bluuebunny/crossref_metadata_2025 huggingface dataset:
Joint Inference on HIV Viral Dynamics and Immune Suppression in Presence of Measurement Errors
Authors: Wu L. , Liu W. , Hu X. J.
Published: August 2009

Summary:  In an attempt to provide a tool to assess antiretroviral therapy and to monitor disease progression, this article studies association of human immunodeficiency virus (HIV) viral suppression and immune restoration. The data from a recent acquired immune deficiency syndrome (AIDS) study are used for illustration. We jointly model HIV viral dynamics and time to decrease in CD4/CD8 ratio in the presence of CD4 process with measurement errors, and estimate the model parameters simultaneously via a method based on a Laplace approximation and the commonly used Monte Carlo EM algorithm. The approaches and many of the points presented apply generally.
Tracing Lines of Flight: Implications of the Work of Gilles Deleuze for Narrative Practice
Authors: WINSLADE JOHN
Published: August 2009

The philosophical groundwork of Gilles Deleuze is examined for its relevance for narrative practice in therapy and conflict resolution. Deleuze builds particularly on Foucault's analytics of power as “actions upon actions” and represents power relations diagrammatically in terms of lines of power. He also conceptualizes lines of flight through which people become other. These concepts are explored in relation to a conversation with a couple about a crisis in their relationship. Tracing lines of power and lines of flight are promoted as fresh descriptions of professional practice that fit well with the goals of narrative practice.
Narrative Ideas for Consulting with Communities and Organizations: Ripples from the Gatherings
Authors: FREEDMAN JILL , COMBS GENE
Published: August 2009

This paper reviews Michael White's early work with communities and extends ideas and practices from that work into the realm of consulting with organizations. We draw on Michael's writing and the records of two specific projects, as well as the recollections of team members in those projects, to describe how ideas and practices that were originally developed in working with individuals and families came to be applied in community settings. Specifically, we show how the central intention of the work is to use narrative ideas and practices in ways that allow communities to articulate, appreciate, document, utilize, and share their own knowledges of life and skills of living. We discuss the basic narrative ideas of stories, double listening, telling and retelling, making documents, and linking lives through shared purposes. For these projects, the teams developed structures that made it possible to use the basic idea with whole communities. We show how this work with communities has offered inspiration and ideas for our work in consulting to organizations. Finally, we describe and illustrate a particular way of working with organizations that carries the spirit of Michael's community work into situations requiring shorter blocks of time and more limited commitments than the original community contexts.
Integrating Sex and Couples Therapy: A Multifaceted Case History
Authors: SHOSHANA BULOW LCSW
Published: August 2009

Traditionally, sexuality has not been a focus in couples therapy training, research, or practice, although it is an important, often complex issue for many couples. This article tells the story of a couple presenting for sex therapy due to their unconsummated marriage, and is told to exemplify how sex therapy and couples therapy can be integrated in order to best meet the needs of couples. As the story unfolds, the multilayered facets of the presenting issue are revealed. The therapy incorporates and weaves together family of origin history, intrapsychic and cognitive issues, relational dynamics, patterns of interaction, and physiological/medical concerns into a postmodern couples therapy with behavioral interventions. This combined approach recognizes the value of each method on its own and their greater usefulness when blended together.
Utilizing Family Strengths and Resilience: Integrative Family and Systems Treatment with Children and Adolescents with Severe Emotional and Behavioral Problems
Authors: LEE MO YEE , GREENE GILBERT J. , HSU KAI SHYANG , SOLOVEY ANDY , GROVE DAVID , FRASER J. SCOTT , WASHBURN PHIL , TEATER BARBARA
Published: August 2009

Community mental health agencies are consistently challenged to provide realistic and effective home‐based family‐centered treatment that meets local needs and can realistically fit within available budget and resource capabilities. Integrated Family and Systems Treatment (I‐FAST) is developed based on existing evidence‐based approaches for working with at‐risk children, adolescents, and families and a strengths perspective. I‐FAST identified 3 evidence‐based, core treatment components and integrated them into a coherent treatment protocol; this is done in a way that builds on and is integrated with mental health agencies' existing expertise in home‐based treatment. This is an intervention development study in which we conducted an initial feasibility trial of I‐FAST for treating families with children at risk of out‐of‐home placement. The outcomes of the study provide initial empirical evidence that supports the effectiveness of I‐FAST. Findings indicate that there were significant improvements in child behavior, significant increases in parental competency, and significant increases in the level of cohesion and adaptability in these families. All observed changes were significant from pre‐ to posttreatment with the families able to maintain these positive changes at 6‐month follow‐up. A more rigorous and robust research design, however, will be needed to establish definitive evidence of the effectiveness of I‐FAST.
Family Focused Treatment for Patients with Bipolar Disorder in Turkey: A Case Series
Authors: OZERDEM AYSEGUL , OGUZ MERAL , MIKLOWITZ DAVID , CIMILLI CAN
Published: August 2009

Family‐focused therapy (FFT) is a 9‐month, 21‐session structured psychoeducational treatment for bipolar disorder. Several US‐based studies have documented its efficacy as adjunctive to medication for depression stabilization and relapse prevention. However, FFT has never been applied outside of the United States. The objective of this case series is to explore the applicability of FFT in a non‐Western culture. Ten patients with bipolar disorder and their family members attended the 9‐month FFT as adjunctive to pharmacotherapy in an outpatient specialty clinic in Izmir, Turkey. Patients improved in Global Assessment of Functioning Scores and Clinical Global Impression Scores from pre‐ to posttreatment. Case studies are given, which illustrate the differences between Western and non‐Western families coping with bipolar disorder. FFT was easily applied to a Turkish sample with few changes in format or focus. Adaptations included substitution of oral for written therapeutic tasks or homework assignments. Randomized controlled trials are needed to test the clinical effectiveness of FFT and other psychosocial interventions in non‐Western cultures.
The Importance of Emergency Medicine in Organ Donation: Successful Donation Is More Likely When Potential Donors Are Referred From the Emergency Department
Authors: Michael Glen E. , O’Connor Robert E.
Published: August 2009

Objectives:  This study sought to identify factors that are associated with successful organ retrieval among patients referred to organ procurement services for potential organ donation. Particular attention was paid to the frequency, patient characteristics, and outcomes of patients referred for donation from the emergency department (ED).

Methods:  For this retrospective cohort study, data were collected on all solid‐organ donor referrals made to a single organ procurement organization serving 78 hospitals over a 45‐month period. Data retrieved included patient age, sex, race, referral site (ED vs. inpatient), and mechanism of injury. Outcome of referral (organs retrieved or not) was the primary outcome variable. Pearson chi‐square and Student’s t‐tests were used for bivariate statistical analysis. Multiple logistic regression analysis was used to determine which variables remained associated with organ retrieval after controlling for potential confounders.

Results:  A total of 6,886 donor referrals were made in the study population. Of these, 155 were excluded due to incomplete data, leaving 6,731 subjects for analysis. Using bivariate statistical analysis, we found that successful organ retrieval was associated with younger age (donor mean age 40.8 years, 95% confidence interval [CI] = 39.1 to 42.5 vs. nondonor mean age 59.4, 95% CI = 58.9 to 59.9), mechanism of injury (p < 0.001), and referral from the ED (ED 15.5% retrieved, inpatient 5.9%, odds ratio [OR] = 2.92, 95% CI = 2.32 to 3.67). After controlling for potential confounders with multiple logistic regression, referral from the ED remained significantly associated with successful organ retrieval (OR = 1.52, 95% CI = 1.18 to 1.97), as did age (OR = 0.96, 95% CI = 0.96 to 0.97) and mechanism of injury (p < 0.001). On regression analysis, race emerged as a significant predictor of organ retrieval (p < 0.001). Medically suitable patients referred from the ED were significantly more likely on bivariate analysis to have consent for donation granted compared to patients referred from inpatient settings (OR = 1.48, 95% CI = 1.03 to 2.12), but this association was not found to be significant on regression analysis (OR = 1.37, 95% CI = 0.93 to 2.02).

Conclusions:  Referral of potential organ donors from the ED is associated with an increased likelihood of successful organ retrieval. The authors conclude that further attention and resources should be directed toward the role of emergency medicine (EM) in the organ procurement process, owing to the relatively high likelihood of successful organ retrieval among patients referred from the ED.
Can Unannounced Standardized Patients Assess Professionalism and Communication Skills in the Emergency Department?
Authors: Zabar Sondra , Ark Tavinder , Gillespie Colleen , Hsieh Amy , Kalet Adina , Kachur Elizabeth , Manko Jeffrey , Regan Linda
Published: August 2009

Objectives:  The authors piloted unannounced standardized patients (USPs) in an emergency medicine (EM) residency to test feasibility, acceptability, and performance assessment of professionalism and communication skills.

Methods:  Fifteen postgraduate year (PGY)‐2 EM residents were scheduled to be visited by two USPs while working in the emergency department (ED). Multidisciplinary support was utilized to ensure successful USP introduction. Scores (% well done) were calculated for communication and professionalism skills using a 26‐item, behaviorally anchored checklist. Residents’ attitudes toward USPs and USP detection were also surveyed.

Results:  Of 27 USP encounters attempted, 17 (62%) were successfully completed. The detection rate was 44%. Eighty‐three percent of residents who encountered a USP felt that the encounter did not hinder daily practice and did not make them uncomfortable (86%) or suspicious of patients (71%). Overall, residents received a mean score of 60% for communication items rated “well done” (SD ± 28%, range = 23%–100%) and 53% of professionalism items “well done” (SD ± 20%, range = 23%‐85%). Residents’ communication skills were weakest for patient education and counseling (mean = 43%, SD ± 31%), compared with information gathering (68%, SD ± 36% and relationship development (62%, SD ± 32%). Scores of residents who detected USPs did not differ from those who had not.

Conclusions:  Implementing USPs in the ED is feasible and acceptable to staff. The unpredictability of the ED, specifically resident schedules, accounted for most incomplete encounters. USPs may represent a new way to assess real‐time resident physician performance without the need for faculty resources or the bias introduced by direct observation.
In vivo and in vitro assessment of brain bioenergetics in aging rats
Authors: Vančová Ol’ga , Bačiak Ladislav , Kašparová Svatava , Kucharská Jarmila , Palacios Hector H. , Horecký Jaromír , Aliev Gjumrakch
Published: August 2009

Brain energy disorders can be present in aged men and animals. To this respect, the mitochondrial and free radical theory of aging postulates that age‐associated brain energy disorders are caused by an imbalance between pro‐ and anti‐oxidants that can result in oxidative stress. Our study was designed to investigate brain energy metabolism and the activity of endogenous antioxidants during their lifespan in male Wistar rats. In vivo brain bioenergetics were measured using 31P nuclear magnetic resonance (NMR) spectroscopy and in vitro by polarographic analysis of mitochondrial oxidative phosphorylation. When compared to the young controls, a significant decrease of age‐dependent mitochondrial respiration and adenosine‐3‐phosphate (ATP) production measured in vitro correlated with significant reduction of forward creatine kinase reaction (kfor) and with an increase in phosphocreatine (PCr)/ATP, PCr/Pi and PME/ATP ratio measured in vivo. The levels of enzymatic antioxidants catalase, GPx and GST significantly decreased in the brain tissue as well as in the peripheral blood of aged rats. We suppose that mitochondrial dysfunction and oxidative inactivation of endogenous enzymes may participate in age‐related disorders of brain energy metabolism.
Demographic and ADAMTS13 biomarker data as predictors of early recurrences of idiopathic thrombotic thrombocytopenic purpura
Authors: Cataland Spero R. , Yang Shang‐bin , Witkoff Leslie , Kraut Eric H. , Lin Shili , George James N. , Wu Haifeng M.
Published: August 2009

Objective:  Approximately 40% of idiopathic thrombotic thrombocytopenic purpura (TTP) patients will suffer an exacerbation (recurrence of TTP within 30 d after their last plasma exchange (PE) procedure), but there are no data to predict who is at greater risk. We studied the clinical utility of demographic and ADAMTS13 biomarker data to predict the risk for exacerbation.

Patients:  Forty‐four acute episodes of idiopathic TTP from 26 patients were studied.

Methods:  PE was performed plus either prednisone (1 mg/kg/d) or cyclosporin (2–3 mg/kg/d) as adjuncts. PE was continued daily until response (platelet count >150 000/μL and normalized lactate dehydrogenase) and tapered uniformly in all patients. ADAMTS13 biomarkers were studied prior to PE and after achieving a response, but within 7 d of the last PE.

Results:  African American race (AA) was associated with an increased risk for exacerbation (P = 0.046). ADAMTS13 at presentation was also significantly lower in patients experiencing an exacerbation (P = 0.0364). After adjusting for the race effect, ADAMTS13 remained marginally significant (P = 0.0569).

Conclusions:  AA is significantly associated with an increased risk for exacerbations of TTP. These data also suggest that decreasing pretreatment ADAMTS13 activity was associated with an increased risk for exacerbation, even after accounting for the effect of race.
Dynactin Subunit p150Glued Isoforms Notable for Differential Interaction with Microtubules
Authors: Zhapparova Olga N. , Bryantseva Sofiya A. , Dergunova Liudmila V. , Raevskaya Natalia M. , Burakov Anton V. , Bantysh Olga B. , Shanina Nina A. , Nadezhdina Elena S.
Published: August 2009

Dynactin is a multiprotein complex that enhances dynein activity. The largest dynactin subunit, p150Glued, interacts with microtubules through its N‐terminal region that contains a globular cytoskeleton‐associated protein (CAP)‐Gly domain and basic microtubule‐binding domain of unknown structure. The p150Glued gene has a complicated intron–exon structure, and many splice isoforms of p150Glued protein have been predicted. Here we describe novel natural 150 kDa isoforms: the p150Glued‐1A isoform, whose basic domain is composed of 41 amino acids, and p150Glued‐1B with a basic domain of 21 aa because of the lack of exons 5–7 in the corresponding messenger RNA (mRNA). According to reverse transcriptase‐polymerase chain reaction (RT‐PCR) and western blot data, p150Glued‐1A is expressed in nerve tissues, in cultured cells and in embryonic tissues, while 1B is expressed ubiquitously. Overexpression of GFP‐p150Glued‐1A and ‐1B fusion proteins and immunostaining of cultured cells with 1A‐specific antibodies show that the p150Glued‐1A isoform is distributed along microtubules, whereas 1B is associated with microtubule plus‐ends. The higher affinity of the p150Glued‐1A isoform for microtubules is confirmed by a co‐pelleting assay. In fibroblast‐like cells, the interaction of p150Glued‐1A with microtubules is less dependent on EB1/EB3 and CLIP170 proteins, compared with p150Glued‐1B. In polarized cells, p150Glued‐1A decorates microtubules that face the leading edge of the cell. The pattern of p150Glued‐1A and p150Glued‐1B interaction with microtubules and their tissue‐specific expression patterns suggest that these isoforms might be involved in cell differentiation and proliferation.
Diagnosis of perinatal stroke II: mechanisms and clinical phenotypes
Authors: Govaert P , Ramenghi L , Taal R , Dudink J , Lequin M
Published: August 2009

Introduction:  Here (and in an accompanying article dealing with definitions, differential diagnosis and registration), a structured sequential diagnostic flow is proposed to discern clinical phenotypes for perinatal stroke, including arterial ischaemic stroke (AIS), cerebral sinovenous thrombosis (CSVT) and haemorrhagic stroke.

Material and results:  For neonatal AIS, the diagnostic sequence is infection, trauma, embolism, arteriopathy, other, primary thrombosis and unclassifiable; for neonatal CSVT, the sequence is infection, trauma, venopathy, other, primary thrombosis and unclassifiable. The proposed hierarchical diagnostic flows are an initial step towards a standard for registration of the causes of neonatal stroke. Such standardization should guide attempts at prevention and intervention. An extensive literature search and study of a retrospective cohort of 134 newborn infants with stroke suggest that embolism is the most common identifiable cause for stroke in general (25%), preceding trauma (10%) and infection (8%). Other causes, such as asphyxia, acute blood loss, extracorporeal membrane oxygenation, genetic disorders or prothrombotic conditions, are seen in <5% of cases. For neonatal AIS, the presence of an embolic phenotype is 33% in this cohort. The designation unclassifiable scored 34% for the entire stroke group and 25% for neonatal AIS. Complex arterial stroke with multiple arteries involved is often seen when the underlying cause is infection, cranial trauma or embolism. One important conclusion is that a means of prevention is avoidance of embolism from thrombosis outside the brain.

Conclusion:  To prevent the occurrence and recurrence of neonatal ischaemic stroke, clinicians must develop a standardized diagnostic approach that results in characterization of the clinical phenotype.
Intestinal flora in very low‐birth weight infants
Authors: Björkström Markus V. , Hall Lina , Söderlund Stina , Håkansson Eva Grahn , Håkansson Stellan , Domellöf Magnus
Published: August 2009

Aim:  To study the early faecal microbiota in very low‐birth weight infants (VLBW, <1500 g), possible associations between faecal microbiota and faecal calprotectin (f‐calprotectin) and to describe the faecal microbiota in cases with necrotizing enterocolitis (NEC) before diagnosis.

Methods:  Stool samples from the first weeks of life were analysed in 48 VLBW infants. Bacterial cultures were performed and f‐calprotectin concentrations were measured. In three NEC cases, cultures were performed on stool samples obtained before diagnosis.

Results:  Bifidobacteria and lactobacilli were often identified in the first stool sample, 55% and 71% of cases, respectively within the first week of life. A positive correlation between lactic acid bacteria (LAB) and volume of enteral feed was found. Other bacteria often identified were Escherichia coli, Enterococcus and Staphyloccus sp. F‐calprotectin was not associated with any bacterial species. All NEC cases had an early colonization of LAB. Prior to onset of disease, all cases had a high colonization of non‐E. coli Gram‐negative species.

Conclusion:  In contrast to the previous studies in VLBW infants, we found an early colonization with LAB. We speculate that this may be due to early feeding of non‐pasteurized breast milk.
Intrabdominal fat is related to metabolic risk factors in Hispanic Americans, African Americans and in girls
Authors: Casazza K , Dulin‐Keita A , Gower BA , Fernandez JR
Published: August 2009

Aim:  This study aimed to test the association of individual adipose depots on cardiometabolic outcomes, whether the association varied by depot and if the associations differed by race/ethnicity or gender in early pubertal children.

Methods:  Three hundred and twenty children (53% male) aged 7–12 years self‐identified as African American (AA; n = 114), European American (EA; n = 120) or Hispanic American (HA; n = 86) participated. Insulin dynamics were assessed by intravenous glucose tolerance test; body composition with DXA; fat distribution with CT.

Results:  AA had the least fat in each depot and HA had the most. Fat accumulation negatively impacted cardiometabolic outcomes independent of race/ethnicity or gender. AA and females were reproductively more mature. In AA and HA, each measure of adiposity influenced the insulin sensitivity index (SI), whereas intra‐abdominal adipose tissue (IAAT) did not contribute to SI in EA. IAAT was positively associated with blood pressure in AA only. In females, adiposity adversely influenced cardiometabolic outcomes such that total fat mass, IAAT and/or SAAT was inversely associated with SI, and positively associated with blood pressure and fasting insulin.

Conclusion:  IAAT is uniquely related to metabolic risk factors in Hispanic Americans, African Americans and girls, suggesting that either the threshold for adverse effects of IAAT is lower, or the IAAT metabolism differs in these groups.
Changes in microRNAs associated with hepatic stellate cell activation status identify signaling pathways
Authors: Guo Can‐Jie , Pan Qin , Cheng Tao , Jiang Bo , Chen Guang‐Yu , Li Ding‐Guo
Published: August 2009

Activation of hepatic stellate cells (HSCs), which is regulated by multiple signal transduction pathways, is the key event in liver fibrosis. Moreover, members of these pathways are important targets for microRNAs (miRNAs). To better understand the critical pathways of HSC activation, we performed comprehensive comparative bioinformatics analysis of microarrays of quiescent and activated HSCs. Changes in miRNAs associated with HSC activation status revealed that 13 pathways were upregulated and 22 pathways were downregulated by miRNA. Furthermore, mitochondrial integrity, based on highly upregulated Bcl‐2 and downregulated caspase‐9, was confirmed in HSCs and fibrotic livers by immnofluorescence assay, quantitative RT‐PCR, and western blot analysis. These findings provide in vitro and in vivo evidence that the mitochondrial pathway of apoptosis plays a significant role in the progression of liver fibrogenesis via HSC activation.
Mutation of epidermal growth factor receptor is associated with MIG6 expression
Authors: Nagashima Takeshi , Ushikoshi‐Nakayama Ryoko , Suenaga Atsushi , Ide Kaori , Yumoto Noriko , Naruo Yoshimi , Takahashi Kaoru , Saeki Yuko , Taiji Makoto , Tanaka Hiroshi , Tsai Shih‐Feng , Hatakeyama Mariko
Published: August 2009

Controlled activation of epidermal growth factor receptor (EGFR) is systematically guaranteed at the molecular level; however, aberrant activation of EGFR is frequently found in cancer. Transcription induced by EGFR activation often involves the coordinated expression of genes that positively and negatively regulate the original signaling pathway; therefore, alterations in EGFR kinase activity may reflect changes in gene expression associated with the pathway. In the present study, we investigated transcriptional changes after EGF stimulation with or without the EGFR kinase inhibitor Iressa in H1299 human non‐small‐cell lung cancer cells [parental H1299, H1299 cells that overexpress wild‐type EGFR (EGFR‐WT) and mutant H1299 cells that overexpress EGFR where Leu858 is substituted with Arg (L858R)]. The results obtained clearly demonstrate differences in transcriptional activity in the absence or presence of EGFR kinase activity, with genes sharing the same molecular functions showing distinct expression dynamics. The results show the particular enrichment of EGFR/ErbB signaling‐related genes in a differentially expressed gene set, and significant protein expression of MIG6/RALT(ERRFI1), an EGFR negative regulator, was confirmed in L858R. High MIG6 protein expression was correlated with basal EGFR phosphorylation and inversely correlated with EGF‐induced extracellular signal‐regulated protein kinase phosphorylation levels. Investigation of the NCI‐60 cell lines showed that ERRFI1 expression was correlated with EGFR expression, regardless of tissue type. These results suggest that cells accumulate MIG6 as an inherent negative regulator to suppress excess EGFR activity when basal EGFR kinase activity is considerably high. Taking all the above together, an EGFR mutation can cause transcriptional changes to accommodate the activation potency of the original signaling pathway at the cellular level.
Nitrite‐Induced Methemoglobinaemia Affects Blood Ionized and Total Magnesium Level by Hydrolysis of Plasma Adenosine Triphosphate in Rat
Authors: Rahman Md. Mizanur , Kim Shang‐Jin , Kim Gi‐Beum , Hong Chul‐Un , Lee Young‐Up , Kim Sung‐Zoo , Kim Jin‐Shang , Kang Hyung‐Sub
Published: August 2009

Abstract:  The objective of this study was to evaluate the effects of sodium nitrite (NaNO2)‐induced methemoglobinaemia on plasma ATP (adenosine triphosphate) and corresponding changes of blood‐ionized magnesium (iMg2+) as well as total magnesium (tMg2+) in a time‐dependent manner. This study was performed on male Sprague–Dawley rats to which NaNO2 was injected (10 mg/kg i.p.) to induce methemoglobinaemia. Methemoglobin (MetHb) in blood was measured before (0 min.) and after 10, 30, 60 and 120 min. of NaNO2 injection. At respective time points, the tMg2+, blood ions and gases were measured by atomic absorption spectrometry and ion selective electrode, respectively. Haematological parameters were checked by automatic blood cell count, and blood films were observed under light microscope. Plasma ATP was measured by bioluminescence assay using a luminometer, and plasma proteins were measured by an automatic analyser. Blood cell count (RBC, WBC and platelet), haematocrit, and haemoglobin were found to be decreased with the advancement of MetHb concentration. With the gradual increase of MetHb concentration, the plasma ATP decreased and blood iMg2+ and plasma tMg2+ increased significantly as time passed by in comparison with the pre‐drug values. A significant decrease of the ratio of ionized calcium to iMg2+, Na+ and increase of K+ was observed. In conclusion, NaNO2‐induced methemoglobinaemia is a cause of hydrolysis of plasma ATP which is responsible for the increase of blood iMg2+ and plasma tMg2+ in rats.
Pulse Pressure and QRS Width Evaluation as an Inexpensive Tool for Heart Failure Assessment
Authors: Beck‐da‐Silva Luís , Goldraich Lívia , Bonzanini Laísa , Rossi Gabriela , Nuernberg Gabriela , Camey Suzi A. , Rohde Luís Eduardo , Clausell Nadine
Published: August 2009

Decreased pulse pressure (PP) is associated with low cardiac output and increased mortality in heart failure (HF) inpatients. QRS width is a well‐known prognostic factor in HF. The study purpose was to explore the mortality effect of combining PP and QRS width in HF outpatients. Initial sphygmomanometrically determined PP and QRS width on the first electrocardiograph in 327 consecutive patients at an HF clinic were recorded. According to PP ≥ or <40 mm Hg and QRS width ≥ or <120 ms, patients were classified into 4 groups. Study groups were analyzed for their effect on mortality using Cox proportional hazards regression analysis. Patients with PP <40 mm Hg had higher mortality (59% vs 45%; P=.015). QRS width ≥120 ms indicated a trend toward higher mortality (57% vs 48%; P=.067). Actuarial survival curves showed that group 4 (QRS width ≥120 ms and PP <40 mm Hg) had significant increased mortality risk in 3.5 years’ mean follow‐up. Group 4 had a mean survival time of 1124 days (SD=124) vs 2233 days (SD=285) in group 1 (QRS width <120 ms and PP ≥40 mm Hg) (P=.022). There was a linear association between left ventricular ejection fraction (LVEF) and study groups. PP and QRS width are readily available, inexpensive, and relevant clinical measures to help identify HF outpatients with significantly worse prognosis and decreased LVEF.
Identifying Left Ventricular Dysfunction in Pulmonary Hypertension
Authors: Rajagopalan Navin , Simon Marc A. , Edelman Kathy , Mathier Michael A. , López‐Candales Angel
Published: August 2009

The significance of left ventricular (LV) dysfunction in patients with pulmonary hypertension (PH) is unknown. Our purpose was to quantify LV function in PH patients by measuring LV myocardial performance index (MPI) and correlating it with invasively determined hemodynamic variables. The authors prospectively measured LV MPI via transthoracic echocardiography in 50 patients with PH (53±11 years; 35 women) who also underwent right heart catheterization within 1 day of echocardiography. For comparative purposes, LV MPI was also measured in 15 healthy volunteers who served as controls. LV MPI was significantly increased in the PH group compared with controls (0.62±0.27 vs 0.36±0.08; P<.001), indicating worse LV dysfunction despite that LV ejection fraction was not significantly different between the groups (58%±4% vs 60%±3%). LV MPI demonstrated significant correlations with invasively determined mean pulmonary artery pressure (r=.50; P<.001), pulmonary vascular resistance (r=.57; P<.001), and cardiac index (r=−.64; P<.001). By receiver operating characteristic analysis, LV MPI >0.75 predicted cardiac index <2 L/min/m2 with 89% sensitivity and 78% specificity (area under the curve, 0.89). In a multivariate model, LV MPI was independently associated with cardiac index (P<.01). Patients with PH demonstrate abnormal LV function as quantified by elevated LV MPI, which correlates significantly with pulmonary vascular resistance and cardiac index.
Maximal Dyspnea on Exertion During Cardiopulmonary Exercise Testing Is Related to Poor Prognosis and Echocardiography With Tissue Doppler Imaging in Heart Failure
Authors: Guazzi Marco , Myers Jonathan , Peberdy Mary Ann , Bensimhon Daniel , Chase Paul , Arena Ross
Published: August 2009

This study tested the hypothesis that increasing levels of maximal dyspnea on exertion (DOE) during cardiopulmonary exercise testing (CPX) is associated with heart failure (HF) disease severity and worsening prognosis. Three hundred seventy‐six HF patients underwent CPX where ventilatory efficiency (minute ventilation/carbon dioxide production; VE/VCO2 slope), peak oxygen consumption (VO2), and maximal DOE were determined. A subgroup of 243 patients underwent echocardiography with tissue Doppler imaging to measure the ratio between mitral early (E) to mitral annular (E′) velocity as well as other variables. Maximal DOE was significantly correlated with E/E′ (rs=.49; P<.001). In the multivariate Cox regression, the VE/VCO2 slope was the strongest prognostic marker obtained from CPX (Multivariate chi‐square, 48.0; P<.001) while maximal DOE (residual chi‐square, 17.4; P<.001) and peak VO2 (residual chi‐square, 7.5; P=.006) added predictive value. These results suggest that increasing DOE reflects the degree of disease severity and adds prognostic value to established CPX variables.
Heart Diseases in Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke Syndrome
Authors: Fayssoil Abdallah
Published: August 2009

Mitochondrial encephalomyopathy, lactic acidosis, and stroke (MELAS) syndrome is a mitochondrial genetic disorder caused by a point mutation, resulting in the substitution of guanine for adenine at nucleotide 3243 (A3243G) of mitochondrial DNA. This disease is characterized by a multisystem disorder with variable manifestations. The authors review heart involvement in this disease.
Early Vasoactive Drugs Improve Heart Failure Outcomes
Authors: Peacock William Frank , Emerman Charles , Costanzo Maria R. , Diercks Deborah B. , Lopatin Margarita , Fonarow Gregg C.
Published: August 2009

Vasoactive therapy is often used to treat acute decompensated heart failure (ADHF). The authors sought to determine whether clinical outcomes are temporally associated with time to vasoactive therapy (vasoactive time) in ADHF. Using the Acute Decompensated Heart Failure (ADHERE) Registry, the authors examined the relationship between vasoactive time and inpatient mortality within 48 hours of hospitalization. Vasoactive agents were used early (defined as <6 hours) in 22,788 (63.8%) patients and late in 12,912 (36.2%). Median vasoactive time was 1.7 and 14.7 hours in the early and late groups, respectively. In‐hospital mortality was significantly lower in the early group (odds ratio, 0.87; 95% confidence interval, 0.79–0.96; P=.006), and the adjusted odds of death increased 6.8% for every 6 hours of treatment delay (95% confidence interval, 4.2–9.6; P<.0001). Early vasoactive initiation is associated with improved outcomes in patients hospitalized for ADHF.
Preparation of Five China Sea and Continental Shelf Sediment Reference Materials (MSCS‐1–5) with Ultra‐Fine Particle Size Distributions
Authors: Wang Xiaohong , Wang Yimin , Gao Yushu , Huang Yongyang , Wang Zhenyu , Shi Xuefa
Published: August 2009

We report the preparation and characterisation of five sediment reference materials MSCS‐1–5 from the China Sea and continental shelf. The raw samples were individually collected from the East China Sea and the South China Sea. They were first ground by ball mill to a homogenous powder of ‐200 mesh (< 74 μm). Then, half of each sample was further processed by an ultra‐fine powder processing technique, a jet mill, to form a powder with an average particle size of < 4 μm (about 800 mesh). The homogeneity was tested by high‐precision WD‐XRF and the precision was found to be less than 1% RSD, which is compatible with the precision range for modern analytical techniques. An F‐test showed that all five samples were homogeneous. Twelve laboratories participated in the cooperative study and sixty constituents were determined. Between fifty and fifty‐two analytes were characterised as recommended values in MSCS‐1–5 in compliance with Chinese national norms. The sum of the major and minor elements or components in the five reference materials MSCS‐1–5 was 99.91%, 99.86%, 100.43%, 100.12% and 99.66%, respectively.
Determination of Ge, As, Se and Te in Silicate Samples Using Isotope Dilution‐Internal Standardisation Octopole Reaction Cell ICP‐QMS by Normal Sample Nebulisation
Authors: Makishima Akio , Nakamura Eizo
Published: August 2009

A method for the determination of Ge, As, Se and Te in silicate samples using isotope dilution‐internal standardisation (ID‐IS) octopole reaction cell (ORC) ICP‐QMS by normal sample nebulisation was developed. The method does not involve either hydride generation or ion exchange. Germanium, Se and Te were determined by isotope dilution (ID), and As was determined by ID‐IS. A silicate sample with an added Ge‐Se‐Te spike was digested with an HF‐HNO3‐HBr mixture, dried, re‐dissolved with HF and the supernatant liquid was directly aspirated into an ORC‐ICP‐QMS instrument with He or H2 gas. No matrix effects were observed down to a dilution factor (DF) of ∼ 70 for Ge, Se and Te and DF of ∼ 1000 for As, which resulted in 3s detection limits in silicates of 2, 1, 0.1 and 4 ng g−1, respectively. Advantages of the method are the simple sample introduction as well as a capability of determining S, Ti, Zr, Nb, Mo, Sn, Sb, Hf and Ta by ID‐IS‐ICP‐QMS/SFMS from the same solution. Furthermore, the total sample solution consumption was only 0.253 ml with DF = 2000. Therefore, only a 0.13 mg test portion was required. To demonstrate the applicability of this technique, Ge, As, Se and Te in eight silicate reference materials were determined, as well as S, Ti, Zr, Nb, Mo, Sn, Sb, Hf and Ta in four carbonaceous chondrites.
Genetic estimates of contemporary effective population size in an endangered butterfly indicate a possible role for genetic compensation
Authors: Saarinen Emily V. , Austin James D. , Daniels Jaret C.
Published: August 2009

The effective population size (Ne) is a critical evolutionary and conservation parameter that can indicate the adaptive potential of populations. Robust estimates of Ne of endangered taxa have been previously hampered by estimators that are sensitive to sample size. We estimated Ne on two remaining populations of the endangered Miami blue butterfly, a formerly widespread taxon in Florida. Our goal was to determine the consistency of various temporal and point estimators on inferring Ne and to determine the utility of this information for understanding the role of genetic stochasticity. We found that recently developed ‘unbiased estimators’ generally performed better than some older methods in that the former had more realistic Ne estimates and were more consistent with what is known about adult population size. Overall, Ne/N ratios based on census point counts were high. We suggest that this pattern may reflect genetic compensation caused by reduced reproductive variance due to breeding population size not being limited by resources. Assuming Ne and N are not heavily biased, it appears that the lack of gene flow between distant populations may be a greater genetic threat in the short term than the loss of heterozygosity due to inbreeding.
Mathematical Representations in Science: A Cognitive–Historical Case History
Authors: Tweney Ryan D.
Published: August 2009

The important role of mathematical representations in scientific thinking has received little attention from cognitive scientists. This study argues that neglect of this issue is unwarranted, given existing cognitive theories and laws, together with promising results from the cognitive historical analysis of several important scientists. In particular, while the mathematical wizardry of James Clerk Maxwell differed dramatically from the experimental approaches favored by Michael Faraday, Maxwell himself recognized Faraday as “in reality a mathematician of a very high order,” and his own work as in some respects a re‐representation of Faraday’s field theory in analytic terms. The implications of the similarities and differences between the two figures open new perspectives on the cognitive role of mathematics as a learned mode of representation in science.
Reverse Shoulder Arthroplasty
Authors: Ekelund Anders
Published: August 2009

In order to improve results of shoulder arthroplasty in cuff deficient shoulders constrained or reverse arthroplasties were tried. However, the results were unpredictable until the unique design of the Delta reverse shoulder by Professor Grammont. This arthroplasty, with a large hemisphere on the glenoid side resulting in a medialized centre of rotation, has shown very good results in short- and mid-term follow-up studies. It is now routinely used for a variety of different shoulder pathologies where the function of the rotator cuff is lost. Active elevation and abduction is restored together with excellent pain relief. Active external rotation, however, is not restored and therefore the procedure has been combined with muscle transfer in selected patients. This is a review of the history, indications, results and complications of the reverse arthroplasty.
Subacromial Impingement: Is there Correlation between Symptoms, Arthroscopic Findings and Outcomes?
Authors: Snow Martyn , Cheong Daniel , Funk Lennard
Published: August 2009

Background

To determine whether a correlation exists between the clinical symptoms and signs of impingement, and the severity of the lesions seen at bursoscopy.

Methods

Fifty-five patients who underwent arthroscopic subacromial decompression were analyzed. Pre-operatively patients completed an assessment form consisting of visual analogue pain score, and shoulder satisfaction. The degree of clinical impingement was also recorded. At arthroscopy impingement was classified according to the Copeland-Levy classification. Post-operatively the shoulder assessment was repeated. Statistical analysis was carried to determine if the degree of impingement at arthroscopy correlated with pre-operative pain, satisfaction and clinical signs of impingement.

Results

Pre-operative pain level, shoulder satisfaction and degree of clinical impingement did not correlate significantly with severity of the lesions of the acromion and cuff. (average correlation coefficient r2 0.018.) There was no correlation between the improvement in the shoulders post-operatively and the severity of lesions (r2 0.008).

Conclusion

There was no correlation between pain, clinical signs or outcomes of subacromial decompression and the severity of impingement lesions seen at arthroscopy.
The Gross–Kohnen–Zagier theorem over totally real fields
Authors: Yuan Xinyi , Zhang Shou-Wu , Zhang Wei
Published: August 2009

On Shimura varieties of orthogonal type over totally real fields, we prove a product formula and the modularity of Kudla’s generating series of special cycles in Chow groups.
Once Daily Valacyclovir for Reducing Viral Shedding in Subjects Newly Diagnosed with Genital Herpes
Authors: Martens Mark G. , Fife Kenneth H. , Leone Peter A. , Dix Lynn P. , Brennan Clare A.
Published: August 2009

Objective. Genital herpes (GH) recurrences and viral shedding are more frequent in the first year after initial HSV-2 infection. The objective of this study was to provide the first evaluation of valacyclovir 1 g once daily compared to placebo in reducing viral shedding in subjects newly diagnosed with GH.Methods. 70 subjects were randomized to receive valacyclovir 1 g daily or placebo in a crossover design for 60 days with a 7-day washout period. A daily swab of the genital/anal-rectal area was self-collected for HSV-2 detection by PCR. Subjects attended the clinic for routine study visits and GH recurrence visits. Treatment differences were assessed using a nonparametric crossover analysis.Results. 52 subjects had at least one PCR measurement in both treatment periods and comprised the primary efficacy population. Valacyclovir significantly reduced HSV-2 shedding during all days compared to placebo (mean 2.9% versus 13.5% of all days (P<.01), a 78% reduction). Valacyclovir significantly reduced subclinical HSV-2 shedding during all days compared to placebo (mean 2.4% versus 11.0% of all days (P<.01), a 78% reduction). However, 79% of subjects had no GH recurrences while receiving valacyclovir compared to 52% of subjects receiving placebo (P<.01).Conclusion. In this study, the frequency of total and subclinical HSV-2 shedding was greater than reported in earlier studies involving subjects with a history of symptomatic genital recurrences. Our study is the first to demonstrate a significant reduction in viral shedding with valacyclovir 1 g daily compared to placebo in a population of subjects newly diagnosed with HSV-2 infection.
Traces Synchronization in Distributed Networks
Authors: Clément Eric , Dagenais Michel
Published: August 2009

This article proposes a novel approach to synchronize a posteriori the detailed execution traces from several networked computers. It can be used to debug and investigate complex performance problems in systems where several computers exchange information. When the distributed system is under study, detailed execution traces are generated locally on each system using an efficient and accurate system level tracer, LTTng. When the tracing is finished, the individual traces are collected and analysed together. The messaging events in all the traces are then identified and correlated in order to estimate the time offset over time between each node. The time offset computation imprecision, associated with asymmetric network delays and operating system latency in message sending and receiving, is amortized over a large time interval through a linear least square fit over several messages covering a large time span. The resulting accuracy is such that it is possible to estimate the clock offsets in a distributed system, even with a relatively low volume of messages exchanged, to within the order of a microsecond while having a very low impact on the system execution, which is sufficient to properly order the events traced on the individual computers in the distributed system.
Collapse Scenarios of High-Rise Buildings Using Plastic Limit Analysis
Authors: Liu G. , Liu D. K. , Chow W. K.
Published: August 2009

The Twin Towers of the World Trade Center (WTC) in New York, USA collapsed on 11 September, 2001. The incident is regarded as the most severe disaster for high-rise buildings in history. Investigations into the collapse scenarios are still being conducted. Possible collapse scenarios assessed by local and international experts were reported. Another possible collapse scenario of the WTC based on two hypotheses was proposed in this paper, and the idea of plastic limit analysis was applied to evaluate the approximate limit load. According to the theory analysis and numerical calculations, a conclusion can be drawn that the large fires, aroused by the terrorist attack, play a significant role on the collapse of the WTC.
Photonic Crystal Fiber Sensors for Strain and Temperature Measurement
Authors: Ju Jian , Jin Wei
Published: August 2009

This paper discusses the applications of photonic crystal fibers (PCFs) for strain and temperature measurement. Long‐period grating sensors and in‐fiber modal interferometric sensors are described and compared with their conventional single‐mode counterparts. The strain sensitivities of the air‐silica PCF sensors are comparable or higher than those implemented in conventional single‐mode fibers but the temperature sensitivities of the PCF sensors are much lower.
On the Tensor Products of Maximal Abelian JW‐Algebras
Authors: Jamjoom F. B. H.
Published: August 2009

It is well known in the work of Kadison and Ringrose (1983)that if A and B are maximal abelian von Neumann subalgebras of von Neumann algebras M and N, respectively, then is a maximal abelian von Neumann subalgebra of . It is then natural to ask whether a similar result holds in the context of
JW‐algebras and the JW‐tensor product. Guided to some extent by the close
relationship between a JW‐algebra M and its universal enveloping von Neumann algebra W*(M), we seek in this article to investigate the answer to this question.
An Extragradient Method for Mixed Equilibrium Problems and Fixed Point Problems
Authors: Yao Yonghong , Liou Yeong-Cheng , Wu Yuh-Jenn
Published: August 2009

The purpose of this paper is to investigate the problem of approximating a common element of the set of fixed points of a demicontractive mapping and the set of solutions of a mixed equilibrium problem. First, we propose an extragradient method for solving the mixed equilibrium problems and the fixed point problems. Subsequently, we prove the strong convergence of the proposed algorithm under some mild assumptions.
On the Norm of Certain Weighted Composition Operators on the Hardy Space
Authors: Haji Shaabani M. , Khani Robati B.
Published: August 2009

We obtain a representation for the norm of certain compact weighted
composition operator Cψ,φ on the Hardy space H2, whenever φ(z) = az + b and ψ(z) = az − b. We also estimate the norm and essential norm of a class of noncompact weighted composition operators under certain conditions on φ and ψ. Moreover, we characterize the norm and essential norm of such operators in a special case.