bluuebunny/crossref_metadata_2025 huggingface dataset:
Exclusive enteral nutrition for children with Crohn's disease: Use in Australia and attitudes of Australian paediatric gastroenterologists
Authors: Day Andrew S , Stephenson Tracey , Stewart Michael , Otley Anthony R
Published: May 2009

Aim:  Although available data support a role for exclusive enteral nutrition (EEN) in children with Crohn's disease (CD), use of this therapy varies. The aim of this study was to define the patterns of use of EEN across Australia and to better understand the reasons for this variation.

Methods:  Using an existing email network, Australian paediatric gastroenterologists were asked to provide details of their attitudes towards, and use of, EEN in children. A questionnaire was designed to direct responses, with regard to use of EEN, to current EEN protocols and patterns of use.

Results:  Twenty‐one replies were received (58% response). Although 12 respondents felt that EEN was an appropriate therapy for CD, only 8 regularly used EEN for their patients. Usage varied between states and within units. Current use was related to practitioners' experiences of EEN during their gastroenterology training. The concerns of those who did not recommend EEN included compliance, cost and resource demands. The doctors who recommend EEN reported that family support, team approach and disease location were important factors for a positive outcome from EEN. Current protocols varied in terms of type of formula, length of therapy and use of concurrent medications.

Conclusions:  Variations in care were illustrated across these paediatric gastroenterologists. Practitioners have many reasons and concerns about the use of EEN: these impede the wider use of EEN for paediatric CD. More consistent protocols for the use of EEN and an improved understanding of the mechanisms of EEN could lead to enhanced use of this therapy.
Social support, peer victimisation, and somatic complaints: A mediational analysis
Authors: Gini Gianluca , Carli Giuseppe , Pozzoli Tiziana
Published: May 2009

Aim:  This study investigated the associations among social support, peer victimisation and somatic problems in children and adolescents. Specifically, we tested a model that posited a mediational role of peer victimisation on the association between low social support and somatic symptoms in three age groups.

Methods:  A total of 1570 Italian children and adolescents aged 9 to 15 years participated in this study during Winter 2006. Students completed self‐report measures of perceived social support, somatic complaints and peer victimisation. A series of regression analyses were used to test the hypothesised mediational model.

Results:  Age differences emerged for somatic complaints and peer victimisation, with primary school children reporting more somatic problems and victimisation experiences than older participants. Three series of regression analyses, performed separately for the three age groups, confirmed the mediational model. Low levels of social support received by peers were associated with more reported somatic complaints and more peer victimisation. When victimisation was entered as the mediator variable in the last regression equation, the association between social support and somatic problems was non‐significant.

Conclusions:  In our sample, social support was negatively associated with somatic complaints. In all age groups, this association was completely mediated by peer victimisation experiences. These findings may suggest the importance of using targeted screening and interventions to address peer victimisation and its negative consequences on children's and adolescents' health.
The contact principle and utilitarian moral judgments in young children
Authors: Pellizzoni Sandra , Siegal Michael , Surian Luca
Published: May 2009

In three experiments involving 207 preschoolers and 28 adults, we investigated the extent to which young children base moral judgments of actions aimed to protect others on utilitarian principles. When asked to judge the rightness of intervening to hurt one person in order to save five others, the large majority of children aged 3 to 5 years advocated intervention in contrast to another situation with the reverse cost/benefit ratio. This course of action was seen as acceptable by most children only when it did not require the agent to have physical contact with the victim and the victim’s harm was intended to produce the greatest good for the greatest number. Overall, the children’s responses were remarkably similar to those reported in adult studies. These findings document the extent to which some constraints on moral judgment are present in early human development.
Everyday scale errors
Authors: Ware Elizabeth A. , Uttal David H. , DeLoache Judy S.
Published: May 2009

Young children occasionally make scale errors– they attempt to fit their bodies into extremely small objects or attempt to fit a larger object into another, tiny, object. For example, a child might try to sit in a dollhouse‐sized chair or try to stuff a large doll into it. Scale error research was originally motivated by parents’ and researchers’ informal accounts of these behaviors. However, scale errors have only been documented using laboratory procedures designed to promote their occurrence. To formally document the occurrence of scale errors in everyday settings, we posted a survey on the internet. Across two studies, participants reported many examples of everyday scale errors that are similar to those observed in our labs and were committed by children of the same age. These findings establish that scale errors occur in the course of children’s daily lives, lending further support to the account that these behaviors stem from general aspects of visual processing.
How do symbols affect 3‐ to 4‐year‐olds' executive function? Evidence from a reverse‐contingency task
Authors: Apperly Ian A. , Carroll Daniel J.
Published: May 2009

In two experiments, 330 3‐ to 4‐year‐olds competed for stickers in a game in which the optimal response strategy was to point to an empty box that their opponent would receive in order to obtain a baited box for themselves. When the baited box contained stickers, children showed a strong tendency to point at the baited box and therefore lose the stickers to their opponent. In Experiment 1 children performed better when the number of stickers to be won was represented with one of five different types of symbol: numerals, number words, dots, a photograph or sweets. In Experiment 2 children transferred their improved performance in symbolic conditions to non‐symbolic conditions. These findings suggest that symbols enable children to formulate an efficient response strategy, and that this effect may be qualitatively different in children from the effect of symbols in non‐human primates.
Adults' social cues facilitate young children's use of signs and symbols
Authors: Leekam Susan R. , Solomon Tracy L. , Teoh Yee‐San
Published: May 2009

Three experiments investigated the effect of an adult’s social cues on 2‐ and 3‐year‐old children’s ability to use a sign or symbol to locate a hidden object. Results showed that an adult’s positive, engaging facial expression facilitated children’s ability to identify the correct referent, particularly for 3‐year‐olds. A neutral facial expression and the presence of the adult’s hand also facilitated performance, but to a lesser degree than did an engaging facial expression. The effect of the adult’s social cues was greater for relatively unfamiliar signs and symbols (replica or arrow) than it was for a more familiar sign (pointing finger). These findings indicate that non‐directional social cues such as facial expression help to convey communicative intent and facilitate children’s comprehension of signs and symbols.
Economics in the Backyard: How Much Convergence is there between China and her Special Regions?
Authors: Hughes Hallett Andrew , Richter Christian
Published: May 2009

This paper tests the hypothesis that the links and dependency relationships between China and her special regions have changed over the past 20 years with the industrialisation of China, and the emergence of Taiwan as a source of investment and sophisticated manufactures, and Hong Kong as financial centre and supplier of services. Has this changed the size and direction of spillovers in the region, and has it curtailed or eliminated American economic leadership? We use time‐varying spectral methods to decompose the links between six advanced Asian economies and the US. We find: (a) the links with the US have been weakening, while those within a bloc based on China have strengthened; (b) that this is not new – it has been happening since the 1980s, but has now been reversed by the surge in trade; (c) that Taiwan is more integrated with, and dependent on, the Chinese economy, while Hong Kong continues her separate development based on specialisation and comparative advantage; (d) that the links with the US are rather complex, with the US able to shape the cycles elsewhere through her control of monetary conditions, but the China zone able to control the size of their cycles; and (e) there appears to be no real evidence that pegged exchange rates encourage convergence; in fact the reverse may be true.
Basic Needs, Government Debt and Economic Growth
Authors: Perlo‐Freeman Samuel , Webber Don J.
Published: May 2009

This paper investigates the relationships between basic needs and economic growth where the interactions between output, health, nutrition and education are explicitly simultaneous. We find a unidirectional relationship that improving basic welfare contributes strongly to labour productivity change, but a clear reverse causation only from growth to nutrition. There are substantial differences in the patterns of simultaneous interactions at different income and welfare levels. There are strong self‐reinforcing effects of literacy and debt service on poverty, making it difficult for poor countries to rectify their situation. Channelling resources towards improving health, education and nutrition could bring dramatic economic returns.
Speed Intensity and the Rise of the Chinese Economies
Authors: Olds Kelly B.
Published: May 2009

Producers of speed‐intensive goods, e.g. clothing or electronics, face markets that are in constant flux due to changing fashion or technology. Throughout the twentieth century, Chinese business networks have had a comparative advantage in producing speed‐intensive goods due to their quick reaction time. This comparative advantage was of relatively little value prior to the Second World War, but since the war, international telephone and air services have made international trade in speed‐intensive goods practical. This has caused the demand for speed‐intensive goods on the international market to grow at an extremely rapid pace. This growth in demand can explain the post‐Second World War economic booms experienced by Hong Kong, Taiwan and finally China.
Analysis of Gene Polymorphisms Associated with K+ Ion Circulation in the Inner Ear of Patients Susceptible and Resistant to Noise‐induced Hearing Loss
Authors: Pawelczyk Malgorzata , Van Laer Lut , Fransen Erik , Rajkowska Elzbieta , Konings Annelies , Carlsson Per‐Inge , Borg Erik , Van Camp Guy , Sliwinska‐Kowalska Mariola
Published: May 2009

Noise‐induced hearing loss (NIHL) is one of the leading occupational health risks in industrialized countries. It results from an interaction between environmental and genetic factors, however the nature of the genetic factors contributing to NIHL has not yet been clarified. Here, we investigated whether genetic variations in 10 genes putatively involved in the potassium recycling pathway in the inner ear may influence susceptibility to noise. 99 SNPs were genotyped in Polish noise‐exposed workers, categorized into susceptible and resistant subjects. The most interesting results were obtained for KCNE1 and KCNQ4 as we replicated associations that were previously reported in a Swedish sample set, hence confirming that they are NIHL susceptibility genes. Additionally we report significant associations in GJB1, GJB2, GJB4, KCNJ10 and KCNQ1, however due to the lack of replication in the Swedish sample set, these results should be seen as suggestive.
Impacts of increased sediment loads on the ecology of lakes
Authors: Donohue Ian , Garcia Molinos Jorge
Published: May 2009

Increased sediment loading comprises one of the most important and pervasive anthropogenic impacts on aquatic ecosystems globally. In spite of this, little is known of the overall effects of increased sediment loads on lakes. By modifying both bottom‐up and top‐down ecological processes and restructuring energy flow pathways, increased sediment loads not only alter biotic assemblage structure and ecological functioning significantly, but frequently result in reduced biological diversity and productivity. Although lake food‐webs can be subsidised to some extent by the adsorption of organic carbon to fine sediments, trophic structure and the composition of biotic assemblages remain likely to be modified considerably. The mineralogy and particle size of sediments and the availability of nutrients, by influencing both the scale and nature of impacts, are key determinants of the overall effects of increased sediment loads on lake ecosystems. Although interactions with other global anthropogenic pressures, such as invasion by exotic species and climate change, are likely to be significant, little remains known about the nature or likely strength of those interactions. Widespread increases in sediment loading to lakes have, therefore, profound implications for the conservation and management of global aquatic biological diversity.
Correlation between gross anatomical topography, sectional sheet plastination, microscopic anatomy and endoanal sonography of the anal sphincter complex in human males
Authors: Al‐Ali S. , Blyth P. , Beatty S. , Duang A. , Parry B. , Bissett I. P.
Published: May 2009

This study elucidates the structure of the anal sphincter complex (ASC) and correlates the individual layers, namely the external anal sphincter (EAS), conjoint longitudinal muscle (CLM) and internal anal sphincter (IAS), with their ultrasonographic images. Eighteen male cadavers, with an average age of 72 years (range 62–82 years), were used in this study. Multiple methods were used including gross dissection, coronal and axial sheet plastination, different histological staining techniques and endoanal sonography. The EAS was a continuous layer but with different relations, an upper part (corresponding to the deep and superficial parts in the traditional description) and a lower (subcutaneous) part that was located distal to the IAS, and was the only muscle encircling the anal orifice below the IAS. The CLM was a fibro‐fatty‐muscular layer occupying the intersphincteric space and was continuous superiorly with the longitudinal muscle layer of the rectum. In its middle and lower parts it consisted of collagen and elastic fibres with fatty tissue filling the spaces between the fibrous septa. The IAS was a markedly thickened extension of the terminal circular smooth muscle layer of the rectum and it terminated proximal to the lower part of the EAS. On endoanal sonography, the EAS appeared as an irregular hyperechoic band; CLM was poorly represented by a thin irregular hyperechoic line and IAS was represented by a hypoechoic band. Data on the measurements of the thickness of the ASC layers are presented and vary between dissection and sonographic imaging. The layers of the ASC were precisely identified in situ, in sections, in isolated dissected specimens and the same structures were correlated with their sonographic appearance. The results of the measurements of ASC components in this study on male cadavers were variable, suggesting that these should be used with caution in diagnostic and management settings.
Exocytosis and cell polarity in plants – exocyst and recycling domains
Authors: Žárský Viktor , Cvrčková Fatima , Potocký Martin , Hála Michal
Published: May 2009

In plants, exocytosis is a central mechanism of cell morphogenesis. We still know surprisingly little about some aspects of this process, starting with exocytotic vesicle formation, which may take place at the trans‐Golgi network even without coat assistance, facilitated by the local regulation of membrane lipid organization. The RabA4b guanosine triphosphatase (GTPase), recruiting phosphatidylinositol‐4‐kinase to the trans‐Golgi network, is a candidate vesicle formation organizer. However, in plant cells, there are obviously additional endosomal source compartments for secretory vesicles. The Rho/Rop GTPase regulatory module is central for the initiation of exocytotically active domains in plant cell cortex (activated cortical domains). Most plant cells exhibit several distinct plasma membrane domains, established and maintained by endocytosis‐driven membrane recycling. We propose the concept of a ‘recycling domain’, uniting the activated cortical domain and the connected endosomal compartments, as a dynamic spatiotemporal entity. We have recently described the exocyst tethering complex in plant cells. As a result of the multiplicity of its putative Exo70 subunits, this complex may belong to core regulators of recycling domain organization, including the generation of multiple recycling domains within a single cell. The conventional textbook concept that the plant secretory pathway is largely constitutive is misleading.

Contents

Summary
255

I.
Introduction
256

II.
Donor compartments for plant exocytotic vesicles: where do they come from?
256

III.
Mechanisms of exocytotic vesicle formation: is the truth naked?
257

IV.
Building the tracks for exocytotic vesicles: cytoskeleton in exocytosis and cell polarization
259

V.
Manysidedness of a plant cell: delimiting functional plasmalemma domains within a cell
260

VI.
Vesicle tethering, docking and fusion
262

VII.
Polarity by recycling: exocytosis, endocytosis and recycling domains in plant cells
264

VIII
Conclusions: constitutive or regulated secretion in plant cells?
266

Acknowledgements
267

References
267
Successfully overcoming the inhibitory impact of the “forget” instruction: A voxel‐based morphometric study of directed forgetting
Authors: Nowicka Anna , Jednoróg Katarzyna , Marchewka Artur , Brechmann André
Published: May 2009

In directed‐forgetting studies, test items are followed by an instruction either to “remember” or to “forget” (F). Many to‐be‐forgotten (TBF) stimuli are not retrieved at the recognition phase. However, some subjects are able to correctly recollect a high number of TBF stimuli. We examined whether this ability is reflected in the structure of brain regions involved in memory and the control of retrieval processes. In subjects with high recognition rates for TBF stimuli, voxel‐based morphometry revealed increased gray matter (GM) volume in the left ventrolateral prefrontal cortex (VLPFC) and the right hippocampus (H). GM volume in these regions correlated positively with the TBF recognition rate. No significant differences were detected in subjects who forgot many TBF stimuli. Our findings indicate that the right H and left VLPFC are of particular relevance in releasing TBF items from inhibition caused by the F instruction.
Early Contact versus Separation: Effects on Mother–Infant Interaction One Year Later
Authors: Bystrova Ksenia , Ivanova Valentina , Edhborg Maigun , Matthiesen Ann‐Sofi , Ransjö‐Arvidson Anna‐Berit , Mukhamedrakhimov Rifkat , Uvnäs‐Moberg Kerstin , Widström Ann‐Marie
Published: May 2009

Background:
A tradition of separation of the mother and baby after birth still persists in many parts of the world, including some parts of Russia, and often is combined with swaddling of the baby. The aim of this study was to evaluate and compare possible long‐term effects on mother‐infant interaction of practices used in the delivery and maternity wards, including practices relating to mother‐infant closeness versus separation.
Methods:
A total of 176 mother‐infant pairs were randomized into four experimental groups: Group I infants were placed skin‐to‐skin with their mothers after birth, and had rooming‐in while in the maternity ward. Group II infants were dressed and placed in their mothers’ arms after birth, and roomed‐in with their mothers in the maternity ward. Group III infants were kept in the nursery both after birth and while their mothers were in the maternity ward. Group IV infants were kept in the nursery after birth, but roomed‐in with their mothers in the maternity ward. Equal numbers of infants were either swaddled or dressed in baby clothes. Episodes of early suckling in the delivery ward were noted. The mother‐infant interaction was videotaped according to the Parent‐Child Early Relational Assessment (PCERA) 1 year after birth.
Results:
The practice of skin‐to‐skin contact, early suckling, or both during the first 2 hours after birth when compared with separation between the mothers and their infants positively affected the PCERA variables maternal sensitivity, infant's self‐regulation, and dyadic mutuality and reciprocity at 1 year after birth. The negative effect of a 2‐hour separation after birth was not compensated for by the practice of rooming‐in. These findings support the presence of a period after birth (the early “sensitive period”) during which close contact between mother and infant may induce long‐term positive effect on mother‐infant interaction. In addition, swaddling of the infant was found to decrease the mother’s responsiveness to the infant, her ability for positive affective involvement with the infant, and the mutuality and reciprocity in the dyad.
Conclusions:
Skin‐to‐skin contact, for 25 to 120 minutes after birth, early suckling, or both positively influenced mother‐infant interaction 1 year later when compared with routines involving separation of mother and infant.
Breastfeeding Rates and Hospital Breastfeeding Practices in Canada: A National Survey of Women
Authors: Chalmers Beverley , Levitt Cheryl , Heaman Maureen , O'Brien Beverley , Sauve Reg , Kaczorowski Janusz ,   for the Maternity Experiences Study Group of the Canadian Perinatal Surveillance System, Public Health Agency of Canada
Published: May 2009

Background:
The Baby‐Friendly Hospital Initiative was launched by the World Health Organization and UNICEF in 1989 to promote, protect, and support breastfeeding worldwide. The objective of this study was to report breastfeeding rates and adherence to the Baby Friendly Hospital Initiative of the World Health Organization and UNICEF in Canada, as reported by participants in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System.
Methods:
Eligible women (n = 8,244) were identified from a randomly selected sample of infants born 3 months before the May 2006 Canadian Census, and stratified by province or territory. Birth mothers living with their infants at the time of interview were invited to participate in a computer‐assisted telephone interview conducted by Statistics Canada on behalf of the Public Health Agency of Canada. Interviews took approximately 45 minutes and were completed when infants were between 5 and 10 months old (between 9 and 14 months in the territories). Completed responses were obtained from 6,421 women (78% response rate). Nineteen of 309 questions concerned early mother‐infant contact and breastfeeding practices.
Results:
Breastfeeding intention (90.0%) and initiation (90.3%) rates were high, although exclusive breastfeeding rates at 6 months after birth (14.4%) were lower than desirable. The findings suggested a low adherence to several best practices advocated by the Baby‐Friendly Hospital Initiative.
Conclusion:
Although breastfeeding initiation rates were relatively high in Canada, exclusive breastfeeding duration fell short of globally recommended standards.
“It's All the Rage These Days”: University Students' Attitudes Toward Vaginal and Cesarean Birth
Authors: Stoll Kathrin , Fairbrother Nichole , Carty Elaine , Jordan Nané , Miceli Carole , Vostrcil Yarra , Willihnganz Laura
Published: May 2009

Background:
At 30 percent, British Columbia has the highest cesarean section rate in Canada. Little is known about the childbirth views and birthing preferences of college‐aged women and men. The objectives of this study were to document (a) the prevalence of cesarean versus vaginal delivery as the preferred mode of delivery among nonpregnant university students without a history of childbirth, (b) the reasons for reported childbirth preferences, and (c) confidence in vaginal birth as a predictor of childbirth preference.
Methods:
A cohort of 3,680 male and female university students without a history of childbirth participated in an online survey of childbirth preferences. The study used a mixed methods approach (quantitative thematic analysis and logistic regression modeling). Prevalence of, and reasons for, preferred mode of delivery were analyzed separately for male and female respondents.
Results:
Most men and women responded that they preferred vaginal delivery, with 9 percent stating a preference for cesarean delivery. Reasons for preferred mode of delivery were similar for men and women. For women, confidence in vaginal birth emerged as a significant predictor of childbirth preference.
Conclusions:
Results indicate that a preference for cesarean section is linked to fear of childbirth and driven by low confidence in vaginal birth. Educational strategies targeting university‐aged men and women may be helpful in alleviating fears of vaginal birth and providing evidence‐based information about different birth options.
Re‐Conceptualizing the Hospital Labor Room: The PLACE (Pregnant and Laboring in an Ambient Clinical Environment) Pilot Trial
Authors: Hodnett Ellen D. , Stremler Robyn , Weston Julie A. , McKeever Patricia
Published: May 2009

Background:
Nearly all hospitalized laboring women spend most of the time in bed. We made simple but radical modifications to a hospital labor room, which included the removal of the standard hospital bed and the addition of equipment to promote relaxation, mobility, and calm. We designed a pilot study, the objectives of which were to test the feasibility of a randomized trial and the acceptability of the modified labor room to women and their care providers.
Methods:
Women were assessed and invited to participate just before their admission to the labor and delivery suite. Sixty‐two women at two Toronto teaching hospitals were randomly allocated to either the standard labor room or the “ambient room.” Data about labor and birth events were abstracted from the medical records. Participants and their nurses and physicians completed questionnaires to elicit their views of their experiences with the labor rooms.
Results:
Women's and practitioners’ evaluations of the ambient room were generally very positive. Nineteen women (65.5%) in the ambient group, compared with 4 (13.3%) in the standard group, reported spending 50 percent or less of their hospital labor in the standard labor bed. Twelve women allocated to the ambient room had artificial oxytocin infusions, compared with 21 allocated to the standard room (X 2 = 4.73, p = 0.03).
Conclusion:
We conclude that the ambient labor room should be evaluated in an adequately powered randomized controlled trial. (BIRTH 36:2 June 2009)
Environmental Impact and Intensity of Processes in Selected Services Companies
Authors: Junnila Seppo
Published: May 2009

The study fills the gap in existing literature by comparing the economic costs and environmental impacts of processes in four services companies in Europe and the United States. Process‐based life cycle assessment (LCA) and the case study method are used to compare companies both on four global‐scale impacts and on environmental intensity (impacts per unit cost). The study builds on prior publications on the environmental contribution of processes. The processes include all the activities of the companies that result in an entry into the bookkeeping records. The results show that despite the substantial differences in organizational characteristics and line of business, all the cases had similar environmental contributions and intensity profiles. Wages, which accounted for over half of the costs, were assumed not to cause any environmental impacts. By contrast, the office premises, which generated less than 10% of the costs, caused around 50% of the environmental impacts. At a more general level, the results suggest that both the high environmental impact and the high intensity are attributed mostly to a few premises‐related processes in the services industry. The results also seem to imply that the companies could gain added value by using life cycle assessment in determining the significant environmental impacts of their operations.
Symptomatic and Asymptomatic Atrial Fibrillation after Pulmonary Vein Ablation and the Impact on Quality of Life
Authors: PONTOPPIDAN JACOB , NIELSEN JENS COSEDIS , POULSEN STEEN HVITFELDT , HANSEN PETER STEEN
Published: May 2009

Background: The aim of this prospective study was to evaluate the recurrences of atrial fibrillation (AF) and flutter (AFL) after circumferential pulmonary vein ablation (CPVA) using repetitive long‐term Holter recordings, and to evaluate the change in quality of life (QoL), especially in patients with asymptomatic AF recurrences.

Methods: A total of 149 patients with AF were followed up with 7‐day Holter monitoring at 3, 6, and 12 months after CPVA. We calculated the burden of AF/AFL defined as the percentage of time in AF/AFL, and patients with documented arrhythmia were divided into isolated symptomatic episodes of arrhythmia, mixed symptomatic/asymptomatic arrhythmia, or isolated asymptomatic arrhythmia. The QoL was analyzed with SF‐36 questionnaires in patients with sinus rhythm after CPVA, and in patients with recurrence of symptomatic and asymptomatic arrhythmia, respectively.

Results: Asymptomatic arrhythmia was observed in 44% of the patients with documented arrhythmia at 12 months of follow‐up. In patients with persistent AF, 63% of the documented arrhythmia at 12 months of follow‐up was asymptomatic and often persistent. In the subgroup of patients with asymptomatic arrhythmia, the QoL improved significantly in the physical scores, in contrast to patients with symptomatic arrhythmia who had unchanged or worsened QoL scores.

Conclusions: Asymptomatic arrhythmia is very common after AF ablation. Our data indicate that these patients improve their physical component of the QoL significantly, which may be considered a palliative success of treatment. We suggest that patients with asymptomatic AF recurrences are carefully evaluated before considering reablation. Repetitive rhythm monitoring after AF ablation is very important considering the postablation management of anticoagulant therapy.
Ventricular Arrhythmia Inducibility Predicts Subsequent ICD Activation in Nonischemic Cardiomyopathy Patients: A DEFINITE Substudy
Authors: DAUBERT JAMES P. , WINTERS STEPHEN L. , SUBAČIUS HARIS , BERGER RONALD D. , ELLENBOGEN KENNETH A. , TAYLOR SARAH G. , SCHAECHTER ANDI , HOWARD ADAM , KADISH ALAN ,   for the Defibrillators In Nonischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators
Published: May 2009

Objectives:

We evaluated whether electrophysiologic (EP) inducibility predicts the subsequent occurrence of spontaneous ventricular tachycardia (VT) or ventricular fibrillation (VF) in the Defibrillators in Nonischemic Cardiomyopathy Treatment Evaluation (DEFINITE) trial.

Background:

Inducibility of ventricular arrhythmias has been widely used as a risk marker to select implantable cardioverter defibrillator (ICD) candidates, but is believed not to be predictive in nonischemic cardiomyopathy patients.

Methods:

In DEFINITE, patients randomized to the ICD arm, but not the conventional arm, underwent noninvasive EP testing via the ICD shortly after ICD implantation using up to three extrastimuli at three cycle lengths plus burst pacing. Inducibility was defined as monomorphic or polymorphic VT or VF lasting 15 seconds. Patients were followed for a median of 29 ± 14 months (interquartile range = 2–41). An independent committee, blinded to inducibility status, characterized the rhythm triggering ICD shocks.

Results:

Inducibility, found in 29 of 204 patients (VT in 13, VF in 16), was associated with diabetes (41.4% vs 20.6%, P = 0.014) and a slightly higher ejection fraction (23.2 ± 5.9 vs 20.5 ± 5.7, P = 0.021). In follow‐up, 34.5% of the inducible group (10 of 29) experienced ICD therapy for VT or VF or arrhythmic death versus 12.0% (21 of 175) noninducible patients (hazard ratio = 2.60, P = 0.014).

Conclusions:

In DEFINITE patients, inducibility of either VT or VF was associated with an increased likelihood of subsequent ICD therapy for VT or VF, and should be one factor considered in risk stratifying nonischemic cardiomyopathy patients.
Pilsicainide‐Induced ST Segment Elevation and ST Segment Depression in Two Patients with Variant Forms of Brugada‐Type Electrocardiographic Abnormalities
Authors: CHINUSHI MASAOMI , TAGAWA MINORU , IZUMI DAISUKE , FURUSHIMA HIROSHI , AIZAWA YOSHIFUSA
Published: May 2009

In two patients with variant forms of Brugada electrocardiographic abnormalities, ST segment elevation, and reciprocal ST segment depression developed during intravenous administration of pilsicainide. In one patient, pilsicainide accentuated the ST segment elevation in leads I, aVL, and V1–V3 and caused ST segment depression in leads II, III, and aVF. Coronary angiograms at the time of ST segment elevation were normal. In the other patient, pilsicainide accentuated the coved‐type ST segment elevation in leads II, III, and aVF and caused ST segment depression in leads I, aVL, and V2–V5. Frequent premature ventricular complexes (PVCs) with two different left bundle branch block patterns developed during ST segment elevation. Intravenous isoproterenol returned the ST segment to baseline in both patients and suppressed the PVCs in the second patient. We hypothesize that a wide area of epicardial myocardium with large Ito current might explain the reciprocal ST segment depression observed at the time of accentuated ST segment elevation.
Meteorological influences on the spatial and temporal variability of NO2 in Toronto and Hamilton
Authors: ARAIN M. ALTAF , BLAIR ROSE , FINKELSTEIN NORM , BROOK JEFF , JERRETT MICHAEL
Published: May 2009

The spatial and temporal variability of nitrogen dioxide (NO2) concentrations and their relationships with meteorology was evaluated in the Toronto–Hamilton urban airshed. NO2 concentrations were highest in the early morning and late evening. Mean concentrations were highest in winter, although individual one‐hour NO2 concentrations were found to be highest in summer. Wind direction was the strongest control on hourly NO2 concentration, and temperature and wind speed also had an effect. Our analysis of NO2 concentration variation by wind direction showed that areas downwind of major highways, urban centres and industry were exposed to higher pollutant concentrations. Seasonal patterns of NO2 concentration displayed significant spatial heterogeneity, in particular, in Toronto. Onshore winds sheltered coastal inhabitants from the full extent of NO2 exposure they would otherwise experience. Seasonal variations in meteorology and emissions mean that the degree of spatial variability in NO2 concentrations changes from season to season. This study will help to improve existing land‐use regression‐based NO2 prediction models by incorporating meteorological controls on NO2 distributions for health effect studies.
Retinopathy of prematurity: Perspective for the nineties
Authors: Flynn John T.
Published: May 2009

Abstract. In any discussion of the eye problems of the premature retinopathy of prematurity is today the major problem. Four areas where progress is needed suggest themselves. Further work needs to be done on the International Classification of Retinopathy of Prematurity (ICROP), particularly with regard to Zone 2 disease where 75% of the disease is concentrated. Treatment of Zone 1 disease is the next important area in terms of its outcome and the critical question of whether to use cryotherapy or laser. The third area which needs open discussion is the problem of screening prematures in excess of 1250 g birth weight and 32 weeks gestational age. In the United States, this constitutes hundreds of thousands of infants and is well beyond the capabilities of the ophthalmic community interested and knowledgeable in the techniques of examining these premature eyes. Finally, the other important area is the striking difference between the infant of today and the infant of the previous ‘epidemic’ of the forties and fifties.
Retinal blood vessel width measured on color fundus photographs by image analysis
Authors: Wu Da‐Ching , Schwartz Bernard , Schwoerer Joan , Banwatt Ramnik
Published: May 2009

Abstract. The purpose of this paper was to develop a technique using computerized image analysis to measure the width of retinal arteries and veins on color fundus photographs. The width of the retinal vessel was determined from digitized fundus photographs by programs based on edge detection and boundary tracing. The average vessel width was determined at different distances or eccentricities from the center of the optic disc and using various lengths of vessel segment. Measurements of superior and inferior temporal vessel width for 20 eyes by 2 operators showed that about 75% of the measurements could be obtained without the use of plan points. The average percent coefficient of variation of the measurements was 2.17% for 3 measurements of each vessel. This technique provides a reproducible and objective method for obtaining the following parameters: the edges of the vessel, the length of the vessel segment to be measured, location of the measurement along the vessel and subsequent retinal vessel width. This technique is readily suitable for application to clinical studies particularly clinical trials.
Ocular findings and sphenoid bone morphology in tuberous sclerosis
Authors: Russell Bjørn G. , Jensen Hanne , Kjær Inger
Published: May 2009

ABSTRACT The aim of the study was to focus on the correlation between the ocular findings and the morphology of the sphenoid bone supporting the optic nerve in patients with tuberous sclerosis. Ten patients participated in the investigation. The sphenoid bone morphology was analyzed from existing radiographs of the cranium. The results were compared to the individual ophthalmologic diagnosis. Changes in the midline osseous structure, the sella turcica and optic sulcus seem to be correlated with the severity of the ocular findings.
Persisting corneal oedema following intracapsular cataract extraction
Authors: Baggesen Kirsten , Ehlers Niels
Published: May 2009

Purpose: The purpose of this study was to reveal the frequency of persisting corneal oedema following intracapsular cataract extraction and at the same time to examine whether the survival rate after penetrating keratoplasty due to this diagnosis differs from the survival rate following penetrating keratoplasty due to primary Fuchs' endothelial dystrophy.

Methods and Material: A series of 2455 eyes underwent intracapsular cataract extraction between January 1, 1986 and December 31, 1988, at the Department of Ophthalmology, Århus University Hospital. The medical files were examined to study the frequency of persisting corneal oedema. Patients with persisting corneal oedema were offered penetrating keratoplasty and the survival rate following this procedure was calculated.

Results: The frequency of pseudophakic persisting corneal oedema was 5.3% in the group of patients who underwent intracapsular cataract extraction. The survival of the following corneal transplantation was 54% after 2 years of follow‐up. This is a low survival rate compared to the survival rate in primary Fuchs' endothelial dystrophy, but there is a similarity to this disease in a development of a slowly progressive oedema in 17% compared to 13% in primary Fuchs' endothelial dystrophy.

Conclusion: 5.3% of a group of patients who underwent intracapsular cataract extraction developed persisting corneal oedema within a 5 to 7‐year follow‐up period. When these patients underwent penetrating keratoplasty the survival rate of the graft was 54% after 2 years of follow‐up.
In vitro evidence for UV‐protection of the eye by the corneal epithelium mediated by the cytoplasmic protein, RNA, and ascorbate
Authors: Ringvold Amund
Published: May 2009

Purpose: (1) To evaluate the effect of ribonucleic acid (RNA) and ascorbate on UV‐absorption and their impact on ultraviolet‐induced (UV) fluorescence from various proteins, and (2) to compare RNA and DNA reduction of protein fluorescence. These informations will be useful for later work on the UV‐filtering effect of the corneal epithelium.

Method: Spectrophotometry and spectrofluorimetry.

Results: (1) RNA and ascorbate caused a significant UV‐absorption and reduced the fluorescence from various water‐soluble proteins, the degree of reduction varying independently from one protein to the other. (2) RNA and DNA showed protein fluorescence reduction of roughly the same order.

Conclusion: The results are discussed both in the context of UV‐protection of the cell nucleus in general, and the possible UV‐filtering effect for the eye of bovine corneal epithelium.
Influence of lens autofluorescence on retinal nerve fiber layer evaluation
Authors: Siik S. , Airaksinen P. J. , Tuulonen A. , Nieminen H.
Published: May 2009

Background: Yellow‐brown coloration of the human lens increases with age and is associated with increasing lens autofluorescence. This may interfere with retinal image through scatter and absorption.

Patients and Methods: We measured the lens autofluorescence (AF) of 30 eyes of 30 healthy subjects and evaluated their retinal nerve fiber layer (RNFL) visibility from fundus photographs. These otherwise healthy eyes showed a varying degree of yellow‐brown coloration of the lens. Lens fluorometry was carried out with a previously described technique using blue‐green AF range (495 nm/520 nm). RNFL photographs were taken with a Canon CF‐60 ZA wide angle camera with blue (495 nm) interference filter and low‐sensitivity, high resolution black‐and‐white film.

Results and Conclusion: Lens yellowing expressed here by means of lens autofluorescence measurements, was statistically significantly (r = ‐ 0.53, p = 0.0008) correlated with the RNFL visibility score. In stepwise regression analysis adding age to the model including only the maximum AF did not reduce the residual standard deviation statistically significantly (p = 0.1). This suggests that lens yellowing has an effect on RNFL visibility and may be an important confounding factor in clinical RNFL evaluation.
A new scoring system for comparing the results of high‐pass resolution perimetry and differential light sensitivity perimetry in glaucoma patients
Authors: Kono Yoshiki , Yamamoto Tetsuya , Kitazawa Yoshiaki
Published: May 2009

Using a new standard, we compared the visual field defects detected by high‐pass resolution perimetry (HRP) and differential light sensitivity (DLS) perimetry in 61 eyes of 61 open‐angle glaucoma patients. Abnormal test points were determined using probability plot analysis of HRP and total deviation probability maps of the Humphrey Field Analyzer. To evaluate the agreement between the two tests, we developed a new scoring system. Thirty‐three eyes, 23 eyes, and 5 eyes had good, fair, and poor agreement, respectively. In relation to Aulhorn's stage classification, the more advanced the glaucomatous stage, the more increased the percentages of good agreement. These results suggest that the distribution and severity of visual field defects demonstrated by HRP agree closely with those found using DLS perimetry in glaucomatous eyes, especially those with advanced visual field changes.
Residual symptoms and signs after untreated acute optic neuritis
Authors: Frederiksen J. L. , Sørensen T. L. , Sellebjerg F. T.
Published: May 2009

Purpose: To study the symptoms and signs one year after optic neuritis.

Methods: Seventy population‐based untreated patients, (44F, 26M; median age 35 years, range 14–48 years) were eligible for study, but the 11 bilateral cases were excluded. Among 59 patients participating in a one‐year follow‐up of the visual function, 58 answered a questionnaire.

Results: At follow‐up 59% of the patients complained of visual impairment, though 49% of these patients had a Snellen visual acuity of 6/9 or better. The affected eyes showed decreased visual acuity in 34%, decreased contrast sensitivity in 63%, an abnormal score in 40% with the Lanthony D‐15 desaturated panel, and in 13% with the Ishihara test, prolonged latencies of VEP in 58%, and decreased amplitudes of VEP in 41%.

Conclusions: All tests except for VEP correlated significantly to the degree of per‐cieved visual impairment. Subjective visual complaints and more sensitive tests than visual acuity should be used to evaluate the visual function following optic neuritis.
Quality of life among patients with glaucoma in Sweden
Authors: Wändell Per E. , Lundström M. , Brorsson B. , Åberg H.
Published: May 2009

Purpose: To assess the health‐related quality of life (HRQOL) in an unselected sample of patients with glaucoma.

Methods: The HRQOL was studied in a cross‐sectional survey in 270 patients from two departments of ophthalmology in different parts of Sweden by using the Swedish Health‐Related Quality of Life Survey, a generic HRQOL‐instrument adapted from the Medical Outcomes Study.

Results: Compared to a random Standard Population Sample, the glaucoma patients showed lower mean score only in the scale of ‘Pain’ (p<0.05, effect size 0.17), but higher mean score in ‘Sexual functioning’ (p<0.01, effect size 0.35). Significant factors correlated to a lower score on HRQOL‐scales were decreased visual acuity and visual field, and comorbidity of cardiovascular and non‐vascular systemic diseases. Regarding the topical medications, beta‐blockers with or without miotic agents had no negative impact on the HRQOL.

Conclusion: Our findings indicate that health‐related quality of life in glaucoma patients in general is good, especially when vision is intact, and that topical beta‐blockers do not have any negative influence.
Fluorometric evaluation of panretinal photocoagulation in diabetic subjects
Authors: Knudsen L. L. , Olsen T. , Nielsen‐Kudsk F.
Published: May 2009

The effect of panretinal photocoagulation on the blood‐retinal barrier was examined by long‐term kinetic vitreous fluorophotometry in eight insulin treated diabetic subjects, before and one month after unilateral panretinal photocoagulation. The fluorophotometric investigations revealed an increased permeability‐index following this treatment. A further analysis based upon a two‐compartment fluorescein kinetic model revealed a decreased penetration rate constant together with increased zero‐time concentration coefficients for fluorescein following panretinal photocoagulation. No alterations were observed in kinetic parameters in the group of untreated eyes. This points towards a delayed but increased fluorescein penetration to the vitreous following panretinal photocoagulation, probably indicating an increased net flux of fluorescein across the entire retina. In patients with unilateral proliferative retinopathy the permeability‐index obtained from eyes with classified proliferative retinopathy was 18.1%, whereas the permeability‐index from eyes without proliferative retinopathy was 15.4%. This relatively small difference seems to indicate that the main part of vitreous fluorescence comes from an increased penetration across the entire retina, whereas a direct leakage from the proliferations themselves is less in magnitude. This increased retinal penetration might possibly be caused by affected transport processes for fluorescein within the retina.