bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunohistochemical evaluation of fibrovascular and cellular pre‐iridal membranes in dogs
Authors: Bauer Bianca S. , Sandmeyer Lynne S. , Hall Riley B. , Grahn Bruce H.
Published: September 2011

Objective  Histologically, two morphologically distinct types of pre‐iridal membranes appear to occur in diseased canine globes: fibrovascular and cellular. Cellular pre‐iridal membranes of corneal endothelial origin exist in iridocorneal endothelial (ICE) syndrome in humans and arise through metaplastic transformation of corneal endothelial cells into epithelial‐like cells.1 The purpose of this study was to (i) evaluate immunohistochemical staining of these two types of membranes in diseased canine globes, (ii) determine whether endothelial cell metaplasia or iridal vascular budding plays a role in cellular membrane formation and (iii) compare the primary histopathologic diagnosis between the two groups.

Procedures  Hematoxylin and eosin (H&E)‐stained slides of 28 enucleated canine specimens with pre‐iridal membranes were randomly selected and examined with light microscopy. The globes were divided into two groups based on the appearance of the membrane: fibrovascular or cellular, and the histopathologic diagnoses were recorded. Immunohistochemical staining for vimentin, cytokeratin AE1/AE3, and Von Willebrand’s factor (Factor VIII) was completed on the slides of each globe. The histopathologic diagnoses were compared between the two groups.

Results  The fibrovascular and cellular membranes stained positive for vimentin and negative for cytokeratin AE1/AE3. All fibrovascular membranes stained positive for Factor VIII compared with the cellular membranes which stained negative. In the cellular membrane group, primary glaucoma was a common histologic diagnosis.

Conclusions  Immunohistochemical evaluation in this study does not support the hypothesis of metaplastic transformation of endothelial cells into epithelial‐like cells in the canine globes with cellular membranes. The cellular membranes in this study do not represent a canine version of ICE syndrome and are not of vascular endothelial origin.
A STEINDLIAN MODEL OF CONCENTRATION, DEBT AND GROWTH
Authors: Azad Rohit
Published: September 2011

Income distribution plays a crucial role in the Kaleckian models of growth. The recent US experience has seemingly turned the Kaleckian argument on stagnationism on its head. Does it, therefore, render the Kaleckian growth framework redundant? We argue that while there is a tendency towards underconsumption, there could be other counteracting tendencies like the wealth effect of the capitalists or the possibility of debt for the workers. But such a growth process, which is primarily driven by the asset price markets, is, by its very nature, iniquitous and extremely volatile and the downturn is far more severe than the normal business cycles.
Building Relationships for Business in Taiwanese Hostess Clubs: the Psychological and Social Processes of Guanxi Development
Authors: Bedford Olwen , Hwang Shu‐Ling
Published: September 2011

Guanxi refers to personal ties between individuals as well as to an individual's whole network of personal relationships. Most studies of business guanxi have focused on how guanxi may be used to achieve business goals and little attention has been paid to the process of guanxi development. We examined this process in a particular context commonly believed to be important for building business relationships in Taiwan: hostess clubs. We used an indigenous psychological framework to conduct a qualitative study in order to fully capture the participants' own perspectives of these processes. The participants were 43 Taiwanese men (mean age = 38.5) with a range of occupations. The results highlight the psychological and social processes associated with building guanxi for business in hostess clubs. The main purpose of socializing was to bond with and test other men by demonstrating a facility with the social etiquette and exchanging mianzi (face) and renqing (favours). Most participants said that the practice was helpful to their jobs or was part of their job description. The implications for women of the results are discussed.
Incidental findings from cone beam computed tomography of the maxillofacial region: a descriptive retrospective study
Authors: Price Jeffery B. , Thaw Khin L. , Tyndall Donald A. , Ludlow John B. , Padilla Ricardo J.
Published: September 2011

Objective

To evaluate the type and prevalence of incidental findings from cone beam computed tomography (CBCT) of the maxillofacial region. Findings are divided into those that require (i) intervention/referral, (ii) monitoring, and (iii) no further evaluation.

Methods

Three hundred consecutive CBCT scans conducted in the University of North Carolina School of Dentistry Oral and Maxillofacial Radiology Clinic from January 1 to August 31, 2008 were retrospectively reviewed. Findings were categorized into airway, soft tissue calcifications, bone, temporomandibular joint (TMJ), endodontic, dental developmental, and pathological findings.

Results

A total of 272 scans revealed 881 incidental findings (3.2 findings/scan). The most prevalent was airway findings (35%) followed by soft tissue calcifications (20%), bone (17.5%), TMJ (15.4%), endodontic (11.3%), dental developmental (0.7%), and pathological (0.1%). 16.1% required intervention/referral, 15.6% required monitoring, and the remainder (68.3%) required neither.

Conclusion

This study underscores the need to thoroughly examine all CBCT volumes for clinically significant findings within and beyond the region of interest.
Role of anti‐β1 adrenergic antibodies from patients with periodontitis in cardiac dysfunction
Authors: Segovia Marcela , Ganzinelli Sabrina , Reina Silvia , Borda Enri , Sterin‐Borda Leonor
Published: September 2011

J Oral Pathol Med (2012) 41: 242–248

Background:  The presence of serum autoantibodies against β1 adrenoreceptors (β1‐ARs) in human gingival fibroblast from patients with periodontitis inhibits primary cell‐specific growth and induces over‐expression of pro‐inflammatory mediators. Serum β1‐AR autoantibodies from patients with periodontitis react with myocardium and modify cardiac contractility. The relationship between the presence of serum β1‐AR autoantibodies and alterations in heart rate variability (HRV) was also studied.

Methods:  An enzyme‐linked immunosorbent assay (ELISA) using cardiac and gingival fibroblast membranes or synthetic peptides corresponding to the second extracellular loop of human β1‐AR was used to detect serum autoantibodies. The HRV was assessed from RR interval files generated from 22:00 to 08:00 hours. The autoantibody effects on contractility were measured on spontaneous rat isolated atria.

Results:  Circulating autoantibodies from 36 patients with periodontitis and 20 healthy individuals (controls) interacted with fibroblasts, the cardiac surface, and β1‐AR synthetic peptides. The distributions of serum antibodies against gingival and myocardium membranes and β1‐AR synthetic peptide were 88.8%, 77.7%, and 92.8%, respectively. Moreover, 88.5% of patients with periodontitis whose sera were positive against β1‐AR synthetic peptide had decreased HRV. The corresponding affinity‐purified anti‐β1‐AR peptide IgG displayed partial agonist‐like activity modifying the isolated atria contractility.

Conclusion:  This manuscript describes that patients with periodontitis showed increased levels of serum IgG with reactive activity against β1‐AR. Those patients demonstrated decrease in heart rate, and IgG derived from their sera induced aberrant contractility of heart atrium. We propose that periodontitis increases the risk of cardiovascular diseases, although it increases anti‐β1‐AR autoantibody that alters myocardial contractility.
Bisphosphonates‐related osteonecrosis of the jaws: a concise review of the literature and a report of a single‐centre experience with 151 patients
Authors: Vescovi Paolo , Merigo Elisabetta , Meleti Marco , Manfredi Maddalena , Guidotti Rebecca , Nammour Samir
Published: September 2011

J Oral Pathol Med (2012) 41: 214–221

The osteonecrosis of the jaws (ONJ) is an adverse side effect of long‐term bisphosphonate therapy (BPT) firstly described in 2003. The aetiology of BRONJ remains unknown, and the pathogenesis seems multifactorial and related to several local or general factors. Many expert panel developed preventive protocols to facilitate specialists involved in the multidisciplinary management of BRONJ patients. In this paper, we present a concise review of the literature, and we report the experience of the University of Parma with 151 patients that assumed BPT for both oncological (121 patients) and non‐oncological (30 patients) diseases. One hundred and thirty‐nine BRONJ sites were treated with different approaches (surgical and non‐surgical, laser‐assisted and non‐laser‐assisted): in terms of clinical improvement, a statistically significant difference was found between the group treated with the only medical therapy; in terms of complete healing, the introduction in the treatment protocols of both laser‐assisted approach and surgical approach improves the therapeutical results.
Effects of a physical education program on physical activity, fitness, and health in children: The JuvenTUM project
Authors: Siegrist M. , Lammel C. , Haller B. , Christle J. , Halle M.
Published: September 2011

The purpose of the study was to investigate the effects of a school‐based prevention program on physical activity, fitness, and obesity. We performed a prospective study in eight Bavarian primary schools (n = 724 children, 8.4 ± 0.7 years) randomized one to one to either an intervention school (IS, n = 427) or a control school (CS, n = 297). Children in IS attended 10 health‐related lessons at school over a period of 1 year. Parents and teachers attended two and three educational health‐related lessons, respectively, and also received 10 newsletters on health issues. Daily physical activity (≥ 60 min/day), physical fitness (six‐item test battery), and anthropometric data were obtained at baseline and after 1 year. Physical activity and physical fitness increased in IS, but it failed to reach significant intervention effects. Nevertheless, a reduction in waist circumference was observed for all children [mean change 1.7 cm; 95% confidence interval (CI) 1.2–2.3; P < 0.001). This effect was more pronounced in overweight children (> 90th percentile, n = 99, mean change 3.2 cm; 95% CI 1.5–4.8; P < 0.001). This easily administered preventative program involving children, parents, and teachers revealed that a generalized approach increasing physical activity will even be favorable in a subgroup of obese children.
Intervention fidelity: Ensuring application to practice for youth and families
Authors: Faulkner Melissa Spezia
Published: September 2011

Purpose.  Limited information on intervention fidelity is available in published studies with youth and families. The components of intervention fidelity, the complexity of measurement in these studies, and strategies for measuring intervention fidelity are described.

Conclusions.  Strategies for ensuring intervention fidelity according to the Treatment Fidelity Workgroup of the Behavior Change Consortium in the areas of study design, provider training, treatment delivery, treatment receipt, and treatment enactment provide guidance for evaluating or developing intervention fidelity plans.

Practice Implications.  Ensuring the quality of intervention fidelity in evidence‐based reviews or when developing new interventions is essential for translating findings into practice.
100 years of microbial electricity production: three concepts for the future
Authors: Arends Jan B. A. , Verstraete Willy
Published: September 2011

Bioelectrochemical systems (BES) have been explored according to three main concepts: to produce energy from organic substrates, to generate products and to provide specific environmental services. In this work, by using an engineering approach, biological conversion rates are calculated for BES resp. anaerobic digestion. These rates are compared with currents produced by chemical batteries and chemical fuel cells in order to position BES in the ‘energy’‐market. To evaluate the potential of generating various products, the biochemistry behind the biological conversion rates is examined in relation to terminal electron transfer molecules. By comparing kinetics rather than thermodynamics, more insight is gained in the biological bottlenecks that hamper a BES. The short‐term future for BES research and its possible application is situated in smart niches in sustainable environmental development, i.e. in processes where no large currents or investment cost intensive reactors are needed to obtain the desired results. Some specific examples are identified.
Ionic Liquid–Mediated Selective Conversion of CO
2
to CO at Low Overpotentials
Authors: Rosen Brian A. , Salehi-Khojin Amin , Thorson Michael R. , Zhu Wei , Whipple Devin T. , Kenis Paul J. A. , Masel Richard I.
Published: September 2011

Carbon dioxide reduction reactions, a key step in creating fuels from this gas, can be achieved in an ionic liquid.
Exploring child car passenger safety practices in China: experience from a parental survey in Shanghai
Authors: Pan Shuming , Du Wei , Jiang Fan , Bilston Lynne E , Brown Julie , Shen Xiaoming
Published: September 2011

Little is known about child passenger safety practice in China. This study aims to describe child passenger seating and restraint practice in Shanghai. Information on 970 children enrolled in five randomly selected kindergartens in the Songjiang and Pudong districts of Shanghai was collected from a parental survey during 2008–2009. The adjusted rate ratios for optimal (rear-seated alone) versus suboptimal seating position (including front-seated or sitting in adult laps) and restraint use versus non-use of restraints among child passengers were evaluated using multivariate binomial regression. Suboptimal seating position (16.9%) and non-use of restraints (60.8%) was common among child passengers. Younger age (≤4 years) and having parents who are licensed drivers decreased the likelihood of being rear-seated alone; whereas having a tertiary-educated mother increased the likelihood of a child being seated optimally. Compared with unlicensed parents, guardian parents who have a driver's licence were more likely to use restraints for their child passengers. This study suggests restraint non-use and suboptimal seating position are common for child passengers in the Songjiang and Pudong districts of Shanghai, and identifies risk factors influencing restraint use and seating position choice for child passengers. There is an urgent need to improve child passenger safety in China and these findings indicate potential targets for educational interventions in the absence of child restraint laws.
Regulation of Ca2+release through inositol 1,4,5-trisphosphate receptors by adenine nucleotides in parotid acinar cells
Authors: Park Hyung Seo , Betzenhauser Matthew J. , Zhang Yu , Yule David I.
Published: September 2011

Secretagogue-stimulated intracellular Ca2+signals are fundamentally important for initiating the secretion of the fluid and ion component of saliva from parotid acinar cells. The Ca2+signals have characteristic spatial and temporal characteristics, which are defined by the specific properties of Ca2+release mediated by inositol 1,4,5-trisphosphate receptors (InsP3R). In this study we have investigated the role of adenine nucleotides in modulating Ca2+release in mouse parotid acinar cells. In permeabilized cells, the Ca2+release rate induced by submaximal [InsP3] was increased by 5 mM ATP. Enhanced Ca2+release was not observed at saturating [InsP3]. The EC50for the augmented Ca2+release was ∼8 μM ATP. The effect was mimicked by nonhydrolysable ATP analogs. ADP and AMP also potentiated Ca2+release but were less potent than ATP. In acini isolated from InsP3R-2-null transgenic animals, the rate of Ca2+release was decreased under all conditions but now enhanced by ATP at all [InsP3]. In addition the EC50for ATP potentiation increased to ∼500 μM. These characteristics are consistent with the properties of the InsP3R-2 dominating the overall features of InsP3R-induced Ca2+release despite the expression of all isoforms. Finally, Ca2+signals were measured in intact parotid lobules by multiphoton microscopy. Consistent with the release data, carbachol-stimulated Ca2+signals were reduced in lobules exposed to experimental hypoxia compared with control lobules only at submaximal concentrations. Adenine nucleotide modulation of InsP3R in parotid acinar cells likely contributes to the properties of Ca2+signals in physiological and pathological conditions.
Kv7 potassium channels in airway smooth muscle cells: signal transduction intermediates and pharmacological targets for bronchodilator therapy
Authors: Brueggemann Lioubov I. , Kakad Priyanka P. , Love Robert B. , Solway Julian , Dowell Maria L. , Cribbs Leanne L. , Byron Kenneth L.
Published: September 2011

Expression and function of Kv7 (KCNQ) voltage-activated potassium channels in guinea pig and human airway smooth muscle cells (ASMCs) were investigated by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR), patch-clamp electrophysiology, and precision-cut lung slices. qRT-PCR revealed expression of multiple KCNQ genes in both guinea pig and human ASMCs. Currents with electrophysiological and pharmacological characteristics of Kv7 currents were measured in freshly isolated guinea pig and human ASMCs. In guinea pig ASMCs, Kv7 currents were significantly suppressed by application of the bronchoconstrictor agonists methacholine (100 nM) or histamine (30 μM), but current amplitudes were restored by addition of a Kv7 channel activator, flupirtine (10 μM). Kv7 currents in guinea pig ASMCs were also significantly enhanced by another Kv7.2–7.5 channel activator, retigabine, and by celecoxib and 2,5-dimethyl celecoxib. In precision-cut human lung slices, constriction of airways by histamine was significantly reduced in the presence of flupirtine. Kv7 currents in both guinea pig and human ASMCs were inhibited by the Kv7 channel blocker XE991. In human lung slices, XE991 induced robust airway constriction, which was completely reversed by addition of the calcium channel blocker verapamil. These findings suggest that Kv7 channels in ASMCs play an essential role in the regulation of airway diameter and may be targeted pharmacologically to relieve airway hyperconstriction induced by elevated concentrations of bronchoconstrictor agonists.
Brief daily exposure to low-intensity vibration mitigates the degradation of the intervertebral disc in a frequency-specific manner
Authors: Holguin Nilsson , Uzer Gunes , Chiang Fu-Pen , Rubin Clinton , Judex Stefan
Published: September 2011

Hindlimb unloading of the rat causes rapid hypotrophy of the intervertebral disc (IVD) as well as reduced IVD height and glycosaminoglycan content. Here we tested the hypothesis that low-intensity mechanical vibrations (0.2 g), as a surrogate for exercise, will mitigate this degradation. Four groups of Sprague-Dawley rats (4.5 mo, n = 11/group) were hindlimb unloaded (HU) for 4 wk. In two of the HU groups, unloading was interrupted for 15 min/day by placing rats in an upright posture on a platform that was vertically oscillating at 45 or 90 Hz (HU+45, HU+90). Sham control rats stood upright on an inactive plate for 15 min/day (HU+SC). These three experimental groups were compared with HU uninterrupted by weightbearing (HU) and to normally ambulating age-matched controls. In the HU and HU+SC rats, 4 wk of unloading resulted in a 10% smaller IVD height, as well as less glycosaminoglycan in the whole IVD (7%) and nucleus pulposus (17%) and a greater collagen-to-glycosaminoglycan ratio in the whole IVD (17%). Brief daily exposure to 90 Hz mechanical oscillations mitigated this degradation; compared with HU ± SC, the IVD of HU+90 had an 8% larger height and greater glycosaminoglycan content in the whole IVD (12%) and nucleus pulposus (24%). In contrast, the 45 Hz signal failed to mitigate changes in height or glycosaminoglycan content brought with altered spinal loading, but normalized the collagen-to-glycosaminoglycan ratio to levels observed in age-matched controls. In summary, unloading caused marked phenotypic and biochemical changes in the IVD, a deterioration that was not slowed by brief weightbearing. However, low-intensity 90 Hz vibrations superimposed on weightbearing largely preserved the morphology and biochemistry of the IVD and suggest that these biomechanically based signals may help protect the IVD during long bouts of nonambulation.
Adaptive strength gains in dystrophic muscle exposed to repeated bouts of eccentric contraction
Authors: Call Jarrod A. , Eckhoff Michael D. , Baltgalvis Kristen A. , Warren Gordon L. , Lowe Dawn A.
Published: September 2011

The objective of this study was to determine the functional recovery and adaptation of dystrophic muscle to multiple bouts of contraction-induced injury. Because lengthening (i.e., eccentric) contractions are extremely injurious for dystrophic muscle, it was considered that repeated bouts of such contractions would exacerbate the disease phenotype in mdx mice. Anterior crural muscles (tibialis anterior and extensor digitorum longus) and posterior crural muscles (gastrocnemius, soleus, and plantaris) from mdx mice performed one or five repeated bouts of 100 electrically stimulated eccentric contractions in vivo, and each bout was separated by 10–18 days. Functional recovery from one bout was achieved 7 days after injury, which was in contrast to a group of wild-type mice, which still showed a 25% decrement in electrically stimulated isometric torque at that time point. Across bouts there was no difference in the immediate loss of strength after repeated bouts of eccentric contractions for mdx mice (−70%, P = 0.68). However, after recovery from each bout, dystrophic muscle had greater torque-generating capacity such that isometric torque was increased ∼38% for both anterior and posterior crural muscles at bout 5 compared with bout 1 ( P < 0.001). Moreover, isolated extensor digitorum longus muscles excised from in vivo-tested hindlimbs 14–18 days after bout 5 had greater specific force than contralateral control muscles (12.2 vs. 10.4 N/cm2, P = 0.005) and a 20% greater maximal relaxation rate ( P = 0.049). Additional adaptations due to the multiple bouts of eccentric contractions included rapid recovery and/or sparing of contractile proteins, enhanced parvalbumin expression, and a decrease in fiber size variability. In conclusion, eccentric contractions are injurious to dystrophic skeletal muscle; however, the muscle recovers function rapidly and adapts to repeated bouts of eccentric contractions by improving strength.
A Phase I Study of UFT-Oral Vinorelbine in Metastatic Breast Cancer
Authors: Ferrero J.M. , Largillier R. , Michel C. , Amiot V. , Milano G. , Hébert C. , Mari V. , Courdi A. , Figl A. , Follana P. , Barrière J. , Chamorey E.
Published: September 2011

Background: Despite current treatment options, metastatic breast cancer (MBC) remains essentially incurable, requiring research on new drugs or combinations to improve survival and quality of life. Patients and Methods: This phase I study was designed to define the maximum-tolerated dose (MTD), dose-limiting toxicity (DLT) and recommended dose of all-oral tegafur-uracil (UFT)/folinic acid combined with vinorelbine as chemotherapy for MBC. Starting doses were 40 mg/m2/week of oral vinorelbine administered continuously and 250 mg/m2/day of UFT plus 90 mg/day of folinic acid from day 1 to day 28, followed by a 1-week rest period. Results: Ten patients were included. Eight were evaluable for toxicity and antitumor response. The second dose level was shown to be the MTD. At this dose, 2 out of 5 patients receiving oral vinorelbine at 40 mg/m2/week and UFT at 300 mg/m2/day developed DLT consisting of grade 3 asthenia and grade 3nausea despite standard prophylaxis. Other toxicities were grade 1 diarrhea and anemia. There were no treatment-related deaths. Conclusions: The recommended dose for this combination seems to be the first dose level. A stable response was observed for 6 patients (average 33 weeks). This combination appears to be well-tolerated and offers an alternative to intravenous chemotherapy.
Predictors of Residual Cardiovascular Risk in Patients on Statin Therapy for Primary Prevention
Authors: Afonso Luis , Veeranna Vikas , Zalawadiya Sandip , Ramesh Krithi , Niraj Ashutosh , Panaich Sidakpal
Published: September 2011

Background: Low-density lipoprotein cholesterol-lowering therapy is an important aspect of primary prevention of cardiovascular disease (CVD). Statins are the most widely used drug therapy for achieving low-density lipoprotein goals based on an individual’s 10-year risk. However, substantial risk of CVD events still exists even when a person is on statins. We sought to explore the predictors of future CVD events in individuals on statins with no pre-existing CVD. Methods: The analysis was done on subjects who were on statins (n = 919) at baseline in the Multi-Ethnic Study of Atherosclerosis limited access dataset from the National Heart, Lung and Blood Institute. The primary outcome variable was all-cause CVD events (n = 67). Multivariate regression Cox proportional hazard analysis was done to identify potential independent predictors of all-cause CVD. Results: Our cohort consisted of 47% males, with a mean age of 66 ± 9 years. Sixty-seven participants (7.3%) experienced CVD events during a mean follow-up of 4.4 years. A higher coronary artery calcium score, homocysteine levels, waist circumference and a lower large arterial elasticity index were identified as independent predictors of CVD events. Conclusion: Homocysteine, waist circumference, coronary artery calcification and the large artery elasticity index appear to be the major independent predictors of CVD events in individuals on statins with no pre-existing CVD. In addition to emphasizing weight loss, alternative approaches beyond lipid reduction may need to be explored to better characterize and attenuate the residual risk in subjects on statin therapy for primary prevention.
Rip2
Deficiency Leads to Increased Atherosclerosis Despite Decreased Inflammation
Authors: Levin Malin C. , Jirholt Pernilla , Wramstedt Anna , Johansson Maria E. , Lundberg Anna M. , Trajkovska Maria Gustafsson , Ståhlman Marcus , Fogelstrand Per , Brisslert Mikael , Fogelstrand Linda , Yan Zhong-Qun , Hansson Göran K. , Björkbacka Harry , Olofsson Sven-Olof , Borén Jan
Published: September 2011

Rationale:

The innate immune system and in particular the pattern-recognition receptors Toll-like receptors have recently been linked to atherosclerosis. Consequently, inhibition of various signaling molecules downstream of the Toll-like receptors has been tested as a strategy to prevent progression of atherosclerosis. Receptor-interacting protein 2 (Rip2) is a serine/threonine kinase that is involved in multiple nuclear factor-κB (NFκB) activation pathways, including Toll-like receptors, and is therefore an interesting potential target for pharmaceutical intervention.

Objective:

We hypothesized that inhibition of Rip2 would protect against development of atherosclerosis.

Methods and Results:

Surprisingly, and contrary to our hypothesis, we found that mice transplanted with
Rip2
−/−
bone marrow displayed markedly increased atherosclerotic lesions despite impaired local and systemic inflammation. Moreover, lipid uptake was increased whereas immune signaling was reduced in
Rip2
−/−
macrophages. Further analysis in
Rip2
−/−
macrophages showed that the lipid accumulation was scavenger-receptor independent and mediated by Toll-like receptor 4 (TLR4)–dependent lipid uptake.

Conclusions:

Our data show that lipid accumulation and inflammation are dissociated in the vessel wall in mice with
Rip2
−/−
macrophages. These results for the first time identify Rip2 as a key regulator of cellular lipid metabolism and cardiovascular disease.
Rapid Reversal of Anticoagulation Prevents Excessive Secondary Hemorrhage After Thrombolysis in a Thromboembolic Model in Rats
Authors: Sun Li , Zhou Wei , Ploen Robert , Heiland Sabine , Zorn Markus , Veltkamp Roland
Published: September 2011

Background and Purpose—

Thrombolysis is the only approved therapy for ischemic stroke, but secondary hemorrhage is a severe complication. Because oral anticoagulants are believed to increase the risk of hemorrhage, thrombolysis is usually contraindicated in patients on vitamin K antagonists. We studied whether thrombolysis in a thromboembolic middle cerebral artery occlusion model in rats pretreated with warfarin increases secondary hemorrhage, and whether substitution of coagulation factors before thrombolysis prevents hemorrhagic complications.

Methods—

Wistar rats were anticoagulated using warfarin in drinking water (0.4 mg/kg per 24 hours). Strength of anticoagulation was monitored using benchside international normalized ratio (INR) coagulometry. Two hours after middle cerebral artery occlusion, recombinant tissue-type plasminogen activator (9 mg/kg) was administered. Two of 5 groups of animals received prothrombin complex concentrate (PCC, 50 U/kg) 15 minutes before thrombolysis. Serial magnetic resonance imaging was performed 20 minutes, 2.5 hours, and 24 hours after middle cerebral artery occlusion. Secondary hemorrhage was quantified on T2* magnetic resonance images as previously established.

Results—

Severity of hypoperfusion on initial perfusion-weighted imaging –magnetic resonance did not differ among groups. Thrombolysis resulted in successful reperfusion in all groups. Anticoagulated animals had significantly more secondary hemorrhage and a higher mortality rate compared with nonanticoagulated animals. PCC rapidly reversed the increased international normalized ratio. Although PCC failed to prevent hemorrhage in the strongly anticoagulated, it reduced the incidence of severe hemorrhage in moderately anticoagulated rats (INR, 2–3) to the level of nonanticoagulated controls.

Conclusions—

Preceding anticoagulation increases risk and extent of secondary hemorrhage after thrombolysis. Reversal of moderate anticoagulation using PCC may allow thrombolytic therapy without increasing the risk of secondary hemorrhage.
Validation of the Stroke Prognostic Instrument-II in a Large, Modern, Community-Based Cohort of Ischemic Stroke Survivors
Authors: Navi Babak B. , Kamel Hooman , Sidney Stephen , Klingman Jeffrey G. , Nguyen-Huynh Mai N. , Johnston S. Claiborne
Published: September 2011

Background and Purpose—

The risk of recurrent stroke in the modern era of secondary stroke prevention is not well defined. Several prediction models, including the Stroke Prognostic Instrument-II (SPI-II), have been created to identify patients at highest risk, but their performance in modern populations has been infrequently tested. We aimed to assess the 1-year risk of recurrence after hospital discharge in a recent, large, community-based cohort of patients with ischemic stroke and to validate the SPI-II prediction model in this cohort.

Methods—

From 2004 through 2006, 5575 patients with acute ischemic stroke were prospectively identified and followed for recurrent events. Kaplan-Meier statistics were used to analyze the cumulative incidence of recurrent ischemic stroke. Harrell c-statistic was calculated to determine the performance of SPI-II in predicting stroke or death at 1 year, and the log-rank test was used to compare the differences among low-, middle-, and high-risk groups.

Results—

Among 5575 patients with ischemic stroke, recurrence was observed in 221 during the subsequent year. Kaplan-Meier estimates of cumulative rates of recurrent stroke were 2.5%, 3.6%, and 4.8% at 3, 6, and 12 months, respectively. Rates of stroke or death for SPI-II in the low-, middle-, and high-risk groups were 8.2%, 24.5%, and 35.6%, respectively (trend,
P
=0.001). The c-statistic for SPI-II was 0.62 (95% CI, 0.61–0.64).

Conclusions—

The modern 1-year rate of recurrent stroke after hospital discharge is low but still substantial at 4.8%. SPI-II is a modestly effective tool in identifying patients with ischemic stroke at highest risk of developing recurrence or death.
Crossed Ataxia
Authors: Bally Julien , Mégevand Pierre , Nguyen Duy , Landis Theodor , Granziera Cristina
Published: September 2011

Background and Purpose—

Ever since the seminal description of ataxic hemiparesis contralateral to a pontine lesion by Miller-Fisher, the question of why contralesional crossing pontocerebellar fibers do not more frequently produce ipsilesional hemiataxia was raised. The few cases of “quadrataxic hemiparesis” or bilateral leg ataxia remain exceptions.

Summary of Case—

We report an even more unusual variant, namely “crossed ataxia” of the contralesional arm and the ipsilesional leg subsequent to an anteromedial pontine ischemic stroke.

Conclusions—

MRI diffusion tensor imaging tractography shows that caudal contralesional crossing pontocerebellar fibers (those for the leg) travel trough the lesion, whereas more rostral fibers (those for the arm) are spared.
Traditional Risk Factors as the Underlying Cause of Racial Disparities in Stroke
Authors: Howard George , Cushman Mary , Kissela Brett M. , Kleindorfer Dawn O. , McClure Leslie A. , Safford Monika M. , Rhodes J. David , Soliman Elsayed Z. , Moy Claudia S. , Judd Suzanne E. , Howard Virginia J.
Published: September 2011

Background and Purpose—

Black/white disparities in stroke incidence are well documented, but few studies have assessed the contributions to the disparity. Here we assess the contribution of “traditional” risk factors.

Methods—

A total of 25 714 black and white men and women, aged ≥45 years and stroke-free at baseline, were followed for an average of 4.4 years to detect stroke. Mediation analysis using proportional hazards analysis assessed the contribution of traditional risk factors to racial disparities.

Results—

At age 45 years, incident stroke risk was 2.90 (95% CI: 1.72–4.89) times more likely in blacks than in whites and 1.66 (95% CI: 1.34–2.07) times at age 65 years. Adjustment for risk factors attenuated these excesses by 40% and 45%, respectively, resulting in relative risks of 2.14 (95% CI: 1.25–3.67) and 1.35 (95% CI: 1.08–1.71). Approximately one half of this mediation is attributable to systolic blood pressure. Further adjustment for socioeconomic factors resulted in total mediation of 47% and 53% to relative risks of 2.01 (95% CI: 1.16–3.47) and 1.30 (1.03–1.65), respectively.

Conclusions—

Between ages 45 to 65 years, approximately half of the racial disparity in stroke risk is attributable to traditional risk factors (primarily systolic blood pressure) and socioeconomic factors, suggesting a critical need to understand the disparity in the development of these traditional risk factors. Because half of the excess stroke risk in blacks is not attributable to traditional risk factors and socioeconomic factors, differential impact of risk factors, residual confounding, or nontraditional risk factors may also play a role.
Plasma α-Melanocyte Stimulating Hormone Predicts Outcome in Ischemic Stroke
Authors: Zierath Dannielle , Tanzi Pat , Cain Kevin , Shibata Dean , Becker Kyra
Published: September 2011

Background and Purpose—

α-Melanocyte stimulating hormone (α-MSH) is an endogenously produced neuropeptide derived from the same precursor as adrenocorticotropic hormone. α-MSH has profound immunomodulatory properties and may also be neuroprotective. Nothing is known about α-MSH and changes in its plasma concentrations in patients with acute ischemic stroke.

Methods—

In this prospective observational study, plasma concentrations of α-MSH, adrenocorticotropic hormone, cortisol, and interleukin 6 were assessed longitudinally over the course of 1 year after stroke onset in 111 patients. Logistic regression was used to the effect of initial plasma α-MSH, adrenocorticotropic hormone, cortisol, and interleukin 6 on long-term outcome.

Results—

There was an early decrease in plasma α-MSH in patients with severe stroke (National Institutes of Health Stroke Scale ≥17) that normalized over the course of the year; these same patients evidenced elevations in plasma cortisol and interleukin 6. Higher initial plasma α-MSH, but not adrenocorticotropic hormone, cortisol, or interleukin 6, was independently predictive of good long-term outcome.

Conclusions—

This research is the first to study endogenous changes in plasma α-MSH after stroke. The independent effect of early plasma α-MSH on stroke outcome, as well as a growing body of experimental data demonstrating improved stroke outcome with exogenous α-MSH administration, suggests a potential therapeutic role for α-MSH in the treatment of stroke.
Oxytocin Mediates Social Neuroprotection After Cerebral Ischemia
Authors: Karelina Kate , Stuller Kathleen A. , Jarrett Brant , Zhang Ning , Wells Jackie , Norman Greg J. , DeVries A. Courtney
Published: September 2011

Background and Purpose—

The reduced incidence, morbidity, and mortality of stroke among humans with strong social support have been well-documented; however, the mechanisms underlying these socially mediated phenomena remain unknown, but may involve oxytocin (OT), a hormone that modulates some aspects of social behavior in humans and other animals.

Methods—

In the present study, adult male mice were socially isolated (housed individually) or socially paired (housed with an ovariectomized female); social pairing increased hypothalamic OT gene expression. To determine whether a causal relationship exists between increased OT and improved stroke outcome, mice were treated with exogenous OT or OT receptor antagonist beginning 1 week before induction of experimental stroke via middle cerebral artery occlusion.

Results—

Relative to social isolation, social housing attenuated infarct size, neuroinflammation, and oxidative stress following experimental stroke; the neuroprotective effect of social housing was eliminated by receptor antagonist treatment. In contrast, administration of OT to socially isolated mice reproduced the neuroprotection conferred by social housing. We further report evidence for a direct suppressive action of OT on cultured microglia, which is a key instigator in the development of neuroinflammation after cerebral ischemia.

Conclusions—

These findings support the hypothesis that OT mediates the neuroprotective effect of social interaction on stroke outcome.
Late-Phase Contrast-Enhanced Ultrasound Reflects Biological Features of Instability in Human Carotid Atherosclerosis
Authors: Shalhoub Joseph , Monaco Claudia , Owen David R.J. , Gauthier Thomas , Thapar Ankur , Leen Edward L.S. , Davies Alun H.
Published: September 2011

Background and Purpose—

Development of translational functional imaging modalities for atherosclerosis risk stratification is sought for stroke prediction. Our group has developed late-phase contrast-enhanced ultrasound (LP-CEUS) to quantify microbubble contrast retention within carotid atherosclerosis and shown it to separate asymptomatic plaques from those responsible for recent cerebrovascular events. We hypothesized that microbubbles are retained in areas of plaque inflammation, aiming to examine whether LP-CEUS signal reflects plaque biology.

Methods—

Subjects awaiting carotid endarterectomy (n=31) underwent axial LP-CEUS and diseased intimal segments were symmetrically divided in the long axis. Half-specimens underwent quantitative immunohistochemical analysis for CD68 (macrophages) and CD31 (angiogenesis). Half-specimens were processed for atheroma cell culture and supernatant collected at 24 hours for multianalyte profiling for 34 analytes.

Results—

Percentage area immunopositivity was significantly higher in subjects in which normalized plaque late-phase intensity was ≥0 versus <0 (CD68 mean 11.8 versus 6.68,
P
=0.004; CD31 mean 9.45 versus 4.82,
P
=0.025). Interleukin-6, matrix metalloproteinase-1, and matrix metalloproteinase-3 were significantly higher by multianalyte profiling when LP-CEUS was ≥0.

Conclusions—

LP-CEUS reflects biological features of inflammation and angiogenesis, key features predisposing to plaque rupture. Further investigation of LP-CEUS as a tissue-specific marker of inflammation for risk stratification of carotid atherosclerosis is warranted.
A Numerical Study of Urban Aerosol Impacts on Clouds and Precipitation
Authors: Han Ji-Young , Baik Jong-Jin , Khain Alexander P.
Published: September 2011

The impacts of urban aerosols on clouds and precipitation are investigated using a spectral (bin) microphysics cloud model. For this purpose, extensive numerical experiments with various aerosol concentrations are performed under different environmental moisture conditions. To take into account the urban heat island and urban air pollution, it is considered that there is low-level heating in the urban area and that the aerosol concentration in the urban area is higher than that in the surrounding rural area. Simulation results show that a low-level updraft induced by the urban heat island leads to the formation of a low-level cloud and then a deep convective cloud downwind of the urban area. The onset of precipitation produced by the low-level cloud is delayed at higher aerosol concentrations. This is because when the aerosol concentration is high, a narrow drop size distribution results in a suppressed collision–coalescence process and hence in late raindrop formation. However, after the deep convective cloud develops, a higher aerosol concentration generally leads to the development of a stronger convective cloud. This is mainly due to increased release of latent heat resulting from the enhanced condensation process with increasing aerosol concentration. The low collision efficiency of smaller cloud drops and the resulting stronger updraft at higher aerosol concentrations result in higher liquid water content at higher levels, leading to the enhanced riming process to produce large ice particles. The melting of a larger amount of hail leads to precipitation enhancement downwind of the urban area with increasing urban aerosol concentration in all moisture environments considered.
Acculturation Process and Distress
Authors: Wu Ellery K. Y. , Mak Winnie W. S.
Published: September 2011

The present study applied the theory of planned behavior (TPB) to unfold the social cognitive antecedents of acculturation and investigated the effects of acculturation on psychological distress using a longitudinal design. A total of 180 mainland Chinese university students studying in Hong Kong completed three sets of questionnaires every 2 months for a period of 6 months. Findings from structural equation modeling (CFI = 0.97, NNFI = 0.96, RMSEA = 0.05) confirmed the explanatory power of TPB on acculturation. The effect of acculturation on psychological distress was mediated by sociocultural adaptation and acculturative stress. The results highlight the importance of sociocultural adaptation in the course of acculturation and confirm acculturation as an identifier of risk rather than a direct predictor of psychological distress. Practical implications for university counseling centers in facilitating better cultural adjustment among students with a different cultural background are suggested.
Mahar–Dalit–Buddhist
Authors: Paik Shailaja
Published: September 2011

By examining practices of naming, especially the recent adoption of a ‘Buddhist’ identity by middle-class Dalits in contemporary Maharashtra, this article analyses the multiple, shifting, and contested meanings of being Dalit. Examining the politics of this plurality shows the varied concerns at work in applying and contesting different names, especially the social and psychological challenges inherent in such acts of self-identification. By in-vestigating the ambiguities and ambivalences of being Dalit and Buddhist, the article demonstrates that the strategies of naming struggle against the burdens of a stigmatised past as well as the challenge of exclusion and inclusion vis-à-vis different Dalit castes.
A cell decomposition approach to visibility-based pursuit evasion among obstacles
Authors: Bhattacharya Sourabh , Hutchinson Seth
Published: September 2011

In this paper, we address the problem of surveillance in an environment with obstacles. We consider the problem in which a mobile observer attempts to maintain visual contact with a target as it moves through an environment containing obstacles. This surveillance problem is a variation of traditional pursuit–evasion games, with the additional condition that the pursuer immediately loses the game if at any time it loses sight of the evader. We analyze this tracking problem as a game of kind. We use the method of explicit policy to compute guaranteed strategies for surveillance for the observer in an environment containing a single corner. These strategies depend on the initial positions of the observer and the target in the workspace. Based on these strategies a partition of the visibility polygon of the players is constructed. The partitions have been constructed for varying speeds of the observer and the target. Using these partitions we provide a sufficient condition for escape of a target in a general environment containing polygonal obstacles. Moreover, for a given initial target position, we provide a polynomial-time algorithm that constructs a convex polygonal region that provides an upper-bound for the set of initial observer positions from which it does not lose the game. We extend our results to the case of arbitrary convex obstacles with differentiable boundaries. We also present a sufficient condition for tracking and provide a lower-bound on the region around the initial position of the target from which the observer can track the target. Finally, we provide an upper bound on the area of the region in which the outcome of the game is unknown.
New daily persistent headache: Should migrainous features be incorporated?
Authors: Peng Kuan-Po , Fuh Jong-Ling , Yuan Hsiang-Kuo , Shia Ben-Chang , Wang Shuu-Jiun
Published: September 2011

Introduction: International Classification of Headache Disorders (ICHD-2) criteria for new daily persistent headache (NDPH) require tension-type headache features. Many patients with ‘new-onset persistent’ headache fail to fulfil such criteria due to prominent migrainous features.

Subjects and methods: We reviewed all NDPH patients in our headache clinic, using the definition of persistent headache < 3 days after onset for > 3 months. The patients were dichotomised: patients meeting ICHD-2 criteria (NDPH-S) and patients failing to meet ICHD-2 criteria due to prominent migrainous features (NDPH-M). All patients had completed a structured intake form including demographics, headache profiles, Beck Depression Inventory (BDI), Short Form 36 (SF-36) Health Survey, and Migraine Disability Assessment (MIDAS). A telephone interview was conducted for follow-up.

Results: A total of 92 NDPH patients were enrolled (59 (64.1%) NDPH-M, 33 (35.9%) NDPH-S). Between the two subgroups, the sociodemographics were indistinguishable, but the patients with NDPH-M had higher headache intensity, BDI scores, MIDAS scores, and lower scores of most SF-36 subscales. After an average of 2 years of follow-up, 57 (66%) had a good outcome (≥ 50% reduction in headache frequency). Cox proportional analysis showed that disease duration ≤ 6 months and NDPH-S diagnosis predicted good outcomes.

Conclusion: Migrainous features were common in patients with NDPH. Unlike prior studies, our study showed NDPH-M represented a more severe subgroup with a poorer outcome compared with NDPH-S.