bluuebunny/crossref_metadata_2025 huggingface dataset:
The Grandmother Effect
Authors: Lachmann Peter J.
Published: March 2011

Two classes of explanation have been advanced to explain women’s long post-menopausal life span – that it is an epiphenomenon of increased longevity or an evolved adaptation. While there is no decisive evidence to choose between them, the latter appears more likely. Two mechanisms for the evolved adaptation have been proposed, the ‘mother effect’ and the ‘grandmother effect’. It is argued that both these effects, insofar as they have been shown to occur, are likely to be culturally rather than genetically evolved.
A Novel TGFBI Phenotype with Amyloid Deposits and Arg124Leu Mutation
Authors: Paliwal Preeti , Gupta Jaya , Tandon Radhika , Kashyap Seema , Sen Seema , Agarwal Aditi , Bakshi Ramendra , Sharma Arundhati
Published: March 2011

Aim: To report a unique transforming-growth-factor-β-induced (TGFBI) gene phenotype with Arg124Leu mutation in an Indian family. Methods: A family with 5 affected members presented to our hospital and were clinically diagnosed as suffering from Bowman layer dystrophy after examination. Peripheral blood samples were collected in EDTA from all for genomic DNA isolation. Keratoplasty was performed in 2 patients followed by histopathological evaluation of the cornea. DNA was subjected to PCR amplification of TGFBI and tumor-associated calcium signal transducer 2 (TACSTD2) genes followed by direct sequencing of all coding exons to identify the causative mutations. Results: Slitlamp examination of the cornea revealed superficial reticular opacities with diffuse anterior stromal haze suggestive of Bowman layer dystrophy but histopathological examination revealed the presence of both hyaline and amyloid deposits in the cornea. TGFBI sequencing revealed a heterozygous mutation, Arg124Leu (c.418 G→T) in all the affected members while TACSTD2 did not show any changes. Conclusions: Molecular analysis established the diagnosis of a novel TGFBI variant with Arg124Leu mutation. The presence of lattice- like lines clinically and histopathological demonstration of both amyloid and hyaline deposits with the occurrence of Arg124Leu mutation in all the affected family members are an unusual phenomenon and are here described for the first time.
Theory of Mind Deficits following Acute Alcohol Intoxication
Authors: Mitchell I.J. , Beck S.R. , Boyal A. , Edwards V.R.
Published: March 2011

Acute alcohol consumption is associated with socially inappropriate behaviour. Such behaviour could in part reflect the potential of alcohol to interfere with social cognition. In this experiment we tested the hypothesis that acute alcohol consumption by regular heavy social drinking young adults would compromise an aspect of social cognition, namely theory of mind (understanding intentions, emotions and beliefs). Participants who had consumed 6–8 units of alcohol showed specific impairments on two theory of mind tests: identification of faux pas and emotion recognition. This result suggests that alcohol consumption could lead to social problems secondary to difficulties in interpreting the behaviour of others due to theory of mind impairments.
Macular Dysfunction in Oguchi Disease with the Frequent Mutation 1147delA in the SAG Gene
Authors: Hayashi Takaaki , Tsuzuranuki Satoshi , Kozaki Kenichi , Urashima Mitsuyoshi , Tsuneoka Hiroshi
Published: March 2011

Aim/Background: A 1-bp deletion (1147delA) in the SAG (also known as arrestin or S-antigen) gene is the most frequently seen mutation in Japanese patients suffering from Oguchi disease, a recessively inherited stationary night blindness. We investigated macular function in a patient with Oguchi disease with the 1147delA mutation. Methods: A 43-year-old Japanese male patient was diagnosed with Oguchi disease. The patient underwent complete ophthalmic examinations, including spectral-domain optical coherence tomography and Humphrey visual field testing. Full-field electroretinograms (ff-ERG) and multifocal ERG (mf-ERG) were recorded. Mutational analysis of the SAG gene was performed. Results: Corrected visual acuity was good in both eyes. Funduscopy showed retinal pigment epithelium atrophy along the vascular arcade bilaterally. The inner segment-outer segment (ISOS) boundary lines were preserved in the foveal and parafoveal areas, whereas ISOS boundary defects and thinning of the outer nuclear layer (ONL) were seen outside the preserved ISOS boundary. Humphrey testing showed significant paracentral field defects in both eyes. In addition to an absence of rod responses, cone and 30-Hz flicker responses were markedly reduced in ff-ERG. The central (ring 1) and paracentral (ring 2) responses with normal latencies were relatively preserved, but the outer waveforms (rings 3–5) were attenuated and prolonged in mf-ERG. The deletion mutation (1147delA) was identified homozygously. Conclusions: The reduced/delayed mf-ERG responses and visual field defects in paracentral macula areas are most likely to be correlated with ISOS boundary defects and thinning of the ONL. Macular dysfunction can occur in Oguchi disease with the 1147delA mutation in the SAG gene.
Incremental Prognostic Significance of Combined Cardiac Magnetic Resonance Imaging, Adenosine Stress Perfusion, Delayed Enhancement, and Left Ventricular Function Over Preimaging Information for the Prediction of Adverse Events
Authors: Bingham Scott E. , Hachamovitch Rory
Published: March 2011

Background—

Although cardiac magnetic resonance imaging (CMR) is capable of yielding extensive data in routine practice, the relative incremental prognostic value of adenosine stress perfusion, myocardial delayed enhancement (DE), and left ventricular volumes and function is unclear.

Methods and Results—

We followed up 908 consecutive patients who underwent combined CMR for suspicion of coronary stenosis and/or ischemia at 2.6±1.2 years, during which 101 total cardiac events occurred (all-cause death, myocardial infarction, or late revascularization). Increase in Cox proportional-hazards model global χ
2
(χ
2
) with the addition of CMR data after adjustment for clinical data defined incremental prognostic value. Cardiac magnetic resonance imaging without abnormalities had a 2.4% event rate per year (<1% cardiac death or myocardial infarction). Abnormal CMR was associated with event rates of 5.6% to 7.0% per year, varying with which and how many components were abnormal. After adjusting for the pre-CMR data (age, dyspnea, prior coronary artery disease, resting heart rate, renal disease, and diabetes mellitus, χ
2
:43.6,
P
<0.0001; C index 0.695), the addition of left ventricular ejection fraction, aortic flow, delayed enhancement, and stress perfusion data all incrementally increased χ
2
(55.2, 63.3, 68.0, and 68.9, respectively; all
P
<0.00001; C indices 0.717, 0.722, 0.747, and 0.736). The number of abnormal CMR domains both added incremental prognostic value and risk stratified patients with respect to risk of events.

Conclusions—

CMR analysis of ventricular volume, aortic flow, myocardial viability, and stress perfusion all add incremental value for prediction of adverse events over pre-CMR data and can be combined to further enhance prognostication. Normal combined CMR confers a low risk of subsequent cardiac events.
On T2* Magnetic Resonance and Cardiac Iron
Authors: Carpenter John-Paul , He Taigang , Kirk Paul , Roughton Michael , Anderson Lisa J. , de Noronha Sofia V. , Sheppard Mary N. , Porter John B. , Walker J. Malcolm , Wood John C. , Galanello Renzo , Forni Gianluca , Catani Gualtiero , Matta Gildo , Fucharoen Suthat , Fleming Adam , House Michael J. , Black Greg , Firmin David N. , St. Pierre Timothy G. , Pennell Dudley J.
Published: March 2011

Background—

Measurement of myocardial iron is key to the clinical management of patients at risk of siderotic cardiomyopathy. The cardiovascular magnetic resonance relaxation parameter R2* (assessed clinically via its reciprocal, T2*) measured in the ventricular septum is used to assess cardiac iron, but iron calibration and distribution data in humans are limited.

Methods and Results—

Twelve human hearts were studied from transfusion-dependent patients after either death (heart failure, n=7; stroke, n=1) or transplantation for end-stage heart failure (n=4). After cardiovascular magnetic resonance R2* measurement, tissue iron concentration was measured in multiple samples of each heart with inductively coupled plasma atomic emission spectroscopy. Iron distribution throughout the heart showed no systematic variation between segments, but epicardial iron concentration was higher than in the endocardium. The mean±SD global myocardial iron causing severe heart failure in 10 patients was 5.98±2.42 mg/g dry weight (range, 3.19 to 9.50 mg/g), but in 1 outlier case of heart failure was 25.9 mg/g dry weight. Myocardial ln[R2*] was strongly linearly correlated with ln[Fe] (
R
2
=0.910,
P
<0.001), leading to [Fe]=45.0×(T2*)
−1.22
for the clinical calibration equation with [Fe] in milligrams per gram dry weight and T2* in milliseconds. Midventricular septal iron concentration and R2* were both highly representative of mean global myocardial iron.

Conclusions—

These data detail the iron distribution throughout the heart in iron overload and provide calibration in humans for cardiovascular magnetic resonance R2* against myocardial iron concentration. The iron values are of considerable interest in terms of the level of cardiac iron associated with iron-related death and indicate that the heart is more sensitive to iron loading than the liver. The results also validate the current clinical practice of monitoring cardiac iron in vivo by cardiovascular magnetic resonance of the midseptum.
Absolute and Attributable Risks of Atrial Fibrillation in Relation to Optimal and Borderline Risk Factors
Authors: Huxley Rachel R. , Lopez Faye L. , Folsom Aaron R. , Agarwal Sunil K. , Loehr Laura R. , Soliman Elsayed Z. , Maclehose Rich , Konety Suma , Alonso Alvaro
Published: March 2011

Background—

Atrial fibrillation (AF) is an important risk factor for stroke and overall mortality, but information about the preventable burden of AF is lacking. The aim of this study was to determine what proportion of the burden of AF in blacks and whites could theoretically be avoided by the maintenance of an optimal risk profile.

Methods and Results—

This study included 14 598 middle-aged Atherosclerosis Risk in Communities (ARIC) Study cohort members. Previously established AF risk factors, namely high blood pressure, elevated body mass index, diabetes mellitus, cigarette smoking, and prior cardiac disease, were categorized into optimal, borderline, and elevated levels. On the basis of their risk factor levels, individuals were classified into 1 of these 3 groups. The population-attributable fraction of AF resulting from having a nonoptimal risk profile was estimated separately for black and white men and women. During a mean follow-up of 17.1 years, 1520 cases of incident AF were identified. The age-adjusted incidence rates were highest in white men and lowest in black women (7.45 and 3.67 per 1000 person-years, respectively). The overall prevalence of an optimal risk profile was 5.4% but varied according to race and gender: 10% in white women versus 1.6% in black men. Overall, 56.5% of AF cases could be explained by having ≥1 borderline or elevated risk factors, of which elevated blood pressure was the most important contributor.

Conclusion—

As with other forms of cardiovascular disease, more than half of the AF burden is potentially avoidable through the optimization of cardiovascular risk factors levels.
Impact of Remote Telemedical Management on Mortality and Hospitalizations in Ambulatory Patients With Chronic Heart Failure
Authors: Koehler Friedrich , Winkler Sebastian , Schieber Michael , Sechtem Udo , Stangl Karl , Böhm Michael , Boll Herbert , Baumann Gert , Honold Marcus , Koehler Kerstin , Gelbrich Goetz , Kirwan Bridget-Anne , Anker Stefan D.
Published: March 2011

Background—

This study was designed to determine whether physician-led remote telemedical management (RTM) compared with usual care would result in reduced mortality in ambulatory patients with chronic heart failure (HF).

Methods and Results—

We enrolled 710 stable chronic HF patients in New York Heart Association functional class II or III with a left ventricular ejection fraction ≤35% and a history of HF decompensation within the previous 2 years or with a left ventricular ejection fraction ≤25%. Patients were randomly assigned (1:1) to RTM or usual care. Remote telemedical management used portable devices for ECG, blood pressure, and body weight measurements connected to a personal digital assistant that sent automated encrypted transmission via cell phones to the telemedical centers. The primary end point was death from any cause. The first secondary end point was a composite of cardiovascular death and hospitalization for HF. Baseline characteristics were similar between the RTM (n=354) and control (n=356) groups. Of the patients assigned to RTM, 287 (81%) were at least 70% compliant with daily data transfers and no break for >30 days (except during hospitalizations). The median follow-up was 26 months (minimum 12), and was 99.9% complete. Compared with usual care, RTM had no significant effect on all-cause mortality (hazard ratio, 0.97; 95% confidence interval, 0.67 to 1.41;
P
=0.87) or on cardiovascular death or HF hospitalization (hazard ratio, 0.89; 95% confidence interval, 0.67 to 1.19;
P
=0.44).

Conclusions—

In ambulatory patients with chronic HF, RTM compared with usual care was not associated with a reduction in all-cause mortality.

Clinical Trial Registration:—

URL:
http://www.ClinicalTrials.gov
. Unique identifier: NCT00543881.
Clinical Features of 8295 Patients With Resistant Hypertension Classified on the Basis of Ambulatory Blood Pressure Monitoring
Authors: de la Sierra Alejandro , Segura Julián , Banegas José R. , Gorostidi Manuel , de la Cruz Juan J. , Armario Pedro , Oliveras Anna , Ruilope Luis M.
Published: March 2011

We aimed to estimate the prevalence of resistant hypertension through both office and ambulatory blood pressure monitoring in a large cohort of treated hypertensive patients from the Spanish Ambulatory Blood Pressure Monitoring Registry. In addition, we also compared clinical features of patients with true or white-coat–resistant hypertension. In December 2009, we identified 68 045 treated patients with complete information for this analysis. Among them, 8295 (12.2% of the database) had resistant hypertension (office blood pressure ≥140 and/or 90 mm Hg while being treated with ≥3 antihypertensive drugs, 1 of them being a diuretic). After ambulatory blood pressure monitoring, 62.5% of patients were classified as true resistant hypertensives, the remaining 37.5% having white-coat resistance. The former group was younger, more frequently men, with a longer duration of hypertension and a worse cardiovascular risk profile. The group included larger proportions of smokers, diabetics, target organ damage (including left ventricular hypertrophy, impaired renal function, and microalbuminuria), and documented cardiovascular disease. Moreover, true resistant hypertensives exhibited in a greater proportion a riser pattern (22% versus 18%;
P
<0.001). In conclusion, this study first reports the prevalence of resistant hypertension in a large cohort of patients in usual daily practice. Resistant hypertension is present in 12% of the treated hypertensive population, but among them more than one third have normal ambulatory blood pressure. A worse risk profile is associated with true resistant hypertension, but this association is weak, thus making it necessary to assess ambulatory blood pressure monitoring for a correct diagnosis and management.
Application of Cluster Analysis to Climate Model Performance Metrics
Authors: Yokoi Satoru , Takayabu Yukari N. , Nishii Kazuaki , Nakamura Hisashi , Endo Hirokazu , Ichikawa Hiroki , Inoue Tomoshige , Kimoto Masahide , Kosaka Yu , Miyasaka Takafumi , Oshima Kazuhiro , Sato Naoki , Tsushima Yoko , Watanabe Masahiro
Published: March 2011

The overall performance of general circulation models is often investigated on the basis of the synthesis of a number of scalar performance metrics of individual models that measure the reproducibility of diverse aspects of the climate. Because of physical and dynamic constraints governing the climate, a model’s performance in simulating a certain aspect of the climate is sometimes related closely to that in simulating another aspect, which results in significant intermodel correlation between performance metrics. Numerous metrics and intermodel correlations may cause a problem in understanding the evaluation and synthesizing the metrics. One possible way to alleviate this problem is to group the correlated metrics beforehand. This study attempts to use simple cluster analysis to group 43 performance metrics. Two clustering methods, the K-means and the Ward methods, yield considerably similar clustering results, and several aspects of the results are found to be physically and dynamically reasonable. Furthermore, the intermodel correlation between the cluster averages is considerably lower than that between the metrics. These results suggest that the cluster analysis is helpful in obtaining the appropriate grouping. Applications of the clustering results are also discussed.
Interannual Changes of Stratospheric Temperature and Ozone: Forcing by Anomalous Wave Driving and the QBO
Authors: Salby Murry L.
Published: March 2011

A 3D model of dynamics and photochemistry is used to investigate interannual changes of stratospheric dynamical and chemical structure through their dependence on tropospheric planetary waves and on the quasi-biennial oscillation (QBO). The integrations reproduce the salient features of the climate sensitivities of temperature and ozone, which have been composited from the observed records of ECMWF and the Total Ozone Mapping Spectrometer (TOMS). Characterized by a strong anomaly of one sign at polar latitudes and a comparatively weak anomaly of opposite sign at subpolar latitudes, each bears the signature of the residual mean circulation. The structure is very similar to that associated with the Arctic Oscillation.

The integrations imply that, jointly, anomalous Eliassen–Palm (EP) flux transmitted from the troposphere by planetary waves and the QBO are the major mechanisms behind interannual changes in the stratosphere. An analogous conclusion follows from the observational record. During early winter, anomalous temperature and ozone are accounted for almost entirely by anomalous EP flux from the troposphere, as they are in the observational record. During late winter, both mechanisms are required to reproduce observed anomalies. Although the QBO forces anomalous structure equatorward of 40°N, the strong anomaly over the Arctic follows principally from anomalous upward EP flux. Reflecting anomalous wave driving of residual mean motion, the change of EP flux leads to anomalous downwelling of ozone-rich air. In concert with isentropic mixing by planetary waves, the anomalous enrichment that ensues at extratropical latitudes sharply modifies total ozone over the Arctic. Integrations distinguished by the omission of heterogeneous processes indicate that chemical destruction accounts for approximately 20% of the anomaly in Arctic ozone between warm and cold winters. Analogous to estimates derived from the observed record of the Solar Backscatter Ultraviolet, version 8 (SBUV-V8) instrument, the remaining approximately 80% follows from anomalous transport.

The climate sensitivities of temperature and ozone describe random changes between years, introduced by anomalous EP flux and the QBO. Those interannual changes evolve with a particular seasonality. Like their structure, the seasonal dependence of anomalous temperature and ozone bears the signature of the residual mean circulation. Systematic changes in the observed record, which comprise stratospheric trends, have similar structure and seasonality.
Spatial Statistics of the Sea Surface in Fetch-Limited Conditions
Authors: Romero Leonel , Melville W. Kendall
Published: March 2011

An analysis of airborne wave observations collected in the Gulf of Tehuantepec is presented. The data include lidar measurements of the surface displacement as a function of two horizontal dimensions in fetch-limited conditions, with fetches between 20 and 500 km and winds between 10 and 20 m s−1. The spatial data have an advantage over the commonly used single-point time series measurements, allowing direct estimates of the wavelength and wave slope, including spatial information such as the lengths of crests exceeding various thresholds. This study presents an analysis of several statistical wind wave parameters, including the joint probability distribution function (pdf) of wave amplitudes and wavelengths; the pdf of wave heights, wavenumber vectors, and wave slopes; as well as the statistics of the lengths of crests exceeding threshold wave heights and slopes. The empirical findings from the lidar data are compared against analytical theories in the literature, including some that had not been tested previously with field data such as the work by M. S. Longuet-Higgins describing the length of contours surrounding large wave heights per unit surface area. The effect of second-order nonlinearities on the distribution of crest lengths per unit surface area is investigated with analytical approximations and stochastic numerical simulations from computed directional wavenumber spectra. The results show that second-order nonlinearities can increase the crest-length distribution of large waves by a factor of 2 or more.
Contradiction and Sensemaking in Acquisition Integration
Authors: Chreim Samia , Tafaghod Marzieh
Published: March 2011

The authors draw on research on acquisitions and on newcomer adjustment to analyze acquired managers’ sensemaking experiences. They pursue three interrelated objectives: how acquired managers, as newcomers, make sense of role changes; how these managers’ frames contrast with new frames encountered at the acquirer; how relationships with acquiring managers influence adjustment to new roles and frames. The authors report on a study of three acquisitions of small firms by a large, bureaucratic, serial acquirer. Findings showed contraction of the managerial role—and the resulting reconfigured role identity—created tensions emanating from managing familiar situations under new frames. Relationships with acquiring managers—a potential source of informational, material, political, and social resources—played a role in mitigating or amplifying the challenges experienced. Comparison of acquired and acquiring managers’ frames showed that absorption of small firms by large, serial acquirers creates in organizations heterogeneous sensemaking spaces characterized by contradiction.
From High School to College: The Transition Experiences of Black and White Students
Authors: Pidi Zhang  , Smith William L.
Published: March 2011

Based on a quantitative study of students at a midsize public university in the Southeast and informed by Astin’s input-environment-outcome model, this article explores how the transition experiences of Black students differed from those of White students. Black students relied more on guidance counselors in high school and orientation programs in college. Although the academic ethic was strongly related to grade point average (GPA) and a substantially larger proportion of Black females had a strong academic ethic, their GPAs were not different from those of Black males and were significantly lower than those of both White females and White males. The analysis found an inflated perception of the amount of help parents provided in the transition.
Integrating Diversity Into Graduate Social Work Education
Authors: Bowie Stan L. , Hall J. Camille , Johnson Oliver J.
Published: March 2011

The study surveyed a national sample of 100 African American master of social work graduates to retroactively assess perceived diversity content in Human Behavior courses before and after the Council on Social Work Education (CSWE) established accreditation standards on diversity. Seventy-one percent of the respondents were females, the mean age was 45.8 years, and their graduation years ranged from 1958 to 2002. Most graduated from northeastern schools (34%), followed by midwestern (28%), southeastern (22%), northwestern (11%), and southwestern (5%) schools. Investigators used the Preparation for Graduate Education Social Work Education Scale and the Human Behavior Survey Addendum (alpha = .97). There were no statistically significant differences on diversity content scores for participants enrolled before and after CSWE diversity standards were established, but graduates of historically Black colleges gave higher diversity content scores in every area. Study includes discussion and implications for Afrocentric theory and the need to prepare practitioners for future social work careers in multicultural communities.
Bearing the unbearable: Trauma, gospel and pastoral care
Authors: Hunsinger Deborah van Deusen
Published: March 2011

This paper examines trauma in light of the gospel of Jesus Christ. Given the profound and long-lasting suffering caused by trauma, how is it to be borne? Moreover, how do those in the helping professions bear the vicarious pain of listening empathically to the cries of the traumatized? Professor Hunsinger first examines trauma and details its psychological effects. Then she describes a process by which one can break out of the vicious cycle of trauma’s impact. Finally, she places trauma in theological context, by claiming that all that is truly unbearable in this world can be borne only because Jesus Christ has already borne the full weight of sin and death on our behalf and for our sakes. The anguish of human trauma is endured as we mediate the love of God by providing a relational home for one another, a place where God’s compassion is attested, prayers of lament are offered, and the worship of the people of God sustains us in hope.
Common word, common ground: the love commandments and the understanding of god
Authors: Ferguson Duncan S.
Published: March 2011

A letter was sent on October 13, 2007 by Muslim leaders to Christian leaders to join with them in affirming and practicing the two love commandments: to love God with our whole being and our neighbor as ourselves. “A Common Word Between Us and You” has been widely circulated and well received by the Christian community. There have been several thoughtful responses, including ones from the Vatican and from ecumenical bodies. The article speaks to the centrality of love in both religious traditions and addresses two doctrines within the Christian faith that need further discussion—the trinity and christology—arguing that these two articles of faith are central to the Christian understanding of love and may be understood in ways that do not radically differ from the teaching of Islam on the unity of the one God. The article also suggests ways to continue the dialogue and to practice jointly the love commandments.
Why theology needs disability
Authors: Basselin Tim
Published: March 2011

This article explores the emerging field of theology and disability studies, beginning with an introduction to disability studies before moving on to consider what significance a disability perspective may have for theology. The author argues that in the same way disability studies critiques cultural ideals of autonomy and self-sufficiency it can likewise critique theology’s participation in these cultural ideals. Using the theological term “image of Christ” and a case study of the L’Arche communities, the author shows in particular how relationality, and not autonomy, more rightly defines what it means to be human.
Pathophysiology of medication overuse headache: Insights and hypotheses from preclinical studies
Authors: Meng Ian D , Dodick David , Ossipov Michael H , Porreca Frank
Published: March 2011

Introduction: Medication overuse headache (MOH) is a clinical concern in the management of migraine headache. MOH arises from the frequent use of medications used for the treatment of a primary headache. Medications that can cause MOH include opioid analgesics as well as formulations designed for the treatment of migraine, such as triptans, ergot alkaloids, or drug combinations that include caffeine and barbiturates.

Literature review: Gathering evidence indicates that migraine patients are more susceptible to development of MOH, and that prolonged use of these medications increases the prognosis for development of chronic migraine, leading to the suggestion that similar underlying mechanisms may drive both migraine headache and MOH. In this review, we examine the link between several mechanisms that have been linked to migraine headache and a potential role in MOH. For example, cortical spreading depression (CSD), associated with migraine development, is increased in frequency with prolonged use of topiramate or paracetamol.

Conclusions: Increased CGRP levels in the blood have been linked to migraine and elevated CGRP can be casued by prolonged sumatriptan exposure. Possible mechanisms that may be common to both migraine and MOH include increased endogenous facilitation of pain and/or diminished diminished endogenous pain inhibition. Neuroanatomical pathways mediating these effects are examined.
Cerebrospinal fluid hypocretin-1 levels during the active period of cluster headache
Authors: Cevoli Sabina , Pizza Fabio , Grimaldi Daniela , Nicodemo Marianna , Favoni Valentina , Pierangeli Giulia , Valko Philipp O , Baumann Christian R , Montagna Pasquale , Bassetti Claudio L , Cortelli Pietro
Published: March 2011

Background: Hypocretins (orexins) are hypothalamic neuropeptides which are involved in a wide range of physiological processes in mammals including central pain processing. Genetic studies in humans evidenced a role for the hypocretinergic system in cluster headache (CH).

Patients and methods: We tested cerebrospinal fluid (CSF) hypocretin-1 (orexin-A) levels in 10 CH patients during an active cluster period. CSF hypocretin-1 levels were measured by radioimmunoassay.

Results: CSF hypocretin-1 levels were within the normal range (mean 457.3 ± 104.98 pg/ml, range 304–639) in our 10 patients, with a slight reduction in one case (304 pg/ml). There were no associations between CSF hypocretin-1 levels and the clinical features of CH. A trend towards higher hypocretin-1 levels was disclosed in patients with chronic CH compared to episodic CH.

Conclusions: CSF hypocretin-1 levels seem not to influence the clinical course of CH, but our results cannot completely exclude a functional involvement of the hypothalamic hypocretinergic system in the pathogenesis of CH.
Neoliberalism and Postmodern Cultures of Aging
Authors: Polivka Larry
Published: March 2011

Chuck Longino and this author began writing together about the benefits and risks of a postmodern perspective on the aging experience more than 9 years ago. Chuck Longino and this author contrasted a progressive strand of postmodernism based on the blended values of individual empowerment and collective responsibility for economic security with a neoliberal strand based on individualism and the free market as the ultimate arbiter of value, arguing that neoliberal postmodernism threatened the economic and psychological security of older people. Here the author summarizes the previous arguments by Chuck Longino and himself, then comment on events that have occurred since their last published collaboration, especially the collapse of the neoliberal economic model.
Protective effects of omega-3 essential fatty acids against formaldehyde-induced cerebellar damage in rats
Authors: Zararsiz Ismail , Meydan Sedat , Sarsilmaz Mustafa , Songur Ahmet , Ozen Oguz Aslan , Sogut Sadik
Published: March 2011

This study aimed to investigate changes in the cerebellum of formaldehyde-exposed rats and the effects of omega-3 fatty acids on these changes. The study involved 21 male Wistar-Albino rats which were divided into three groups. The rats in Group I comprised the control group. The rats in Group II were injected with intraperitoneal 10% formaldehyde every other day. The rats in Group III received omega-3 fatty acids daily while exposed to formaldehyde. At the end of the 14-day experimental period, all rats were killed by decapitation and the cerebellum removed. The activities of catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), xanthine oxidase (XO), and malondialdehyde (MDA) levels were determined in cerebellum specimens by using spectrophotometric methods. In our study, levels of SOD and CAT were significantly decreased, and GSH-Px, XO, MDA levels were significantly increased in rats treated with formaldehyde compared with those of the controls. Whereas, it was seen that there was an increase in SOD and CAT enzyme activities and decrease in MDA, XO, and GSH-Px levels in rats administered to omega-3 fatty acids with exposure of formaldehyde. It was determined that exposure of formaldehyde increased free radicals in cerebellum of rats and this increase was prevented by administration of omega-3 fatty acids.
Nutritional and Dietary Aspects of Celiac Disease
Authors: García‐Manzanares Álvaro , Lucendo Alfredo J.
Published: March 2011

Celiac disease (CD) is a primarily digestive systemic disease triggered and maintained by the ingestion of gluten in the diet. Its has a wide clinical spectrum of manifestations, particularly varied in adult patients, in whom, because of their frequent negative serology and mild, nonspecific symptoms, there is a considerable delay in diagnosis. The intestinal lesion caused by CD leads to various deficiencies of nutrients, vitamins, and dietary minerals, with ferropenia, vitamin B12, folic acid, and fat‐soluble vitamin deficiencies being especially frequent. The deficiencies, together with dairy intolerance, cause low bone density and an increased risk of fractures. Treatment using a gluten‐free diet (GFD) does involve certain complications, since gluten is found in up to 70% of manufactured food products and manufacturing regulations are not standard in all countries. In addition, certain nutrient deficiencies require specific management. This article reviews the nutritional aspects of CD and provides practical guidelines to correct these deficiencies and to ensure optimum GFD compliance. (Nutr Clin Pract. 2011;26:163–173)
Low‐Residue Diet in Diverticular Disease: Putting an End to a Myth
Authors: Tarleton Sherry , DiBaise John K.
Published: March 2011

Residue refers to any indigestible food substance that remains in the intestinal tract and contributes to stool bulk. Historically, low‐residue diets have been recommended for diverticulosis because of a concern that indigestible nuts, seeds, corn, and popcorn could enter, block, or irritate a diverticulum and result in diverticulitis and possibly increase the risk of perforation. To date, there is no evidence supporting such a practice. In contrast, dietary fiber supplementation has been advocated to prevent diverticula formation and recurrence of symptomatic diverticulosis, although this is based mostly on low‐quality observational studies. This report focuses on the evidence that fiber intake may be beneficial in the prevention and recurrence of symptomatic and complicated diverticular disease and provides recommendations regarding fiber supplementation in individuals with diverticulosis. (Nutr Clin Pract. 2011;26:137–142)
Nutrition Assessment as a Predictor of Clinical Outcomes for Infants With Cardiac Surgery: Using the Prognostic Nutritional Index
Authors: Wakita Maki , Fukatsu Akiko , Amagai Teruyoshi
Published: March 2011

Background: The aim of the present study was to determine whether nutrition assessment helps predict clinical outcomes (COs) in infants who have undergone cardiac surgery. Methods: Study subjects were infants, aged less than 18 months, who had undergone cardiac surgery between April 2007 and August 2008. The nutrition parameters assessed include Onodera's prognostic nutritional index (PNI), height for age, weight for height, and weight for age. COs included mortality rate during hospitalization, length of stay in intensive care unit (LOS‐1), length of stay in the hospital after surgery (LOS‐2), and duration of mechanical ventilation support. Method‐1: the correlation between nutrition parameters and COs was examined by statistical analysis. Method‐2: the cutoff point of nutrition parameters was determined using the minimum P value approach. Results: The following results were obtained: Results‐1: PNI was the only nutrition parameter found to be correlated with LOS‐1. Results‐2: the cutoff point for PNI as a predictor of LOS‐1 was 55. Conclusions: It appeared that preoperative PNI was the most influential factor on LOS‐1 for infants after they underwent cardiac surgery. The PNI cutoff point 55 in infants who underwent cardiac surgery seems to be the best predictor of CO. (Nutr Clin Pract. 2011;26:192–198)
Erythromycin to Promote Bedside Placement of a Self‐Propelled Nasojejunal Feeding Tube in Non—Critically Ill Patients Having Pancreatitis: A Randomized, Double‐Blind, Placebo‐Controlled Study
Authors: van den Bosch Sven , Witteman Ellen , Kho YuHan , Tan Adriaan C. I. T. L.
Published: March 2011

Background: Postpyloric enteral feeding often requires endoscopic or fluoroscopic placement of a feeding tube. Self‐propelled feeding tubes are designed to facilitate spontaneous migration into the jejunum. This study aimed to assess the rate of success and time to migrate a self‐propelled feeding tube to jejunal position using erythromycin, a prokinetic agent. Methods: Non‐critically ill patients with pancreatitis who required jejunal enteral feeding were included. A self‐propelled nasoenteric feeding tube was placed into the stomach using either placebo or erythromycin. At 24 and 48 hours after initial placement, an abdominal x‐ray was taken to determine the position of the tube. Results: Forty subjects were included and randomized. After 48 hours, there was no difference in the rates of success between placebo 56% (9/16) and erythromycin 50% (10/20) (P = .71). Conclusions: Self‐propelled feeding tubes migrated into the jejunum in 53% of the subjects within 48 hours. However, this study failed to determine any benefit of erythromycin in terms of success or time to migrate to jejunal position using a self‐propelled feeding tube. Selection of subjects without impaired motility and tachyphylaxis may have contributed to clinical failure of erythromycin as a prokinetic agent in this study. (Nutr Clin Pract. 2011;26:181–185)
Postgastrectomy Nutrition
Authors: Rogers Christie
Published: March 2011

Gastric resection, whether partial or total gastrectomy, often results in nutrition‐related complications including weight loss, diet intolerances, and micronutrient deficiencies. The physiology of normal and postgastrectomy digestion is the basis for most of the current diet recommendations after gastric surgery. A careful review reveals that there is not sufficient literature to support a standard postgastrectomy diet. Rather, individualized diet manipulation for symptom relief is recommended. This review highlights the physiology behind common postgastrectomy complications, provides guidelines for the medical and nutrition management of these complications, and presents a basic approach to postgastrectomy gastrointestinal symptoms.
Low‐Protein Diets for Hepatic Encephalopathy Debunked: Let Them Eat Steak
Authors: Cabral Chad Michael , Burns David L.
Published: March 2011

Hepatic encephalopathy (HE) is an incompletely understood phenomenon and serves as a poor prognosis in patients with cirrhosis. Confusion from HE can affect the ability to eat adequately. Despite the prevalence of malnutrition in cirrhotic patients in the 1950s, it was reported that bouts of overt HE were controlled with low protein intake. This largely uncontrolled observation led to restriction of protein intake in cirrhotic patients with or without HE and was an accepted standard of care for many decades to follow. Published in 2004, the pivotal article “Normal Protein Diet for Episodic Hepatic Encephalopathy: Results of a Randomized Study” by Cordoba and colleagues was the first controlled study randomizing cirrhotic patients with HE to receive different amounts of dietary protein. At the completion of the study, the authors concluded that a normal‐protein diet was safe and did not exacerbate HE. The Cordoba study suggests that low‐protein diets should be abandoned. In light of this evidence, nutrition guidelines have proposed that protein restriction should be avoided in patients with HE as protein requirements are increased in cirrhosis. Despite the advice of experts in the field, it has been shown in recent years that some physicians still believe that protein restriction is needed in patients with HE. This belief has not been substantiated in controlled studies, and societal recommendations have changed. There is no real evidence documenting the advantages of protein restriction in HE. On the contrary, Cordoba and colleagues’ article has shown that there are disadvantages to restricting protein in HE. (Nutr Clin Pract. 2011;26:155–159)
Comment On: Maintenance of Remission in Inflammatory Bowel Disease Using Omega‐3 Fatty Acids (Fish Oil): A Systematic Review and Meta‐Analyses
Authors: Mullin Gerard E.
Published: March 2011

The objective was to systematically review the efficacy and safety of n‐3 (omega‐3 fatty acids, fish oil) for maintaining remission in Crohn's disease (CD) and ulcerative colitis (UC). Electronic databases were searched systematically for randomized controlled trials of n‐3 for maintenance of remission in inflammatory bowel disease (IBD). Studies of patients of any age group who were in remission at the time of recruitment and were followed for at least 6 months were included. The primary outcome was relapse rate at the end of the follow‐up period. Nine studies were eligible for inclusion; six studies of CD (n = 1039) and three of UC (n = 138). There was a statistically significant benefit for n‐3 in CD (relative risk [RR] 0.77; 95% confidence interval [CI] 0.61–0.98); however, the studies were heterogeneous (I 2 = 58%). The absolute risk reduction was —0.14 (95% CI: ‐0.25 to ‐0.02). Opinions may vary on whether this is a clinically significant effect. Two well‐done studies with a larger sample size reported no benefit. A sensitivity analysis excluding a small pediatric study resulted in the pooled RR being no longer statistically significant. A funnel plot analysis suggested publication bias for the smaller studies. For UC, there was no difference in the relapse rate between the n‐3 and control groups (RR 1.02; 95% CI: 0.51–2.03). The pooled analysis showed a higher rate of diarrhea (RR 1.36; 95% CI: 1.01–1.84) and symptoms of the upper gastrointestinal tract (RR 1.96; 95% CI: 1.37–2.80) in the n‐3 treatment group. There are insufficient data to recommend the use of omega‐3 fatty acids for maintenance of remission in CD and UC. (Inflamm Bowel Dis. 2011;17:336–345)
Postoperative Diet Advancement: Surgical Dogma vs Evidence‐Based Medicine
Authors: Warren Jeremy , Bhalla Varun , Cresci Gail
Published: March 2011

Postoperative ileus is a natural part of recovery following abdominal and intestinal surgery. Research in the laboratory and clinical arenas has challenged the long‐held belief that enteral nutrition (EN) should not be administered until bowel function has resumed, which is typically judged by a subjective bowel function assessment. Traditional postoperative management begins with clinical monitoring of return of bowel function, followed by a clear liquid diet that is advanced to regular solid food as tolerated. Studies have consistently demonstrated that early EN is safe and well tolerated, showing a reduction in wound morbidity and healing, fewer septic complications, diminished weight loss, and improved protein kinetics in patients administered early EN. Barriers to early enteral feeding include fear of GI morbidity, anastomotic disruption or leak but have not been proven valid in clinical or experimental trials. A clear liquid diet is the most frequently ordered first postoperative meal regardless of early or delayed administration. Although generally well tolerated, this diet fails to provide adequate nutrients to the postsurgical patient. In contrast, advancement to a regular diet as the initial meal has been shown to be well tolerated and provides significantly more nutrients than a clear liquid diet. This article reviews basic GI physiology, including motility, nutrient absorption, and the changes that occur in regulation and function of the GI tract following surgery, as well as clinical data regarding postoperative GI function and diet advancement. This will be applied to the clinical practices of postoperative dietary advancement to discuss the timing and choice of initial feeding in the postoperative patient. (Nutr Clin Pract. 2011;26:115–125)
Comment On: Clinical Trial: Vitamin D3 Treatment in Crohn's Disease: A Randomized Double‐Blind Placebo‐Controlled Study
Authors: Mullin Gerard E.
Published: March 2011

Background: Vitamin D has immune‐regulatory functions in experimental colitis, and low vitamin D levels are present in Crohn's disease. Methods: We performed a randomized double‐blind placebo‐controlled trial to assess the benefits of oral vitamin D3 treatment in Crohn's disease. We included 108 patients with Crohn's disease in remission, of which fourteen were excluded later. Patients were randomized to receive either 1200 IU vitamin D3 (n = 46) or placebo (n = 48) once daily during 12 months. The primary endpoint was clinical relapse. Results: Oral vitamin D3 treatment with 1200 IU daily increased serum 25OHD from a mean of 69 nmol/L [standard deviation (s.d.) 31 nmol/L] to a mean of 96 nmol/L (s.d. 27 nmol/L) after 3 months (P < 0.001). The relapse rate was lower among patients treated with vitamin D3 (6/46 or 13%) among patients treated with placebo (14/48 or 29%), (P = 0.06). Conclusions: Oral supplementation with 1200 IE vitamin D3 significantly increased serum vitamin D levels and insignificantly reduced the risk of relapse from 29% to 13%, (P = 0.06). Given that vitamin D3 treatment might be effective in Crohn's disease, larger studies are required in order to elucidate this matter further. (Aliment Pharmacol Ther 2010;32:377–383.)
Carboxylic polyurethane/organoclay nanocomposites and their properties
Authors: Melinte Violeta , Buruiana Tinca , Mihai Aura , Buruiana Emil C.
Published: March 2011

New nanocomposite films were prepared from a dispersion of organically modified montmorillonite as the filler and flexible polyurethane as the matrix. The polyurethanes containing a small amount of carboxylic groups were synthesized from 4,4′-diphenylmethane diisocyanate (MDI), 1,4-butanediol (1,4-BD), and poly(tetramethyleneoxide diol) (PTMO) of 1000 average molecular weight, the carboxylic unit being included by means of dimethylol propionic acid (DMPA) or tartaric acid (TA). For comparison, polyurethane without carboxylic moieties was also synthesized. The polymers and their nanocomposites were characterized by 1H-NMR and Fourier transform infrared spectroscopy, thermogravimetric analysis and gel permeation chromatography analysis. Additional information regarding some properties of these materials was obtained from the mechanical evaluation of thin films through stress–strain testing and dynamic mechanical analysis. Moreover, the effects of clay and interlayer ions on the morphology and physical properties of the hybrid nanocomposites were examined using atomic force microscope, X-ray diffractometer and transmission electron microscope.