambiguous between nouns and verbs. The results showed that the homonyms were preferably disambiguated as verbs. We interpret this disambiguation as the result of the application of the thematic constraint to the input items on the basis of the correspondence between the case-markings and the grammatical functions in Japanese. We further examined the effect of pragmatic plausibility on the interpretation of the homonyms by questionnaire, and claim that the thematic constraint is still the chief determinant for their disambiguation even with the possible plausibility effects. We also examined the effect of the verbal working memory capacity estimated by the Japanese Reading Span Test, and we demonstrate that a reader with a high score in the test comprehends sentences more accurately but spends relatively longer time for reanalyses than a reader with a low score. We discuss the relevances of our results to the parsing models for real-time Japanese sentence processing and to the studies of verbal working memory in English.
Is there an Ironic Tone of Voice?
Authors: Bryant Gregory A. , Fox Tree Jean E.
Published: December 2008

Research on nonverbal vocal cues and verbal irony has often relied on the concept of an ironic tone of voice. Here we provide acoustic analysis and experimental evidence that this notion is oversimplified and misguided. Acoustic analyses of spontaneous ironic speech extracted from talk radio shows, both ambiguous and unambiguous in written form, revealed only a difference in amplitude variability compared to matched nonironic speech from the same sources, and that was only among the most clear-cut items. In a series of experiments, participants rated content-filtered versions of the same ironic and nonironic utterances on a range of affective and linguistic dimensions. Listeners did not rely on any set of vocal cues to identify verbal irony that was separate from other emotional and linguistic judgments. We conclude that there is no particular ironic tone of voice and that listeners interpret verbal irony by combining a variety of cues, including information outside of the linguistic context.