bluuebunny/crossref_metadata_2025 huggingface dataset:
Do Early Screening Mammography Outcomes 40 Differentially by Race?
Authors: Kapp JM , Walker R , Haneuse S , Yankaskas BC
Published: March 2010

Purpose: Previous studies suggest 29% of women ages 30-39 report having had a mammogram; this varies by race/ethnicity. Black women have a greater odds than White women of reporting multiple mammograms <40; yet ≥40, Black and Asian women are less likely to receive adequate mammography screening. Could early mammography testing adversely impact future mammography use? Our objective is to determine whether racial/ethnic differences and the outcome of a first mammogram <40 (false positive (FP) or true negative (TN)) may delay the age of the first mammogram ≥40.

Methods: Data were pooled from seven mammography registries of the National Cancer Institute's Breast Cancer Surveillance Consortium (BCSC), a network created to study performance and outcomes in community practice. Using 1996-2006 data, we identified 29,158 women with a screening mammogram between ages 40-45 who also underwent screening mammography for the first time ever at an age <40 in the BCSC data. We used logistic regression to examine the association between race/ethnicity and first mammography outcomes on the odds of delayed mammography after 40 (ages 43-45 compared to 40-42).

Results: Overall, 96% of these women's first screens <40 were at ages 35 or later, and 93% of their first screens >40 were at ages 40-42. Regression models adjusted for age at first screen suggest: (1) Hispanic women have an increased odds of waiting to screen until 43-45 compared to White women, regardless of first screening outcome <40; (2) White and Black women whose first screen <40 was a FP have less odds of delaying future screening than those with a TN; and (3) among women with a TN, Black women have an increased odds of waiting to screen until 43-45 relative to White women, with no observed difference between Asian and White women.

Conclusions: Findings suggest a differential impact of early mammography outcomes on future mammography use by race/ethnicity, among the women in our sample with a known first screening mammogram before and after age 40. The concern for harmful effects of over-screening young women drives the need for additional work in this area.
Reaching Underserved Women with Mammography: 15 month experience with a Mobile Prevention Unit and Prevention Program
Authors: Davis ET , Hembree T , Beache SC , Ballard D , Brooks SE
Published: March 2010

Objective: There is much debate regarding the efficacy of mammography screening in women <50. No cost and low cost service providers may be required to target screening to the population at highest risk in order to maximize utility of resources. We sought to describe outcomes of women >40 undergoing mammography screening in underserved areas through a mobile unit and prevention program affiliated with a large network cancer program in Louisville, Kentucky.

Methods: We conducted a retrospective review of women undergoing mammography during the period 3/08-6/09. Locations determined to be high risk by GIS analysis, income and cancer incidence. Analyses included: descriptive analyses, calculation of odds ratios and confidence intervals and regression analyses.

Results: Of the 1702 women, 735 (43%) were white, 884 (52%) were African American, 54 (3%) other and 236 (14%) Hispanic/Latina. The mean age was 54 (std.dev. 9.4). Twenty-eight percent of the women (471/1702) had either never had a mammogram or not had one in 5 years. Fifty-one percent were uninsured. Of the 1702 women, 662(39%) were between the ages of 40-49 (Group A) and 1040 (61%) were >49 (Group B). The majority of women resided in high risk areas (74% Group A, 51% Group B). Twelve percent (206/1702) of the mammograms were abnormal and required follow up. Women in Group A were 1.4 times more likely than women in Group B to have a screening mammogram classified as abnormal (OR 1.4 95% CI 1.05-1.88). Four women were diagnosed with cancer in group A (0.6%) and 9 in group B (0.8%), P = ns. The median age of women with cancer was 52, mean = 58, range 42-83, (std. dev. 12.5). The overall follow up rate was 92%. All women with cancer received treatment. Logistic regression analysis demonstrated women of African American race and women who had never been screened were more likely to have abnormal results (P < 0.0001 and P = 0.03 respectively).

Conclusion: Our targeted approach of community based screening was successful in identifying a subpopulation of women who are not regularly screened and are at risk for abnormal screening mammograms and breast cancer. Further studies are needed to determine if recommendations for screening should be based on factors other than age.
Maternal Cultural Barriers Correlate with Adolescent HPV Vaccine Use
Authors: Carlos RC , Resnicow K , Dempsey AF , Patel D , Ruffin M , Dalton VA
Published: March 2010

Purpose: Determine maternal cultural barriers in mothers who adhere to their own cancer preventive behavior that correlate with HPV vaccination in their adolescent daughters.

Methods: We conducted a cross-sectional mailed survey of women attending breast and cervical cancer screening at two diverse institutions; one serving mostly black (54.1%) urban inner-city population and another serving a mostly (87.5%) white suburban population. Surveys queried the adolescent daughter's HPV vaccination status (adolescent defined as 9-17 years old), general health beliefs; HPV-specific beliefs; knowledge, perceived benefits and barriers to HPV vaccination; perceived social/peer group attitudes about HPV vaccines. HPV vaccine completion (receipt of all three doses) is the primary outcome. Cultural differences between groups were assessed using linear regression. Correlates of the primary outcome were assessed using univariate logistic regression.

Results: 33% response rate with 68 black and 164 nonblack mothers. 6.8% of adolescent daughters of black mothers adhering to breast/cervical cancer screening completed HPV vaccination, compared 24.5% of nonblacks. In 11-12 year olds, for whom the CDC recommends universal vaccination, none of the daughters of black mothers completed HPV vaccination, compared to 17.5% in nonblacks. Black mothers more likely agreed with “Giving my daughter a new vaccine is like performing an experiment on her” (coefficient 0.38, P = 0.038). Overall knowledge about HPV lagged in black mothers (mean knowledge index 0.587 (95%CI 0.531-0.643)) compared to nonblacks (0.73(95%CI 0.70-0.76)). Black mothers more likely to scored lower on the vaccine benefit scale (coef −0.31, P = 0.007, α = 0.76) and more likely scored higher on the peer group disapproval scale (coef 0.44, P = 0.010, α = 0.73). Belief about vaccine experimentation on her daughter decreased adolescent HPV vaccine use by black moms (OR 0.15, P = 0.002).

Conclusion: HPV vaccine completion in adolescent daughters of mothers who already participate in their own cancer preventive behavior remains suboptimal with significant racial disparity in vaccine use. Significant cultural differences correlate with decreased vaccine completion in daughters of black mothers.
Menopausal Hormone Therapy influences Lung Cancer Survival but not Lung Cancer Risk: Results from the California Teachers Study
Authors: Clague J , Reynolds P , Chang E , Henderson KD , Ma H , Anton-Culver H , Bernstein L
Published: March 2010

Purpose: Most studies have shown a protective or null effect of postmenopausal hormone therapy (HT) on lung cancer risk, whereas the recent post-hoc analysis of the Women's Health Initiative (WHI) showed that estrogen+progestin (E+P) decreased lung cancer survival. Given the substantial clinical implications, it is vital that the risk and survival associations be validated.

Methods: We examined the associations between HT use and lung cancer risk and survival among 60,592 postmenopausal women enrolled in the prospective California Teachers Study cohort. Between 1995 and 2007, 727 women (184 never smokers) were diagnosed with lung cancer; 441 of these died as of December 31, 2007. Age-stratified, multivariable Cox proportional hazards regression was used to calculate hazard ratios (HR).

Results: After adjusting for potential confounders, various measures of HT use were not associated with lung cancer risk. However, any HT use (vs. no use) was associated with a statistically significant increase in lung-cancer-specific survival [HR, 0.70; 95% confidence interval (CI), 0.56-0.87]. Among women who only used E, statistically significant increases in lung cancer survival were seen for recent use (HR, 0.59; 95% CI, 0.43-0.80), but not former use; use of only E+P was not associated with survival. Shorter duration of recent E-only use was associated with improved survival (0-5 years of use: HR, 0.29, 95% CI, 0.12-0.68; 5-15 years of use: HR, 0.60, 95% CI, 0.35-1.05; >15 years of use: HR, 0.58, 95% CI, 0.39-0.88) (trend P = 0.005). Similarly, women who reported recently using E-only for 0-5 years had a median survival time of 42.1 months versus women who reported 5-15 years of use (31 months), >15 years of use (19.1 months), or no HT use (15.6 months) (log-rank P = 0.009). Among former users of HT, a statistically significant 63% (95% CI, 0.16-0.87) decrease in lung-cancer-specific death was observed for E-only use <5 years prior to baseline, but not for E-only use >5 years prior to baseline or E+P-only use.

Conclusions: Contrary to the recent finding that lung cancer survival is poorer among women in WHI taking E+P, our results suggest no effect of E+P. By contrast, postmenopausal E-only use, specifically recent use, is associated with increased lung cancer survival.
Executive Dysfunction and Learning Effect after Continuous Positive Airway Pressure Treatment in Patients with Obstructive Sleep Apnea Syndrome
Authors: Saunamäki Tiia , Himanen Sari-Leena , Polo Olli , Jehkonen Mervi
Published: March 2010

Aims: To assess the impact of continuous positive airway pressure (CPAP) treatment on executive dysfunction in patients with obstructive sleep apnea syndrome (OSAS). Methods: At baseline, 20 OSAS patients and 17 healthy controls underwent polysomnography and neuropsychological assessment focusing on executive functions. After at least 6 months of CPAP treatment, the patients returned for one more full-night polysomnography and neuropsychological control assessment, while the controls underwent a neuropsychological control assessment. Results: All patients and controls were working-age males. OSAS severity ranged from mild to severe. Before CPAP, patients showed poorer performance than controls in the copy of the Rey-Osterrieth Complex Figure Test, the Block Design, the Digit Symbol, the Trails B and the Intra-Extra Dimensional Set-Shifting task. Patients’ executive performance showed no improvement after CPAP, and it remained poorer than the performance of controls. In addition, patients showed no learning effect in the executive tests, whereas the controls did. Conclusion: Even long-term CPAP treatment does not seem to improve OSAS patients’ mental set-shifting performance or their visuospatial organizational skills. In addition, OSAS patients have impaired learning effect in executive tests.
Epidemiology of Thyroid Dysgenesis: The Familial Component
Authors: Castanet Mireille , Marinovic Daniela , Polak Michel , Léger Juliane
Published: March 2010

The pathophysiology of thyroid dysgenesis remains unclear and, until recently, this disorder was generally regarded as sporadic. However, a small but significant proportion of familial cases have been identified (2%) through the study of subjects with congenital hypothyroidism, and more recent work has revealed an even higher proportion of familial thyroid dysgenesis in both symptomatic and asymptomatic individuals. These studies strongly suggest the existence of a familial component of this disorder involving dominant genetic predisposition factors with a low penetrance.
Spontaneous Ovarian Hyperstimulation Syndrome Caused by a Follicle-Stimulating Hormone-Secreting Pituitary Macroadenoma in an Early Pubertal Girl
Authors: Gryngarten Mirta Graciela , Braslavsky Débora , Ballerini Maria Gabriela , Ledesma Jose , Ropelato Maria Gabriela , Escobar Maria Eugenia
Published: March 2010

Gonadotroph adenomas are difficult to diagnose since they usually show as nonsecreting tumors or produce biologically inactive hormones with no clinical effects and classically grow silent until neurological symptoms appear. Presentation with bilateral ovarian masses and ovarian hyperstimulation has been described in fertile years. Gonadotroph adenomas are extremely infrequent in children. We report a 13-year-old postmenarcheal girl referred to our hospital with 6 months of amenorrhea, abdominal palpable mass presumptive of bilateral ovarian tumors. The patient had Tanner IV breast development and a large abdominal mass occupying the whole low hemiabdomen. Laboratory evaluation revealed high estradiol levels with suppressed luteinizing hormone and inappropriately high follicle-stimulating hormone (FSH) levels. Pelvic ultrasound showed enlarged ovaries containing multiple giant cysts. An MRI revealed a pituitary macroadenoma. Transsphenoidal resection of the adenoma was performed with an uneventful postoperative course. Immunohistologic examination only showed staining for FSH, thus confirming pituitary secreting FSH adenoma. Hormonal laboratory levels normalized and ovarian masses showed marked involution 1 month after surgery. Three months later the MRI showed tumor disappearance. Conclusion: The presence of bilateral ovarian tumors requires a careful endocrine and neurological evaluation to exclude the presence of an FSH-producing tumor in order to avoid unnecessary ovarian surgery.
Oral Sex Is a Risk Factor for Human Papillomavirus-Associated Nasopharyngeal Carcinoma in Husbands of Women with Cervical Cancer
Authors: Huang Lee-Wen , Seow Kok-Min
Published: March 2010

Sexually transmitted human papillomavirus (HPV) is etiologically related to cervical carcinoma and a distinct subset of cancers of the nasopharyngeal tract. We report 2 patients with HPV-associated cervical cancer and synchronous diagnoses of HPV-related head and neck cancer of their husbands. These patients had active oral sex for more than 20 years. The first patient was a 64-year-old woman who had an abnormal Papanicolaou smear and was found to have squamous cell carcinoma of the cervix on cervical punched biopsy. Her husband was diagnosed with laryngeal squamous cell carcinoma 1 year previously, and was treated with total laryngectomy and adjuvant radiation. HPV-16 DNA was detected in both their tumor specimens using polymerase chain reaction. The other patient was a 50-year-old female with cervical carcinoma treated surgically and with concurrent chemo-radiotherapy. HPV-31 DNA was detected in her tumor specimen. Three years later, her husband presented with nasopharyngeal carcinoma, although not a tobacco or alcohol user. HPV-18 DNA was detected in his tumor specimen.These findings strongly suggest that HPV may play a major role in the carcinogenesis of urogenital and nasopharyngeal tumors and the transmission potential of orogenital sex.
High Cumulative Live Births in Oocyte Donation Cycles with Cryopreservation of All Embryos
Authors: Tatpati Laura L. , Hudson Susan B. , Gera Puja S. , Allemand Michael C. , Stevens-Hall Sherry , Wentworth Mark A. , Coddington, III Charles C.
Published: March 2010

Background: Cryopreservation of all embryos in stimulated IVF cycles is occasionally necessary. Although it is known that frozen embryo transfer results in lower live birth rates per transfer, there is limited information regarding expected cumulative live birth rates for patients who are in this particular scenario. Methods: The objective was to evaluate long-term outcomes in cycles undergoing pronuclear cryopreservation of all embryos utilizing a retrospective analysis of 154 consecutive recipients from 1995 to 2006. Results: The cumulative rate of first live birth per retrieval was 66.2%, with a 36.4% live birth rate per frozen embryo transfer. Following an average 2.2 ± 0.98 transfers, 32.6% (17/52) of patients who never delivered had remaining embryos making the cumulative first live birth rate previously stated a conservative estimate. 11.7% of recipients had sibling deliveries from a single retrieval. Over 1/3 of the delivered recipients have remaining cryopreserved embryos and could pursue an additional pregnancy. Conclusion: These results suggest that pronuclear cryopreservation of all embryos in an oocyte donation cycle maintains good cumulative live birth rates, as well as chances for a sibling from a single retrieval. Recipients who must delay transfer can be reassured a high potential for live birth from their first donor retrieval.
Influence of Bladder Volume on Pelvic Organ Prolapse Quantification Results
Authors: Reich Andreas , Kohorst Frauke , Kreienberg Rolf , Flock Felix
Published: March 2010

Aims: To compare the degree of pelvic organ prolapse between examinations performed with full and empty bladder in patients without any prolapse and with pelvic organ prolapse stage I or II using the pelvic organ prolapse quantification (POPQ) system. Methods: A prospective observational study with 120 consecutive patients with and without symptoms of pelvic organ prolapse was evaluated. All women were examined with full and empty bladder. The data were analyzed by Wilcoxon’s signed-rank test. Results: With empty bladder 54% had the same stage, 41% had a one-step higher stage and 5% had a two-step higher stage of prolaps. There was an increase in the extent of prolapse in the empty bladder setting at all six site-specific points (Aa, Ba, C, D, Ap, Bp; p < 0.001) but not in the results of genital hiatus, perineal body and total vaginal length. Conclusion: Our results suggest that the full extent of prolapse may be only assessed with an empty bladder.
Incidence of Health Problems Associated with Tattooed Skin: A Nation-Wide Survey in German-Speaking Countries
Authors: Klügl Ines , Hiller Karl-Anton , Landthaler Michael , Bäumler Wolfgang
Published: March 2010

Background: Millions of people are tattooed. However, the frequency of health problems is unknown. Methods: We performed an Internet survey in German-speaking countries. Results: The provenance of tattooed participants (n = 3,411) was evenly distributed in Germany. The participants had many (28%; >4) and large tattoos (36%; ≧900 cm2). After tattooing, the people described skin problems (67.5%) or systemic reactions (6.6%). Four weeks after tattooing, 9% still had health problems. Six percent reported persistent health problems due to the tattoo, of which females (7.3%) were more frequently concerned than males (4.2%). Colored tattoos provoked more short-term skin (p = 0.003) or systemic (p = 0.0001) reactions than black tattoos. Also the size of tattoos and the age at the time of tattooing play a significant role in many health problems. Conclusions: Our results show that millions of people in the Western world supposedly have transient or persisting health problems after tattooing. Owing to the large number and size of the tattoos, tattooists inject several grams of tattoo colorants into the skin, which partly spread in the human body and stay for a lifetime. The latter might cause additional health problems in the long term.
In vitro Sun Protection Factor: Still a Challenge with No Final Answer
Authors: Rohr M. , Klette E. , Ruppert S. , Bimzcok R. , Klebon B. , Heinrich U. , Tronnier H. , Johncock W. , Peters S. , Pflücker F. , Rudolph T. , Flösser-Müller H. , Jenni K. , Kockott D. , Lademann J. , Herzog B. , Bielfeldt S. , Mendrok-Edinger C. , Hanay C. , Zastrow L.
Published: March 2010

In the past, several attempts have been made to develop in vitro methods for determining protection against UV radiation. To date however, there is no broadly accepted method. Various known and unknown parameters influence the transmission measurements of scattering films, such as the multifaceted compositions of sunscreens, the technical limitations of measurement devices as well as the difficulty to apply very thin films of sunscreen in a reproducible manner throughout different laboratories. In vitro data were measured in this multicenter study to compare possible methodologies and strategies for an in vitro approach to the sun protection factor (SPF). This publication will not present a final in vitro SPF test method, but it will point out which technical side effects may influence such a method. Influential factors such as the quality of spectrophotometer used, the amount of product applied, pretreatment of samples, time and temperature of equilibration, size of the measured surface, the application process or the calculation on the basis of standardized data are presented and discussed. Finally, a reduction of the standard deviations within single laboratories could be realized for in vitro SPF testing, but no improvement of the interlaboratory comparison was obtained. The development of a valid and reliable SPF in vitro test still remains a challenge, and further work is necessary to develop a satisfactory method.
A Comparison of Three Types of Autobiographical Memories in Old-Old Age: First Memories, Pivotal Memories and Traumatic Memories
Authors: Cohen-Mansfield Jiska , Shmotkin Dov , Eyal Nitza , Reichental Yael , Hazan Haim
Published: March 2010

Background: Autobiographical memory enables us to construct a personal narrative through which we identify ourselves. Especially important are memories of formative events. Objective: This study describes autobiographical memories of people who have reached old-old age (85 years and above), studying 3 types of memories of particular impact on identity and adaptation: first memories, pivotal memories and traumatic memories. In this paper, we examine the content, characteristic themes and environments, and structural characteristics of each of the 3 types of memory. Methods: The participants were 26 persons from a larger longitudinal study with an average age of 91 years; half were men and the other half women. The study integrated qualitative and quantitative tools. An open-ended questionnaire included questions about the participants’ life story as well as questions about the 3 types of memories. The responses were rated by 3 independent judges on dimensions of central themes and structural characteristics. Results: First memories had a more positive emotional tone, more references to characters from the participant’s social circle, a stronger sense of group belonging, and a more narrative style than the other types of memories. Pivotal and traumatic memories were described as more personal than first memories. Conclusion: The 3 types of memories reflect different stages in life development, which together form a sense of identity. They present experiences from the past on select themes, which may assist in the complex task of coping with the difficulties and limitations that advanced old age presents. Future research should examine the functional role of those memories and whether they enable the old-old to support selfhood in the challenging period of last changes and losses.
Age- and Gender-Dependent Changes in Connective Tissue Remodeling: Physiological Differences in Circulating MMP-3, MMP-10, TIMP-1 and TIMP-2 Level
Authors: Komosinska-Vassev Katarzyna , Olczyk Pawel , Winsz-Szczotka Katarzyna , Kuznik-Trocha Kornelia , Klimek Katarzyna , Olczyk Krystyna
Published: March 2010

Background: The mechanisms which cause age-dependent remodeling of connective tissue are still not fully understood. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) constitute an important proteolytic pathway affecting physiological matrix remodeling. Objective: The way in which changes in the extracellular matrix metabolism during the ageing process influence the level of circulating MMP-3 and MMP-10, as well as their tissue inhibitors TIMP-1 and TIMP-2, in a healthy population was investigated in this study. Methods: Blood samples were taken from 81 healthy individuals aged 6–62 years and measured for MMP-3, MMP-10, TIMP-1 and TIMP-2 levels using enzyme-linked immunosorbent assays. Polyacrylamide gel electrophoresis followed by Western immunoblotting allowed for the detection of pro- and active forms of both MMPs. Results: Serum MMP-3 and TIMP-1 values were positively correlated with age (r = 0.44, p = 0.00001 and r = 0.28, p = 0.012, respectively). A contrary tendency was found for MMP-10 and TIMP-2 serum levels. A strong age-related decrease in MMP-10 (–0.53; p = 0.000) and TIMP-2 (–0.52; p = 0.000) was noticed in our study. Gender was a significant factor modifying MMP/TIMP potential, except for the MMP-10 level. Conclusions: The data presented indicate that changes in MMP/TIMP balance occur in physiological ageing. Moreover, these findings highlight the necessity of utilizing age- and sex-matched values for analysis of MMPs and TIMPs in the pathological conditions.
Recent Declines in Hospitalizations for Acute Myocardial Infarction for Medicare Fee-for-Service Beneficiaries
Authors: Chen Jersey , Normand Sharon-Lise T. , Wang Yun , Drye Elizabeth E. , Schreiner Geoffrey C. , Krumholz Harlan M.
Published: March 2010

Background—

Amid recent efforts to reduce cardiovascular risk, whether rates of acute myocardial infarction (AMI) in the United States have declined for elderly patients is unknown.

Methods and Results—

Medicare fee-for-service patients hospitalized in the United States with a principal discharge diagnosis of AMI were identified through the use of data from the Centers for Medicare and Medicaid Services from 2002 to 2007, a time period selected to reduce changes arising from the new definition of AMI. The Medicare beneficiary denominator file was used to determine the population at risk. AMI hospitalization rates were calculated annually per 100 000 beneficiary-years with Poisson regression analysis and stratified according to age, sex, and race. The annual AMI hospitalization rate in the fee-for-service Medicare population fell from 1131 per 100 000 beneficiary-years in 2002 to 866 in 2007, a relative 23.4% decline. After adjustment for age, sex, and race, the AMI hospitalization rate declined by 5.8%/y. From 2002 to 2007, white men experienced a 24.4% decrease in AMI hospitalizations, whereas black men experienced a smaller decline (18.0%;
P
<0.001 for interaction). Black women had a smaller decline in AMI hospitalization rate compared with white women (18.4% versus 23.3%, respectively;
P
<0.001 for interaction).

Conclusions—

AMI hospitalization rates fell markedly in the Medicare fee-for-service population between 2002 and 2007. However, black men and women appeared to have had a slower rate of decline compared with their white counterparts.
Augmentation of Left Ventricular Contractility by Cardiac Sympathetic Neural Stimulation
Authors: Meyer Christian , Rana Obaida R. , Saygili Erol , Gemein Christopher , Becker Michael , Nolte Kay W. , Weis Joachim , Schimpf Thomas , Knackstedt Christian , Mischke Karl , Hoffmann Rainer , Kelm Malte , Pauza Dainius , Schauerte Patrick
Published: March 2010

Background—

Electric stimulation of mediastinal sympathetic cardiac nerves increases cardiac contractility but is not selective for the left ventricle because it elicits sinus tachycardia and enhanced atrioventricular conduction. The aim of this study was to identify sympathetic neural structures inside the heart that selectively control left ventricular inotropy and can be accessed by transvenous catheter stimulation.

Methods and Results—

In 20 sheep, high-frequency stimulation (200 Hz) during the myocardial refractory period with electrode catheters inside the coronary sinus evoked a systolic left ventricular pressure increase from 97±20 to 138±32 mm Hg (
P
<0.001) without changes in sinus rate or PR time. Likewise, the rate of systolic pressure development (1143±334 versus 1725±632 mm Hg/s;
P
=0.004) and rate of diastolic relaxation (531±128 versus 888±331 mm Hg/s;
P
=0.001) increased. The slope of the end-systolic pressure-volume relationship increased (2.3±0.8 versus 3.1±0.6 mm Hg/mL;
P
=0.04), as did cardiac output (3.5±0.8 versus 4.4±0.8 L/min;
P
<0.001). Systemic vascular resistance and right ventricular pressure remained unchanged. There was a sigmoid dose-response curve. Ultrasound analysis revealed an increase in circumferential and radial strain in all left ventricular segments that was significant for the posterior, lateral, and anterior segments. Pressure effects were maintained for at least 4 hours of continued high-frequency stimulation and abolished by β1-receptor blockade. Histology showed distinct adrenergic nerve bundles at the high-frequency stimulation site.

Conclusions—

Cardiac nerve fibers that innervate the left ventricle are amenable to transvenous electric catheter stimulation. This may permit direct interference with and modulation of the sympathetic tone of the left ventricle.
Adipocyte Modulation of High-Density Lipoprotein Cholesterol
Authors: Zhang YuZhen , McGillicuddy Fiona C. , Hinkle Christine C. , O'Neill Sean , Glick Jane M. , Rothblat George H. , Reilly Muredach P.
Published: March 2010

Background—

Adipose harbors a large depot of free cholesterol. However, a role for adipose in cholesterol lipidation of high-density lipoprotein (HDL) in vivo is not established. We present the first evidence that adipocytes support transfer of cholesterol to HDL in vivo as well as in vitro and implicate ATP-binding cassette subfamily A member 1 (ABCA1) and scavenger receptor class B type I (SR-BI), but not ATP-binding cassette subfamily G member 1 (ABCG1), cholesterol transporters in this process.

Methods and Results—

Cholesterol efflux from wild-type, ABCA1
−/−
, SR-BI
−/−
, and ABCG1
−/−
adipocytes to apolipoprotein A-I (apoA-I) and HDL3 were measured in vitro. 3T3L1 adipocytes, labeled with
3
H-cholesterol, were injected intraperitoneally into wild-type, apoA-I transgenic, and apoA-I
−/−
mice, and tracer movement onto plasma HDL was monitored. Identical studies were performed with labeled wild-type, ABCA1
−/−
, or SR-BI
−/−
mouse embryonic fibroblast adipocytes. The effect of tumor necrosis factor-α on transporter expression and cholesterol efflux was monitored during adipocyte differentiation. Cholesterol efflux to apoA-I and HDL3 was impaired in ABCA1
−/−
and SR-BI
−/−
adipocytes, respectively, with no effect observed in ABCG1
−/−
adipocytes. Intraperitoneal injection of labeled 3T3L1 adipocytes resulted in increased HDL-associated
3
H-cholesterol in apoA-I transgenic mice but reduced levels in apoA-I
−/−
animals. Intraperitoneal injection of labeled ABCA1
−/−
or SR-BI
−/−
adipocytes reduced plasma counts relative to their respective controls. Tumor necrosis factor-α reduced both ABCA1 and SR-BI expression and impaired cholesterol efflux from partially differentiated adipocytes.

Conclusions—

These data suggest a novel metabolic function of adipocytes in promoting cholesterol transfer to HDL in vivo and implicate adipocyte SR-BI and ABCA1, but not ABCG1, in this process. Furthermore, adipocyte modulation of HDL may be impaired in adipose inflammatory disease states such as type 2 diabetes mellitus.
Prognostic Value of the Morning Blood Pressure Surge in 5645 Subjects From 8 Populations
Authors: Li Yan , Thijs Lutgarde , Hansen Tine W. , Kikuya Masahiro , Boggia José , Richart Tom , Metoki Hirohito , Ohkubo Takayoshi , Torp-Pedersen Christian , Kuznetsova Tatiana , Stolarz-Skrzypek Katarzyna , Tikhonoff Valérie , Malyutina Sofia , Casiglia Edoardo , Nikitin Yuri , Sandoya Edgardo , Kawecka-Jaszcz Kalina , Ibsen Hans , Imai Yutaka , Wang Jiguang , Staessen Jan A.
Published: March 2010

Previous studies on the prognostic significance of the morning blood pressure surge (MS) produced inconsistent results. Using the International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome, we analyzed 5645 subjects (mean age: 53.0 years; 54.0% women) randomly recruited in 8 countries. The sleep-through and the preawakening MS were the differences in the morning blood pressure with the lowest nighttime blood pressure and the preawakening blood pressure, respectively. We computed multivariable-adjusted hazard ratios comparing the risk in ethnic- and sex-specific deciles of the MS relative to the average risk in the whole study population. During follow-up (median: 11.4 years), 785 deaths and 611 fatal and nonfatal cardiovascular events occurred. While accounting for covariables and the night:day ratio of systolic pressure, the hazard ratio of all-cause mortality was 1.32 (95% CI: 1.09 to 1.59;
P
=0.004) in the top decile of the systolic sleep-through MS (≥37.0 mm Hg). For cardiovascular and noncardiovascular death, these hazard ratios were 1.18 (95% CI: 0.87 to 1.61;
P
=0.30) and 1.42 (95% CI: 1.11 to 1.80;
P
=0.005). For all cardiovascular, cardiac, coronary, and cerebrovascular events, the hazard ratios in the top decile of the systolic sleep-through MS were 1.30 (95% CI: 1.06 to 1.60;
P
=0.01), 1.52 (95% CI: 1.15 to 2.00;
P
=0.004), 1.45 (95% CI: 1.04 to 2.03;
P
=0.03), and 0.95 (95% CI: 0.68 to 1.32;
P
=0.74), respectively. Analysis of the preawakening systolic MS and the diastolic MS generated consistent results. In conclusion, a MS above the 90th percentile significantly and independently predicted cardiovascular outcome and might contribute to risk stratification by ambulatory blood pressure monitoring.
Impact of Blood Pressure Lowering on Cardiovascular Outcomes in Normal Weight, Overweight, and Obese Individuals
Authors: Czernichow Sébastien , Ninomiya Toshiharu , Huxley Rachel , Kengne André-Pascal , Batty G. David , Grobbee Diederick E. , Woodward Mark , Neal Bruce , Chalmers John
Published: March 2010

There is considerable uncertainty regarding the efficacy of blood pressure–lowering therapy in reducing cardiovascular risk in obese people. In this report we examine the effects of blood pressure lowering according to baseline body mass index (kilograms per meter squared) in the Perindopril Protection Against Recurrent Stroke Study. A total of 6105 participants with cerebrovascular disease were randomized to perindopril-based blood pressure–lowering therapy or placebo. The overall mean difference in systolic/diastolic blood pressure between participants assigned active therapy or placebo was 9/4 mm Hg (SE: 0.5/0.3 mm Hg), with no difference by body mass index quarters (<23.1, 23.1 to 25.3, 25.4 to 27.8, and ≥27.9 kg/m
2
). A consistent treatment benefit was demonstrated for protection against major vascular events across quarters with the following hazard ratios (95% CIs): 0.80 (0.62 to 1.02), 0.78 (0.61 to 1.01), 0.67 (0.53 to 0.86), 0.69 (0.54 to 0.88), and 0.74 (0.66 to 0.84;
P
for heterogeneity=0.16). Similar results were apparent for stroke and stroke subtypes (all
P
for heterogeneity ≥0.07) or with the standard definitions of overweight and obesity (<25, 25 to 29, and ≥30 kg/m
2
; all
P
for heterogeneity ≥0.28). The absolute effects of treatment were, however, more than twice that in the highest compared with the lowest body mass index quartile. Across increasing quarters of body mass index over 5 years, active therapy prevented 1 major vascular event among every 28, 23, 13, and 13 patients treated. In conclusion, blood pressure–lowering therapy produced comparable risk reductions in vascular disease across the whole range of body mass indices in participants with a history of stroke. However, the greater baseline level of cardiovascular risk in those with higher body mass index meant that these patients obtained the greatest benefit.
Estradiol-17β and Its Cytochrome P450- and Catechol-O-Methyltransferase–Derived Metabolites Stimulate Proliferation in Uterine Artery Endothelial Cells
Authors: Jobe Sheikh O. , Ramadoss Jayanth , Koch Jill M. , Jiang Yizhou , Zheng Jing , Magness Ronald R.
Published: March 2010

Estradiol-17β (E2β) and its metabolites, which are sequentially synthesized by cytochrome P450s and catechol-O-methyltransferase to form 2 and 4-hydroxyestradiol (OHE2) and 2- and 4-methoxestradiol (ME2), are elevated during pregnancy. We investigated whether cytochrome P450s and catechol-O-methyltransferase are expressed in uterine artery endothelial cells (UAECs) and whether E2β and its metabolites modulate cell proliferation via ER-α and/or ER-β and play roles in physiological uterine angiogenesis during pregnancy. Cultured ovine UAECs from pregnant and nonpregnant ewes were treated with 0.1 to 100.0 nmol/L of E2β, 2-OHE2, 4-OHE2, 2-ME2, and 4-ME2. ER-α or ER-β specificity was tested using ICI 182 780, ER-α–specific 1,3-bis(4-hydroxyphenyl)-4-methyl-5-[4-(2-piperidinyleth oxy)phenol]-1H-pyrazole dihydrochloride, ER-β–specific 4-[2-phenyl-5,7-bis(trifluoromethyl)pyrazolo [1,5-a]pyrim idin-3-yl]phenol antagonists and their respective agonists ER-α–specific 4,4′,4"-(4-propyl-[1H]-pyrazole-1,3,5-triyl)trisphenol and ER-β–specific 2,3-bis(4-Hydroxyphenyl)-propionitrile. Angiogenesis was evaluated using 5-bromodeoxyuridine proliferation assay. Using confocal microscopy and Western analyses to determine enzyme location and levels, we observed CYP1A1, CYP1A2, CYP1B1, CYP3A4, and catechol-O-methyltransferase expression in UAECs; however, expressions were similar between nonpregnant UAECs and pregnant UAECs. E2β, 2-OHE2, 4-OHE2, and 4-ME2treatments concentration-dependently stimulated proliferation in pregnant UAECs but not in nonpregnant UAECs; 2-ME2did not stimulate proliferation in either cell type. Proliferative responses of pregnant UAECs to E2β were solely mediated by ER-β, whereas responses to E2β metabolites were neither ER-α nor ER-β mediated. We demonstrate an important vascular role for E2β, its cytochrome P450- and catechol-O-methyltransferase–derived metabolites, and ER-β in uterine angiogenesis regulation during pregnancy that may be dysfunctional in preeclampsia and other cardiovascular disorders.
Arterial Destiffening With Weight Loss in Overweight and Obese Middle-Aged and Older Adults
Authors: Dengo A. Laura , Dennis Elizabeth A. , Orr Jeb S. , Marinik Elaina L. , Ehrlich Elizabeth , Davy Brenda M. , Davy Kevin P.
Published: March 2010

We tested the hypothesis that weight loss via a hypocaloric diet would reduce arterial stiffness in overweight and obese middle-aged and older adults. Thirty-six individuals were randomly assigned to a weight loss (n=25; age: 61.2±0.8 years; body mass index: 30.0±0.6 kg/m
2
) or a control (n=11; age: 66.1±1.9 years; body mass index: 31.8±1.4 kg/m
2
) group. Arterial stiffness was measured via carotid artery ultrasonography combined with applanation tonometry and carotid-femoral pulse wave velocity via applanation tonometry at baseline and after the 12-week intervention. Body weight, body fat, abdominal adiposity, blood pressure, β-stiffness index, and carotid-femoral pulse wave velocity were similar in the 2 groups at baseline (all
P
>0.05). Body weight (−7.1±0.7 versus −0.7±1.1 kg), body fat, and abdominal adiposity decreased in the weight loss group but not in the control group (all
P
<0.05). Brachial systolic and diastolic blood pressures declined (
P
<0.05) only in the weight loss group. Central systolic and pulse pressures did not change significantly in either group. β-Stiffness index (−1.24±0.22 versus 0.52±0.37 U) and carotid-femoral pulse wave velocity (−187±29 versus 15±42 cm/s) decreased in the weight loss group but not in the control group (all
P
<0.05). The reductions in carotid-femoral pulse wave velocity were correlated with reductions in total body and abdominal adiposity (
r
=0.357–0.602; all
P
<0.05). However, neither total body nor abdominal adiposity independently predicted reductions in arterial stiffness indices. In summary, our findings indicate that weight loss reduces arterial stiffness in overweight/obese middle-aged and older adults, and the magnitudes of these improvements are related to the loss of total and abdominal adiposity.
Effects of the Dietary Approaches to Stop Hypertension Diet Alone and in Combination With Exercise and Caloric Restriction on Insulin Sensitivity and Lipids
Authors: Blumenthal James A. , Babyak Michael A. , Sherwood Andrew , Craighead Linda , Lin Pao-Hwa , Johnson Julie , Watkins Lana L. , Wang Jenny T. , Kuhn Cynthia , Feinglos Mark , Hinderliter Alan
Published: March 2010

This study examined the effects of the Dietary Approaches to Stop Hypertension (DASH) diet on insulin sensitivity and lipids. In a randomized control trial, 144 overweight (body mass index: 25 to 40) men (n=47) and women (n=97) with high blood pressure (130 to 159/85 to 99 mm Hg) were randomly assigned to one of the following groups: (1) DASH diet alone; (2) DASH diet with aerobic exercise and caloric restriction; or (3) usual diet controls (UC). Body composition, fitness, insulin sensitivity, and fasting lipids were measured before and after 4 months of treatment. Insulin sensitivity was estimated on the basis of glucose and insulin levels in the fasting state and after an oral glucose load. Participants in the DASH diet with aerobic exercise and caloric restriction condition lost weight (−8.7 kg [95% CI: −2.0 to −9.7 kg]) and exhibited a significant increase in aerobic capacity, whereas the DASH diet alone and UC participants maintained their weight (−0.3 kg [95% CI: −1.2 to 0.5 kg] and +0.9 kg [95% CI: 0.0 to 1.7 kg], respectively) and had no improvement in exercise capacity. DASH diet with aerobic exercise and caloric restriction demonstrated lower glucose levels after the oral glucose load, improved insulin sensitivity, and lower total cholesterol and triglycerides compared with both DASH diet alone and UC, as well as lower fasting glucose and low-density lipoprotein cholesterol compared with UC. DASH diet alone participants generally did not differ from UC in these measures. Combining the DASH diet with exercise and weight loss resulted in significant improvements in insulin sensitivity and lipids. Despite clinically significant reductions in blood pressure, the DASH diet alone, without caloric restriction or exercise, resulted in minimal improvements in insulin sensitivity or lipids.
Initial Maintenance of Tropical Cyclone Size in the Western North Pacific
Authors: Lee Cheng-Shang , Cheung Kevin K. W. , Fang Wei-Ting , Elsberry Russell L.
Published: March 2010

A tropical cyclone (TC) size parameter, which is defined here as the radius of 15 m s−1 near-surface wind speed (R15), is calculated for 145 TCs in the western North Pacific during 2000–05 based on QuikSCAT oceanic winds. For the 73 TCs that intensified to typhoon intensity during their lifetimes, the 33% and 67% respective percentiles of R15 at tropical storm intensity and at typhoon intensity are used to categorize small, medium, and large TCs. Whereas many of the small TCs form from an easterly wave synoptic pattern, the monsoon-related formation patterns are favorable for forming medium to large TCs. Most of these 73 TCs stay in the same size category during intensification, which implies specific physical mechanisms for maintaining TC size in the basin. The 18 persistently large TCs from the tropical storm to the typhoon stage mostly have northwestward or north-northwestward tracks, while the 16 persistently small TCs either move westward–northwestward in lower latitudes or develop at higher latitudes with various track types. For the large TCs, strong low-level southwesterly winds exist in the outer core region south of the TC center throughout the intensification period. The small TCs are more influenced by the subtropical high during intensification. The conclusion is that it is the low-level environment that determines the difference between large and small size storms during the early intensification period in the western North Pacific.
Incorporating Ensemble Covariance in the Gridpoint Statistical Interpolation Variational Minimization: A Mathematical Framework
Authors: Wang Xuguang
Published: March 2010

Gridpoint statistical interpolation (GSI), a three-dimensional variational data assimilation method (3DVAR) has been widely used in operations and research in numerical weather prediction. The operational GSI uses a static background error covariance, which does not reflect the flow-dependent error statistics. Incorporating ensemble covariance in GSI provides a natural way to estimate the background error covariance in a flow-dependent manner. Different from other 3DVAR-based hybrid data assimilation systems that are preconditioned on the square root of the background error covariance, commonly used GSI minimization is preconditioned upon the full background error covariance matrix. A mathematical derivation is therefore provided to demonstrate how to incorporate the flow-dependent ensemble covariance in the GSI variational minimization.
Please Consider Not Taking the Lord’s Name in Vain
Authors: Lerner Berel Dov
Published: March 2010

This paper discusses Judaism’s prohibition against uttering the Tetragrammaton and suggests that Christians should consider the sensitivities of Jewish listeners before using the Tetragrammaton in speech.
Context, strategy and financial participation: A comparative analysis
Authors: Croucher Richard , Brookes Michael , Wood Geoffrey , Brewster Chris
Published: March 2010

This article investigates where financial participation is most likely to be encountered, and explores its compatibility with collective forms of employee voice. It is based on the findings of a major international survey of human resource management (HRM) practices. We found that financial participation was not affected by collective employee voice, but that national context and associated HRM strategies had significant effects on its nature and extent. As financial participation is likely to make for greater variation in wage rates, it tends to weaken industry-level bargaining. By re-casting the fundamental determinants of wages, it is also likely to facilitate greater wage dispersion within the firm. Hence, it was found that financial participation is more commonly encountered in liberal market contexts, and in firms practising calculative HRM, where countervailing employee power is weak, whether or not collective bargaining is formally present.
La dimension conséquentielle et la nouvelle pluralité religieuse de l’Espagne actuelle
Authors: Santiago Jose
Published: March 2010

L’auteur approfondit la dimension conséquentielle de la vie religieuse, qui a acquis une popularité remarquable en sociologie de la religion, grâce à Stark et à Glock. Il évoque, à l’appui des thèses de Dobbelaere, les différentes dimensions de la sécularisation, puis entre dans le débat sur le contenu de la dimension conséquentielle, pour privilégier une façon de la concevoir héritée des travaux de Weber. Après avoir souligné son importance pour rendre compte du processus de sécularisation des sociétés occidentales, l’auteur se centre sur l’analyse de cette dimension dans le cas espagnol. D’une part, il montre, grâce à une série historique de données quantitatives, le changement qu’a subi la société espagnole durant les dernières décennies. D’autre part, les données les plus récentes lui permettent d’étudier les différences entre les immigrants et les autochtones dans le nouveau contexte de pluralité religieuse.
A transactional analysis of maternal negativity and child externalizing behavior
Authors: Zadeh Zohreh Yaghoub , Jenkins Jennifer , Pepler Debra
Published: March 2010

A transactional model was used to examine the reciprocal relationship between maternal negativity and child externalizing behavior over three time points. Data were collected from 1,479 children and their mothers every two years, as part of the National Longitudinal Survey of Children and Youth (NLSCY). Children were 10—11 years old at Time 1, 12—13 at Time 2, and 14—15 at Time 3. Measures of maternal negativity were obtained from both mothers and children, while measures of child externalizing behavior were obtained from children only. Structural Equation Modeling revealed that both members of the dyad influenced one another’s behavior, with evidence of a recursive feedback loop over time. These influences were not equal (across persons) or stable (across time). Children’s influence on the development of maternal negativity increased over time.