bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolution of extrafloral nectaries: adaptive process and selective regime changes from forest to savanna
Authors: Nogueira A. , Rey P. J. , Lohmann L. G.
Published: September 2012

Much effort has been devoted to understanding the function of extrafloral nectaries (EFNs) for ant–plant–herbivore interactions. However, the pattern of evolution of such structures throughout the history of plant lineages remains unexplored. In this study, we used empirical knowledge on plant defences mediated by ants as a theoretical framework to test specific hypotheses about the adaptive role ofEFNs during plant evolution. Emphasis was given to different processes (neutral or adaptive) and factors (habitat change and trade‐offs with new trichomes) that may have affected the evolution of ant–plant associations. We measured sevenEFNquantitative traits in all 105 species included in a well‐supported phylogeny of the tribeBignonieae (Bignoniaceae) and collected field data on ant–EFNinteractions in 32 species. We identified a positive association between ant visitation (a surrogate of ant guarding) and the abundance ofEFNs in vegetative plant parts and rejected the hypothesis of phylogenetic conservatism ofEFNs, with most traits presentingK‐values < 1. Modelling the evolution ofEFNtraits using maximum likelihood approaches further suggested adaptive evolution, with static‐optimum models showing a better fit than purely drift models. In addition, the abundance ofEFNs was associated with habitat shifts (with a decrease in the abundance ofEFNs from forest to savannas), and a potential trade‐off was detected between the abundance ofEFNs and estipitate glandular trichomes (i.e. trichomes with sticky secretion). These evolutionary associations suggest divergent selection between species as well as explainsK‐values < 1. Experimental studies with multiple lineages of forest and savanna taxa may improve our understanding of the role of nectaries in plants. Overall, our results suggest that the evolution ofEFNs was likely associated with the adaptive process which probably played an important role in the diversification of this plant group.
Evaluation of selective cyclooxygenase‐2 inhibitor‐induced small bowel injury: Randomized cross‐over study compared with loxoprofen in healthy subjects
Authors: Mizukami Kazuhiro , Murakami Kazunari , Yamauchi Mika , Matsunari Osamu , Ogawa Ryo , Nakagawa Yoshifumi , Okimoto Tadayoshi , Kodama Masaaki , Fujioka Toshio
Published: September 2012

Aim

Non‐steroidal anti‐inflammatory drugs have the potential to injure the mucosa of the upper digestive tract and small bowel, whereas celecoxib (a selective cyclooxygenase‐2 inhibitor) has less influence on the entire digestive tract mucosa. The present study was conducted to compare the extents of small bowel mucosal injury induced by celecoxib and loxoprofen (the most frequently used non‐steroidal anti‐inflammatory drugs in Japan).

Methods

Ten healthy adult males were given celecoxib (200 mg/day, Group C) and loxoprofen (180 mg/day, Group L) in a cross‐over design for 14 days, and the influence of each drug on small bowel mucosa was evaluated by comparing pre‐ and post‐treatment capsule endoscopy findings. We measured the percentage of patients with small bowel mucosal injury following administration of these drugs as primary endpoint. Additionally, mean number of small bowel mucosal injuries per subject was analyzed as secondary endpoint.

Results

The percentage of subjects experiencing small bowel mucosal injury as primary endpoint was 10% in Group C and 70% in Group L after treatment. This magnitude of the difference of between Group C and Group L was statistically significant (P = 0.031). The number of small bowel mucosal injuries as secondary endpoint differed significantly between the two groups, and the influence of celecoxib on small bowel injury was less than that of loxoprofen.

Conclusion

These results indicate that celecoxib has less influence on small bowel mucosa than loxoprofen and can be used safely.
Statin use and the risk of biochemical recurrence of prostate cancer after definitive local therapy: a meta‐analysis of eight cohort studies
Authors: Scosyrev Emil , Tobis Scott , Donsky Heather , Wu Guan , Joseph Jean , Rashid Hani , Messing Edward
Published: September 2012

What's known on the subject? and What does the study add?

Over the last few years, several observational studies examined the association of statin use with the risk of biochemical recurrence of prostate cancer after definitive local therapy. The objective of our present study was to summarise available evidence on this subject using the method of meta‐analysis.

Combined evidence from eight cohort studies did not definitively support the hypothesis that statins influence the risk of biochemical recurrence. However, there was considerable disagreement between individual studies in reported findings and conclusions.

OBJECTIVE

To perform a systematic review and meta‐analysis of clinical studies with statin use as the exposure variable and biochemical recurrence after definitive local therapy for prostate cancer as the outcome.

METHODS

Relevant publications were identified through PubMed/Medline/Embase databases.

Pooled estimates of the hazard ratios (HRs) were computed using the inverse‐variance weighting approach.

Heterogeneity was assessed using the Cochran's Q test.

RESULTS

We identified a total of eight eligible studies, all based on the retrospective cohort design. Five of these were based on radical prostatectomy (RP) series and three on radiotherapy (RT) series.

There was evidence of heterogeneity in the entire set of eight studies (P= 0.002) as well as in the RP series (P= 0.05) and in the RT series (P= 0.01), when these were considered separately.

Based on the random effects inverse‐variance weighting approach, pooled estimates of the HRs for the risk of biochemical recurrence in statin users v non‐users were 0.91 (95% confidence interval [CI] 0.72–1.13) for the entire set of eight studies, 1.02 (95% CI 0.80–1.29) for the RP series and 0.71 (95% CI 0.44–1.16) for the RT series.

CONCLUSION

The pooled estimates of the HRs were not significantly different from the null value in this meta‐analysis; however, evidence of heterogeneity between the studies was present.
Phase I study of concurrent weekly docetaxel, high‐dose intensity‐modulated radiation therapy (IMRT) and androgen‐deprivation therapy (ADT) for high‐risk prostate cancer
Authors: Chen Ronald C. , Rosenman Julian G. , Hoffman Leroy G. , Chiu Wing‐Keung , Wang Andrew Z. , Pruthi Raj S. , Wallen Eric M. , Crane Jeffrey M. , Kim William Y. , Rathmell W. Kimryn , Godley Paul A. , Whang Young E.
Published: September 2012

Study Type – Therapy (phase 1)

Level of Evidence 2a

What's known on the subject? and What does the study add?

High‐risk and locally advanced prostate cancers are difficult to cure with the standard regimen of radiation therapy (RT) with concurrent androgen‐deprivation therapy (ADT). Multiple studies have explored the addition of docetaxel chemotherapy in attempt to improve patient outcomes. Prior Phase I studies have shown that docetaxel 20 mg/m2 is a safe dose, when given concurrently with 70 Gy of radiation. But current standard RT for prostate cancer uses higher doses, and it is unclear if concurrent chemotherapy is safe with modern RT.

This is a Phase I study that explored the addition of concurrent docetaxel chemotherapy to modern RT (intensity‐modulated RT to 78 Gy) plus ADT. The study showed that weekly docetaxel at 20 mg/m2 is safe with modern RT. At a median follow‐up of 2.2 years, biochemical progression‐free survival was 94%. This triple‐therapy regimen is safe and promising for further evaluation in prospective trials.

OBJECTIVE

To evaluate in a phase I trial, the feasibility of adding concurrent weekly docetaxel chemotherapy to high‐dose intensity modulated radiation therapy (IMRT) and androgen‐deprivation therapy (ADT) for treatment of high‐risk prostate cancer.

PATIENTS AND METHODS

Patients with high‐risk prostate cancer were treated with a luteinising hormone‐releasing hormone agonist (starting 2–3 months before IMRT and lasting 2 years), IMRT of 78 Gy to the prostate and seminal vesicles, and weekly docetaxel during RT.

All patients had computed tomography and bone scans to exclude metastatic disease.

A standard 3 + 3 design was used for docetaxel dose escalation. Successive patients were treated on dose levels of 10, 15, and 20 mg/m2 of weekly docetaxel.

RESULTS

In all, 18 patients participated in the study: 15 (83%) had Gleason 8–10 disease; the other three had either clinical T3 disease and/or a prostate‐specific antigen (PSA) level of >20 ng/mL.

Grade 3 diarrhoea (a defined dose‐limiting toxicity, DLT) occurred in one patient in each of the first two dose levels. However, when the cohorts were expanded, no further DLT was seen.

Weekly docetaxel at 20 mg/m2 (dose level 3) was successfully given without DLT.

No patient had grade 4 or 5 toxicity.

At a median follow‐up of 2.2 years, all patients achieved a PSA nadir of <1 ng/mL, including 13 patients who had an undetectable PSA level. The 2‐year biochemical progression‐free survival was 94%.

CONCLUSION

A dose of 20 mg/m2 of weekly docetaxel given concurrently with high‐dose IMRT and ADT appears safe for further study in patients with high‐risk prostate cancer.
Pathological findings after primary chemotherapy in patients undergoing simultaneous orchidectomy and retroperitoneal lymph node dissection for advanced germ cell tumours
Authors: Miller Rowan E. , Dudderidge Tim , Huddart Robert , Seckl Michael J. , Rustin Gordon J.S. , Christmas Timothy J.
Published: September 2012

What's known on the subject? and What does the study add?

Testicular cancer is a chemosensitive disease. Treatment with primary chemotherapy leads to eradication of metastatic disease and high cure rates. Completion orchidectomy is usually performed after primary chemotherapy with viable tumour and teratoma often identified in the orchidectomy specimen. The need for completion orchidectomy in patients with a complete response to systemic chemotherapy is uncertain.

The present study confirms the discordance in pathology in patients undergoing simultaneous orchidectomy and retroperitoneal lymph node dissection (RPLND) after chemotherapy for metastatic disease. Viable tumour is frequently present in the testis despite tumour‐free RPLNs. These findings support the need for completion orchidectomy as part of the management for advanced testicular germ cell cancer.

OBJECTIVE

To determine the differential response to systemic chemotherapy in patients undergoing simultaneous orchidectomy and retroperitoneal lymph node dissection (RPLND) after chemotherapy for metastatic testicular cancer.

PATIENTS AND METHODS

Patients who underwent simultaneous RPLND and orchidectomy after chemotherapy were identified from our clinical databases.

Postoperative pathological findings and patient characteristics were reviewed.

RESULTS

In all, 42 patients were identified.

After chemotherapy, necrosis, teratoma and cancer were identified in 25 (59.5%), 14 (33.3%) and three (7.1%) RPLN specimens and 15 (35.7%), 15 (35.7%) and 12 (28.6%) orchidectomy specimens respectively.

Of the 25 patients with necrotic RPLN specimens 12 (48.0%) had active disease within the orchidectomy specimen (eight invasive cancer and four mature teratoma).

The overall histological discordance rate was 38.1%. Findings in the orchidectomy specimens were more aggressive than those in the RPLN specimens (i.e. cancer worse than teratoma, which is worse than necrosis) in 33.3%.

CONCLUSIONS

There is significant disparity between orchidectomy and RPLND findings with viable tumour appearing frequently in the testis despite tumour‐free RPLNs.

These findings support completion orchidectomy as part of advanced testicular germ cell treatment.
Speculating on Slums: Infrastructural Fixes in Informal Housing in the Global South
Authors: Desai Vandana , Loftus Alex
Published: September 2012

In this paper, we seek to revisit earlier work on the theory of rent, situating it in the current period of economic crisis and in relation to informal housing in the global South. More than ever, land is treated as a pure financial asset. Finance capital now exerts a profound influence over the production of space and exposes the built environment to the kinds of speculative binges that we have witnessed over the last decade. This is now as much a feature of living conditions in the poorest settlements of the global South as it is in the financial heartlands of the global North. We question key assumptions behind development interventions by arguing that infrastructural upgrading may decrease the security of tenure of residents of informal housing and call for a more nuanced approach that recognises the (post)colonial histories of urbanisation structuring access to land and housing.
Identification of Effective Strategies to Promote Language in Deaf Children With Cochlear Implants
Authors: Cruz Ivette , Quittner Alexandra L. , Marker Craig , DesJardin Jean L. ,   CDaCI Investigative Team
Published: September 2012

Parental involvement and communication are essential for language development in young children. However, hearing parents of deaf children face challenges in providing language input to their children. This study utilized the largest national sample of deaf children receiving cochlear implants, with the aim of identifying effective facilitative language techniques. Ninety‐three deaf children (≤ 2 years) were assessed at 6 implant centers prior to and for 3 years following implantation. All parent–child interactions were videotaped, transcribed, and coded at each assessment. Analyses using bivariate latent difference score modeling indicated that higher versus lower level strategies predicted growth in expressive language and word types predicted growth in receptive language over time. These effective, higher level strategies could be used in early intervention programs.
QUANTIFYING THE EUROPEAN CENTRAL BANK'S INTEREST RATE SMOOTHING BEHAVIOR*
Authors: PINKWART NICOLAS
Published: September 2012

Against the background of the recent discussion whether the smoothing behavior of the Fed detected by empirical Taylor rules is indeed a fact or rather a statistically fiction, this paper re‐examines the empirical evidence for interest rate smoothing for the case of the European Central Bank (ECB). Based on data representing true ECB behavior, our findings reject the hypothesis of no smoothing but also find a role of serially correlated shocks. The degree of smoothing is estimated in the range of [0.38;0.82], reflecting model uncertainty with respect to the output gap and indicating a rather moderate extent of partial adjustment.
PRODUCTIVITY DIFFERENCES AND STRATEGIC PLANT LOCATION*
Authors: GUARIGLIA ALESSANDRA , MUKHERJEE ARIJIT , SUETRONG KULLAPAT
Published: September 2012

We consider the plant location decision of a multinational company (MNC), which has the option to invest in technologically differentiated countries. We show that the MNC's investment decision depends on the market structure of the host countries and on the possibility of exporting by the host‐country firms. We also show that a conflict of interest does not necessarily arise between the plant location decision of the MNC and the preferences of the host countries.
Stigma, Ex-convicts and Labour Markets
Authors: Dominguez Alvarez Rocio , Loureiro Maria L.
Published: September 2012

Rasmusen (1996) has shown that inmates not only suffer public penalties but also economic and social stigma. In this article, we analyse the economic consequences of imprisonment which can be identified as lower wages and difficulty in re-entering the labour market. Analysing data from a German survey, we find that having been in prison reduces the probability of finding a job and that the total time sentenced to imprisonment reduces both labour market opportunities and earnings. The penalty is worst for those who have committed murder.
RNA interference‐mediated phosphodiesterase 4D splice variants knock‐down in the prefrontal cortex produces antidepressant‐like and cognition‐enhancing effects
Authors: Wang Zhen‐Zhen , Zhang Yi , Liu Yan‐Qin , Zhao Nan , Zhang You‐Zhi , Yuan Li , An Lei , Li Jing , Wang Xiao‐Yun , Qin Juan‐Juan , Wilson Steven P , O'Donnell James M , Zhang Han‐Ting , Li Yun‐Feng
Published: September 2012

Background and Purpose

Phosphodiesterase 4 (PDE4) inhibitors produce potent antidepressant‐like and cognition‐enhancing effects. However, their clinical utility is limited by the major side effect of emesis, which appears to be PDE4 isoform‐specific. Although PDE4D subtype plays the pivotal role in these therapeutic profiles, it is also the primary subtype responsible for emesis. Therefore, the aim of present research was to investigate whether long‐form PDE4D variants mediate antidepressant‐like and cognition‐enhancing effects, but are irrespective with emesis.

Experimental Approach

In mice microinfused with lentiviral vectors that contained shRNA‐mir hairpin structure targeting long‐form PDE4Ds into bilateral prefrontal cortices, the tail‐suspension and forced‐swim tests were used to measure antidepressant‐like effects; novel object recognition and Morris water‐maze tasks were used to determine cognition‐enhancing effects. The emetic potential was assessed by alpha2 adrenergic receptor‐mediated anaesthesia, a surrogate measure of emesis. Intracellular cAMP signalling was analysed by time‐resolved FRET immunoassay and Western‐blot. Dendritic complexity was assessed by Golgi staining.

Key Results

Microinfusions of lentiviral PDE4D‐shRNA down‐regulated PDE4D4 and PDE4D5, and imitated the antidepressant‐like and cognition‐enhancing effects of the prototypical PDE4 inhibitor rolipram. The behavioural effects were related to dendritic complexity and mediated by the increased cAMP signalling. In addition, these effects were not enhanced in the presence of rolipram. Finally, while rolipram shortened the duration of combined anaesthesia, RNA interference‐mediated PDE4D knock‐down in the prefrontal cortex did not.

Conclusion and Implications

These data suggest that long‐form PDE4Ds, at least PDE4D4 and PDE4D5, may be the promising targets for the development of PDE4 variant‐selective inhibitors as the new pharmacotherapies for depressive disorders and neurodegenerative diseases involving memory deficits.
Effects of ρ‐Da1a a peptidic α1A‐adrenoceptor antagonist in human isolated prostatic adenoma and anaesthetized rats
Authors: Palea S , Maiga A , Guilloteau V , Rekik M , Guérard M , Rouget C , Rischmann P , Botto H , Camparo P , Lluel P , Gilles N
Published: September 2012

Background and Purpose

ρ‐Da1a, a 65 amino‐acid peptide, has subnanomolar affinity and high selectivity for the human α1A‐adrenoceptor subtype. The purpose of this study was to characterize the pharmacological effects of ρ‐Da1a on prostatic function, both in vivo and in vitro.

Experimental Approach

ρ‐Da1a was tested as an antagonist of adrenaline‐induced effects on COS cells transfected with the human α1A‐adrenoceptor as well as on human isolated prostatic adenoma obtained from patients suffering from benign prostatic hyperplasia. Moreover, we compared the effects of ρ‐Da1a and tamsulosin on phenylephrine (PHE)‐induced increases in intra‐urethral (IUP) and arterial pressures (AP) in anaesthetized rats, following i.v. or p.o. administration.

Key Results

On COS cells expressing human α1A‐adrenoceptors and on human prostatic strips, ρ‐Da1a inhibited adrenaline‐ and noradrenaline‐induced effects. In anaesthetized rats, ρ‐Da1a and tamsulosin administered i.v. 30 min before PHE significantly antagonized the effects of PHE on IUP. The pKB values for tamsulosin and ρ‐Da1a for this effect were similar. With regards to AP, ρ‐Da1a only reduced the effect of PHE on AP at the lowest dose tested (10 μg·kg−1), whereas tamsulosin significantly reduced PHE effects at doses between 10 and 150 μg·kg−1.

Conclusions and Implications

ρ‐Da1a exhibited a relevant effect on IUP and a small effect on AP. In contrast, tamsulosin antagonized the effects of PHE on both IUP and AP. We conclude that ρ‐Da1a is more uroselective than tamsulosin. ρ‐Da1a is the most selective peptidic antagonist for α1A‐adenoceptors identified to date and could be a new treatment for various urological diseases.
Modulation of Kv7 potassium channels by a novel opener pyrazolo[1,5‐a]pyrimidin‐7(4H)‐one compound QO‐58
Authors: Zhang F , Mi Y , Qi JL , Li JW , Si M , Guan BC , Du XN , An HL , Zhang HL
Published: September 2012

Background and Purpose

Modulation of Kv7/M channel function represents a relatively new strategy to treat neuronal excitability disorders such as epilepsy and neuropathic pain. We designed and synthesized a novel series of pyrazolo[1,5‐a] pyrimidin‐7(4H)‐one compounds, which activate Kv7 channels. Here, we characterized the effects of the lead compound, QO‐58, on Kv7 channels and investigated its mechanism of action.

Experimental Approach

A perforated whole‐cell patch technique was used to record Kv7 currents expressed in mammalian cell lines and M‐type currents from rat dorsal root ganglion neurons. The effects of QO‐58 in a rat model of neuropathic pain, chronic constriction injury (CCI) of the sciatic nerve, were also examined.

Key Results

QO‐58 increased the current amplitudes, shifted the voltage‐dependent activation curve in a more negative direction and slowed the deactivation of Kv7.2/Kv7.3 currents. QO‐58 activated Kv7.1, Kv7.2, Kv7.4 and Kv7.3/Kv7.5 channels with a more selective effect on Kv7.2 and Kv7.4, but little effect on Kv7.3. The mechanism of QO‐58's activation of Kv7 channels was clearly distinct from that used by retigabine. A chain of amino acids, Val224Val225Tyr226, in Kv7.2 was important for QO‐58 activation of this channel. QO‐58 enhanced native neuronal M currents, resulting in depression of evoked action potentials. QO‐58 also elevated the pain threshold of neuropathic pain in the sciatic nerve CCI model.

Conclusions and Implications

The results indicate that QO‐58 is a potent modulator of Kv7 channels with a mechanism of action different from those of known Kv7 openers. Hence, QO‐58 shows potential as a treatment for diseases associated with neuronal hyperexcitability.
Ozone applications for after‐clearing of disperse‐dyed poly(lactic acid) fibres
Authors: Avinc Ozan , Eren Hüseyin Aksel , Uysal Pınar
Published: September 2012

In this study, the effectiveness of the ozonation process, in neutral distilled water at room temperature, as a clearing process for disperse‐dyed poly(lactic acid) fibre fabrics is investigated. The efficiency of simultaneous decolorisation of dyebath effluent and clearing of dyed poly(lactic acid) in the cooled dyebath after completion of the poly(lactic acid) dyeing cycle is also explored. Conventional alkaline reduction clearing with sodium dithionite was chosen as a control clearing process for comparison. Wash fastness, colour difference, colour removal (in Hazen) and chemical oxygen demand values were determined and compared. Long ozone treatment times at high ozone dose resulted in unacceptable colour differences. The colour difference problem was solved by use of lower ozone dose; however, a warm soaping step had to be added to the after‐clearing sequence in order to achieve the desired fastness properties. A 33% reduction on the chemical oxygen demand load of the total process (dyeing + after‐clearing) could be achieved by ozone after‐clearing instead of using a conventional reduction clearing treatment. The addition of the warm soaping step to improve the fastness properties of the ozonated samples increased the total chemical oxygen demand of the process (dyeing + ozonation in water + warm soaping), but a 12–18% reduction on the chemical oxygen demand load of the total process was observed when compared with the conventional treatment sequence (dyeing + reduction clearing).
Association between Adverse Life Events and Addictive Behaviors among Male and Female Adolescents
Authors: Lee Grace P , Storr Carla L , Ialongo Nicholas S , Martins Silvia S
Published: September 2012

Background: Adverse life events have been associated with gambling and substance use as they can serve as forms of escapism. Involvement in gambling and substance use can also place individuals in adversely stressful situations.

Objectives: To explore potential male–female differences in the association between addictive behavior and adverse life events among an urban cohort of adolescents.

Method: The study sample comprised of 515 adolescent participants in a randomized prevention trial. With self‐reported data, four addictive behavior groups were created: nonsubstance users and nongamblers, substance users only, gamblers only, and substance users and gamblers. Multinomial logistic regression analyses with interaction terms of sex and adverse life events were conducted.

Results: Adverse life events and engaging in at least one addictive behavior were common for both sexes. Substance users and gamblers had more than twice the likelihood of nonsubstance users and nongamblers to experience any event as well as events of various domains (ie, relationship, violence, and instability). Neither relationship nor instability events’ associations with the co‐occurrence of substance use and gambling significantly differed between sexes. Conversely, females exposed to violence events were significantly more likely than similarly exposed males to report the co‐occurrence of substance use and gambling.

Conclusion: Findings from the current study prompt future studies to devote more attention to the development of effective programs that teach adaptive coping strategies to adolescents, particularly to females upon exposure to violence. (Am J Addict 2012;21:516–523)
Effect of Specialty and Recent Experience on Perioperative Decision‐Making for Abdominal Aortic Aneurysm Repair
Authors: Dale William , Hemmerich Joshua , Moliski Elizabeth , Schwarze Margaret L. , Tung Avery
Published: September 2012

Objectives

To determine whether recent experience and specialty choice would affect physician adherence to evidence‐based guidelines.

Design

In a series of computer‐simulated encounters, participants weighed the risk of spontaneous abdominal aortic aneurysm (AAA) rupture against the risk of perioperative death to determine timing for elective repair. Guideline recommendations and statistical information on the risks of rupture and surgical death were provided.

Setting

Annual meetings of the American Geriatrics Society, American College of Surgeons, and American Society of Anesthesiologists.

Participants

Physicians.

Intervention

Before the simulation, each participant was randomly exposed to one of three simulated outcomes: death during watchful waiting (WWD), perioperative death (PD), or successful outcome (SO).

Measurements

Adherence to recommended guidelines for AAA treatment.

Results

Against guideline recommendations, 67% of geriatricians, 74% of anesthesiologists, and 77% of surgeons chose surgery when the rupture risk was lower than the risk of perioperative death (P < .05). Surgeons exposed to the WWD experience chose surgery significantly earlier than if they were exposed to a PD or SO experience (P < .001). Anesthesiologist choices did not differ with recent experience.

Conclusion

Geriatrician decisions more closely followed guideline recommendations for AAA management than those of two other specialties typically involved in AAA care. A prior WWD affected surgeons most, geriatricians next, and anesthesiologists least. Geriatricians referring patients for AAA surgery should be aware of specialty‐specific differences in perioperative decision behavior.
Effect of Exposure to Evidence‐Based Pharmacotherapy on Outcomes After Acute Myocardial Infarction in Older Adults
Authors: Zuckerman Ilene H. , Yin Xianghua , Rattinger Gail B. , Gottlieb Stephen S. , Simoni‐Wastila Linda , Pierce Sarah A. , Huang Ting‐Ying , Shenolikar Rahul , Stuart Bruce
Published: September 2012

Objectives

To assess the effect of exposure to evidence‐based medication after hospital discharge for Medicare beneficiaries with acute myocardial infarction (AMI).

Design

A discrete‐time hazard model was used to estimate time to outcome associated with exposure to four drug classes (angiotensin‐converting enzyme inhibitors (ACEIs)/angiotensin‐II receptor blockers (ARBs), beta‐blockers (BBs), statins, and clopidogrel) used for post‐AMI secondary prevention of cardiovascular events and mortality.

Setting

Medicare administrative data for a 5% random sample of beneficiaries.

Participants

Medicare beneficiaries (N = 9,538) hospitalized for an AMI between April 1, 2006, and December 31, 2007, who survived for at least 30 days after discharge. The cohort was followed until death or December 31, 2008.

Measurements

Time‐varying exposure was measured as proportion of days covered (PDC) for each quarter during the follow‐up period. PDC was classified into five categories (0–0.2, 0.2–0.4, 0.4–0.6, 0.6–0.8, 0.8–1.0). Outcomes were mortality and a composite outcome of death or post‐AMI hospitalization.

Results

Over a median follow‐up of 18 months, mean PDC rates ranged from 0.37 (clopidogrel) to 0.50 (statins). When comparing the highest versus lowest categories of exposure, the hazard of the composite outcome was significantly lower for all drug classes except BBs (statins, adjusted hazard ratio (aHR) = 0.71, ACEIs/ARBs, aHR = 0.81, clopidogrel, aHR = 0.85, BBs, aHR = 0.93). All four drug classes were significantly associated with reductions in mortality; the magnitude of effect for the mortality outcome was largest for statins and smallest for BBs. Age modified the effect of statins on mortality.

Conclusion

Use of evidence‐based medications for secondary prevention after AMI is suboptimal in the Medicare population, and low exposure rates are associated with significantly higher risk for subsequent hospitalization and death.
A reporting guideline for clinical platelet transfusion studies from the BEST Collaborative
Authors: Meyer Erin , Delaney Meghan , Lin Yulia , Morris Anna , Pavenski Katerina , Tinmouth Alan , Murphy Mike , Slichter Sherrill J. , Heddle Nancy , Dumont Larry J.
Published: September 2012

BACKGROUND: A systematic review of randomized controlled trials and observational studies assessing platelet (PLT) transfusion therapy identified gaps in the descriptions of trial design, variables of the PLT products transfused, and outcomes. We aimed to systematically develop a reporting guideline to aid in designing, reporting, and critiquing PLT trials.

STUDY DESIGN AND METHODS: With the use of expert opinion, a preliminary checklist of 23 items was created. The Delphi method, an iterative forecasting method, was used to achieve consensus among experts to systematically improve upon the preliminary checklist. Items were ranked for inclusion using a 7‐point Likert scale from “definitely should not” to “very important to” include. Criteria were established a priori based on the mean score: at least 5.5 accept, 2.6 to 5.4 intermediate, and not more than 2.5 eliminate. Intermediate items were edited and sent out in subsequent rounds for review. Three rounds were undertaken to determine the final checklist.

RESULTS: Initially 33 experts participated, decreasing to 25 by the third round. The preliminary checklist consisted of 23 items spread over four sections: methods and intervention, PLT‐specific outcomes, PLT‐specific results, and PLT‐specific adverse events. After three rounds of the Delphi method, the checklist was expanded and refined to include 30 items. The final checklist was further enhanced by adding an explanatory guide.

CONCLUSION: Use of the Delphi method was successful in finding consensus on items to include in reports of a clinical PLT transfusion study. The final checklist and explanatory guide will be useful for authors and editors to improve the reporting of PLT transfusion trials.
Neovascularized Myxoma‐Causing Abnormal Blood Flow in the Left Atrium Diagnosed by Transesophageal Echocardiography
Authors: Wang Xiaobing , Ren Weidong , Yang Jun
Published: September 2012

Myxomas are the most common primary cardiac tumor, and neovascularization of cardiac myxoma has been shown in previous case reports. However, it is seldom reported that abnormal blood flow spurted from a neovascularized myxoma into the cardiac chamber. In this unusual case report, we present a left atrial myxoma in a 44‐year‐old woman with atypical angina. Transesophageal echocardiography (TEE) revealed several small blood streams spurting from the surface of massively vascularized myxoma into the left atrium. Coronary angiography showed a feeding artery which arose from the right coronary artery and supplied the left atrial myxoma, with no evidence of coronary artery stenosis. This case demonstrated that TTE might be helpful for confirming the neovascularization of myxoma in the left atrium and finding the abnormal blood flow that spurts from the neovascularized myxoma. We speculate that the abnormal blood flow spurting from the neovascularized myxoma into the left atrium may have caused a coronary steal phenomenon thus resulting in myocardial ischemia.
Importance of regional climates for plant species distribution patterns in moist Afromontane forest
Authors: Schmitt Christine B. , Senbeta Feyera , Woldemariam Tadesse , Rudner Michael , Denich Manfred
Published: September 2012

Questions

How are plant species distribution patterns in tropical montane forest linked to altitude, regional climate and geographic location? Which climatic variables are most important in explaining variations in floristic diversity? What are potential effects of climate change on species diversity?

Location

Ethiopia.

Methods

Vegetation surveys were conducted in 180 study plots distributed across five moist montane forest areas in southwest and southeast Ethiopia (1000–2300 m a.s.l.). Temperature and precipitation data, as well as bioclimatic variables, were derived for each study plot from the WorldClim global climate data set. Species and climate data were analysed with direct and indirect ordination techniques and multivariate regression trees (MRT).

Results

Each of the sampled forest areas showed a distinct species composition and was governed by a particular regional temperature and precipitation pattern related to the topographic variability of the Ethiopian highlands. Hence, a general altitudinal cut‐off level for different forest types applicable in all five moist montane forest areas could not be identified. The most important bioclimatic variable in determining species distribution patterns was the amount of precipitation after the dry season (i.e. precipitation in the warmest quarter), followed by minimum temperature in the coldest month. At a lower hierarchical level, temperature and precipitation seasonality were also identified as significant discriminating variables. Generally, in areas with high precipitation during the warmest quarter (≥288 mm) and low minimum temperature in the coldest month (<10.9 °C), the number of Afromontane species was highest and that of Guineo–Congolian species lowest.

Conclusions

The altitudinal effect on species diversity in the Ethiopian moist montane forests is strongly modified by regional differences in precipitation and temperature regime. The predicted increase in temperature for the Ethiopian highlands due to climate change is likely to affect the distribution of the endemic Afromontane species. Furthermore, the study highlights the need for systematic on‐the‐ground measurements of climate variables in tropical montane areas in order to understand the current climate regime and as a basis for modelling future changes.
Phast4Windows: A 3D Graphical User Interface for the Reactive‐Transport Simulator PHAST
Authors: Charlton Scott R. , Parkhurst David L.
Published: September 2012

Phast4Windows is a Windows® program for developing and running groundwater‐flow and reactive‐transport models with the PHAST simulator. This graphical user interface allows definition of grid‐independent spatial distributions of model properties—the porous media properties, the initial head and chemistry conditions, boundary conditions, and locations of wells, rivers, drains, and accounting zones—and other parameters necessary for a simulation. Spatial data can be defined without reference to a grid by drawing, by point‐by‐point definitions, or by importing files, including ArcInfo® shape and raster files. All definitions can be inspected, edited, deleted, moved, copied, and switched from hidden to visible through the data tree of the interface. Model features are visualized in the main panel of the interface, so that it is possible to zoom, pan, and rotate features in three dimensions (3D). PHAST simulates single phase, constant density, saturated groundwater flow under confined or unconfined conditions. Reactions among multiple solutes include mineral equilibria, cation exchange, surface complexation, solid solutions, and general kinetic reactions. The interface can be used to develop and run simple or complex models, and is ideal for use in the classroom, for analysis of laboratory column experiments, and for development of field‐scale simulations of geochemical processes and contaminant transport.
A descriptive study of waterpipe smoking among college students
Authors: Noonan Devon
Published: September 2012

Purpose

The purpose of this cross‐sectional study was to examine waterpipe smoking and beliefs about waterpipe smoking in a sample of college students from a public university in Virginia.

Data sources

A web‐based survey was sent to 1000 undergraduate students recruiting them to participate in the study. Measures from the investigator‐developed Theory of Reasoned Action (TRA) Waterpipe Questionnaire were used to capture belief‐based components of the TRA related to waterpipe use. Descriptive statistics were used to examine the prevalence of waterpipe smoking and beliefs associated with waterpipe smoking.

Conclusions

Of the sample (n = 223), 71% of males and 52% of females reporting ever smoking tobacco using a waterpipe and 22% of males and 5% of females reporting current waterpipe smoking. Of the sample, 28% of males and 10% of females were current cigarette smokers and 25% of males and 10% of females were current marijuana users. Common beliefs associated with waterpipe smoking are also presented.

Implications for practice

Nurse practitioners working with college students need to be aware of the multiple forms of tobacco that students may engage in. They also should be aware of the common beliefs about waterpipe smoking. This information is useful when targeting and counseling patients about alternative tobacco products like waterpipe smoking.
Adherence to the Dietary Approaches to Stop Hypertension eating plan in candidates awaiting coronary artery bypass graft surgery, Tehran, Iran
Authors: NEJATI‐NAMIN Sara , ATAIE‐JAFARI Asal , AMIRKALALI Bahareh , HOSSEINI Saeed , SHEIKH FATHOLLAHI Mahmood , NAJAFI Mahdi
Published: September 2012

Aims:  Hypertension (HTN) is a major risk factor for cardiovascular disease. We evaluated the degree of adherence to ‘Dietary Approaches to Stop Hypertension’ (DASH) diet in hypertensive (H) and normotensive (N) candidates awaiting coronary artery bypass graft surgery.

Methods:  This was a cross‐sectional study on 417 coronary artery bypass graft candidates (219 normotensives and 198 hypertensives) hospitalised at a large heart centre. We created an adherence score to a DASH eating plan using food intake assessed via food frequency questionnaire.

Results:  Diet score categories were specified as 0–5.4 (weak adherence), 5.5–7.4 (moderate adherence) and 7.5–10 (excellent adherence). Only 28% of all the participants were in the top score category. The mean of scores were not different between N and H groups (6.5 ± 1.2 vs 6.5 ± 1.2, P= 0.757). Regardless of HTN status, smokers had lower scores than non‐smokers (P= 0.023) and diabetics had higher scores than non‐diabetics (P= 0.045). The majority of participants met the goal for servings of meat followed by servings of vegetable and percent of energy from fat (87%, 81% and 71%, respectively). However, 68% of participants did not meet the sweet target and 49% of H patients did not reach the sodium intake recommendations. H patients consumed significantly lower sodium and sweets than N patients (P= 0.01 and P < 0.001, respectively).

Conclusions:  Our results indicate moderate adherence to the DASH diet among candidates awaiting coronary artery bypass graft in both H and N patients. The adherence was lower among smokers and non‐diabetic patients.
Combined Full-Dose IV and Endovascular Thrombolysis in Acute Ischaemic Stroke
Authors: Bhatia Rohit , Shobha Nandavar , Menon Bijoy K. , Bal Simerpreet P. , Kochar Puneet , Palumbo Vanessa , Wong John H. , Morrish William F. , Hudon Mark E. , Hu William , Coutts Shelagh B. , Barber Phillip A. , Watson Tim , Goyal Mayank , Demchuk Andrew M. , Hill Michael D.
Published: September 2012

Background

There is an increasing trend to treating proximal vessel occlusions with intravenous–inter-arterial (IV-IA) thrombolysis. The best dose of IV tissue plasminogen activator (tPA) remains undetermined. We compared the combination of full-dose IV recombinant tissue plasminogen activator (rtPA) and IA thrombolytic therapy to IA therapy.

Methods

Between 2002 and 2009, we reviewed our computed tomographic angiography database for patients who received full-dose intravenous rtPA and endovascular therapy or endovascular therapy alone for acute ischaemic stroke treatment. Details of demographics, risk factors, endovascular procedure, and symptomatic intracranial haemorrhage were noted. Modified Rankin Scale ≤2 at three-months was used as good outcome. Recanalization was defined as Thrombolysis in Myocardial Ischaemia 2–3 flow on angiography.

Results

Among 157 patients, 104 patients received IV-IA treatment and 53 patients underwent direct IA therapy. There was a higher recanalization rate with IV-IA therapy compared with IA alone (71% vs. 60%, P < 0·21) which was driven by early recanalization after IV rtPA. Mortality and independent outcome were comparable between the two groups. Symptomatic intracranial haemorrhage occurred in 8% of patients (12% in the IA group, 7% in the IV-IA group) but was more frequent as the intensity of intervention increased from device alone to thrombolytic drug alone to device plus thrombolytic drug(s). Recanalization was a strong predictor of reduced mortality risk ratio (RR) 0·48 confidence interval95 0·27–0·84) and favourable outcome (RR 2·14 confidence interval95 1·3–3·5).

Conclusions

Combined IV-IA therapy with full-dose intravenous rtPA was safe and results in good recanalization rates without excess symptomatic intracranial haemorrhage. Testing of full-dose IV tPA followed by endovascular treatment in the IMS3 trial is justified.
Stroke Mortality Variations in South-East Asia: Empirical Evidence from the Field
Authors: Hoy Damian G. , Rao Chalapati , Hoa Nguyen Phuong , Suhardi S. , Lwin Aye Moe Moe
Published: September 2012

Background

Stroke is a leading cause of death in Asia; however, many estimates of stroke mortality are based on epidemiological models rather than empirical data. Since 2005, initiatives have been undertaken in a number of Asian countries to strengthen and analyse vital registration data. This has increased the availability of empirical data on stroke mortality.

Aims

The aim of this paper is to present estimates of stroke mortality for Indonesia, Myanmar, Viet Nam, Thailand, and Malaysia, which have been derived using these empirical data.

Methods

Age-specific stroke mortality rates were calculated in each of the five countries, and adjusted for data completeness or misclassification where feasible. All data were age-standardized and the resulting rates were compared with World Health Organization estimates, which are largely based on epidemiological models.

Results

Using empirical data, stroke ranked as the leading cause of death in all countries except Malaysia, where it ranked as the second leading cause. Age-standardized rates for males ranged from 94 per 100 000 in Thailand, to over 300 per 100 000 in Indonesia. In all countries, rates were higher for males than for females, and those compiled from empirical data were generally higher than modelled estimates published by World Health Organization.

Conclusions

This study highlights the extent of stroke mortality in selected Asian countries, and provides important baseline information to investigate the aetiology of stroke in Asia and design appropriate public health strategies to address the rapidly growing burden from stroke.
Haemorrhagic Transformation of Ischaemic Stroke in Young Adults
Authors: Mustanoja Satu , Haapaniemi Elena , Putaala Jukka , Strbian Daniel , Kaste Markku , Tatlisumak Turgut
Published: September 2012

Background

Frequency, factors associated with, and impact on outcome of haemorrhagic transformation in young adults with ischaemic stroke are unknown.

Methods

Consecutive young patients (age 15–49) with first-ever ischaemic stroke were included, having their first brain computed tomography/magnetic resonance imaging within seven-days of stroke onset, and second within seven-days from the first imaging. Haemorrhagic transformation in any imaging was classified as haemorrhagic infarct or parenchymal haemorrhage within or remote from the infarct. Symptomatic haemorrhagic transformation was defined according to the European Cooperative Acute Stroke Study II (ECASS II) criteria as any haemorrhage leading to a National Institutes of Health Stroke Scale score increase of ≥4 points or death. Unfavourable three-month outcome was defined as a modified Rankin Scale 2–6.

Results

In 636 eligible patients, any haemorrhagic transformation occurred in 79 patients (12·4%; 10·0–15·2%): 66 (10·4%; 8·24–12·9%) had haemorrhagic infarct, and 13 (2·04%; 1·19–3·46%) had parenchymal haemorrhage. Symptomatic haemorrhagic transformation occurred in 16 patients (2·5%; 4·04–1·55%). In logistic regression analysis, independent factors associated with haemorrhagic transformation were large anterior (18·70; 6·72–52·04), large posterior (9·41; 3·13–28·25), medium-sized (odds ratio 3·30; 95% confidence interval 1·14–9·57) lesions, higher low-density lipoprotein level (1·44 per unit increment; 1·10–1·90), and lower platelet count (1·005 per unit decrement; 1·009–1·001). Haemorrhagic infarct (1·76; 0·76–4·11) or parenchymal haemorrhage (2·39; 0·23–24·76) were not associated with unfavourable functional outcome or death at three-months.

Conclusions

In young adults, haemorrhagic transformation of ischaemic stroke occurred in comparable rates to haemorrhagic transformation in elderly patients. Although haemorrhagic transformation was more common in severe strokes, it was the lesion size and baseline stroke severity that were associated with three-month clinical outcome, not haemorrhagic transformation per se.