bluuebunny/crossref_metadata_2025 huggingface dataset:
From Dare I say … ? to I dare say: a case example illustrating the extension of the use of Talking Mats to people with learning disabilities who are able to speak well but unwilling to do so
Authors: Bell Dorothy M. , Cameron Lois
Published: October 2007

Accessible summary

Sometimes people are worried about saying things to staff even if they are usually  good at talking.

Sometimes they think if they say something then someone might blame them.

It can help to use picture symbols to help you say what you want.

Symbols help you remember what you have said because the pictures are there in  front of you.

This article tells you how these picture symbols in Talking Mats work.

It also tells you how one woman was helped to say what she wanted.

This article presents the case of a woman with mild learning disability and with good verbal and expressive language ability. However, she was unable to explore verbally with her clinical psychologist issues concerning her low mood and to discuss strategies to address this. Talking Mats provided a low‐tech communication framework to help the woman think about the issues and express her views. This article explores this approach and the woman’s response and considers the advantages of using Talking Mats in such cases.
Evidence‐Based Imaging Guidelines and Medicare Payment Policy
Authors: Sistrom Christopher L. , McKay Niccie L.
Published: October 2007

Objective. This study examines the relationship between evidence‐based appropriateness criteria for neurologic imaging procedures and Medicare payment determinations. The primary research question is whether Medicare is more likely to pay for imaging procedures as the level of appropriateness increases.

Data Sources. The American College of Radiology Appropriateness Criteria (ACRAC) for neurological imaging, ICD‐9‐CM codes, CPT codes, and payment determinations by the Medicare Part B carrier for Florida and Connecticut.

Study Design. Cross‐sectional study of appropriateness criteria and Medicare Part B payment policy for neurological imaging. In addition to descriptive and bivariate statistics, multivariate logistic regression on payment determination (yes or no) was performed.

Data Collection Methods. The American College of Radiology Appropriateness Criteria (ACRAC) documents specific to neurological imaging, ICD‐9‐CM codes, and CPT codes were used to create 2,510 medical condition/imaging procedure combinations, with associated appropriateness scores (coded as low/middle/high).

Principal Findings. As the level of appropriateness increased, more medical condition/imaging procedure combinations were payable (low = 61 percent, middle = 70 percent, and high = 74 percent). Logistic regression indicated that the odds of a medical condition/imaging procedure combination with a middle level of appropriateness being payable was 48 percent higher than for an otherwise similar combination with a low appropriateness score (95 percent CI on odds ratio=1.19–1.84). The odds ratio for being payable between high and low levels of appropriateness was 2.25 (95 percent CI: 1.66–3.04).

Conclusions. Medicare could improve its payment determinations by taking advantage of existing clinical guidelines, appropriateness criteria, and other authoritative resources for evidence‐based practice. Such an approach would give providers a financial incentive that is aligned with best‐practice medicine. In particular, Medicare should review and update its payment policies to reflect current information on the appropriateness of alternative imaging procedures for the same medical condition.
Upper and Lower Common Pathways in Atrioventricular Nodal Reentrant Tachycardia:
Authors: KATRITSIS DEMOSTHENES G.
Published: October 2007

The concepts of upper and lower common pathways represent long‐standing controversies of atrioventricular nodal reentrant tachycardia (AVNRT). Over the last years there has been considerable evidence against the presence of a lower and, especially, an upper common pathway as distinct entities that can be identified in most patients with atrioventricular reentrant tachycardia. The mechanism and relevance of these concepts remain speculative.
Substrate Characterization of Ventricular Tachycardia in a Porcine Model of Tetralogy of Fallot Using Noncontact Mapping
Authors: KALTMAN JONATHAN R. , GILLESPIE MATTHEW J. , SEYMOUR TRAVIS , KHAN AZEEM , ZELTSER ILANA J. , RHODES LARRY A. , TANEL RONN E. , VETTER VICTORIA L. , WILLIAM GAYNOR J. , SHAH MAULLY J.
Published: October 2007

Background:

Ventricular tachycardia (VT) in patients following tetralogy of Fallot (TOF) repair is challenging to map because of the presence of scar, patch material, and hemodynamic residua of surgery. This study investigates whether noncontact mapping can identify the arrhythmia substrate in a porcine model that involves a right ventricular outflow tract (RVOT) patch and either chronic volume or pressure load on the right ventricle.

Methods:

Nine infant pigs (3–5 kg) underwent surgery involving an RVOT patch and creation of pulmonary insufficiency (PI, n = 4) or pulmonary stenosis (PS, n = 5). After a mean of 4.2 months, pigs underwent invasive electrophysiology studies (EPS) with noncontact mapping (Ensite, St. Jude Medical, St. Paul, MN USA) of the right ventricle. Automated, unipolar voltage maps (VM) were constructed during sinus rhythm. Threshold for substrate was set at −0.5 mV and incrementally adjusted to higher values until a contiguous region of low voltage was delineated. Programmed stimulation was performed to induce VT. VT activation was correlated to location of VM defined substrate. Three control pigs underwent EPS and VM.

Results:

Free‐wall RVOT substrate was identified in each of the model animals, correlating to location of the patch. The mean voltage threshold was −1.1 mV. VT was induced in 6/9 animals. Diastolic activation approximated the inferior or lateral border of the substrate in all animals. No RVOT substrate was identified in the control pigs.

Conclusion:

Automated voltage mapping of sinus beats identifies substrate for VT in a porcine model of TOF. Consistent diastolic activation of the substrate border was found during VT. Targeting this area may be useful in the ablation of VT after repair of TOF.
QRS Duration Following the Norwood Procedure:
Authors: GRAHAM ERIC M. , SCHEURER MARK A. , PHILIP SAUL J. , BRADLEY SCOTT M. , ATZ ANDREW M.
Published: October 2007

Background:

To describe the incidence of QRS prolongation, intraventricular conduction delay (IVCD), and presence of ventricular arrhythmias in patients undergoing the Norwood procedure with subsequent superior cavopulmonary anastomosis. Differences between the modified Blalock‐Taussig shunt (BTS) and the right ventricle to pulmonary artery shunt (RV‐PA) on these variables were investigated.

Methods:

Eighty‐two consecutive patients underwent Norwood palliation with a BTS (n = 41) or a RV‐PA (n = 41). Standard 12‐lead surface ECGs were retrospectively reviewed at three separate times: (1) prior to the Norwood procedure, (2) immediately post‐Norwood procedure, and (3) prior to the superior cavopulmonary anastomosis. Groups were compared at these times for the absolute QRS duration, the change in QRS duration from one time interval to the other, and the number of patients with IVCD. The presence of ventricular rhythm abnormalities requiring treatment at any time was recorded.

Results:

Immediately after the Norwood procedure, QRS duration was slightly longer and median QRS change slightly larger for the RV‐PA than the BTS group (P = 0.04). However, there were no differences in these variables at the time of pre superior cavopulmonary anastomosis. Within both groups, there was a significant increase in median QRS duration over time; from both pre‐ and post‐Norwood to presuperior cavopulmonary anastomosis (P < 0.001).

Conclusions:

IVCD is common in patients following a Norwood procedure regardless of the type of shunt received. A ventriculotomy had small effects on QRS duration in the short term, but had no effect on the incidence of treatable ventricular rhythm abnormalities.
Effect of Transvenous Cardiac Resynchronization Therapy Device Implantation on Cardiac Troponin I Release
Authors: ALTIN TIMUCIN , AKYUREK OMER , VURGUN KUTAY , BETON OSMAN , SAYIN TAMER , KILICKAP MUSTAFA , KARAOGUZ REMZI , GULDAL MUHARREM , EROL CETIN
Published: October 2007

Background: Pacemaker and implantable cardioverter defibrillator (ICD) implantation increases cardiac troponin I (cTnI) levels which indicates myocardial injury. During implantation of a cardiac resynchronization therapy (CRT) device, balloon inflation for coronary sinus (CS) venogram, cannulation of CS side branch, and electrode advancement may interfere with CS drainage and, hence, may decrease the washout of toxic metabolites from the heart. Thus, CRT implantation may further increase cTnI levels. In this study, we investigated the effects of CRT implantation on cTnI release.

Methods: We included 10 patients (mean age = 57 ± 15 years) in whom a successful transvenous CRT system was implanted (CRT group). Twenty patients (mean age = 65 ± 10 years) who underwent a transvenous pacemaker or ICD implantation were included as the control group. Blood samples for cTnI were drawn at baseline and at six, 12, 18, and 24 hours thereafter.

Results: Baseline median cTnI levels were similar in CRT and control groups (0.03 ng/mL vs 0.02 ng/mL, respectively; P = 0.1). Postoperative cTnI levels during 24 hours were significantly higher in the CRT group (P < 0.05) by two‐way repeated measures of analyis of variance. Post hoc analysis revealed that cTnI levels were higher at the 6th, 12th, 18th, and 24th hours compared to baseline levels (P < 0.001, P < 0.001, P < 0.01, and P < 0.01, respectively). There was a significant difference in the area under the curves (AUCs) of cTnI measurements (1.79 hr·ng/mL in the CRT group and 0.78 hr·ng/mL in the control group, P < 0.05).

Conclusion: Postoperative cTnI levels were higher after CRT implantation than simple pacemaker/ICD implantation. This may be due to CS manipulation during CRT implantation.
Cardiac Resynchronization Therapy Response is Associated with Shorter Duration of Atrial Fibrillation
Authors: LELLOUCHE NICOLAS , DE DIEGO CARLOS , VASEGHI MARMAR , BUCH ERIC , CESARIO DAVID A. , MAHAJAN AMAN , WIENER ISAAC , FONAROW GREGG C , BOYLE NOEL G. , SHIVKUMAR KALYANAM
Published: October 2007

Background: Atrial fibrillation (AF) is commonly associated with heart failure. The benefit of cardiac resynchronization therapy (CRT) on atrial remodeling has been demonstrated. However, biventricular pacing did not reduce the global incidence of AF. We evaluated the relationship between CRT response and AF duration.

Methods: We retrospectively analyzed data from 96 patients (59 ± 15 years; 78% male) who underwent CRT. All patients had class III–IV New York Heart Association (NYHA) symptoms despite maximal medical therapy, left ventricular ejection fraction (LVEF) ≤ 35%, QRS >130 ms, and sinus rhythm before implantation. CRT response in patients who survived at six months of follow‐up was defined as: (1) no hospitalization for heart failure and (2) improvement of one or more grades in the NYHA classification.

Results: CRT responders (n = 54) and non‐responders (n = 42) had similar baseline characteristics, including the incidence of persistent AF within six months before implantation. Six months after implantation, when compared to baseline, CRT responders exhibited a significant decrease in left atrial size (47.5 ± 7.1 mm vs 44.6 ± 7.7 mm, P < 0.01) and in the incidence of persistent AF (17% vs 2%, P = 0.02). At six months, CRT responders demonstrated shorter mean AF duration (7.5 ± 43.3 hours vs 48.8 ± 129.0 hours, P = 0.03) and lower incidence of persistent AF (2% vs 19%, P = 0.004) compared to nonresponders.

Conclusion: CRT response is associated with a reversal of atrial remodeling and a shorter AF duration.
Electrocardiographic Patterns during:
Authors: GIUDICI MICHAEL C. , TIGRETT DARRYN W. , CARLSON JACQUELINE I. , LORENZ TERRI D. , PAUL DEBORAH L. , BAROLD S. SERGE
Published: October 2007

Background: The electrocardiogram (ECG) patterns during pacing from the great cardiac vein (GCV) and the middle cardiac vein (MCV) are not well known.

Methods: We recorded 12‐lead ECGs during GCV and MCV pacing in 26 patients undergoing implantation of a cardiac resynchronization device. The left ventricular (LV) lead was passed down the GCV (n = 19) or MCV (n = 7) prior to moving it to a lateral or posterolateral vein for permanent implantation.

Results and Conclusions: Pacing within the GCV resulted in a left bundle branch block (LBBB) morphology with no or minimal R‐wave in V1 in 14 patients and a right bundle branch block (RBBB) pattern (R > S in lead V1) in four patients. In one patient, lead V1 during GCV pacing was isoelectric (R = S). A more distal pacing site in the GCV yielded a LBBB pattern in all the patients. All leads placed in the MCV resulted in a LBBB configuration. An ECG pattern with a RBBB pattern was invariably recorded during LV pacing in 125 consecutive outpatients with biventricular pacemakers and LV leads in the posterolatral and lateral coronary veins. Knowledge of the ECG patterns from various pacing sites in the coronary venous system may be helpful for troubleshooting all types of pacing systems, especially those where the coronary venous pacing site is unintentional.
Clinical and neurocognitive correlates of insight in patients with bipolar I disorder in remission
Authors: Dias V. V. , Brissos S. , Carita A. I.
Published: October 2007

Objective:  The relationship between insight and neurocognition in bipolar disorder has not been clearly established.

Method:  A neuropsychological battery assessing attention, mental control, perceptual‐motor skills, executive functions, verbal fluency and abstraction, and visuo‐spatial attention was administered to 50 bipolar remitted patients and 50 healthy controls. Insight was assessed with the Scale to Assess Unawareness of Mental Disorder.

Results:  Patients presented significantly worse neurocognitive performance. Insight was impaired in 60% of patients, and age, educational level, manic symptoms, age of disease onset, number of admissions, and performance on several neurocognitive tests correlated significantly with insight. A regression model revealed that age and Trail Making Test part B (TMT‐B) performance accounted for 32% of the variance in overall illness awareness, while performance on the TMT‐B alone accounted for 28% of the variance.

Conclusion:  Impaired insight and neurocognitive dysfunction seem to be present in euthymic bipolar patients. Insight in bipolar disorder may be partially dependent on intact neurocognition.
Influence of facial convexity on facial attractiveness in Japanese
Authors: Ioi H , Nakata S , Nakasima A , Counts AL
Published: October 2007

Structured Abstract

Authors –  Ioi H, Nakata S, Nakasima A, Counts AL

Objective –  The purpose of this study was to assess and determine the range of the top three most‐favored facial profiles for each sex from a series of varying facial convexity, and to evaluate the clinically acceptable facial profiles for Japanese adults.

Design –  Questionnaire‐based study.

Subjects and methods –  Silhouettes of average male and female profiles were constructed from the profiles of 30 Japanese males and females with normal occlusions. Chin positions were protruded or retruded by 2°, 4°, 6°, 8° and 10°, respectively, from the average profile. Forty‐one orthodontists and 50 dental students were asked to select the three most‐favored profiles for each sex, and they were also asked to indicate whether they would seek surgical orthodontic treatment if that image represented their own profile.

Results –  For males, both the orthodontists and dental students chose the average profile as the most‐favored profile. For females, both the orthodontists and dental students chose a slightly more retruded chin position as the most‐favored profile. Japanese raters tended to choose class II profiles as more acceptable profiles than class III profiles for both males and females.

Conclusions –  These findings suggest that Japanese patients with class III profiles tend to seek surgical orthodontic treatment more often.
Clinical and microbiological effects of fixed orthodontic appliances on periodontal tissues in adolescents
Authors: Ristic M , Svabic M Vlahovic , Sasic M , Zelic O
Published: October 2007

Structured Abstract

Authors –  Ristic M, Vlahovic Svabic M, Sasic M, Zelic O

Objective– –  To determine the effects of fixed orthodontic appliances on periodontal health and microbiological composition of subgingival dental plaque.

Material and methods –  This prospective longitudinal self‐controlled study was conducted on 32 adolescents (13 males, 19 females), who were scheduled for fixed orthodontic treatment between 2002 and 2005. Dental plaque accumulation, gingival inflammation and pocket probing depth were measured at the mesio‐vestibular angle of the examined group of teeth followed by collection of subgingival dental plaque samples in the same points. These periodontal indices and microbiological parameters were determined prior to the placement of fixed appliances and 1, 3 and 6 months after the beginning of orthodontic treatment.

Results –  All values of both clinical and microbiological parameters started to increase after the placement of fixed appliances. Maximum values were reached 3 months after fixed appliance placement followed by their decrease in the last registration period of 6 months after the placement of fixed appliances.

Conclusions –  Treatment with fixed appliances in adolescents may transitionally increase the values of all periodontal indices and stimulate the growth of periodontopathogenic bacteria, but without destructive effects on deep periodontal tissues.
Anthropometric and cephalometric measurements in X‐linked hypohidrotic ectodermal dysplasia
Authors: Lexner MO , Bardow A , Bjorn‐Jorgensen J , Hertz JM , Almer L , Kreiborg S
Published: October 2007

Structured Abstract

Authors – Lexner MO, Bardow A, Bjorn‐Jorgensen J, Hertz JM, Almer L, Kreiborg S.

Objective – To describe the somatic development and craniofacial morphology in males affected with hypohidrotic ectodermal dysplasia (HED) and female carriers and to find clinical markers for early clinical diagnosis of possible female carriers.

Design – A clinical and radiographic examination of the affected males and the female carriers.

Setting and sample population – Twenty‐four affected males and 43 female carriers with a known mutation in theED1gene were examined in a dental clinic in either Copenhagen or Aarhus, Denmark.

Experimental variables – Height, body mass index (BMI) and head circumference. Cephalometric analysis of the craniofacial morphology.

Outcome measure – Data on the somatic and craniofacial development in the affected males and female carriers.

Results – No difference was observed regarding body height in the affected males and female carriers, BMI values were lower than the mean in most affected boys and adolescence and head circumference was somewhat decreased in both groups compared to normative data. The cephalometric analysis showed a reduced maxilla length and prognathism, a normal size and shape of the mandible and a reduced sagittal jaw relationship in both HED groups. Furthermore, affected males had a retroclined nasal bone and a more anteriorly inclined maxilla. A short nose, protruding lips, reduced facial convexity and facial height, characterized the soft tissue profile of the affected males. In female carriers, the lips were significantly retruded when compared with controls.

Conclusion – No specific somatic or cephalometric markers could be observed, in the female carrier group.
Changes in cranial base morphology in different malocclusions
Authors: Polat ÖÖ , Kaya B
Published: October 2007

Structured Abstract

Authors –  Polat ÖÖ, Kaya B

Objectives –  To evaluate the differences in cranial base flexure between skeletal and dental Class I, Class II and Class III malocclusions.

Design –  Lateral cephalometric radiographs, matched for age, of skeletal Class I, Class II and Class III patients with an average vertical growth pattern were analyzed and compared.

Setting and sample population –  A total of 75 patients having skeletal Class I (n = 25), Class II (n = 25) and Class III (n = 25) malocclusions of Baskent University.

Experimental variable –  Anterior (SN) and posterior (SBa) cranial base lengths, cranial base angle (N‐S‐Ba, N‐S‐Ar) and both anterior (SN‐FH) and posterior (SBa‐FH) cranial base inclinations were measured on the pretreatment lateral cephalograms.

Outcome measure –  Size and shape differences in cranial base between different malocclusions.

Results –  Anterior and posterior cranial base lengths, and cranial base angles did not show statistically significant differences between the three groups studied. Both anterior and posterior cranial base inclinations were increased significantly in the Class III group compared with Class I and Class II groups.

Conclusions –  No differences were observed in anterior and posterior cranial base lengths, and cranial base angles between the three malocclusions. However, cranial base inclinations were increased in Class III malocclusions.
Can There Be a Just War Without a Just Peace?
Authors: Pabst Adrian
Published: October 2007

This essay explores the political and legal problem of legitimate wars in relation to the theological question of justice and peace. It begins by charting a brief genealogical account of how in the modern era the Christian ‘just war’ tradition was formalised and thus drained of much of its substantive and practical context.

The essay also examines and rejects a number of contemporary attempts to use ‘just war’ theory in order to legitimate modern warfare. The argument is that both neoconservative realism and political liberalism instrumentalise the ‘just war’ tradition to defend and extend central state power. Christian pacifism has a compelling critique of realism and liberalism, but it fails to offer a genuinely transformative ontology and politics.

The essay concludes by calling for a metaphysics of peace that can resist the modern primacy of violence and make real the divine promise of a harmoniously ordered cosmos.
A Feminist Appraisal of Augustine
Authors: Duran Jane
Published: October 2007

Employing several major lines of argument, I claim that Augustine exhibits styles of thought, literary methods and modes of inquiry that are not only accessible to feminist scholarship, but that are genuinely feminist‐friendly. I first examine the Confessions, and then proceed with analyses of Augustine's style, a comparison of his work to that of another major thinker in the Christian tradition, an analysis of his use of the notion of unity, and a final look at City of God. The work of commentators such as Chadwick, Clark, McMahon and Mallard is used in order to support the argument. Augustine's standing as one of the founding Church Fathers may make it difficult for us to mention him in the same breath as the concept of “feminism.”1 Yet in our attempts to try to come to grips with thinkers as diverse as Nietzsche, Kierkegaard, and Quine, we have frequently noticed that concepts useful to feminists are where one finds them.
Proteolytic degradation of nitric oxide synthase isoforms by calpain is modulated by the expression levels of HSP90
Authors: Averna Monica , Stifanese Roberto , De Tullio Roberta , Salamino Franca , Bertuccio Mara , Pontremoli Sandro , Melloni Edon
Published: October 2007

Ca2+ loading of Jurkat and bovine aorta endothelium cells induces the degradation of the neuronal and endothelial nitric oxide synthases that are selectively expressed in these cell lines. For neuronal nitric oxide synthase, this process involves a conservative limited proteolysis without appreciable loss of catalytic activity. By contrast, endothelial nitic oxide synthase digestion proceeds through a parallel loss of protein and catalytic activity. The chaperone heat shock protein 90 (HSP90) is present in a large amount in Jurkat cells and at significantly lower levels in bovine aorta endothelium cells. The differing ratios of HSP90/nitric oxide synthase (NOS) occurring in the two cell types are responsible for the conservative or nonconservative digestion of NOS isozymes. Consistently, we demonstrate that, in the absence of Ca2+, HSP90 forms binary complexes with NOS isozymes or with calpain. When Ca2+ is present, a ternary complex containing the three proteins is produced. In this associated state, HSP90 and NOS forms are almost completely resistant to calpain digestion, probably due to a structural hindrance and a reduction in the catalytic efficiency of the protease. Thus, the recruitment of calpain in the HSP90–NOS complexes reduces the extent of the proteolysis of these two proteins. We have also observed that calpastatin competes with HSP90 for the binding of calpain in reconstructed systems. Digestion of the proteins present in the complexes can occur only when free active calpain is present in the system. This process can be visualized as a novel mechanism involving the association of NOS with HSP90 and the concomitant recruitment of active calpain in ternary complexes in which the proteolysis of both NOS isozymes and HSP90 is significantly reduced.
Role of Megalin, a Proximal Tubular Endocytic Receptor, in Calcium and Phosphate Homeostasis
Authors: Saito Akihiko , Iino Noriaki , Takeda Tetsuro , Gejyo Fumitake
Published: October 2007

Abstract:  Megalin is expressed at the apical membranes of proximal tubule cells, acting as an endocytic receptor for a variety of ligands filtered by glomeruli. Megalin, also known as a Ca2+‐binding receptor, is thought to be involved in systemic and intrarenal calcium and phosphate homeostasis. The complex of 25(OH)D3 and vitamin D‐binding protein is endocytosed via megalin into proximal tubule cells, leading to the activation of 25(OH)D3 to 1, 25(OH)D3 in the cells. Megalin knockout mice revealed impaired osteogenesis due to vitamin D deficiency. Megalin is also involved in the metabolism of parathyroid hormone and the regulation of the sodium phosphate cotransporter NaPi‐IIa. Decreased expression of megalin may be associated with the pathogenesis of hyperphosphaturia observed in patients with Dent's disease. Further studies will elucidate more detailed roles of megalin in pathological states and the mechanisms for interacting with other molecules for the endocytic functions.
Roles of Organic Anion Transporters in the Progression of Chronic Renal Failure
Authors: Enomoto Atsushi , Niwa Toshimitsu
Published: October 2007

Abstract:  Renal proximal and distal tubules carry out specialized directional transport of various solutes. The family of organic anion transporters (OATs), which belongs to the major facilitator superfamily (SLC22A), are expressed in the renal epithelial cells to regulate the excretion and the reabsorption of endogenous and exogenous organic anions that include various kinds of drugs and their metabolites. In recent years, it is revealed that indoxyl sulfate, one of uremic toxins, is a novel physiological substrate for OAT family, and its accumulation within the renal tubules via OATs induces renal dysfunction. The OATs are also expressed in the blood‐brain barrier, muscle cells, and bone osteoblasts, which hint at various pathogenic roles of OAT‐mediated transport of uremic toxins. In this review, we introduce and discuss the function of OATs in the context of their roles in the progression of chronic renal disease.
Japanese Society of Dialysis Therapy Treatment Guidelines for Secondary Hyperparathyroidism
Authors: Kazama Junichiro James
Published: October 2007

Abstract:  Impairment of renal function causes various abnormalities of bone mineral metabolism including secondary hyperparathyroidism. The Japanese Society of Dialysis Therapy proposed the guidelines for the treatment of secondary hyperparathyroidism in chronic dialysis patients (JSDT guidelines) in 2006. From the perspective of better survival rate, the control goal value was determined to be 3.5–6 mg/dl for phosphorus, 8.4–10.0 mg/dl for calcium, and 60–180 pg/ml for intact PTH levels. When the 3 items cannot be controlled by treatment with an active vitamin D preparation, treatment is considered to be a failure, and intervention treatment of the parathyroid gland is recommended. The adequacy of the JSDT guideline must be evaluated by its clinical application.
Calcium and Phosphorus Control in Patients Undergoing Hemodialysis: From the View‐Points of Activities of Daily Living
Authors: Osawa Yutaka
Published: October 2007

Abstract:  To determine the compliance with the JSDT guidelines and activities of daily living (ADLs), phosphorus levels, calcium levels and Barthel index of patients under maintenance hemodialysis therapy in Shinrakuen hospital at December 2005 were evaluated. Of 369 patients, 28.7 % were controlled in the range of JSDT guidelines both phosphorus and calcium. Administration of sevelamer hydrochloride were low both in number of patients and also of using dose. Barthel index were higher in the patients with high phosphorus levels and low calcium level. Patients mortality at February 2007 was highest in the group of low phosphorus and high calcium levels in which the ADLs were the lowest. Concerned about vascular complication, patients in the group with target level or higher level of calcium and phosphorus were frequently noted.
Role of slow delayed rectifier K+‐current in QT prolongation in the alloxan‐induced diabetic rabbit heart
Authors: Lengyel Cs. , Virág L. , Kovács P. P. , Kristóf A. , Pacher P. , Kocsis E. , Koltay Zs. M. , Nánási P. P. , Tóth M. , Kecskeméti V. , Papp J. Gy. , Varró A. , Jost N.
Published: October 2007

Aim:  In diabetes mellitus, several cardiac electrophysiological parameters are known to be affected. In rodent experimental diabetes models, changes in these parameters were reported, but only limited relevant information is available in other species, having cardiac electrophysiological properties more resembling the human, including the rabbit. The present study was designed to analyse the effects of experimental type 1 diabetes on ventricular repolarization and the underlying transmembrane potassium currents in rabbit hearts.

Methods:  Diabetes was induced by a single injection of alloxan (145 mg kg−1 i.v.). After the development of diabetes (3 weeks), electrophysiological studies were performed using whole cell voltage clamp and ECG measurements.

Results:  The QTc interval in diabetic rabbits was moderately but statistically significantly longer than measured in the control animals (155 ± 1.8 ms vs. 145 ± 2.8 ms, respectively, n = 9–10, P < 0.05). This QTc‐lengthening effect of diabetes was accompanied by a significant reduction in the density of the slow delayed rectifier K+ current, IKs (from 1.48 ± 0.35 to 0.86 ± 0.17 pA pF−1 at +50 mV, n = 19–21, P < 0.05) without changes in current kinetics. No differences were observed either in the density or in the kinetics of the inward rectifier K+ current (IK1), the rapid delayed rectifier K+ current (IKr), the transient outward current (Ito) and the L‐type calcium current (ICaL) between the control and alloxan‐treated rabbits.

Conclusion:  It is concluded that type 1 diabetes mellitus, although only moderately, lengthens ventricular repolarization. Diabetes attenuates the repolarization reserve by decreasing the density of IKs current, and thereby may enhance the risk of sudden cardiac death.
Trace Metal Concentrations in an Intensive Agricultural Watershed in British Columbia, Canada1
Authors: Smith Ione M. , Hall Ken J. , Lavkulich Les M. , Schreier Hans
Published: October 2007

Abstract:  Effects of agricultural intensification and a naturally occurring landslide of asbestos material upon water and sediment quality in a transboundary watershed were investigated. The water and sediments of the Sumas River watershed were analyzed for copper (Cu), zinc (Zn), chromium (Cr), and nickel (Ni) concentrations in 1993/1994 and 2003/2004 and differences within sites over time were examined. Based upon a review of the literature, Cu and Zn were used as indicators of agricultural impacts while Cr and Ni were used as indicators of impacts from an asbestos landslide. Animal unit equivalents (AUEs) were calculated on a per area basis as an indicator of livestock density using detailed statistical census data. Whatman #42 filtered metals, bioavailable metals, and sediment‐bound metals (in the <63 μm fraction) were determined at 22 sites along the mainstem and tributaries, including two reference sites. Temperature, pH, and dissolved organic carbon (DOC) were also measured. The bioavailable metal fraction was determined using the diffusive gradient thin film technique (DGT). Sediment‐bound results were compared with British Columbia’s Interim Sediment Quality Guidelines (ISQGs) and Severe Effects Levels (SELs). A Wilcoxon signed rank test was used to determine if the concentrations of metals changed significantly within sites between 1993/1994 and 2003/2004. Spearman rank correlation analysis was used to determine relationships between trace metals, water quality parameters, and AUEs/hectare. The results indicate that Cu and Zn levels in sediments increased significantly to concentrations above the ISQGs of 35.7 mg/kg and 123 mg/kg, respectively from 1993/1994 to 2003/2004 in streams, where associated land use was dominated by intensive agriculture. Higher AUEs/hectare were significantly correlated with greater bioavailable levels of Zn as well as higher sediment‐bound Zn concentrations. Neither Cu nor Cr were detected by the DGTs on any of the sampling occasions. The Cr and Ni sediment concentrations were highest in Swift Creek, the headwater tributary affected by the natural landslide of asbestos material, and decreased in the Sumas River downstream from the point of input. Cr and Ni concentrations have increased in the mid‐region of the Sumas River since 1993/1994, suggesting downstream movement of the asbestos material over time. DGT results indicated that bioavailable Zn is significantly positively correlated to sediment‐bound Zn and livestock density, and bioavailable Ni is significantly correlated to sediment‐bound Ni.
Approaches to Evaluate Water Quality Model Parameter Uncertainty for Adaptive TMDL Implementation1
Authors: Stow Craig A. , Reckhow Kenneth H. , Qian Song S. , Lamon Estel Conrad , Arhonditsis George B. , Borsuk Mark E. , Seo Dongil
Published: October 2007

Abstract: The National Research Council recommended Adaptive Total Maximum Daily Load implementation with the recognition that the predictive uncertainty of water quality models can be high. Quantifying predictive uncertainty provides important information for model selection and decision‐making. We review five methods that have been used with water quality models to evaluate model parameter and predictive uncertainty. These methods (1) Regionalized Sensitivity Analysis, (2) Generalized Likelihood Uncertainty Estimation, (3) Bayesian Monte Carlo, (4) Importance Sampling, and (5) Markov Chain Monte Carlo (MCMC) are based on similar concepts; their development over time was facilitated by the increasing availability of fast, cheap computers. Using a Streeter‐Phelps model as an example we show that, applied consistently, these methods give compatible results. Thus, all of these methods can, in principle, provide useful sets of parameter values that can be used to evaluate model predictive uncertainty, though, in practice, some are quickly limited by the “curse of dimensionality” or may have difficulty evaluating irregularly shaped parameter spaces. Adaptive implementation invites model updating, as new data become available reflecting water‐body responses to pollutant load reductions, and a Bayesian approach using MCMC is particularly handy for that task.
Upland Controls on the Hydrological Functioning of Riparian Zones in Glacial Till Valleys of the Midwest1
Authors: Vidon P. , Smith A. P.
Published: October 2007

Abstract: Identifying relationships between landscape hydrogeological setting, riparian hydrological functioning and riparian zone sensitivity to climate and water quality changes is critical in order to best use riparian zones as best management practices in the future. In this study, we investigate water table dynamics, water flow path and the relative importance of precipitation, deep ground water (DG) and seep water as sources of water to a riparian zone in a deeply incised glacial till valley of the Midwest. Data indicate that water table fluctuations are strongly influenced by soil texture and to a lesser extent by upland sediment stratigraphy producing seeps near the slope bottom. The occurrence of till in the upland and at 1.7‐2 m in the riparian zone contributes to maintaining flow parallel to the ground surface at this site. Lateral ground‐water fluxes at this site with a steep topography in the upland (16%) and loam soil near the slope bottom are small (<10 l/d/m stream length) and intermittent. A shift in flow path from a lateral direction to a down valley direction is observed in the summer despite the steep concave topography and the occurrence of seeps at the slope bottom. Principal component and discriminant analysis indicate that riparian water is most similar to seep water throughout the year and that DG originating from imbedded sand and gravel layers in the lower till unit is not a major source of water to riparian zones in this setting. Water quality data and the dependence of the riparian zone for recharge on seep water suggest that sites in this setting may be highly sensitive to changes in precipitation and water quality in the upland in the future. A conceptual framework describing the hydrological functioning of riparian zones on this setting is presented to generalize the finding of this study.
Impacts of Residential Development on Humid Subtropical Freshwater Resources: Southwest Florida Experience1
Authors: Maliva Robert G. , Hopfensperger Karl P.
Published: October 2007

Abstract:  The population of Collier and Lee Counties in southwestern Florida has increased 11‐fold from 1960 to 2004 with a concomitant increase in freshwater demand. Water levels and salinity within the water table aquifer over the past two to three decades have generally been stable, with more monitoring wells showing statistically significant temporal increases in water level than decreases. Residential development has had a neutral impact on the water table aquifer because the total annual evapotranspiration of residential communities is comparable to that of native vegetation and less than that of most agricultural land uses. Public water supply systems and private wells also result in net recharge to the water table aquifer with water produced from deeper aquifers. Confined freshwater aquifers have overall trends of decreasing water levels. However, with the exception of the mid‐Hawthorn aquifer, water levels in most areas recover to near background levels each summer wet season. Freshwater resources in humid subtropical areas, such as southwestern Florida, are relatively robust because of the great aquifer recharge potential from the excess of rainfall over ET during the wet season. Proper management can result in sustainable water resources.
Comparison of 85Kr and 3H Apparent Ground‐Water Ages for Source Water Vulnerability in the Collyer River Catchment, Maine1
Authors: Sidle William C.
Published: October 2007

Abstract:  Apparent ground‐water ages as determined by the noble gas isotope 85Kr and the water isotope 3H are compared. Refined gas extraction methodology at the wellhead permits efficient collection of Kr for 85Kr isotope enrichment. 85Kr isochrones elucidate areas of much younger ground‐water ages than 3H. Declining 3H activities in the catchment prevent its correlation with the youngest measured 85Kr ages. Source water for most drinking water supplies in the Collyer River catchment is recharged within 40 years BP (2004). Mean‐age (τ) transport modeling suggests uncertainty of ground‐water ages is greatest in the central basin area.
Automated Algorithms for Heuristic Base‐Flow Separation1
Authors: Schwartz Stuart S.
Published: October 2007

Abstract:  The subjective nature of graphical base‐flow separation combined with the many applications of base‐flow time series derived from continuous streamflow data, motivates the development and application of automated algorithms for heuristic base‐flow separation. Base‐flow time series derived from gauged streamflow support diverse applications in engineering hydrology, catchment analysis, hydrogeologic investigations, regional low‐flow analysis, and recharge estimation. Whether based on graphical procedures for recession analysis or analytical expressions derived from fundamental equations of ground‐water flow, the variety of base‐flow separation algorithms belies the array of base‐flow definitions and interpretations that variously refer to dominant process, source, flow path, and characteristic response time. Algorithms that are invariant in their consistent – though heuristic – characterization of base‐flow response are particularly useful for interbasin comparisons of low‐flow characteristics and hydrologic regionalization. More adaptable algorithms provide application‐specific flexibility in allocating flow components like interflow to either quickflow or slowflow. Four widely used algorithms that produce consistent base‐flow time series using only gauged streamflow records are compared and contrasted with a complementary heuristic algorithm that incorporates hydrologic judgment explicitly, through manual parameterization. The utility of these inherently subjective algorithms is illustrated through a simple example of flow phase separation in a two‐component end‐member mixing model of dissolved chlorides in the Cuyahoga River.
Revisiting the Thornthwaite and Mather Water Balance1
Authors: Black Peter E.
Published: October 2007

Abstract:  This technical note clarifies confusion currently present in research using and/or citing the 1955 and 1957 editions of the Thornthwaite and Mather Water Balance (or Budget) resulting from corrections to errant tables in the 1955 edition made by the authors for the 1957 edition. Confusion over the two editions and the formulas used have clouded the results of research, management, and educational publications ever since, resulting in frequent misunderstanding of the method’s utility as well as how its results compare with other frequently used methods for estimating evapotranspiration.
Effect of Phosphonated Carbocyclic 2′-Oxa-3′-Aza-Nucleoside on Human T-Cell Leukemia Virus Type 1 Infection In Vitro
Authors: Balestrieri Emanuela , Matteucci Claudia , Ascolani Arianna , Piperno Anna , Romeo Roberto , Romeo Giovanni , Chiacchio Ugo , Mastino Antonio , Macchi Beatrice
Published: October 2007

There is currently little research and development of new compounds with specific anti-human T-cell leukemia virus type 1 (HTLV-1) activity. The few antiretrovirals that have been tested against HTLV-1 in vitro have already been developed into anti-human immunodeficiency virus (HIV) drugs. Here, we show the effects of a newly synthesized family of phosphonated nucleoside compounds, phosphonated carbocyclic 2′-oxa-3′-aza-nucleosides (PCOANs), on HTLV-1 infection in vitro. To ascertain the anti-HTLV-1 activity of PCOANs, peripheral blood mononuclear cells from healthy donors were infected in vitro by coculture with an HTLV-1 donor cell line in the presence of three prototype PCOAN compounds. PCOANs were able to completely inhibit HTLV-1 infection in vitro at a concentration of 1 μM, similar to what has been observed for tenofovir and azidothymidine. Treatment with PCOANs was associated with inhibited growth of HTLV-1-infected cells, and their effects were 100 to 200 times more potent than that of tenofovir. The mechanisms involved in the anti-HTLV-1 effects of PCOANs can mainly be ascribed to their capacity to inhibit HTLV-1 reverse transcriptase activity, as ascertained by means of a cell-free assay. PCOANs caused little reduction in proliferation or induction of apoptotic cell death of uninfected cells, showing toxicity levels similar to tenofovir and lower than azidothymidine. Overall, these results indicate that the family of PCOANs includes potential candidate compounds for long-lasting control of HTLV-1 infection.
Pharmacokinetics and Efficacy of Piperaquine and Chloroquine in Melanesian Children with Uncomplicated Malaria
Authors: Karunajeewa Harin A. , Ilett Kenneth F. , Mueller Ivo , Siba Peter , Law Irwin , Page-Sharp Madhu , Lin Enmoore , Lammey Jovitha , Batty Kevin T. , Davis Timothy M. E.
Published: October 2007

The disposition of chloroquine (CQ) and the related 4-aminoquinoline, piperaquine (PQ), were compared in Papua New Guinean children with uncomplicated malaria. Twenty-two children were randomized to 3 days of PQ phosphate at 20 mg/kg/day (12 mg of PQ base/kg/day) coformulated with dihydroartemisinin (DHA-PQ), and twenty children were randomized to 3 days of CQ at 10 mg base/kg/day with a single dose of sulfadoxine-pyrimethamine (CQ-SP). After a 42-day intensive sampling protocol, PQ, CQ, and its active metabolite monodesethyl-chloroquine (DECQ) were assayed in plasma by using high-performance liquid chromatography. A two-compartment model with first-order absorption was fitted to the PQ and CQ data. There were no significant differences in age, gender, body weight, or admission parasitemia between the two groups. The PCR-corrected 42-day adequate clinical and parasitological responses were 100% for DHA-PQ and 94% for CQ-SP, but
P. falciparum
reinfections during follow-up were common (33 and 18%, respectively). For PQ, the median volume of distribution at steady state, allowing for bioavailability (
V
ss
/F), was 431 liters/kg (interquartile range [IQR], 283 to 588 liters/kg), the median clearance (CL/F) was 0.85 liters/h/kg (IQR, 0.67 to 1.06 liters/h/kg), the median distribution half-life (
t
1/2
α
) was 0.12 h (IQR, 0.05 to 0.66 h), and the median elimination half-life (
t
1/2
β
) was 413 h (IQR, 318 to 516 h). For CQ, the median
V
ss
/F was 154 liters/kg (IQR, 101 to 210 liters/kg), the median CL/F was 0.80 liters/h/kg (IQR, 0.52 to 0.96 liters/h/kg), the median
t
1/2
α
was 0.43 h (IQR, 0.05 to 1.82 h), and the median
t
1/2
β
was 233 h (IQR, 206 to 298 h). The noncompartmentally derived median DECQ
t
1/2
β
was 290 h (IQR, 236 to 368 h). Combined molar concentrations of DECQ and CQ were higher than those of PQ during the elimination phase. Although PQ has a longer
t
1/2
β
than CQ, its prompt distribution and lack of active metabolite may limit its posttreatment malaria-suppressive properties.
Antimicrobial Resistance Genes Associated with
Salmonella enterica
Serovar Newport Isolates from Food Animals
Authors: Lynne Aaron M. , Rhodes-Clark Bobbie S. , Bliven Kimberly , Zhao Shaohua , Foley Steven L.
Published: October 2007

Salmonella enterica
serotype Newport is an important cause of salmonellosis, with strains increasingly being resistant to multiple antimicrobial agents. The increase is associated with the acquisition of multiple resistance genes. This study characterizes the genetic basis of resistance of serotype Newport isolates collected from veterinary sources by PCR and DNA sequencing analysis.
Human Immunodeficiency Virus Types 1 and 2 Exhibit Comparable Sensitivities to Zidovudine and Other Nucleoside Analog Inhibitors In Vitro
Authors: Smith Robert A. , Gottlieb Geoffrey S. , Anderson Donovan J. , Pyrak Crystal L. , Preston Bradley D.
Published: October 2007

Using an indicator cell assay that directly quantifies viral replication, we show that human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2, respectively) exhibit similar sensitivities to 3′-azido-3′-deoxythymidine (zidovudine) as well as other nucleoside analog inhibitors of reverse transcriptase. These data support the use of nucleoside analogs for antiviral therapy of HIV-2 infection.