bluuebunny/crossref_metadata_2025 huggingface dataset:
Variation in litter under individual tree crowns: Implications for scattered tree ecosystems
Authors: MCELHINNY CHRIS , LOWSON CHARLES , SCHNEEMANN BART , PACHÓN CARLOS
Published: July 2009

In forest ecosystems litter is usually assessed in terms of the average amount produced by the canopy. In scattered tree ecosystems this approach is problematic because the canopy is discontinuous and the spatial arrangement of litter highly variable. We addressed this problem by quantifying the spatial variation in litter load and litter composition associated with individual trees in a Eucalyptus melliodora – Eucalyptus blakelyi woodland. Litter was sampled under crowns and in grassland adjacent to 10 E. blakelyi and 10 E. melliodora trees ranging in diameter at breast height (dbh) from 14 to 129 cm. A total of 302 L samples were collected from these trees, at distances ranging from 0 to 42 m from main stem. The sampled litter loads ranged from 0.02 to 109.3 t ha−1 and were significantly higher under tree crowns than in grassland for litter and each component of litter (leaves, bark, fine twigs, coarse twigs). In particular, the mean litter load under tree crowns (12.5 t ha−1) was an order of magnitude higher than the mean litter load in grassland (1.27 t ha−1). There was a significant (P = 0.0103) positive relationship between mean litter load under the tree crown and dbh, indicating larger trees produced more litter per unit area of ground than smaller trees. Generalized Linear Modelling produced highly significant (P < 0.0001) models predicting the spatial variation in litter load and litter composition in terms of distance from main stem and dbh. Our models demonstrate gradients in litter load and composition under tree crowns. These gradients were most pronounced for the large trees in our study. The disproportionate input of litter and variety of litter components associated with large trees in our study supports their keystone role in scattered tree ecosystems and highlights the need to maintain these structures in agricultural landscapes.
Publication ethics
Authors: MORTON NEIL S.
Published: July 2009

The editor of any medical journal has to be aware of the ethical and legal framework within which medical research is conducted. When research and publications relate to children, then particularly high standards are required in the design, conduct, and reporting of research in order to protect the rights of children and their families. Authors have a number of duties and responsibilities that are mirrored by those of editors and publishers. Of particular importance are the principles of transparency and integrity. Authors should be explicit about who carried out the work and who funded the study. They should declare whether the work has been published before and is not being considered for publication elsewhere. The authors must protect the rights of research participants including their anonymity. Editors and publishers have a duty to ensure high editorial standards and efficient and effective peer review systems. They should follow ethical and responsible publication practices and should safeguard the intellectual property of the authors. This review discusses in detail the duties and responsibilities of authors, editors, and publishers in modern medical publishing.
Efficacy and safety of insulin glulisine in Japanese patients with type 1 diabetes mellitus
Authors: Kawamori R. , Kadowaki T. , Ishii H. , Iwasaki M. , Iwamoto Y.
Published: July 2009

Aim: The rapid‐acting insulin analogue insulin glulisine (glulisine) was compared with insulin lispro (lispro) for efficacy and safety in Japanese patients with type 1 diabetes mellitus (T1DM), using insulin glargine (glargine) as basal insulin.

Methods: This was an open, randomized, parallel‐group, comparative non‐inferiority study. The primary efficacy measure was change in adjusted mean haemoglobin A1c (HbA1c) from baseline to endpoint. Safety and treatment satisfaction using the Diabetes Treatment Satisfaction Questionnaire (DTSQ) were also assessed. Patients were treated for 28 weeks with either glulisine or lispro administered 0–15 min before a meal. Doses were titrated to obtain 2‐h postprandial plasma glucose (2h‐PPG) of 7.11–9.55 mmol/l (128–172 mg/dl). All patients were concomitantly treated with glargine at bedtime, titrated to obtain a fasting (prebreakfast) plasma glucose level of 5.27–7.11 mmol/l (95–128 mg/dl).

Results: Baseline mean HbA1c values were similar for the glulisine (n = 132) and lispro (n = 135) groups (7.44 and 7.50% respectively). From baseline to endpoint, adjusted mean HbA1c increased by 0.10% in the glulisine group and by 0.04% in the lispro group. Non‐inferiority of glulisine compared with lispro was shown. There were no significant differences between glulisine and lispro in adjusted mean 2h‐PPG [glulisine, 9.06 mmol/l (163 mg/dl) vs. lispro, 8.13 mmol/l (146 mg/dl); p = 0.065] and change in adjusted mean daily rapid‐acting insulin dose (glulisine, 0.26 U vs. lispro, 0.26 U; p = 0.994) at study endpoint. There was a significant difference for change in adjusted mean daily basal insulin dose from baseline to study endpoint (glulisine, –0.54 U vs. lispro, 0.26 U; p = 0.013). The most common serious adverse events were hypoglycaemia‐related events (hypoglycaemia, hypoglycaemic seizure and hypoglycaemic coma) with no difference observed between the two groups [glulisine, 6.8% (9/132) vs. lispro, 4.4% (6/135); p = 0.437]. No noteworthy differences were observed for change in insulin antibodies from baseline to endpoint. Assessment of treatment satisfaction score and perceived frequency of hyperglycaemia and hypoglycaemia by DTSQ showed no changes from baseline in either group.

Conclusions: Glulisine was as effective as lispro with respect to change in HbA1c and was well tolerated when used in combination with glargine in Japanese patients with T1DM.
Poverty, Risk Aversion, and Path Dependence in Low‐Income Countries: Experimental Evidence from Ethiopia
Authors: Yesuf Mahmud , Bluffstone Randall A.
Published: July 2009

In most low‐income countries, rural households depend on mixed rain‐fed agriculture/livestock production, which is very risky. Due to numerous market failures, there are few ways to shift risks to third parties. The literature has focused on what determines the responses of households in such environments. Of special concern are path dependencies in which households experiencing failure are prone to further failure and potential poverty traps. This paper estimates levels and determinants of risk aversion in the highlands of Ethiopia. We find high risk aversion and evidence that constraints have important impacts on risk‐averting behavior with perhaps significant implications for long‐term poverty. The results also suggest the possibility of path dependence and offer insights into links between risk aversion and poverty traps.
The Benefit Function Approach to Modeling Price‐Dependent Demand Systems: An Application of Duality Theory
Authors: McLaren Keith R. , Wong K. K. Gary
Published: July 2009

In this article, we advocate more extensive use of the benefit function in specifying price‐dependent or inverse demand models. We demonstrate how duality theory may be used to establish the interrelationships between the Marshallian (or Hicksian) inverse demands and Luenberger's adjusted price functions, allowing estimable inverse demands to be derived directly from a benefit function. We estimate two systems of inverse demands for Japanese quarterly fish consumption. Results indicate that the procedures and methods employed here appear promising, and may prove beneficial for quantity and welfare analysis when modeling systems of inverse demand functions.
Customs and Incentives in Contracts
Authors: Allen Douglas W. , Lueck Dean
Published: July 2009

This article examines contractual practices that are often assumed customary. In particular it examines discreteness in agricultural contracts, and focuses on the distinction between the use of simple discrete fraction terms in cropshare contracts and the nearly continuous payment terms used in cash rent contracts. We show that the pattern of shares is best explained as a response to moral hazard problems spread over large numbers of inputs. A contracting model explains the pattern of shares, the difference in flexibility with cash rent contracts, and the lower bound on shares. Empirical analysis using micro data on over 3,000 contracts are used to test implications of the model. A wide range of support is found for a model based on moral hazard and measurement costs.
The Transition to ‘New’ Social Democracy: The Role of Capitalism, Representation and (Hampered) Contestation
Authors: Bailey David J.
Published: July 2009

This article argues that existing accounts of the transformation from ‘traditional’ to ‘new’ social democracy has thus far only identified the contextual changes that have prompted this move. In doing so, they have failed to account for the motives of social democratic party actors in undertaking the transition to ‘new’ social democracy in response to those changes. The article draws upon a critical realist method, and Marxist and anti-representational theories, to conceptualise ‘traditional’ social democratic party relations as suffering from tensions between constituents' demands for decommodification, the attempt by party elites to contain (and thereby ‘represent’) those demands and the (in)compatibility of this process of containment with the need to recommodify social relations in the light of periodic crises in contemporary capitalism. It argues that these tensions explain the attempt by party elites to promote the move towards ‘new’ social democracy, the (eventual) acquiescence of party constituents to those attempts and the subsequent exit from social democratic constituencies which has resulted. The argument is made with reference to the British Labour Party and Social Democratic Party of Germany (SPD).
Risk factors in medication-overuse headache: A 1-year follow-up study (care II protocol)
Authors: Sances G , Ghiotto N , Galli F , Guaschino E , Rezzani C , Guidetti V , Nappi G
Published: July 2009

To investigate factors influencing prognosis in medication-overuse headache (MOH), we conducted a 12-month follow-up of patients with probable MOH. We recruited 215 patients consecutively admitted to our headache centre for an inpatient detoxification treatment. We analysed likely predictor factors for headache resolution (sex, age, primary headache, psychiatric comorbidity, type and timing of overuse). Mann–Whitney U-test and chi-squared test were used. One year after withdrawal, we had complete data on 172 patients (80%): 38 of these patients (22%) had relapsed into overuse and 134 (78%) had not. The negative prognostic factors for relapse were: intake of more than 30 doses/month ( P = 0.004), smoking ( P = 0.012), alcohol consumption ( P = 0.037), non-confirmation of MOH diagnosis 2 months after detoxification ( P = 0.000), and return to overused drug(s) ( P = 0.000). The 1-year relapse rate was 22%. The existence of sub-groups of MOH patients with such risk factors could influence treatment strategies.
Guidelines for Controlled Trials of Drugs in Tension-Type Headache: Second Edition
Authors: Bendtsen L , Bigal ME , Cerbo R , Diener HC , Holroyd K , Lampl C , Mitsikostas DD , Steiner TJ , Tfelt-Hansen P
Published: July 2009

The Clinical Trials Subcommittee of the International Headache Society published its first edition of the guidelines on controlled trials of drugs in tension-type headache in 1995. These aimed ‘to improve the quality of controlled clinical trials in tension-type headache’, because ‘good quality controlled trials are the only way to convincingly demonstrate the efficacy of a drug, and form the basis for international agreement on drug therapy’. The Committee published similar guidelines for clinical trials in migraine and cluster headache. Since 1995 several studies on the treatment of episodic and chronic tension-type headache have been published, providing new information on trial methodology for this disorder. Furthermore, the classification of the headaches, including tension-type headache, has been revised. These developments support the need for also revising the guidelines for drug treatments in tension-type headache. These Guidelines are intended to assist in the design of well-controlled clinical trials in tension-type headache.
Skin pigmentation after NB‐UVB and three analogues of prostaglandin F2α in guinea pigs: a comparative study
Authors: Anbar TS , El‐Ammawi TS , Barakat M , Fawzy A
Published: July 2009

Background  Ultraviolet B (UVB) is a well‐known modality in increasing skin pigmentation through a variety of proposed mechanisms. Prostaglandin release is one of these mechanisms. Prostaglandin F2α (PGF2α) analogues, which are used to control ocular hypertension, were reported to induce periocular skin hyperpigmentation.

Objectives  This study aims to evaluate the local effect of three prostaglandin F2α analogues, namely Latanoprost, Bimatoprost and Travoprost on skin pigmentation. Assessment of the role of combination with narrow band UVB (NB‐UVB) to each of these drugs is evaluated as well.

Methods  This study involved 18 female adult wild guinea pigs with patchy white and red/brown fur. The hair was shaved from four red/brown areas on the dorsal skin of each animal. In two areas of each animal, one of the above‐mentioned drugs was applied alone and in conjunction with NB‐UVB. In the other two areas, the vehicle was applied alone and in conjunction with NB‐UVB exposure. Skin biopsies from each area were done at the start of the study and 4 weeks after, and stained with haematoxylin and eosin (H&E) and Masson‐Fontana (MF) stains. Clinical and histopathological changes were evaluated.

Results  Increased pigmentation was found in all areas with PGF2α analogues with and without NB‐UVB. However, the former group had more effect both clinically and histopathologically.

Conclusion  PGF2α analogues are promising drugs in inducing skin pigmentation. This effect can be enhanced with NB‐UVB exposure.
Superficial community‐acquired skin infections: prevalence of bacteria and antibiotic susceptibility in France
Authors: Lorette G , Beaulieu Ph , Allaert FA , Mahmoudi A , Jarlier V
Published: July 2009

Objective  Evaluation of the susceptibility to currently used antibiotics of bacteria, particularly S. aureus isolated from superficial community‐ acquired skin infection and to compare results with those from an earlier study.

Methods  Every dermatologist in community practice participating in the study was asked to include the first two patients consulting them for superficial cutaneous bacterial infection. Swab specimens collected from the skin infection were sent to a central laboratory.

Results  The dermatologist enrolled 390 patients in the study. The rate of positive culture was 49%, 259 bacterial strains were isolated. S. aureus was the major species (56.8% of all isolated strains). S. aureus was resistant to methicillin in 4%. All strains of S. aureus were susceptible to pristinamycin and mupirocin.

Conclusions  The results of the two epidemiological studies of superficial community acquired skin infections with a comparable methodology at a 6‐year interval demonstrated that the prevalence of CA‐MRSA skin infection remained low in this setting.
Randomised placebo‐controlled trial of outpatient (at home) cervical ripening with isosorbide mononitrate (IMN) prior to induction of labour – clinical trial with analyses of efficacy and acceptability. The IMOP Study
Authors: Bollapragada SS , MacKenzie F , Norrie JD , Eddama O , Petrou S , Reid M , Norman JE
Published: July 2009

Objective  To determine whether isosorbide mononitrate (IMN), self‐administered vaginally by women at home, improves the process of induction of labour.

Design  Randomised double blind placebo‐controlled trial.

Setting  Large UK maternity hospital.

Population or Sample  Nulliparous women with a singleton pregnancy, cephalic presentation ≥37 weeks gestation, requiring cervical ripening prior to induction of labour.

Methods  IMN (n = 177) or placebo (n = 173) self‐administered vaginally at home at 48, 32 and 16 hours prior to the scheduled time of admission for induction.

Main outcome measures  Admission to delivery interval and women’s experience of induction of labour.

Results  IMN did not shorten the admission to delivery interval as compared with placebo [mean difference of −1.6 hours (95% CI −5.1,1.9, P = 0.37)], despite being more effective than placebo in inducing a change in Bishop score [mean difference of 0.65 (95% CI 0.14,1.17, P = 0.013)]. While both groups found the overall experience of home treatment to be positive, (mean score of 3.8/10 ± 2.3/10 for the IMN group, where 1 = extremely good and 10 = not at all good) women in the placebo group found it marginally more positive than those in the IMN group (just over half a unit on a 10‐point scale, P = 0.043). There were no differences between the groups in the pain or anxiety experienced or willingness to take the treatment in a subsequent pregnancy.

Conclusions  IMN self‐administered vaginally at home does not shorten admission to delivery interval despite a significant effect on cervical ripeness assessed using the Bishop score. However, women report positive views on cervical ripening at home, and the setting deserves further investigation.
Validating Household Reports of Health Care Use in the Medical Expenditure Panel Survey
Authors: Zuvekas Samuel H. , Olin Gary L.
Published: July 2009

Background. The Medical Expenditure Panel Survey (MEPS) is a widely used nationally representative survey of health care use and expenditures. Numerous studies raise concerns that use is underreported in household surveys.

Objective. To assess the quality of household reports in the MEPS and the impact of misreporting on descriptive and behavioral analyses.

Research Design. Participants in MEPS with Medicare coverage during 2001–2003 were matched to their Medicare enrollment and claims data (4,045 person‐year observations). Household reports of Medicare‐covered services for the matched sample were validated against Medicare claims. Standard models of the determinants of health care utilization were estimated with both MEPS and claims‐based utilization measures.

Measures. In‐person interviews with household informants obtained data on hospital inpatient, emergency department (ED), and office‐based visits. Comparable measures were created from the claims.

Results. In the validation sample, households accurately reported inpatient stays (agreement rate=0.96, κ=0.89) and number of nights (Lin's concordance statistic=0.88). Households underreported ED visits by one‐third (Lin's concordance statistic=0.51) and office visits by 19 percent (Lin's concordance statistic=0.67).

Conclusions. Household respondents in the validation sample accurately report inpatient hospitalizations but underreport ED and office visits. Behavioral analyses are largely unaffected because underreporting cuts across all sociodemographic groups.
Conservation Biology in Asia: the Major Policy Challenges
Authors: McNEELY JEFFREY A. , KAPOOR‐VIJAY PROMILA , ZHI LU , OLSVIG‐WHITTAKER LINDA , SHEIKH KASHIF M. , SMITH ANDREW T.
Published: July 2009

Abstract:  With about half the world's human population and booming economies, Asia faces numerous challenges to its biodiversity. The Asia Section of the Society for Conservation Biology has identified some key policy issues in which significant progress can be made. These include developing new sources of funding for forest conservation; identifying potential impacts of energy alternatives on the conservation of biodiversity; curbing the trade in endangered species of plants and animals; a special focus on the conservation of mountain biodiversity; enhancing relevant research; ensuring that conservation biology contributes to major international conventions and funding mechanisms; using conservation biology to build a better understanding of zoonotic diseases; more effectively addressing human–animal conflicts; enhancing community‐based conservation; and using conservation biology to help address the pervasive water‐deficit problems in much of Asia. These challenges can be met through improved regional cooperation among the relevant stakeholders.
Integrating Top‐Down with Bottom‐Up Conservation Policy in Africa
Authors: ABRAMS R. W. , ANWANA ENO D. , ORMSBY ALISON , DOVIE DELALI B. K. , AJAGBE ADEMOLA , ABRAMS AMBER
Published: July 2009

Abstract:  Developed nations intervened in conservation policy across Africa during the 20th century to address needs to protect species and biodiversity that were based on their own perceptions and priorities. In the 21st century, conservationists in Africa have revised these perceptions and begun the process of identifying conservation priorities from an African perspective and in consideration of Africans’ priorities. Although foreign conservation interveners struggled to identify mechanisms to which local people would respond, African conservationists are now demonstrating how to integrate the continent's unique socioeconomic circumstances into efforts to protect biodiversity. In Africa effective conservation policy must include the generation of wealth, reduction of disease and hunger, and support of traditional land‐use practices.
Conservation Challenges for the Austral and Neotropical America Section
Authors: CEBALLOS GERARDO , VALE MARIANA M. , BONACIC CRISTIAN , CALVO‐ALVARADO JULIO , LIST RURIK , BYNUM NORA , MEDELLÍN RODRIGO A. , SIMONETTI JAVIER A. , RODRÍGUEZ JON PAUL
Published: July 2009

Abstract:  The Austral and Neotropical America (ANA) section of the Society for Conservation Biology includes a vast territory with some of the largest relatively pristine ecosystems in the world. With more than 573 million people, the economic growth of the region still depends strongly on natural resource exploitation and still has high rates of environmental degradation and biodiversity loss. A survey among the ANA section membership, with more than 700 members, including most of the section's prominent ecologists and conservationists, indicates that lack of capacity building for conservation, corruption, and threats such as deforestation and illegal trade of species, are among the most urgent problems that need to be addressed to improve conservation in the region. There are, however, strong universities and ecology groups taking the lead in environmental research and conservation, a most important issue to enhance the ability of the region to solve conservation and development conflicts.
Major Conservation Policy Issues for Biodiversity in Oceania
Authors: KINGSFORD R. T. , WATSON J. E. M. , LUNDQUIST C. J. , VENTER O. , HUGHES L. , JOHNSTON E. L. , ATHERTON J. , GAWEL M. , KEITH D. A. , MACKEY B. G. , MORLEY C. , POSSINGHAM H. P. , RAYNOR B. , RECHER H. F. , WILSON K. A.
Published: July 2009

Abstract:  Oceania is a diverse region encompassing Australia, Melanesia, Micronesia, New Zealand, and Polynesia, and it contains six of the world's 39 hotspots of diversity. It has a poor record for extinctions, particularly for birds on islands and mammals. Major causes include habitat loss and degradation, invasive species, and overexploitation. We identified six major threatening processes (habitat loss and degradation, invasive species, climate change, overexploitation, pollution, and disease) based on a comprehensive review of the literature and for each developed a set of conservation policies. Many policies reflect the urgent need to deal with the effects of burgeoning human populations (expected to increase significantly in the region) on biodiversity. There is considerable difference in resources for conservation, including people and available scientific information, which are heavily biased toward more developed countries in Oceania. Most scientific publications analyzed for four threats (habitat loss, invasive species, overexploitation, and pollution) are from developed countries: 88.6% of Web of Science publications were from Australia (53.7%), New Zealand (24.3%), and Hawaiian Islands (10.5%). Many island states have limited resources or expertise. Even countries that do (e.g., Australia, New Zealand) have ongoing and emerging significant challenges, particularly with the interactive effects of climate change. Oceania will require the implementation of effective policies for conservation if the region's poor record on extinctions is not to continue.
Adaptation and Organizational Connectedness in Corporate Radical Innovation Programs*
Authors: Kelley Donna
Published: July 2009

This research examines how established companies organize programs for fostering technology‐based radical innovation. It addresses conflicts revealed in the innovation literature concerning the appropriate design of the strategic, structural, and process components of these programs. In developing innovation strategies, managers must balance the desire for strategic clarity with the need to allow for creativity and exploration. They must structure programs that ensure innovations benefit from the organization's resources while minimizing the numerous constraints that can impede these unconventional activities. Additionally, though they may favor management processes that provide accountability and effective resource allocation, managers must also ensure these do not restrict the flexibility required for successful innovation. The study is a longitudinal, comparative case analysis of interviews with managers involved in innovation programs in 12 industry‐leading multinational corporations. Site visits at each company were followed by biannual interviews with key managers in each company. A total of 81 follow‐up interviews were conducted over a three‐year period. These interviews were aimed at identifying the changes and progress in the programs over time and internal and external impacts on the organization's innovation activity. The analysis reveals (1) distinct but evolving objectives that maintain a logical strategic connection, (2) adaptive structures that shift and transform but preserve relationships with the broader organization, and (3) flexible processes that are understandable beyond the innovation program and are modifiable, both for the context and in response to learning over time. This suggests that programs introducing high uncertainty and risk into mature corporate environments are highly flexible systems that maintain organizational connectedness as they evolve. For academics, this implies a need to understand the evolution of innovation programs as an adaptive learning process that, regardless of form and purpose, preserves its connection to the traditional organization. For practitioners, it highlights the importance of considering the process, strategic, and structural connections to the broader organization when designing innovation programs and suggests the need for feedback mechanisms to help adapt these elements over time.
Formal Rules in Product Development: Sensemaking of Structured Approaches*
Authors: Christiansen John K. , Varnes Claus J.
Published: July 2009

Many scholars consider the use of formal structured approaches to manage product development as very significant for successful product innovation. Others consider them a predictor of the likely outcome of the processes. Structured approaches can be considered management technologies for product development. Prior research has addressed the design of structured approaches and has measured how different types or generations of these are related to different processes and outcomes in different ways. However, only limited research has addressed how managers and employees actually understand and makes sense of these methods. This paper investigates how structured approaches are translated through a number of interpretations into daily practices. The research draws on research in sociology and management accounting to analyze structured approaches for product development as a managerial technology that consists of rules that individuals must understand (i.e., make sense of). The paper presents arguments for building a model of factors that influence the sensemaking of structured approaches for product development based on Scandinavian cases. First, structured approaches are presented as a type of managerial technology that consists of rules. Second, a framework to classify structured approaches for product development according to their degree of elaborateness and exhaustiveness is derived. This helps to identify the types of rule systems in companies—and how these influence everyday practices. The sensemaking from rules to practice is implemented through a number of translations, based on the context, the history, and the authorized statements and feedback processes. Empirical findings show that structured approaches differ both with respect to their degree of elaborateness and exhaustiveness. Additionally, firms differ greatly in terms of how rigorously they enforce the rules. Furthermore, the importance assigned to them by functional managers and project managers differ greatly. Even companies with extensive and elaborate rule regimes enforce the rules in a flexible manner, and rules are often applied at the discretion of project managers. Practices are influenced by the interpretation, use, and feedback from senior managers. Observations make it possible to develop a model for the sensemaking processes that influences how a specific structured approach through sensemaking is altered, modified, and sometimes even cut off from influencing innovation processes. The sensemaking of rules might reverse elaborate and exhaustive rules into quite flexible systems in practice. One implication of this is that individual sensemaking of structured approaches for product development thus needs to be analyzed to understand managerial practices. Another implication is that it cannot be assumed, a priori that formal approaches are the same as exercised practices.
Home Monitoring in Patients with Implantable Cardiac Devices: Is There a Potential Reduction of Stroke Risk? Results from a Computer Model Tested Through Monte Carlo Simulations
Authors: RICCI RENATO P. , MORICHELLI LOREDANA , GARGARO ALESSIO , LAUDADIO MARIA T. , SANTINI MASSIMO
Published: July 2009

Introduction: Patients with pacemakers and implantable defibrillators (ICD) may experience asymptomatic atrial fibrillation (AF), detected with a delay depending on the in‐person follow‐up schedule. Home monitoring (HM) remote control with automatic alerts for AF may drive early anticoagulation, potentially reducing stroke risk.

Methods and Results: A sample of 136 pacemaker (103) and ICD (33) patients with or without cardiac resynchronization therapy not taking anticoagulation at implant were monitored remotely with HM. Upon HM alerts for AF, patients were recalled to update therapy. Two‐year data were entered in a computer Monte Carlo model, simulating 4,000 virtual subjects with the same AF and CHADS2 stroke risk distribution of our real population. Simulations reproduced a 2‐year follow‐up. Two thousand subjects were supposed to be followed with HM (HM group) and 2,000 with standard in‐person follow‐up (SF group) at 3, 6, 9, or 12 months.

Two‐year Kaplan‐Meier cumulative probability of ≥24‐hour AF was 15.6% (95%CI 8.5–23.3%); the AF‐related symptom rate was 27% and the median CHADS2 score was 2. As a result of simulations, stroke incidence in case of AF was 2.3 ± 1.1% in the HM group and 2.4 ± 1.1%, 2.5 ± 1.2%, 2.7 ± 1.2%, and 2.9 ± 1.3% in the SF group with 3‐, 6‐, 9‐, and 12‐month follow‐up programs, with odds ratios of 0.97 (95%CI 0.93–1.01), 0.91 (0.88–0.95), 0.87 (0.84–0.90), and 0.82 (0.79–0.85) (HM better if odds ratios <1), respectively.

Conclusions: Daily HM potentially reduces the stroke risk by 9% to 18% with respect to SF with intervisit intervals of 6 to 12 months.
Interatrial Mechanical Dyssynchrony Worsened Atrial Mechanical Function in Sinus Node Disease With or Without Paroxysmal Atrial Fibrillation
Authors: WANG MEI , LAU CHU PAK , ZHANG XUE HUA , SIU CHUNG‐WAH , LEE KATHY L. F. , YAN GUO HUI , YUE WEN SHENG , TSE HUNG FAT
Published: July 2009

Introduction: Atrial electromechanical dysfunction might contribute to the development of atrial fibrillation (AF) in patients with sinus node disease (SND). The aim of this study was to investigate the prevalence and impact of atrial mechanical dyssynchrony on atrial function in SND patients with or without paroxysmal AF.

Methods: We performed echocardiographic examination with tissue Doppler imaging in 30 SND patients with (n = 11) or without (n = 19) paroxysmal AF who received dual‐chamber pacemakers. Tissue Doppler indexes included atrial contraction velocities (Va) and timing events (Ta) were measured at midleft atrial (LA) and right atrial (RA) wall. Intraatrial synchronicity was defined by the standard deviation and maximum time delay of Ta among 6 segments of LA (septal/lateral/inferior/anterior/posterior/anterospetal). Interatrial synchronicity was defined by time delay between Ta from RA and LA free wall.

Results: There were no differences in age, P‐wave duration, left ventricular ejection fraction, LA volume, and ejection fraction between with or without AF. Patients with paroxysmal AF had lower mitral inflow A velocity (70 ± 19 vs 91 ± 17 cm/s, P = 0.005), LA active empting fraction (24 ± 14 vs 36 ± 13%, P = 0.027), mean Va of LA (2.6 ± 0.9 vs 3.4 ± 0.9 cm/s, P = 0.028), and greater interatrial synchronicity (33 ± 25 vs 12 ± 19 ms, P = 0.022) than those without AF. Furthermore, a lower mitral inflow A velocity (Odd ratio [OR]= 1.12, 95% Confidence interval [CI] 1.01–1.24, P = 0.025) and prolonged interatrial dyssynchrony (OR = 1.08, 95% CI 1.01–1.16, P = 0.020) were independent predictors for the presence of AF in SND patients.

Conclusion: SND patients with paroxysmal AF had reduced regional and global active LA mechanical contraction and increased interatrial dyssychrony as compared with those without AF. These findings suggest that abnormal atrial electromechanical properties are associated with AF in SND patients.
Cryoballoon Pulmonary Vein Isolation with Real‐Time Recordings from the Pulmonary Veins
Authors: CHUN K. R. JULIAN , FÜRNKRANZ ALEXANDER , METZNER ANDREAS , SCHMIDT BORIS , TILZ ROLAND , ZERM THOMAS , KÖSTER ILKA , NUYENS DIETER , WISSNER ERIK , OUYANG FEIFAN , KUCK KARL HEINZ
Published: July 2009

Introduction: Cryoballoon (CB) ablation represents a novel technology for pulmonary vein isolation (PVI). We investigated feasibility and safety of CB‐PVI, utilizing a novel spiral catheter (SC), thereby obtaining real‐time PV potential registration.

Methods: Following double transseptal puncture, a Lasso catheter (Biosense Webster, Diamond Bar, CA, USA) and the 28 mm CB were positioned within the left atrium. A novel SC (Promap, ProRhythm Inc., Ronkonkoma, NY, USA) was inserted through the lumen of the CB allowing PV signal registration during treatment. Time to PV conduction block was analyzed. If no stable balloon position was obtained, the SC was exchanged for a regular guide wire and PV conduction was assessed after treatment by Lasso catheter.

Results: In 18 patients, 39 of 72 PVs (54%) were successfully isolated using the SC. The remaining 33 PVs were isolated switching to the regular guide wire. Time to PV conduction block was significantly shorter in PVs in which sustained PVI was achieved as compared to PVs in which PV conduction recovered within 30 minutes (33 ± 21 seconds vs 99 ± 65 seconds). In 40 PVs, time to PV conduction block was not obtained because of: (1) PVI not being achieved during initial treatment; (2) a distal position of the SC; or (3) isolation with regular guide wire. No procedural complications occurred.

Conclusion: Visualization of real‐time PV conduction during CB PVI is safe, feasible, and allows accurate timing of PVI onset in a subset of PVs. Time to PV conduction block predicts sustained PVI. However, mechanical properties of the SC need to be improved to further simplify CB PVI.
Indigenous School Policies and Politics: The Sociopolitical Relationship of Wayãpi Amerindians to Brazilian and French Guianan Schooling
Authors: Da Silva Macedo Silvia Lopes
Published: July 2009

In this article, I aim to demonstrate the relationships between the educational policies of the Brazilian and French Guyana governments and the sociopolitical structure of the Wayãpi in respect to these educational practices. My main objective is to go beyond the normal concept that the school is an external interference that catalyzes processes of “Indigenous acculturation,” to make clear that the Wayãpi sociopolitical forms of interaction that govern their relationships with alterity also govern their relationships with the state and its representatives. This article is based on my ethnographic study of the school experiences among the Wayãpi living in villages in both countries. [Wayãpi Amerindians, Brazil, schooling, sociopolitical interaction, alterity]
Responsibility and Reciprocity: Social Organization of Mazahua Learning Practices
Authors: Paradise Ruth , De Haan Mariëtte
Published: July 2009

This article describes Mazahua children's participation in learning interactions that take place when they collaborate with more knowledgeable others in everyday activities in family and community settings. During these interactions they coordinate their actions with those of other participants, switching between the roles of “knowledgeable performer” and “observing helper.” It is argued that experience with this way of interacting implies readiness to take on responsibility for carrying out important family and community activities, and an understanding of and capacity for reciprocity. Observations in a sixth‐grade classroom with a Mazahua teacher and children show that children continued to interact in ways that allowed for collaborative task‐oriented organization of classroom learning activities. [Indigenous education, family and community learning, interactional practices, Mazahua learning]
The relationship between morphological traits of the spring wheat spike and oviposition deterrence to orange wheat blossom midge
Authors: Gharalari A. H. , Smith M. A. H. , Fox S. L. , Lamb R. J.
Published: July 2009

If morphological traits of a plant cause resistance to an insect pest or are strongly correlated with resistance levels, those traits can be used by plant breeders as phenotypic markers for indirect selection of resistance. To improve our understanding of antixenosis against the orange wheat blossom midge, Sitodiplosis mosellana (Géhin) (Diptera: Cecidomyiidae), expressed as oviposition deterrence in bread wheat, Triticum aestivum L. (Poaceae), 21 morphological traits of the wheat spike were studied in a genetically related wheat population and correlation of the traits with deterrence level was explored. The following traits had larger values in the deterrent parent of the population than the susceptible parent: ligule length, glume length, length of hair inside glume, palea length at post‐anthesis stage, length of hair inside lemma, length of hair at spikelet base, inter‐spikelet distance, and length of hair at rachis edge at post‐anthesis stage. The highest correlation coefficient between mean egg density and a morphological trait of the wheat population was −0.287, which was for inter‐spikelet distance. This represented 8% predictability from the point of view of crop breeding and explained one‐twelfth of the variation in oviposition deterrence among lines. The morphological traits of bread wheat spikes were not highly correlated to deterrence. Therefore, no promising trait could be recommended for use in breeding programs. Studies of the fine‐scale properties of the wheat plant surface, and their interactions with plant surface chemistry, with a greater focus on wheat midge oviposition behavior, may clarify the effect of the morphological traits on oviposition and deterrence.
Prominent papillary dermal edema in dermatophytosis (tinea corporis)*
Authors: Hoss Diane , Berke Adrienne , Kerr Philip , Grant‐Kels Jane , Murphy Michael
Published: July 2009

Background: Commonly described histologic ‘clues’ to the diagnosis of dermatophytosis include neutrophils in the stratum corneum and/or epidermis, compact orthokeratosis and identification of fungal hyphae between two zones of cornified cells. Prominent (striking) papillary dermal edema (PPDE) is not commonly reported with dermatophytosis (tinea corporis).

Methods: We observed an index case in which PPDE was the salient histologic finding in lesions of tinea corporis. Fifteen additional cases of tinea corporis with PPDE were diagnosed in our dermatopathology laboratory over a 9‐year period. The clinical and histologic findings were reviewed.

Results: All 16 cases occurred on the extremities of women, 11 of whom had skin of color. The submitted clinical differential diagnoses varied widely, but included some of the diseases ‘classically’ associated with PPDE, as well as other blistering eruptions. In several cases, only a few dermatophyte hyphae were identified in tissue sections.

Conclusions: Our case series serves as a reminder that dermatophytosis should be strongly considered in the differential diagnosis of lesions with PPDE. Fungal culture may be helpful in patients whose biopsies show PPDE, negative periodic acid‐Schiff (PAS) stains and who fail to respond to conventional anti‐inflammatory therapy. This study lends support for the routine use of PAS stains in biopsies of inflammatory dermatoses.

Hoss D, Berke A, Kerr P, Grant‐Kels J, Murphy M. Prominent papillary dermal edema in dermatophytosis (tinea corporis).
Reassessment of microarray expression data of porokeratosis by quantitative real‐time polymerase chain reaction
Authors: Zhang Zheng‐Hua , Wang Zhi‐Min , Crosby Meredith E. , Kang Ke‐Fei , Luan Jing , Huang Wei , Xiang Lei‐Hong , Zheng Zhi‐Zhong
Published: July 2009

Background: Porokeratosis (PK) is a heterogeneous group of keratinization disorders that exhibit similarities with psoriasis at both the clinical and molecular levels.

Methods: The transcript levels of keratin (KRT) 6A, 16, 17, S100A7, A8, A9, p53 and three candidate genes (i.e. SART3, SSH1 and ARPC3) were reassessed in pairwise lesional and uninvolved skin from nine patients with PK by real‐time quantitative polymerase chain reaction (RTQ–PCR).

Results: The results of RTQ–PCR confirmed that KRT6A, 16, S100A7, A8 and A9 (p = 0.008) were mostly up‐regulated in the lesional skin when compared with uninvolved skin. Different from the microarray data, there was no significant difference observed in KRT17 expression patterns between lesional and normal‐appearing skin (p = 0.066). No statistical difference was observed in p53 and three candidate genes' expression patterns between lesional and uninvolved skin.

Conclusions: In the present study, 9 of the 10 gene expression measured by RTQ–PCR in PK were statistically comparable to microarray data. KRT6A was identified as specific biomarker for porokeratotic keratinocytes, as it was the most significantly up‐regulated gene in the nine patient samples.

Zhang Z‐H, Wang Z‐M, Crosby ME, Kang KF, Luan J, Huang W, Xiang L‐H, Zheng Z‐Z. Reassessment of microarray expression data of porokeratosis by quantitative real‐time polymerase chain reaction.
An atypical presentation of a blastic plasmacytoid dendritic cell tumors
Authors: López Verónica , Martí Nuria , Ferrández Antonio , Martin Jose María , Jordá Esperanza
Published: July 2009

Blastic plasmacytoid dendritic cell tumor is a rare lymphoma, which has been included as an independent entity in the World Health Organization (WHO) 2008 classification for cutaneous lymphomas. This neoplasm usually affects middle‐aged or elderly patients with predominant skin or soft tissues involvement. Although it usually has a good initial response to chemotherapy, relapses are the rule and they occur rapidly. We report a new case of an 81‐year‐old woman with a blastic plasmacytoid dendritic cell tumors with an unusual presentation.

López V, Martí N, Ferrández A, Martín JM, Jordá E. An atypical presentation of a blastic plasmacytoid dendritic cell tumors.
Composite tumors associating trichoblastoma and benign epidermal/follicular neoplasm: another proof of the follicular nature of inverted follicular keratosis
Authors: Battistella Maxime , Peltre Bernard , Cribier Bernard
Published: July 2009

Background: Trichoblastomas (TBs) are benign follicular tumors that can present either as solitary nodule or as multiple facial papules. Only one case of sporadic TB in a composite tumor has been reported, arising in an apocrine poroma. We report the association of TB and benign epidermal/follicular neoplasm in six patients.

Methods: Clinical data available were collected. Serial sections and immunohistochemical (IHC) analysis for CK17 and human papilloma virus (HPV) were performed on available materials.

Results: Five of the six patients were males. Mean age at diagnostic was 56 years. Lesions were localized on the face and scalp in four of six patients. The lesions associated with TB were inverted follicular keratosis (IFK) in three cases, seborrhoeic keratosis (SK) in two cases and IFK with verruca vulgaris pattern in one case. IHC for HPV was negative in the four cases tested. Staining for CK17 was always positive in TB. It was often positive in the associated neoplasm.

Conclusion: TB can be associated with benign epidermal/follicular neoplasm in composite tumors. The association of TB and IFK with direct connection between the lesions is another argument in favor of the follicular origin of IFK. TB can be added to the spectrum of SK‐associated tumors.

Battistella M, Peltre B, Cribier B. Composite tumors associating trichoblastoma and benign epidermal/follicular neoplasm: another proof of the follicular nature of inverted follicular keratosis.
Early skin biopsy is helpful for the diagnosis and management of neonatal and infantile erythrodermas
Authors: Leclerc‐Mercier S. , Bodemer C. , Bourdon‐Lanoy E. , Larousserie F. , Hovnanian A. , Brousse N. , Fraitag S.
Published: July 2009

Background: Erythrodermas are often life‐threatening conditions in infants. Determination of the underlying cause is crucial.

Microscopic changes in adult erythroderma lack specificity.

Objective: To determine if an early skin biopsy is helpful for the diagnosis of neonatal and infantile erythroderma.

Methods: Seventy‐two patients admitted for erythroderma in the first year of life were retrospectively included. One hundred and eleven skin biopsies (12‐year period) were examined by 3 pathologists blinded to the clinical diagnosis, and classified into atopic dermatitis, immunodeficiency (ID), psoriasis, Netherton syndrome (NS), ichthyosis, other. From year 2000, LEKTI antibody was performed when NS was suspected. Pathological diagnosis was then compared with clinical diagnosis.

Results: The final diagnosis was made in 69.3% of the cases. In 57.6%, pathological diagnosis was in accordance, and in 11.7%, it was in accordance, but other diagnosis had also been proposed. For ID, sensitivity and specificity were 58.5 and 98.5%, respectively. Before year 2000, NS was frequently misdiagnosed with psoriasis, but with the use of LEKTI antibody, sensitivity and specificity were 100%.

Conclusion: Skin biopsy is helpful for etiologic diagnosis of early erythroderma of infancy, particularly in ID and NS, the most severe diseases. Consequently, these results justify an early systematic skin biopsy for a better and earlier management.

Leclerc‐Mercier S, Bodemer C, Bourdon‐Lanoy E, Larousserie F, Hovnanian A, Brousse N, Fraitag S. Early skin biopsy is helpful for the diagnosis and management of Neonatal and Infantile Erythrodermas.