bluuebunny/crossref_metadata_2025 huggingface dataset:
Moderate oxygen augments lipopolysaccharide-induced lung injury in mice
Authors: Aggarwal Neil R. , D'Alessio Franco R. , Tsushima Kenji , Files D. Clark , Damarla Mahendra , Sidhaye Venkataramana K. , Fraig Mostafa M. , Polotsky Vsevolod Y. , King Landon S.
Published: December 2009

Despite the associated morbidity and mortality, underlying mechanisms leading to the development of acute lung injury (ALI) remain incompletely understood. Frequently, ALI develops in the hospital, coinciding with institution of various therapies, including the use of supplemental oxygen. Although pathological evidence of hyperoxia-induced ALI in humans has yet to be proven, animal studies involving high oxygen concentration reproducibly induce ALI. The potentially injurious role of lower and presumably safer oxygen concentrations has not been well characterized in any species. We hypothesized that in the setting of a preexisting insult to the lung, the addition of moderate-range oxygen can augment lung injury. Our model of low-dose intratracheal LPS (IT LPS) followed by 60% oxygen caused a significant increase in ALI compared with LPS or oxygen alone with increased alveolar neutrophils, histological injury, and epithelial barrier permeability. In the LPS plus oxygen group, regulatory T cell number was reduced, and macrophage activation markers were increased, compared with LPS alone. Antibody-mediated depletion of neutrophils significantly abrogated the observed lung injury for all measured factors. The enhanced presence of alveolar neutrophils in the setting of LPS and oxygen is due, at least in part, to elevated chemokine gradients signaling neutrophils to the alveolar space. We believe these results strongly support an effect of lower concentrations of oxygen to augment the severity of a mild preexisting lung injury and warrants further investigation in both animals and humans.
Acclimation to decompression sickness in rats
Authors: Montcalm-Smith E. A. , McCarron R. M. , Porter W. R. , Lillo R. S. , Thomas J. T. , Auker C. R.
Published: December 2009

Protection against decompression sickness (DCS) by acclimation to hyperbaric decompression has been hypothesized but never proven. We exposed rats to acclimation dives followed by a stressful “test” dive to determine whether acclimation occurred. Experiments were divided into two phases. Phase 1 rats were exposed to daily acclimation dives of hyperbaric air for 30 min followed by rapid decompression on one of the following regimens: 70 ft of seawater (fsw) for 9 days (L70), 70 fsw for 4 days (S70), 40 fsw for 9 days (L40), 40 fsw for 4 days (S40), or unpressurized sham exposure for 9 days (Control). On the day following the last exposure, all were subjected to a “test” dive (175 fsw, 60 min, rapid decompression). Both L70 and S70 rats had significantly lower incidences of DCS than Control rats (36% and 41% vs. 62%, respectively). DCS incidences for the other regimens were lower than in Control rats but without statistical significance. Phase 2 used the most protective regimen from phase 1 (L70); rats were exposed to L70 or a similar regimen with a less stressful staged decompression. Another group was exposed to a single acclimation dive (70 fsw/30 min) on the day before the test dive. We observed a nonsignificant trend for the rapidly decompressed L70 dives to be more protective than staged decompression dives (44% vs. 51% DCS incidence). The single acclimation dive regimen did not provide protection. We conclude that protection against DCS can be attained with acclimating exposures that do not themselves cause DCS. The deeper acclimation dive regimens (70 fsw) provided the most protection.
Analysis of Isovolumic Relaxation in Failing Hearts by Monoexponential Time Constants Overestimates Lusitropic Change and Load Dependence
Authors: Senzaki Hideaki , Kass David A.
Published: December 2009

Background—

Failing hearts display slow relaxation with apparent increased load sensitivity. However, inaccuracies of monoexponential analysis can contribute to these observations, and different qualitative and quantitative results might be obtained by alternative models. We tested whether pressure relaxation of failing hearts consistently deviates from a monoexponential waveform, leading to overestimations of lusitropic change and load sensitivity by monoexponential-derived time constants.

Methods and Results—

Fourteen dogs were studied before and after tachycardia pacing-induced heart failure. Relaxation time constants were derived by monoexponential fits (τ
E
) with zero or nonzero asymptotes and by a logistic fit (τ
L
). τ
L
assumes nonlinear relations between pressure and its first derivative, whereas τ
E
assumes a linear dependence. Load sensitivity of τ was tested by comparing beats during vena caval occlusion. τ
E
prolonged by 75% to 80% with heart failure, 3 times more than τ
L
(
P
<0.01). τ
E
displayed marked load sensitivity in failing hearts, shortening during preload reduction, whereas τ
L
was little changed by the same loading maneuver. Neither τ
L
nor τ
E
varied with preload in control hearts. The discrepancy between τ
E
and τ
L
results was due to nonmonoexponential decay reflected by nonlinear pressure-time derivative of pressure plots, which was enhanced with heart failure (
P
<0.01). This nonlinearity was reduced by β-adrenergic stimulation, lowering preload sensitivity of τ
E
to control levels.

Conclusions—

Isovolumic relaxation in failing hearts deviates from a monoexponential waveform, leading to overestimated relaxation delay and increased load sensitivity of monoexponential time constants. This deviation is under β-adrenergic modulation. The logistic model improves the fit-to-real pressure decay in failing hearts, providing more stable measures of relaxation.
Role of Mesodermal FGF8 and FGF10 Overlaps in the Development of the Arterial Pole of the Heart and Pharyngeal Arch Arteries
Authors: Watanabe Yusuke , Miyagawa-Tomita Sachiko , Vincent Stéphane D. , Kelly Robert G. , Moon Anne M. , Buckingham Margaret E.
Published: December 2009

Rationale
:

The genes encoding fibroblast growth factor (FGF) 8 and 10 are expressed in the anterior part of the second heart field that constitutes a population of cardiac progenitor cells contributing to the arterial pole of the heart. Previous studies of hypomorphic and conditional
Fgf8
mutants show disrupted outflow tract (OFT) and right ventricle (RV) development, whereas
Fgf10
mutants do not have detectable OFT defects.

Objectives
:

Our aim was to investigate functional overlap between
Fgf8
and
Fgf10
during formation of the arterial pole.

Methods and Results
:

We generated mesodermal
Fgf8; Fgf10
compound mutants with
MesP1Cre
. The OFT/RV morphology in these mutants was affected with variable penetrance; however, the incidence of embryos with severely affected OFT/RV morphology was significantly increased in response to decreasing
Fgf8
and
Fgf10
gene dosage.
Fgf8
expression in the pharyngeal arch ectoderm is important for development of the pharyngeal arch arteries and their derivatives. We now show that
Fgf8
deletion in the mesoderm alone leads to pharyngeal arch artery phenotypes and that these vascular phenotypes are exacerbated by loss of
Fgf10
function in the mesodermal core of the arches.

Conclusions
:

These results show functional overlap of FGF8 and FGF10 signaling from second heart field mesoderm during development of the OFT/RV, and from pharyngeal arch mesoderm during pharyngeal arch artery formation, highlighting the sensitivity of these key aspects of cardiovascular development to FGF dosage.
The C Terminus of Cardiac Troponin I Stabilizes the Ca
2+
-Activated State of Tropomyosin on Actin Filaments
Authors: Galińska Agnieszka , Hatch Victoria , Craig Roger , Murphy Anne M. , Van Eyk Jennifer E. , Wang C. -L. Albert , Lehman William , Foster D. Brian
Published: December 2009

Rationale
:

Ca
2+
control of troponin–tropomyosin position on actin regulates cardiac muscle contraction. The inhibitory subunit of troponin, cardiac troponin (cTn)I is primarily responsible for maintaining a tropomyosin conformation that prevents crossbridge cycling. Despite extensive characterization of cTnI, the precise role of its C-terminal domain (residues 193 to 210) is unclear. Mutations within this region are associated with restrictive cardiomyopathy, and C-terminal deletion of cTnI, in some species, has been associated with myocardial stunning.

Objective
:

We sought to investigate the effect of a cTnI deletion–removal of 17 amino acids from the C terminus– on the structure of troponin-regulated tropomyosin bound to actin.

Methods and Results
:

A truncated form of human cTnI (cTnI
1–192
) was expressed and reconstituted with troponin C and troponin T to form a mutant troponin. Using electron microscopy and 3D image reconstruction, we show that the mutant troponin perturbs the positional equilibrium dynamics of tropomyosin in the presence of Ca
2+
. Specifically, it biases tropomyosin position toward an “enhanced C-state” that exposes more of the myosin-binding site on actin than found with wild-type troponin.

Conclusions
:

In addition to its well-established role of promoting the so-called “blocked-state” or “B-state,” cTnI participates in proper stabilization of tropomyosin in the “Ca
2+
-activated state” or “C-state.” The last 17 amino acids perform this stabilizing role. The data are consistent with a “fly-casting” model in which the mobile C terminus of cTnI ensures proper conformational switching of troponin–tropomyosin. Loss of actin-sensing function within this domain, by pathological proteolysis or cardiomyopathic mutation, may be sufficient to perturb tropomyosin conformation.
Evaluation of the Medtronic Exponent Self-Expanding Carotid Stent System With the Medtronic Guardwire Temporary Occlusion and Aspiration System in the Treatment of Carotid Stenosis
Authors: Higashida Randall T. , Popma Jeffrey J. , Apruzzese Patricia , Zimetbaum Peter
Published: December 2009

Background and Purpose—

Embolic protection devices and improved stent technology have advanced the endovascular treatment of carotid artery disease. A combined analysis was performed of the MAVErIC (
M
edtronic
AVE
Self-expanding Ca
R
otid Stent System with distal protection) I and II trials to evaluate the safety and feasibility of this system among patients at high risk for surgical endarterectomy.

Methods—

Four hundred ninety-eight patients were enrolled in the MAVErIC I (99 patients) and MAVErIC II (399 patients) studies from June 2001 to October 2004. The results were pooled for statistical analysis of a common primary end point, the 365-day rate of major adverse events. Clinical follow-up took place at 30 days, 6 months, and 365 days postprocedure.

Results—

The 365-day major adverse event rate, defined as death, stroke, or myocardial infarction within 30 days, and death, ipsilateral stroke, or myocardial infarction from days 31 to 365 was 12.5%. The incidence of neurological death through 365 days was 1.1%. The 30-day major adverse event rate was 5.4%. Subgroup analyses showed no notable differences in the 365-day major adverse event rate for symptomatic patients compared with asymptomatic patients.

Conclusion—

Treatment of carotid artery disease with carotid artery stenting with a self-expanding stent and distal embolic protection results in a low 30-day adverse event rate, including the occurrence of stroke in patients at high risk for carotid endarterectomy.
Ethnic Influences on Neurovascular Coupling
Authors: Hao Qing , Wong Lawrence K.S. , Lin Wen Hua , Leung Thomas W.H. , Kaps Manfred , Rosengarten Bernhard
Published: December 2009

Background and Purpose—

An ethnic extraintracranial difference in atherosclerosis has been well reported, whereas the potential mechanism remains unclear. We aimed to investigate neurovascular coupling in healthy whites and Asians.

Methods —

Twenty volunteers of each ethnicity were recruited to perform a functional transcranial Doppler examination with standardized checkerboard patterns as visual stimulation (3×4, 6×8, and 12×16 checks subtending a visual field section of 18°×24°, flicker rate 1 Hz). Hemodynamic responses in both posterior cerebral arteries were evaluated with a control system approach.

Results—

The rate time, that is, the initial speed of flow velocity adaptation, was significantly lower in Asians leading to an approximately 2-second delayed hemodynamic adaptation. The other hemodynamic parameters and the dependency of hemodynamic responses in regard to the complexity degree of the stimulus were similar between groups.

Conclusion—

The constellation suggests a greater initial mismatch between functionally increased metabolic demand of neurons and adjusted cerebral blood flow in Asians.
Frequency and Determinants of Lipid Testing in Ischemic Stroke and Transient Ischemic Attack
Authors: Smith Eric E. , Pan Wenqin , Olson DaiWai , Reeves Mathew J. , Ovbiagele Bruce , Peterson Eric D. , Fonarow Gregg C. , Schwamm Lee H.
Published: December 2009

Background and Purpose—

National guidelines recommend lipid testing for all patients with ischemic stroke and transient ischemic attack. This study examined the frequency and predictors for in-hospital low-density lipoprotein testing using data from a nationwide stroke registry.

Methods—

Between 2003 and 2008, Get With The Guideline–Stroke (GWTG–Stroke) hospitals (n=981) contributed 479 284 consecutive ischemic stroke or transient ischemic attack admissions. Logistic regression models were used to determine patient and hospital characteristics associated with lipid testing.

Results—

Frequency of LDL measurement increased from 54.3% in 2003 to 81.9% in 2008 (
P
<0.001), the adjusted OR for LDL measurement was 1.23 per additional calendar year (95% CI, 1.18 to 1.29;
P
<0.001). The frequency of LDL measurement also increased with longer hospital program participation; the adjusted OR was 1.17 per additional year of GWTG–Stroke participation (95% CI, 1.12 to 1.23;
P
<0.001). LDL measurement was lower in women, nonsmokers, those with atrial fibrillation, those with a history of stroke or transient ischemic attack, and in those with transient ischemic attack (versus ischemic stroke; all
P
<0.001). LDL ≥100 mg/dL was seen in 52.1% of those tested, including in 35.5% of patients already prescribed lipid-lowering therapy before admission.

Conclusions—

Rates of LDL measurement in hospitalized patients with ischemic stroke and transient ischemic attack have improved dramatically in this large quality improvement program, although disparities in testing still exist. Testing frequently revealed an LDL level that could prompt a change in clinical management.
Tuberculosis and the Risk of Ischemic Stroke
Authors: Sheu Jau-Jiuan , Chiou Hung-Yi , Kang Jiunn-Horng , Chen Yi-Hua , Lin Herng-Ching
Published: December 2009

Background and Purpose—

The aim of this study is to estimate the risk of ischemic stroke during a 3-year follow-up period after a tuberculosis diagnosis using a nationwide, population-based study and a retrospective cohort design.

Method—

The study cohort comprised 2283 patients who had received treatment for tuberculosis, except tuberculosis of the meninges and central nervous system, between 2000 and 2003; 6849 randomly selected subjects comprised the comparison cohort. Cox proportional hazard regressions were performed as a means of comparing the 3-year ischemic stroke-free survival rate between these 2 cohorts.

Results—

Of the 9132 sampled patients, 392 (4.3%) experienced ischemic stroke during the 3-year follow-up period, including 136 (6.0% of the tuberculosis patients) from the study cohort and 256 (3.7%) from the comparison cohort. After adjusting for patient age, gender, hypertension, diabetes, coronary heart disease, hyperlipidemia, malignancy, monthly income, and the geographical region and urbanization level of the community in which the patient resided, the hazard ratio of ischemic stroke for tuberculosis patients was 1.52-times (95% CI, 1.21–1.91;
P
<0.001) higher than for comparison patients.

Conclusion—

We conclude that patients with a tuberculosis diagnosis are at an increased risk for ischemic stroke but not hemorrhagic stroke in the next 3 years. Further research is necessary to investigate these findings in tuberculosis-endemic areas.
Fluid-Attenuated Inversion Recovery Evolution Within 12 Hours From Stroke Onset
Authors: Ebinger Martin , Galinovic Ivana , Rozanski Michal , Brunecker Peter , Endres Matthias , Fiebach Jochen B.
Published: December 2009

Background and Purpose—

It has recently been proposed that fluid-attenuated inversion recovery (FLAIR) imaging may serve as a surrogate marker for time of symptom onset after stroke. We assessed the hypothesis that FLAIR imaging could be used to decide if an MRI was performed within 4.5 hours from symptom onset or later.

Methods—

All consecutive patients with presumed stroke who underwent an MRI within 12 hours after known symptom onset were included regardless of stroke subtype and severity between May 2008 and May 2009. Blinded to time of symptom onset, 2 raters judged the visibility of lesions on FLAIR. Apparent diffusion coefficient values, lesion volume on diffusion-weighted imaging, and relative signal intensity of FLAIR lesions were determined.

Results—

In 94 consecutive patients with stroke, we found that median time from symptom onset for FLAIR-positive patients (189 minutes; interquartile range, 110 to 369 minutes) was significantly longer compared with FLAIR-negative patients (103 minutes; interquartile range, 75 to 183 minutes;
P
=0.011). Negative FLAIR had a sensitivity of 46% and a specificity of 79% for allocating patients to a time window of less than 4.5 hours. FLAIR positivity increased with diffusion-weighted imaging lesion volume (
P
<0.001) but showed no correlation with apparent diffusion coefficient values (
P
=0.795). There was no significant correlation between relative signal intensity and time from symptom onset (Spearman correlation coefficient −0.152,
P
=0.128).

Conclusions—

Based on our findings, we cannot recommend the use of FLAIR visibility as an estimate of time from symptom onset within the first 4.5 hours.
Science as Commodities
Authors: Agassi Joseph
Published: December 2009

The paucity of literature on the economics of science renders this book valuable. Also, it includes a few interesting papers. Education and research may become more efficient, and their economic aspects want explanations. The explanations may offer suggestion for improvements. The discussions here are mostly unserious and the serious ones are not far-reaching.They concern patent laws more than seems reasonable and ignore many economic aspects of science, mainly its poor communication systems, including university presses, most of which are inept. Practical proposals should address the worst problems and their implementation need repeated checking. For this, they must be transparent and democratically controlled. The book totally ignores all this.
Safety and Pharmacokinetics of Subcutaneously Administered Rilonacept in Patients With Well‐Controlled End‐Stage Renal Disease (ESRD)
Authors: Radin Allen , Marbury Thomas , Osgood Greg , Belomestnov Pavel
Published: December 2009

The safety and pharmacokinetics of a single dose of the IL‐1 inhibitor, rilonacept (IL‐1 Trap; 160 mg, subcutaneously), was studied in a group of 6 patients with well‐controlled end‐stage renal disease (ESRD) who were observed for a period of 42 days following dosing. The safety of rilonacept administration was ascertained by regular monitoring of patients for adverse events, by periodic determination of a battery of standard laboratory and hematology tests, and by testing for binding and neutralizing antibodies to rilonacept. Two of the 6 patients had treatment‐emergent adverse events that were moderate in intensity and unrelated to administration of rilonacept. There were no deaths, serious adverse events, or withdrawals due to adverse events. No patient developed binding or neutralizing antibodies to rilonacept by the 42nd day postdosing. Mean Cmax estimated by a noncompartmental analysis was 17.2 mg/L; tmax, 2.80 days; terminal t1/2, 7.63 days; and AUC0‐∞, 199.3 d·mg/L. Comparison of these results to those obtained in a population of patients with cryopyrin‐associated periodic syndromes, a group of rare, inherited, autoinflammatory disorders (mean [SD] eGFR of 73.1 [13.3] mL/min/1.73m2), shows that ESRD and related hemodialysis procedures do not prolong the elimination of rilonacept, and therefore no dose adjustment should be needed relative to individuals with normal renal function.
Permeability and Concentration of Levofloxacin in Epithelial Lining Fluid in Patients With Lower Respiratory Tract Infections
Authors: Zhang Jing , Xie Xin , Zhou Xin , Chen Yu‐Qing , Yu Ji‐Cheng , Cao Guo‐Ying , Wu Xiao‐Jie , Shi Yao‐Guo , Zhang Ying‐Yuan
Published: December 2009

The purpose of the study was to assess the bactericidal effects of a single oral dose of levofloxacin (LVFX) by examining the concentration of LVFX in alveolar epithelial lining fluid (ELF) from patients with lower respiratory tract infections (LRTI). Forty patients with LRTI took 500 mg of LVFX and then received a fiberoptic bronchoscopic procedure randomly 1, 4, 8, 12, or 24 hours following dosing. Bronchoalveolar lavage fluid and blood were collected at the time of the bronchopulmonary procedure, and the LVFX concentration was determined. The mean peak concentrations of LVFX in plasma and ELF were achieved at 1.5 hours (4.07 mg/L) and 1 hour (3.44 mg/L), respectively. The AUC24h samples were 50.12 mg · h/L and 34.51 mg · h/L, respectively. The permeability of LVFX, which was estimated based on the ratio of LVFX concentration in tissue fluids to that in plasma, was 0.78 on average across all time points. After a single dose of LVFX in patients with LRTI, the drug rapidly distributed into bronchopulmonary tissue, thereby suggesting this dose is capable of achieving the concentration in target organs required for bactericidal efficacy.
Clostridium difficile Infection in the Intensive Care Unit
Authors: Leclair Marc-André , Allard Catherine , Lesur Olivier , Pépin Jacques
Published: December 2009

Clostridium difficile infection (CDI) is an increasing nosocomial problem in North America and Western Europe, where outbreaks caused by a more virulent, toxin-hyperproducing strain have been recently reported. Clostridium difficile infection is now characterized by a higher incidence, more frequent relapses, and a higher case-fatality ratio. As a consequence, fulminant cases requiring admission to the intensive care unit (ICU) are much more common than previously. In recent years, metronidazole has appeared to lose some of its effectiveness in CDI management and vancomycin is now recognized as the first-line treatment of severe cases. Rapid diagnosis and institution of infection control measures are critical components of CDI management. The current review focuses on recent changes in the epidemiology, diagnostic methods, and treatment of CDI, with special emphasis on complicated cases managed in the ICU.
Glycemic Control in Critically Ill Patients Before and After Institution of an Intensive Insulin Infusion Protocol: Circadian Rhythm and the Quality Duration Calculator
Authors: Keene Adam , Hailpern Susan , Anees Syed , Sandhu Jaswinderpal , Harris Mary , Ashton Lori , Bellin Eran
Published: December 2009

Introduction: A circadian rhythm of blood glucose values has been recently reported in critically ill patients, but there are no reports of how this rhythm is altered by a continuous intensive insulin infusion therapy protocol (IIT). We wished to examine the effect of IIT on this rhythm as well as to describe the use of the quality duration calculator (QDC) for the evaluation of glycemic control before and after IIT.

Methods: This was a retrospective multihospital observational study that took place in the medical and surgical intensive care units (ICUs) of 2 tertiary care hospitals. Cohorts of consecutively admitted critically ill patients from 2-year periods before and after institution of an IIT protocol were examined. Laboratory, demographic, and outcome data were extracted from hospital databases.

Results: We studied 167,645 blood glucose measurements from 8,327 patients. We observed a circadian rhythm of blood glucose control in the pre-IIT cohort that was greatly attenuated in the post-IIT cohort. The difference between the morning and the average daily blood glucose in the pre-IIT cohort was 3.53 mg/dL (P < .001), and the difference between these values in the post-IIT cohort was 1.10 mg/dL (P = .031). In addition, the circadian nature of hyperglycemia incidence observed in the pre-IIT cohort was not seen in the post-IIT cohort. The amount of time spent in goal glycemic range increased from 23.69% (95% CI 23.01-24.38) in the pre-IIT cohort to 29.67% (95% CI 29.04-30.31) in the post-IIT cohort as estimated by the QDC. The amount of time spent in the hyperglycemic decreased from 20.17% (95% CI 19.33-20.99) in the pre-IIT cohort to 14.80% (95% CI 14.15-15.39) in the post-IIT cohort.

Conclusions: The circadian rhythm of blood glucose control confirmed in our pre-IIT cohort was lost after institution of IIT. The morning blood glucose value appears to be a reasonable surrogate of overall glycemic control in a critically ill population on IIT, although this may vary based on the degree of control achieved. The QDC method is useful for analyzing glycemic control in patients on IIT.
Organizational Justice, Trustworthiness, and Trust: A Multifoci Examination
Authors: Lance Frazier M. , Johnson Paul D. , Gavin Mark , Gooty Janaki , Bradley Snow D.
Published: December 2009

Drawing from the extant literature on organizational justice and trust, this study examines the effects of justice perceptions on trustworthiness perceptions and interpersonal trust in authority figures. Results indicate differential effects of procedural, interpersonal and informational justice on the three components of perceived trustworthiness: ability, benevolence, and integrity. Consistent with multifoci organizational justice and social exchange theory, the effects are dependent on the authority figure being referenced and the nature of the exchange relationship between authority and subordinate. Results also indicate that trust in the proximal referent led to increased ability to focus on work-related tasks, whereas trust in the distal referent did not influence such ability to focus. Ability to focus on work-related tasks predicted organizational citizenship behaviors directed at both the organization and individuals.
Killings of Police in U.S. Cities since 1980: An Examination of Environmental and Political Explanations
Authors: Kent Stephanie L.
Published: December 2009

Most research on killings of police in urban areas attempted to link lethal violence against officers to the violence and disorder in the communities they work.Yet support for this relationship is inconsistent. Fewer studies considered whether local political arrangements affect killings of police. This study attempts to remedy this gap by using recent data to investigate the relationship between the political conditions of large U.S. cities and the number of homicides of police officers in the line of duty in the years 1980, 1990, and 2000. Negative binomial regression analyses suggest that racial income inequality and the size of the Black population are positively associated with killings of police but cities with African American mayors have less killings. Police killings of citizens are also positively related to officer killings. The results largely support political explanations and uncover time-contingent effects of segregation on violence against state representatives.
Integrated Review of Cytokines in Maternal, Cord, and Newborn Blood: Part I—Associations With Preterm Birth
Authors: Lyon Debra , Cheng Ching-Yu , Howland Lois , Rattican Debra , Jallo Nancy , Pickler Rita , Brown Lisa , McGrath Jacqueline
Published: December 2009

Preterm birth (PTB; spontaneous delivery prior to 37 weeks gestation) affects one out of eight infants born in the United States and is the most common cause of neonatal morbidity and mortality. Although the pathogenesis of PTB is multifactorial, a growing body of literature supports the hypothesis that one cause of PTB is inflammation in pregnancy. Investigators have implicated mediators of inflammation, most notably proinflammatory cytokines, as being associated with and perhaps a playing a causal role in the pathogenesis of preterm labor and adverse early fetal outcomes. Though researchers have pursued the association of cytokines with preterm labor and subsequent early adverse fetal outcomes as a line of research, there has been little integration of diverse findings across studies. This systematic review appraises the empirical evidence from human studies for the association of levels of cytokines in blood with preterm labor and adverse early fetal outcome to examine the current state of the science in this important area of biobehavioral research. The most consistent finding is that increased levels of proinflammatory cytokines, particularly interleukin (IL) 6, IL-β1, and tumor necrosis factor α (TNF-α), are associated with PTB as compared to levels found at term birth. However, there have been relatively few studies and results have not been consistent. Therefore, further research is needed to elucidate the association of these inflammatory mediators with adverse pregnancy outcomes.
Rosiglitazone Ameliorates Endotoxin-Induced Organ Damage in Conscious Rats
Authors: Wu Wen-Tien , Lee Chia-Chi , Lee Chung-Jen , Subeq Yi-Maun , Lee Ru-Ping , Hsu Bang-Gee
Published: December 2009

Rosiglitazone is a peroxisome proliferator-activated receptor (PPAR)-γ agonist. By inhibiting nuclear factor κB (NF-κB), it decreases tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) and has an anti-inflammatory effect. Endotoxin shock can induce the production of several inflammatory mediators such as TNF-α and IL-6, leading to multiple organ dysfunction and death. We investigated the effects of rosiglitazone (.3 mg/kg, intravenous administration) on the physiologic attributes and cytokine levels in endotoxin shock in conscious rats. Endotoxin shock was induced by intravenous injection of Klebsiella pneumoniae lipopolysaccharides (LPSs; 10 mg/kg) in conscious rats. Mean arterial pressure (MAP) and heart rate (HR) were continuously monitored for 24 hr after LPS administration. Levels of biochemical and cytokine parameters, including glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), blood urea nitrogen (BUN), creatinine (Cre), lactic dehydrogenase (LDH), creatine phosphokinase (CPK), glucose, TNF-α, and IL-6 were measured at 0, 1, 3, 6, 12, and 24 hr after sepsis. Endotoxin shock significantly increased blood GOT, GPT, BUN, Cre, LDH, CPK, glucose, TNF-α, and IL-6 levels and HR, while also decreasing MAP. Rosiglitazone diminished the increase in HR, decreased the markers of organ injury (GOT, GPT, BUN, Cre, LDH, CPK, glucose) and inflammatory biomarkers (TNF-α, IL-6), and did not affect MAP after LPS. In conclusion, rosiglitazone ameliorated endotoxin shock-induced markers of organ injury and suppressed the release of TNF-α and IL-6 in conscious rats.
Comment on Hanssen and Meehan, ‘‘Who Integrated Major League Baseball Faster Winning Teams or Losing Teams?’’
Authors: Coyne Christopher J. , Isaacs Justin P. , Schwartz Jeremy T.
Published: December 2009

In this short note, the authors contrast their own recent work on racial integration in Major League Baseball with that of two other groups: Hanssen and Meehan (2009) and Goff, McCormick, and Tollison (2002). While reaching dissimilar conclusions, both groups understate the role of the entrepreneur in the process of integration and rely too heavily on a continuous estimation model for a discrete dependent variable.
For a Culture and Political Economy of the Prophetic: Critical Scholarship and Religious Politics After the 2008 Election
Authors: Healey Kevin
Published: December 2009

The 2008 election crystallized a growing tension between different understandings of the “prophetic” element of religious faith. The contrast between Sarah Palin and Barack Obama’s “pastor problems” reflects a struggle between those who would consolidate established power and those who seek to expand democratic ideals by demanding greater integrity from the social institutions that claim to represent them. Competing discourses of the prophetic unfold in the context of a critical juncture in media and religion, as demographic and technological shifts promise to alter the course of religious politics. The current moment is an opportunity for critical scholars to intervene on behalf of a new, more progressive religious politics. This article contributes to such intervention in two ways: first, by analyzing how competing discourses of the prophetic unfolded during the election and second, by explaining how the “prophetic” can serve as a key organizing concept in contemporary critical scholarship.
How You Gonna Save Y/our Soul? Tempering Corporate Identity in a Global Age
Authors: Elavsky C. Michael
Published: December 2009

This article considers how the intersection of cultural theory and pedagogy in the classroom might be utilized to foster greater global awareness and engagement. Specifically, it addresses how critical examinations of theories regarding the constitution of subjectivity relate to developing and advancing progressive conceptions of global corporate behavior and how liberatory pedagogies (i.e., addressing questions of culture, knowledge, power, representation, and agency) might intercede in the development of more ethically conscious conceptions of corporate professionalism. Such exercises force new considerations for imagining the world and one’s role in it, potentially stimulating new forms of social engagement within and against the logics and reality of global capital; forms that promote progressive thinking and social justice while reinvigorating how we collectively conceptualize and engage the dynamics of the corporate sphere in our global age.
Current Management of Mesenteric Extrahepatic Arterioportal Fistulas: Report of a Case Treated With a Gastroduodenal Artery Stent Graft and Literature Review
Authors: Krishan Sonal , Mcpherson Simon , Pine James , Hayden Jeremy
Published: December 2009

Spontaneous arteriovenous fistulation of a pseudoaneurysm into superior mesenteric vein (SMV) has rarely been reported. We present the case of a 61-year-old woman who presented with a post pancreatic arterioportal fistula (APF) that was successfully managed by stent graft (SG) placement in the gastroduodenal artery (GDA). We also review the published experience of the endovascular management of mesenteric extrahepatic APFs. This review demonstrates the evolution from open surgical to endovascular management for majority of these patients.
Hybrid Procedures for Complex Thoracoabdominal Aortic Aneurysms: Early Results and Secondary Interventions
Authors: Muehling Bernd M. , Bischoff G. , Schelzig H. , Sunder-Plassmann L. , Orend K.H.
Published: December 2009

Background: Hybrid procedures for thoracoabdominal aortic aneurysms (TAAA) have been previously described as an attractive alternative to open reconstruction.

Patients and Methods: Between 1999 and 2009, 16 patients with a median age of 67years underwent hybrid repair of a TAAA (Crawford type I: 3, type II: 3, type III: 1, and type IV: 9). In 94%, 3 and more severe comorbidities were present, with previous aortic surgery in 56% of the patients; elective/urgent repair was done in 10 and emergent surgery in 6 patients.

Results: Primary technical success was 100%, with 31 vessels grafted. Elective/urgent mortality was 20% (2 of 10) and emergent mortality 50% (3 of 6). During follow-up time (median: 12 months) 2 patients died and 2 patients had to undergo secondary interventions.

Conclusion: In high-risk patients especially after prior aortic surgery hybrid repair of TAAA is feasible. However, due to high mortality rates especially in the emergent situation this procedure should be reserved only for decidedly selected patients.
Atorvastatin Modulates Matrix Metalloproteinase Expression, Activity, and Signaling in Abdominal Aortic Aneurysms
Authors: Schweitzer Morris , Mitmaker Benjamin , Obrand Daniel , Sheiner Nathan , Abraham Cherrie , Dostanic Stevan , Meilleur Melissa , Sugahara Tomoko , Chalifour Lorraine E.
Published: December 2009

Statins may reduce abdominal aortic aneurysm (AAA) progression. We sought to measure how atorvastatin (AT) treatment might modulate matrix metalloproteinase (MMP) expression and/or activity in human AAA. Tissue from human AAAs at surgical repair was obtained from patients who were either not on statins (NST, n = 19) or treated with AT (n = 19). Immunoblots measured expression and zymography measured activity. Expression of most proteins was greater in the central compared with distal AAA region. Matrix metalloproteinase 1, MMP2, MMP3, MMP9, Tissue Inhibitor of Metalloproteinase (TIMP2), TIMP3, TIMP4, or total Sma Mothers Against Decapentaplegia (SMAD2) expression did not differ with treatment. There was a trend toward reduced MMP8 and TIMP1 expression and MMP2 zymographic activity in the AT-treatment group. In contrast, AT-treated samples had significantly reduced MMP13 (P = .02), latent-transforming growth factor (TGF)-β (P = .02), and phospho-SMAD2 (P = .029) expression than NST-treated samples. We conclude that the AT-mediated decrease in MMP expression and activity reduces TGF-β signaling in the central region of human AAAs.
Continuous Intraarterial Thrombolysis for Early Hepatic Artery Thrombosis Following Liver Transplantation: Case Report
Authors: Singhal Ashish , Mukherjee Indraneil , Stokes Kenneth , Wright Harlan I. , Sebastian Anthony , Kohli Vivek
Published: December 2009

Hepatic Artery thrombosis remains one of the major causes of graft failure and mortality in liver transplant recipients. Urgent re-transplantation has been considered as mainstay therapy; however, even with re-transplantation mortality of more than 50% has been reported by many series. Early detection on Doppler ultrasonography and subsequent revascularization in asymptomatic patients can avoid graft loss. Endovascular therapy including intra-arterial thrombolysis, percutaneous transluminal angioplasty, and stent placement have shown encouraging results in recent years; nevertheless, their use remains controversial due to potential risk of bleeding. We present a case of early hepatic artery thrombosis following liver transplantation treated successfully with continuous transcatheter intra-arterial thrombolysis using tissue plasminogen activator (t-PA).
Abdominal Aortic Aneurysm Repair in Obese Patients: Improved Outcome After Endovascular Treatment Compared With Open Surgery
Authors: Jonker Frederik H. W. , Schlösser Felix J. V. , Dewan Michael , Huddle Matthew , Sergi Michael , Indes Jeffrey E. , Dardik Alan , Muhs Bart E.
Published: December 2009

Purpose: To investigate outcomes in obese patients with abdominal aortic aneurysm (AAA) treated with elective open or endovascular repair (EVAR).

Study Design: We compared the outcomes of obese patients with AAA treated with elective open repair and EVAR. Obesity was defined as a body mass index (BMI) ≥30 kg/m 2.

Results: A total of 56 patients with a BMI ≥30 kg/m2 were identified for analysis (mean age 70 ± 8 years; mean BMI 34 ± 4 kg/m2, and 95% [n = 53] were male). Open surgery was performed in 55% (n = 31). The in-hospital complication rate (including nonsurvivors) was significantly increased after open repair compared with EVAR (26% vs 4%, P = .033). Mortality did not differ significantly during 3 years of follow-up (P = .816). Length of stay, intensive care unit (ICU) stay, and need for ventilation were significantly increased after open surgery compared with EVAR.

Conclusions: We observed improved short-term outcomes among obese AAA patients after EVAR compared to open repair. Endovascular repair may be preferable in obese patients with AAA.
Management of a Catecholamine-Secreting Paraganglioma Requiring Aortic Reconstruction
Authors: Daab Leo J. , Cook Patrick , Woo Karen , Hye Robert , Paluch Thomas , Plecha Edward
Published: December 2009

Introduction: Retroperitoneal paragangliomas are rare extraadrenal pheochromocytomas that can involve major vascular structures.

Results and discussion: A case of periaortic catecholamine-secreting paraganglioma was reviewed and literature search performed to summarize the current surgical management of this disease process.

Conclusion: Resection for cure of retroperitoneal paragangliomas with vascular reconstruction can be performed with acceptable morbidity and mortality with the use of current vascular techniques.
Traumatic Fracture of Polytetrafluoroethylene Axillofemoral Bypass Graft
Authors: Kitowski Nicholas J. , Gundersen Sigurd B.
Published: December 2009

We report traumatic disruption of a ringed polytetrafluorethylene (PTFE) axillofemoral bypass (AFB) graft due to a fall. We also review the literature of previously reported blunt traumatic PTFE graft disruptions. A 75-year-old man with previous bilateral AFB grafting presented with a painful left chest wall mass after a fall from standing height. Chest computed tomography (CT) revealed a large chest wall hematoma. The patient underwent evacuation of the hematoma, resection of the fractured graft, and placement of an interposition PTFE graft. Two prior case reports have documented the midportion PTFE graft disruption from blunt trauma. Our case report demonstrates the potential for disruption of the midportion of ringed PTFE AFB grafts with direct blunt trauma. The diagnosis was confirmed by CT scan and the graft was successfully repaired with an interposition graft.
Midterm Results From Internal Iliac Artery Branched Endovascular Stent Grafts
Authors: Karthikesalingam Alan , Parmar Jitesh , Cousins Claire , Hayes Paul D. , Varty Kevin , Boyle Jonathan R.
Published: December 2009

Purpose: To evaluate the midterm feasibility, efficacy and safety of internal iliac artery branch grafts for endovascular repair of aortoiliac, common iliac, and internal iliac artery aneurysms.

Methods: Between December 2006 and September 2008, 8 patients underwent elective endovascular repair of aortoiliac, common iliac, and internal iliac artery aneurysms. Computed tomography aortography (CTA) was used to detect postoperative endoleak, stent migration, branch patency, and aneurysm sac expansion.

Results: All stent grafts were correctly implanted. However, intraoperative branch occlusion occurred in 2 of 8 cases. Both occlusions have been managed conservatively, with only 1 patient suffering detrimental symptoms. One endoleak was found. Median follow up by CT was 402 days (range 77 to 718 days). No patients died.

Conclusions: Midterm results are encouraging for endovascular branch grafts to include the internal iliac artery. However, patient selection is of great importance and our series illustrates the value of caution and multidisciplinary teamwork.
Endovascular Repair of 2 Iliac Pseudoaneurysms and Arteriovenous Fistula Following Spine Surgery
Authors: Kiguchi Misaki , O'Rourke Howard J. , Dasyam Anil , Makaroun Michel S. , Chaer Rabih A.
Published: December 2009

Purpose: To describe endovascular repair of traumatic iliac pseudoaneurysm and arteriovenous fistula (AVF) following spinal surgery. Case Report: A 48-year-old male underwent minimally invasive L5-S1 hemilaminectomy, foraminotomy, and microdiscectomy spinal surgery for trauma related to a motor-vehicle accident. Postoperative angiogram demonstrated pseudoaneurysm of the right internal iliac artery and AVF at the common iliac bifurcation with the right iliac vein with prompt filling of the iliac vein and vena cava. The second patient, a 25-year-old female, underwent minimally invasive L4-S1 hemilaminectomy, foraminotomy, and microdiscectomy spinal surgery for intractable pain and was complicated with postoperative symptoms of congestive heart failure. Postoperative angiogram demonstrated AVF between the right common iliac artery and vein with associated pseudoaneurysm formation. Endovascular repair was performed in both cases. Follow-up imaging revealed no endoleak and complete pseudoaneurysm and AVF exclusion. Conclusions: Endovascular repair of iliac injuries following spine surgery can be successfully performed with minimal morbidity.
Suitability of Three Saws for Minimally Invasive Bone Cutting
Authors: Kong Chris , Trejos Ana Luisa , Naish Michael D. , Patel Rajni V. , Leitch K. Kellie
Published: December 2009

This study compares 3 different saw types to determine which is best suited for integration into a minimally invasive bone saw. A handheld electric jigsaw, a coping saw, and a Gigli saw were used to cut into porcine ilium. Heat generated was measured using a thermocouple, and forces applied during cutting were recorded using a force/torque sensor. The coping saw generated an average maximum temperature that was 26°C less than that generated using the jigsaw ( P < .001) and 14°C less than that for the Gigli saw ( P < .001). On average, the maximum force applied through the coping saw was 14 N less than that through the jigsaw ( P < .001) and 18 N less than that through the Gigli saw ( P < .001). Out of the 3 saws tested, the coping saw is optimal for cutting bone based on heat generation and required force.
Leveraging Conflict for Social Justice: How “Leadable” Moments Can Transform School Culture
Authors: Alemán Enrique
Published: December 2009

It is not a question of whether conflict within a school will occur, but rather when it will manifest and by whom. Often times, conflict occurring between key stakeholders such as teachers, parents, and students is looked upon as tainting school culture or sabotaging change strategies. However, conflict may also serve as a catalyst for larger discussions of deficit thinking or shifts in the educational practice of a school. Capitalizing on these instances of conflict as “leadable” moments, school leaders are situated to leverage conflict for social justice aims. This case centers on an elementary school principal who encounters an instance of conflict with multiple constituencies. She is challenged in her resolution of a classroom incident while recognizing that it also represents larger, school- and district-wide issues. Responding to a teacher’s approach in addressing racist and bigoted language, a parent’s frustration with her child’s schooling experience, and a district official’s concern over diversity and equal educational opportunity, the principal is thrust into the micropolitical center of a school and moved to conceptualize how leadership for social justice may be infused into the situation.
Standardized Testing: How Prepared Are We?
Authors: Smolin Andrea , Clayton Jennifer K.
Published: December 2009

This case exemplifies the effects of high stakes standardized testing and accountability on education and stakeholders. When schools are pressured for success, educational leaders and teachers often find themselves in circumstances where regulations and procedures are violated, sometimes with noble intent. The case focuses on the ethical and procedural dilemmas faced by an administrator when teachers violate testing policy to give what they view as necessary assistance to students. Background information is provided to allow students to analyze the situation and propose a solution for the school principal.