bluuebunny/crossref_metadata_2025 huggingface dataset:
DECISION PROBLEMS ON PATH-CONTROLLED GRAMMARS
Authors: MARTIN-VIDE CARLOS , MITRANA VICTOR
Published: October 2007

This work is a continuation of the investigation started in [12], where a new-old type of control on context-free grammars is considered. This type of control is extracted and abstracted from a paper ([2]) with very solid linguistic motivations. The goal of this paper is to complete the picture of path-controlled grammars started in [12] with some mathematical properties which are missing from the aforementioned work: closure and decidability properties, including a polynomial recognition algorithm.
COOPERATING DISTRIBUTED SYSTEMS OF RESTARTING AUTOMATA
Authors: MESSERSCHMIDT HARTMUT , OTTO FRIEDRICH
Published: October 2007

Here we introduce cooperating distributed systems of restarting automata and establish that in mode = 1 they correspond to the non-forgetting restarting automaton.
MEMBRANE ALGORITHM WITH BROWNIAN SUBALGORITHM AND GENETIC SUBALGORITHM
Authors: NISHIDA TAISHIN Y.
Published: October 2007

Membrane algorithms with subalgorithms inspired by simulated annealing are treated in this paper. Simulated annealing is inherently a kind of local search but it modifies a solution to a worse one with a probability determined by "temperature". The temperature of simulated annealing is changed according to "cooling schedule". On the other hand, the subalgorithm introduced here has constant temperature which is determined by the region where the subalgorithm is. It is called Brownian subalgorithm since the subalgorithm incorporates "thermal movement" of a solution in the search space but does not simulate "annealing".

Computer simulations show that a membrane algorithm which has three regions and has a Brownian subalgorithm in each region can obtain very good approximate solutions for several benchmark problems of the traveling salesman problem. However, the algorithm, occasionally, gets quite bad solutions (twice as large as the optimum) for a problem. A membrane algorithm which has both Brownian and genetic subalgorithms never gets such a bad solution (only 8% worse than the optimum) for all problems examined, although, in average, it is not as good as the algorithm with Brownian only. The result indicates that membrane algorithm with subalgorithms under different approximate mechanisms may be robust under a wide range of problems.
A TREE-HEIGHT HIERARCHY OF CONTEXT-FREE LANGUAGES
Authors: REINHARDT KLAUS
Published: October 2007

We consider the minimal height of a derivation tree as a complexity measure for context-free languages and show that this leads to a strict and dense hierarchy between logarithmic and linear (arbitrary) tree height. In doing so, we improve a result obtained by Gabarro in [7]. Furthermore, we provide a counter-example to disprove a conjecture of Čulik and Maurer in [6] who suggested that all languages with logarithmic tree height would be regular. As a new method, we use counter-representations where the successor relation can be handled as the complement of context-free languages.

A similar hierarchy is obtained considering the ambiguity as a complexity measure.
COMPARING SUBWORD OCCURRENCES IN BINARY D0L SEQUENCES
Authors: SALOMAA ARTO
Published: October 2007

We investigate binary words and ω-words, mainly those generated by D0L systems. We compare the numbers of occurrences of ab and ba as (scattered) subwords by introducing a 'difference function'. Of special interest are the 'balanced' or 'fair' words for which the function assumes the value 0. If the three first words in a D0L sequence are fair, so are all words in the sequence. Two kinds of matrices constitute a useful technical tool in the study. An explicit formula, leading to various consequences, is obtained for the difference function.
ON COMPETENCE IN CD GRAMMAR SYSTEMS WITH PARALLEL REWRITING
Authors: TER BEEK MAURICE H. , CSUHAJ-VARJÚ ERZSÉBET , VASZIL GYÖRGY , HOLZER MARKUS
Published: October 2007

We continue our investigation of the generative power of cooperating distributed grammar systems (CDGSs), using the previously introduced ≤k-, =k-, and ≥k-competence-based cooperation strategies and context-free components that rewrite the sentential form in a parallel manner. This leads to new characterizations of the languages generated by (random context) ET0L systems and recurrent programmed grammars.
SC-EXPRESSIONS IN OBJECT-ORIENTED LANGUAGES
Authors: YU SHENG , ZHAO QING
Published: October 2007

In this paper, SC-expressions are developed, based on automata theory, for specifying synchronization constraints in parallel object-oriented languages. The predecessor of SC-expressions, the synchronization expressions, was introduced in the ParC parallel programming language in the early nineties [19]. However, ParC is not an object-oriented language and also a number of basic features of synchronization expressions are inadequate for object-oriented languages. SC-expressions are developed for object-oriented environment. They are different from synchronization expressions in basic ideas and assumptions. Here we describe the basic ideas of SC-expressions and their applications in object-oriented languages. We also study the problem of inheritance of the SC-expressions.
Oxidative Stress, Endothelial Dysfunction and Cerebrovascular Disease
Authors: Zalba Guillermo , Fortuño Ana , San José Gorka , Moreno María U. , Beloqui Oscar , Díez Javier
Published: October 2007

Endothelial dysfunction is a marker of atherosclerosis and contributes to the atherogenic process and the development of atherothrombotic complications. Oxidative stress has been implicated in the development of endothelial dysfunction through alterations of the nitric oxide metabolism. A number of evidence suggests a role for phagocytic-cell-mediated oxidative stress in diminished nitric oxide availability that is present in patients with atherosclerotic risk factors such as arterial hypertension. Thus, the combination of an excessive production of reactive oxygen species, namely superoxide anion, with an impaired antioxidant defense capacity leading to oxidative stress may facilitate the development and progression of atherosclerosis. Findings from recent clinical studies suggest that this mechanism can be operative in patients with cerebrovascular disease. This view may increase our capabilities to understand the pathophysiology of cerebrovascular disease, as well as to stimulate the design of new therapeutic strategies aimed to prevent and control the atherosclerotic process in patients presenting this condition.
Platelets, Arterial Thrombosis and Cerebral Ischemia
Authors: Badimon Lina , Vilahur Gemma
Published: October 2007

Atherosclerosis is a systemic disease that starts early in life, asymptomatically progressing though adulthood, until clinically manifested. In the last few years, experimental, clinical and pathological investigation has led us to a better knowledge of the pathophysiology of atherothrombotic disease. Atherothrombosis is the result of atherosclerosis progression, and its potentially life-threatening clinical consequences include coronary artery disease, cerebrovascular disease and peripheral artery disease. These events are mostly secondary to atherosclerotic plaque disruption and subsequent in situ thrombus formation which may be embolized and dragged by the arterial flow until occluding distal vessels. The demonstrated beneficial role of antiplatelet drugs in reducing the incidence of nonfatal events in many large clinical trials has demonstrated the major role of platelets in the atherothrombotic process in the arterial tree.
Advances in Atheroma Imaging in the Carotid
Authors: Gillard Jonathan H.
Published: October 2007

Atherosclerosis affects all vascular beds, including the coronary, carotid, intracerebral, peripheral and aortic vascular beds, and is responsible for tremendous morbidity and mortality, with the most serious outcomes being myocardial infarction, stroke and death. Historically the effects of vascular narrowing and associated thrombosis have been key indicators of disease in the coronary and carotid territories, with degrees of vascular stenosis being of profound importance in carotid surgery trials. Our improving understanding of the biology of atheromatous lesions and the development of alternative therapeutic agents which can initiate actual plaque regression have created a need to attempt to image plaque itself, with the carotid artery being an achievable target. This article reviews current strategies for assessing carotid atherosclerotic disease, particularly with reference to identifying plaque components and risk of rupture, the so-called vulnerable plaque.
Patients at High Risk for Ischemic Stroke: Identification and Actions
Authors: Gállego Jaime , Martínez Vila Eduardo , Muñoz Roberto
Published: October 2007

Atherosclerosis is a disease of chronic inflammation. It is diffuse, multisystemic and affects the vascular, metabolic and immune systems. The traditional evaluation of risk is based on methods of clinical and biological assessments, and conventional imaging. The existence of symptomatic disease and the number of symptomatic sites of atherothrombosis are critical factors in predicting the recurrence of major vascular events. However, these methods are insufficient to predict near-future episodes, above all in the individual standard clinical practice. Active treatment of modifiable risk factors such as hypertension, dyslipidemia and atrial fibrillation can reduce the number of patients who develop a stroke. There is considerable evidence suggesting that a substantial proportion of the population with high blood pressure receives insufficient treatment. More active treatment of this condition is probably the most efficient single measure. Lifestyle factors such as smoking, diet, physical inactivity and obesity contribute to the relatively high incidence of stroke. There is a need to incorporate new systemic markers and new investigation techniques in the future so as to identify the individuals at risk in the population and to administer more individualized intervention therapies.
Peculiarities of Stroke Risk in Women
Authors: Egido Jose-Antonio , Alonso de Leciñana María
Published: October 2007

Stroke constitutes a serious socioeconomic and health care problem in women because it is the principal cause of incapacity and the first cause of death in this section of the population in several countries. The incidence of cerebral infarction and myocardial infarction is lower in females than in males, but only up to menopause, when, especially after >65 years of age, the differences disappear. This is attributable to the protective role of the natural estrogens during the fertile part of the woman’s life. The estrogens have antiatherogenic and neuroprotective effects and, before menopause, account for a risk profile that is less atherogenic. The risk factors that have higher importance in young women are migraine and oral contraceptive use as well as etiologies specifically associated with pregnancy, birth and puerperium, or even diseases that present more commonly in women (systemic lupus erythematosus, fibromuscular dysplasia). These entities lose their relevance after menopause, when the classical vascular-disease risk factors take on their role, and also include others such as hormone replacement therapy. Due to the specific epidemiology of stroke, females are underrepresented in the clinical trials of primary and secondary prevention, the result being that the outcomes measured in these trials are less consistent and do not show as clear a benefit for women as for men.
Cryptogenic Stroke, Aortic Arch Atheroma and Patent Foramen Ovale
Authors: Molina Carlos A. , Santamarina Estevo , Alvarez-Sabín José
Published: October 2007

Cryptogenic stroke represents a diagnostic challenge. Several conditions have been found to be more frequent in patients with cryptogenic stroke. Aortic arch atheroma (AAA) and patent foramen ovale (PFO) have been shown to be highly prevalent in the adult population, especially in patients with ischemic cerebrovascular events, particularly cryptogenic strokes. In both conditions, clinical relevance and stroke risk are related to age, with AAA being more frequent and severer in patients >55 years, and the relationship between stroke and PFO being stronger in those <55 years of age. This review is focused on the prevalence, risk of stroke and therapeutic strategies in patients with cryptogenic stroke related to AAA or PFO.
Action on Vascular Risk Factors: Importance of Blood Pressure and Lipid Lowering in Stroke Secondary Prevention
Authors: Fuentes B. , Ortega-Casarrubios M.A. , Martínez P. , Díez-Tejedor E.
Published: October 2007

Introduction: Secondary stroke prevention comprises a broad spectrum of therapeutic actions that includes the appropriate management of risk factors and the action on blood pressure and serum lipids that are of great importance to decrease stroke recurrences. Methods: We conducted a review of the published studies analyzing the relevance of the treatment of blood pressure and serum lipids, with special attention to recent findings of clinical trials and current guidelines on stroke secondary prevention. Results: The relationship between blood pressure and stroke has been widely demonstrated; however, the role of serum lipids has been discussed for a long time. Recent results from epidemiological studies and clinical trials have demonstrated its role as modifiable risk factor for stroke. Blood pressure and lipid lowering are associated with significant reductions in recurrent strokes as well as in other vascular events in transient ischemic attack (TIA) or stroke patients. The PROGRESS and MOSES trials suggest that diuretics, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers could confer additional benefits in stroke patients, and the SPARCL study did so for statins. These drugs are not only efficacious in the reduction of stroke recurrences, but also in other cardiovascular events. Conclusions: Blood pressure and serum lipids are two important and modifiable vascular risk factors that should be taken into consideration when planning secondary stroke prevention measures. This approach should include hypotensive drugs (mainly the combination of diuretics and ACE inhibitors) with the objective to maintain normal blood pressure, avoiding levels >130/80 mm Hg in all stroke patients, and statins (atorvastatin 80 mg) in patients with noncardioembolic TIA or stroke.
Anticoagulants, Aspirin and Dipyridamole in the Secondary Prevention of Cerebral Ischaemia: Which Is the Best for Which Patient?
Authors: Halkes P.H.A. , Algra A.
Published: October 2007

In this paper, an overview is given of trials with oral anticoagulants and dipyridamole in the secondary prevention after transient ischaemic attack or minor stroke. In patients with atrial fibrillation, the secondary preventive treatment of first choice is oral anticoagulation with an aimed international normalised ratio between 2.0 and 3.0. In patients without a cardiac source of embolism, a combination therapy of low-dose aspirin and dipyridamole 200 mg twice daily is the treatment of choice. These treatment strategies do however not prevent all recurrent strokes or vascular complications, and research for more effective strategies is warranted.
Usefulness of Antiplatelet Drugs in Ischaemic Stroke Prevention – Update on New Trials
Authors: Röther Joachim
Published: October 2007

Meta-analysis shows that the absolute risk reduction of antiplatelet therapy for the prevention of fatal and non-fatal stroke is only 1%. This stresses the need for further studies that explore the use of combination therapy and focus on more homogeneous stroke populations such as acute-stroke patients. Recent studies are reviewed that extended the database on antiplatelet drugs in ischaemic stroke prevention.
Endarterectomy, Best Medical Treatment or Both for Stroke Prevention in Patients with Asymptomatic Carotid Artery Stenosis
Authors: Cardona Pedro , Rubio Francisco , Martinez-Yélamos Sergio , Krupinski Jerzy
Published: October 2007

Carotid endarterectomy (CEA) is currently frequently performed in subjects with asymptomatic carotid artery stenosis over 70%, as clinical trials like the Asymptomatic Carotid Atherosclerosis Study and Asymptomatic Carotid Surgery Trial demonstrated a significant benefit for stroke prevention. A low risk reduction in the long-term prevention of stroke or death and the required lower than 3% of surgical risk are associated with surgery. That means that an important number of patients needs to be operated to prevent 1 stroke over 5 years (number needed to treat: 21) with an absolute risk reduction of 5.4%. It is reasonable to consider CEA for patients aged 40–75 years and with asymptomatic stenosis of 60–99%, for patients with a life expectancy of at least 5 years, and in centres with a surgical morbidity-mortality of less than 3%. Therefore, it is of interest to identify high-risk patients with asymptomatic carotid stenosis who will more likely benefit from surgery. Techniques such as ultrasound or magnetic resonance imaging may identify plaque morphology or detect clinically asymptomatic embolization. CEA combined with the best medical treatment and good management of modifiable risk factors might be superior to medical management alone or surgery in preventing stroke. There is no level I evidence to support carotid artery stenting in asymptomatic carotid stenosis even in a subgroup of patients with a high surgical risk.
General Care in Stroke: Relevance of Glycemia and Blood Pressure Levels
Authors: Fuentes Blanca , Díez-Tejedor Exuperio
Published: October 2007

Introduction: Several studies have highlighted that the appropriate control of blood pressure, glycemia, body temperature and oxygen saturation is correlated with the clinical evolution of acute stroke when each of these variables is analyzed separately. However, within a biological system all these parameters can be interrelated and can influence the process. Recent studies demonstrate the importance of appropriate maintenance of these variables in what is termed nonpharmacological brain protection. Methods: We conducted a review of the published studies that analyze the influence of the control of these physiological variables in acute stroke, not only in isolation, with specific attention to glycemia and blood pressure, but also in combination. Homeostasis was considered the normalization of these variables. Results: Over the past few years several studies have demonstrated the influence of hyperglycemia and blood pressure changes in the acute phase of stroke on the prognosis of the patients. Recent studies highlight that glucose values >150 mg/dl and systolic blood pressure >180 mm Hg indicate poorer prognosis. However, there are insufficient data on whether pharmacological correction of the variables influences the prognosis. Nevertheless, when these variables are analyzed in combination, the patients in whom the variables are maintained within normality (homeostasis) have a better prognosis. Stroke units are the ideal locations for the application of these treatments. Conclusions: Nonpharmacological brain protection, with the appropriate maintenance of homeostasis, constitutes the basis for optimum treatment of acute stroke.
Neuroprotection in Cerebral Infarction: The Opportunity of New Studies
Authors: Pérez de la Ossa Natalia , Dávalos Antoni
Published: October 2007

Therapeutic options in the acute phase of a stroke are limited despite a great number of neuroprotectant drugs that have been developed in the last few decades. Although neuroprotection has been proved in animal models, translation of experimental efficacy into clinical benefit in humans is a difficult task. With the aim of bringing closer laboratory and clinical results, a change and unification of the methodology used is needed. Evaluating neuroprotectant capacity to salvage the penumbra using MRI both in animals and humans as a surrogate outcome can help to select drugs more likely to demonstrate clinical benefit. In addition, neuroprotection should enlarge the window of opportunity for reperfusion therapies and protect vascular structures to reduce reperfusion injury and the clinical complications related to thrombolytic treatment. A better understanding of ischemic and restorative brain mechanisms beyond the acute phase of stroke may open new therapeutic options to improve stroke recovery.
Poststroke Depression: Importance of Its Detection and Treatment
Authors: Gabaldón Laura , Fuentes Blanca , Frank-García Ana , Díez-Tejedor Exuperio
Published: October 2007

Background: Poststroke depression (PSD) is a complication that occurs in up to 30% of the patients who have had a stroke. Its development is associated with a poor functional prognosis and a negative impact on the patient’s quality of life. Methods: In the present review, we summarize the diagnostic criteria, prevalence, predisposing factors, the lesion site, the impact of PSD on the clinical evolution of the patient, the current therapeutic approaches and even the relationship between depression and cerebrovascular disease. Results: There are differences in relation to prevalence, essentially due to the use of different diagnostic criteria. Also, there have been few studies focusing on the search for factors that are predictive of PSD (age, female sex, single vascular lesion independent of site) and the reluctance to initiate preventive treatments to minimize the effects on the clinical evolution of the patients. There have been several advances with respect to the treatment of PSD. It seems that treatments show improvement trends, but today there is not enough evidence to recommend a preventive therapy for depression in any stroke patient. Conclusions: We consider that the prevalence of PSD is relevant and that the risk factors as well as the early diagnosis are important for the best management and prognosis of stroke patients. Further studies are needed in this field in order to reduce PSD.
Vascular Cognitive Deterioration and Stroke
Authors: Erkinjuntti Timo
Published: October 2007

Vascular cognitive impairment, the recent modification of the terminology related to vascular burden of the brain, reflects the all-encompassing effects of vascular disease or lesions on cognition. It incorporates the complex interactions between vascular aetiologies, risk factors and cellular changes within the brain and cognition. The concept covers the frequent poststroke cognitive impairment and dementia, as well as cerebrovascular disease (CVD) as the second most common factor related to dementia. CVD as well as vascular risk factors including arterial hypertension, history of high cholesterol, diabetes or forms of heart disease are independently associated with an increased risk of cognitive impairment and dementia. Traditional vascular risk factors and stroke are also independent factors for the clinical presentation of Alzheimer’s disease (AD). In addition to these vascular factors, CVD/strokes, infarcts and white-matter lesions may trigger and modify the progression of AD as the most common cause of neurodegenerative dementia. The main subtypes of previously defined vascular dementia (VaD) include the cortical VaD or multi-infarct dementia also referred as poststroke VaD, subcortical ischaemic vascular disease and dementia or small-vessel dementia and strategic-infarct dementia. Whilst CVD is preventable and treatable, it is clearly a major factor in the prevalence of cognitive impairment in the elderly worldwide.
Quality of Life and Voice: Study of a Brazilian Population Using the Voice-Related Quality of Life Measure
Authors: Behlau Mara , Hogikyan Norman D. , Gasparini Gisele
Published: October 2007

Objective: The goal of the present study was to characterize a large population of Brazilian individuals using the Brazilian Portuguese version of the Voice-Related Quality of Life (V-RQOL) Measure. Patients and Methods: We studied a population of 2,214 Brazilian subjects who completed the V-RQOL questionnaire consisting of 10 questions from two domains: physical functioning and social-emotional functioning. The subjects were divided into two groups according to the presence of vocal complaints: group 1, with vocal complaints (1,304 individuals); group 2, without vocal complaints (910 individuals). Subject age ranged from 14 to 90 years in both groups. All subjects self-rated their voice quality upon a five-point categorical scale ranging from poor to excellent. Moreover, the respondents’ professions were classified into four categories according to their level of voice usage. Results: Results indicate that the worse the self-assessment of the voice, the lower the V-RQOL scores, with higher significance in the group with vocal complaints. The total V-RQOL score was 97 for excellent voices, 92 for very good, 84 for good, 65 for fair, and 45 for poor voices. Main correlations for both groups were: total and physical scores (0.96), total and social-emotional scores (0.82); physical and social-emotional scores (0.69); self-assessment of the voice and total score (0.61); self-assessment of the voice and physical score (0.58), and self-assessment of the voice and social-emotional score (0.52). Two interesting negative correlations were found between age and self-assessment of the voice (–0.271), and age and social-emotional score (–0.184). Group 1, with vocal complaints, presented lower scores than group 2. Conclusions: The relationship between self-assessment of voice quality and V-RQOL scores was very clear and statistically significant, especially when considering the group with a known voice disorder.
Effects of Speech Stimuli and Dysarthria Severity on Intelligibility Scores and Listener Confidence Ratings for Speakers with Cerebral Palsy
Authors: Hustad Katherine C.
Published: October 2007

This study examined differences among transcription intelligibility scores and listener confidence ratings for three different types of speech stimuli – single words, unrelated sentences, and sentences forming a narrative – all produced by speakers with dysarthria. Twelve speakers with dysarthria of varying severity secondary to cerebral palsy and 144 listeners participated in this study. Results showed that both intelligibility scores and confidence ratings were differentially affected by both stimuli and severity. For speakers with mild, moderate, and severe dysarthria, intelligibility scores were higher for narratives than for either of the other two types of speech stimuli. For speakers with mild dysarthria, sentences were substantially more intelligible than single words. However, for speakers with moderate, severe, and profound dysarthria, the difference in intelligibility scores for sentences and single words was small or nonsignificant. Confidence ratings did not follow the same pattern as intelligibility data, suggesting a mismatch between listeners’ perception of their performance and their actual performance on intelligibility tasks.
Mutation in Glycerol-3-Phosphate Dehydrogenase 1–Like Gene (
GPD1-L
) Decreases Cardiac Na
+
Current and Causes Inherited Arrhythmias
Authors: London Barry , Michalec Michael , Mehdi Haider , Zhu Xiaodong , Kerchner Laurie , Sanyal Shamarendra , Viswanathan Prakash C. , Pfahnl Arnold E. , Shang Lijuan L. , Madhusudanan Mohan , Baty Catherine J. , Lagana Stephen , Aleong Ryan , Gutmann Rebecca , Ackerman Michael J. , McNamara Dennis M. , Weiss Raul , Dudley Samuel C.
Published: October 2007

Background—

Brugada syndrome is a rare, autosomal-dominant, male-predominant form of idiopathic ventricular fibrillation characterized by a right bundle-branch block and ST elevation in the right precordial leads of the surface ECG. Mutations in the cardiac Na
+
channel SCN5A on chromosome 3p21 cause ≈20% of the cases of Brugada syndrome; most mutations decrease inward Na
+
current, some by preventing trafficking of the channels to the surface membrane. We previously used positional cloning to identify a new locus on chromosome 3p24 in a large family with Brugada syndrome and excluded
SCN5A
as a candidate gene.

Methods and Results—

We used direct sequencing to identify a mutation (A280V) in a conserved amino acid of the glycerol-3-phosphate dehydrogenase 1–like (
GPD1-L
) gene. The mutation was present in all affected individuals and absent in >500 control subjects. GPD1-L RNA and protein are abundant in the heart. Compared with wild-type GPD1-L, coexpression of A280V GPD1-L with SCN5A in HEK cells reduced inward Na
+
currents by ≈50% (
P
<0.005). Wild-type GPD1-L localized near the cell surface to a greater extent than A280V GPD1-L. Coexpression of A280V GPD1-L with SCN5A reduced SCN5A cell surface expression by 31±5% (
P
=0.01).

Conclusions—

GPD1-L
is a novel gene that may affect trafficking of the cardiac Na
+
channel to the cell surface. A GPD1-L mutation decreases SCN5A surface membrane expression, reduces inward Na
+
current, and causes Brugada syndrome.
Molecular and Functional Characterization of Novel Glycerol-3-Phosphate Dehydrogenase 1–Like Gene (
GPD1-L
) Mutations in Sudden Infant Death Syndrome
Authors: Van Norstrand David W. , Valdivia Carmen R. , Tester David J. , Ueda Kazuo , London Barry , Makielski Jonathan C. , Ackerman Michael J.
Published: October 2007

Background—

Autopsy-negative sudden unexplained death, including sudden infant death syndrome, can be caused by cardiac channelopathies such as Brugada syndrome (BrS). Type 1 BrS, caused by mutations in the
SCN5A
-encoded sodium channel, accounts for ≈20% of BrS. Recently, a novel mutation in the glycerol-3-phosphate dehydrogenase 1–like gene (
GPD1-L
) disrupted trafficking of SCN5A in a multigenerational family with BrS. We hypothesized that mutations in
GPD1-L
may be responsible for some cases of sudden unexplained death/sudden infant death syndrome.

Methods and Results—

Using denaturing high-performance liquid chromatography and direct DNA sequencing, we performed comprehensive open-reading frame/splice site mutational analysis of
GPD1-L
on genomic DNA extracted from necropsy tissue of 83 unrelated cases of sudden unexplained death (26 females, 57 males; average age, 14.6±10.7 years; range, 1 month to 48 years). A putative, sudden unexplained death–associated
GPD1-L
missense mutation, E83K, was discovered in a 3-month-old white boy. Further mutational analysis was then performed on genomic DNA derived from a population-based cohort of 221 anonymous cases of sudden infant death syndrome (84 females, 137 males; average age, 3±2 months; range, 3 days to 12 months), revealing 2 additional mutations, I124V and R273C, in a 5-week-old white girl and a 1-month-old white boy, respectively. All mutations occurred in highly conserved residues and were absent in 600 reference alleles. Compared with wild-type GPD1-L, GPD1-L mutations coexpressed with SCN5A in heterologous HEK cells produced a significantly reduced sodium current (
P
<0.01). Adenovirus-mediated gene transfer of the E83K–GPD1-L mutation into neonatal mouse myocytes markedly attenuated the sodium current (
P
<0.01). These decreases in current density are consistent with sodium channel loss-of-function diseases like BrS.

Conclusions—

The present study is the first to report mutations in
GPD1-L
as a pathogenic cause for a small subset of sudden infant death syndrome via a secondary loss-of-function mechanism whereby perturbations in GPD1-L precipitate a marked decrease in the peak sodium current and a potentially lethal BrS-like proarrhythmic substrate.
Acute Myocardial Infarction and Congestive Heart Failure Outcomes at Specialty Cardiac Hospitals
Authors: Nallamothu Brahmajee K. , Wang Yongfei , Cram Peter , Birkmeyer John D. , Ross Joseph S. , Normand Sharon-Lise T. , Krumholz Harlan M.
Published: October 2007

Background—

Outcomes of patients with acute myocardial infarction (AMI) and congestive heart failure (CHF) at specialty cardiac hospitals are uncertain.

Methods and Results—

From 2003 Medicare data, we used hierarchical regression to calculate 30-day standardized mortality ratios and risk-standardized mortality rates for AMI and CHF at 16 cardiac and 121 peer general hospitals in 15 healthcare markets. We then compared cardiac and general hospitals by determining (1) the proportion of facilities with statistically higher, no different, or lower than expected mortality based on 95% interval estimates of standardized mortality ratios and (2) differences in risk-standardized mortality rates between the types of facilities after stratification within healthcare markets. We identified 1912 patients with AMI and 1275 patients with CHF at cardiac hospitals and 13 158 patients with AMI and 18 295 patients with CHF at general hospitals. Patients at cardiac hospitals were younger, were more likely to be male, and had a much lower prevalence of noncardiovascular diseases. After adjustment for patient differences, standardized mortality ratios were significantly better than expected for 4 (25%) and 5 (31%) cardiac hospitals for AMI and CHF, respectively, compared with 5 (4%) and 6 (5%) general hospitals. Risk-standardized mortality rates were modestly lower at cardiac hospitals (15.0% versus 16.2% for AMI,
P
<0.001, and 10.7% versus 11.3% for CHF,
P
<0.01).

Conclusions—

Patients with AMI and CHF at cardiac hospitals differ considerably from those at peer general hospitals. Although outcomes were modestly better at cardiac hospitals, substantial variation was noted across individual facilities.
Overview of New Technologies for Lower Extremity Revascularization
Authors: Rogers Jason H. , Laird John R.
Published: October 2007

Lower extremity peripheral arterial occlusive disease poses a unique challenge to traditional angioplasty-based endovascular therapies. The diffuse nature of lower extremity atherosclerotic disease, the presence of chronic total occlusions, poor distal runoff, and the presence of critical limb ischemia all have contributed to the disappointing results of balloon angioplasty for complex infrainguinal arterial disease. These challenges have spawned the development of a host of new technologies in an attempt to improve the safety and effectiveness of percutaneous revascularization for lower extremity peripheral arterial occlusive disease. This review summarizes the recent advances in available technologies, including novel angioplasty balloons; nitinol stents, stent grafts, and drug-eluting stents; excisional, laser, and rotational atherectomy devices; devices for crossing total occlusions; true-lumen reentry devices; thrombectomy catheters; and embolic protection devices.
Catheter Ablation of Ventricular Tachycardia After Repair of Congenital Heart Disease
Authors: Zeppenfeld Katja , Schalij Martin J. , Bartelings Margot M. , Tedrow Usha B. , Koplan Bruce A. , Soejima Kyoko , Stevenson William G.
Published: October 2007

Background—

Catheter ablation of ventricular tachycardia (VT) after repair of congenital heart disease can be difficult because of nonmappable VTs and complex anatomy. Insights into the relation between anatomic isthmuses identified by delineating unexcitable tissue using substrate mapping techniques and critical reentry circuit isthmuses might facilitate ablation.

Methods and Results—

Sinus rhythm voltage mapping of the right ventricle was performed in 11 patients with sustained VT after repair of congenital heart disease. Unexcitable tissue from patch material, valve annulus, or dense fibrosis, identified from bipolar voltage (<0.5 mV) and pacing threshold (>10 mA), was defined as an anatomic isthmus boundary bordering 4 isthmuses between (1) the tricuspid annulus and scar/patch in the anterior right ventricular outflow, (2) the pulmonary annulus and right ventricular free wall scar/patch, (3) the pulmonary annulus and septal scar/patch, and (4) the septal scar/patch and tricuspid annulus. The reentry circuit isthmuses of all induced 15 VTs (mean cycle length, 276±78 ms; 73% poorly tolerated), identified by activation, entrainment, and/or pace mapping, were located in an anatomic isthmus (11 of 15 VTs in anatomic isthmus 1). Transecting the anatomic isthmuses by ablation lesions abolished all VTs. During 30.4±29.3 months of follow-up, 91% of patients remained free of VT.

Conclusions—

Reentry circuit isthmuses in VT late after repair of congenital heart disease are located within anatomically defined isthmuses bordered by unexcitable tissue. The boundaries can be identified with 3-dimensional substrate mapping and connected by ablation lines during sinus rhythm. These findings should facilitate catheter and surgical ablation of stable and unstable VTs.
Cyclic Stretch Controls the Expression of CD40 in Endothelial Cells by Changing Their Transforming Growth Factor–β1 Response
Authors: Korff Thomas , Aufgebauer Karin , Hecker Markus
Published: October 2007

Background—

CD40 is a costimulatory molecule that acts as a central mediator of various immune responses, including those involved in the progression of atherosclerosis. Correspondent to its function, CD40 is present not only on many immune cells, such as antigen-presenting cells and T cells, but also on nonimmune cells, such as endothelial cells.

Methods and Results—

Ex vivo analyses in mice revealed that CD40 is strongly expressed in distinct venous and capillary but not arterial endothelial cell populations. Therefore, we analyzed to what extent determinants of an arterial environment control CD40 expression in these cells. In vitro studies indicated that the presence of smooth muscle cells or exposure to cyclic stretch significantly downregulates CD40 expression in human endothelial cells. Interestingly, endothelial cells cocultured with smooth muscle cells upregulated CD40 expression in response to cyclic stretch through a transforming growth factor–β1/activin-receptor–like kinase-1 (Alk-1)–dependent mechanism. To corroborate that this mechanism also operates in arteries in vivo, we analyzed the expression of Alk-1 and CD40 at atherosclerosis-prone sites of the mouse aorta that also appear to be exposed to increased stretch. In wild-type mice, both Alk-1 and CD40 revealed a comparably heterogeneous expression pattern along the aortic arch that matched those sites in low-density lipoprotein–receptor–deficient mice where atherosclerotic lesions develop.

Conclusions—

Cyclic stretch thus increases the abundance of CD40 in endothelial cells through transforming growth factor–β1/Alk-1 signaling. This mechanism in turn may be responsible for the heterogeneous expression of CD40 at arterial bifurcations or curvatures and would support a site-specific proinflammatory response that is typical for the early phase of atherosclerosis.
A Community Survey of RESTAURANT DINING HABITS
Authors: Gildea Harry , Labson David E.
Published: October 2007

A recent market research survey was performed for the Hotel Corporation of America which has many hotel and motor hotel restaurant facilities. The survey's general objective was to obtain, by means of telephone and personal interview, information on patterns in restaurant dining. It was further sought to learn the motivation for such dining patterns and also to obtain information useful in evaluating the market potential for a given community. The questions selected for the interview covered aspects of restaurant selection and use, as well as opinions about restaurants. The focus was upon the better quality restaurants, particularly those located in hotels, and directed at dinner meals in a non-business setting. -The Authors.
Training Your Employees
Authors: Ellis Raymond C.
Published: October 2007

Adequately training your hotel staff in fire safety now may help save lives, reduce losses, and help you avoid legal liability in the event of a fire
Solvency, Financial Statements, and the Importance of Cash-Flow Information
Authors: Geller A. Neal , Heath Loyd C.
Published: October 2007

The statement of changes in financial position, while useful to firms operating within an earlier financial environment, has become an anachronism today. The authors recommend a new financial statement—one that reflects changes in cash flows, rather than changes in working capital
Solving Marketing Problems through
Authors: Dee Zive Jessica
Published: October 2007

How to plan a promotion that's a solution, as well as a sensation
The Fine Art of Selecting Fine Art for Hotels
Authors: Rhodes Debra
Published: October 2007

Well-chosen art can add considerably to the ambience of your property—but choosing the right art can often be a perplexing task. This article provides some pointers
Counseling With Gifted and Talented Students
Authors: Zaffrann Ronald T. , Colangelo Nick
Published: October 2007

The purpose of this article is to focus on the counseling function of school guidance personnel. In this article, the authors present a general model within which this counseling function occurs. Various areas of concern for gifted students are discussed; for example, personal and social concerns; education concerns, career concerns. These are not offered as distinct, sterile categories of students' concerns. Nor are students themselves being placed in "pigeon- holes". Rather, a loose, flexible structure is suggested within which these concerns or areas of interest can be placed and examined. As a result, school counselors and others can better understand and provide for these concerns of gifted and talented youngsters.
A Model for Preparing Special and General Education Preservice Teachers for Inclusive Education
Authors: Van Laarhoven Toni R. , Munk Dennis D. , Lynch Kathleen , Bosma Julie , Rouse Joanne
Published: October 2007

Project ACCEPT (Achieving Creative & Collaborative Educational Preservice Teams) represents an initiative at Northern Illinois University, where special and general education preservice teachers are joined in a voluntary project featuring an enhanced curriculum and field experiences in inclusive classrooms. Participants receive intensive preparation in use of assistive technologies, functional behavioral assessment, and instructional accommodations as well as experience designing lesson plans that include features of universal design. This article describes the specific features of the Project ACCEPT curriculum and outcomes for the first year of implementation.
Electrophoretic Studies of Silk
Authors: Sookne Arnold M. , Harris Milton
Published: October 2007

A micro-electrophoretic technique was used to determine the characteristic pH-mobility curves for fibroin and for sericin and to ascertain the extent of removal of the latter during degumming by the soap and enzyme processes. The data suggest that sericin contains a much greater proportion of reactive groups than fibroin, and indicate the importance of obtaining either uniform or complete removal of sericin during degumming processes.

The isoelectric points are shown to vary slightly with ionic strength. In acetate buffers of 0.02 M ionic strength, the isoelectric point of fibroin is 3.6 and that of sericin, 4.3.

Large ions of complex structure such as phthalate or picrate appear to have specific effects which are readily detectable by the electrophoretic technique.

Dissolved fibroin adsorbed on glass particles and fibroin regenerated from similar solutions had the same isoelectric points but different pH-mobility curves. Fibroin regenerated after dissolving in solutions of lithium bromide gave the same pH-mobility curve as untreated fibroin.
A Method of Repetitive Longitudinal Sectioning of Cords and Fabrics for Microscopic Examination
Authors: Davis S. Jack
Published: October 2007

A new device and technique for making repetitive longitudinal microscopic sections of discrete and predetermined thickness from cords and fabrics is presented. The device provides for mounting fabric, which is embedded in resin, and elevating it by calibrated increments to a selected distance above the level of a cutting surface which guides a razor blade in cutting a section for microscopic examination. The technique involved is simple and rapid and should be acquired easily by those who are familar with the Hardy method of cross-sectioning fibers. Examples illustrating the possibilities of such a technique in determining cover factor at various levels in fabrics, of determining the degree and character of penetration of various additives, and of the mechanism of particle retention in fabric filtration are given.
The Principles of Textile Finishing
Authors: Valko Emery I.
Published: October 2007

The historical relationship between the science and the technique of textile finishing is illustrated herein by a description of the principles of indigo dyeing. This ingenious technique was developed thousands of years ago, but it has been understood only recently. The rapid progress of polymer and colloid science has reversed the situation and enabled the theory of finishing to take the lead. A need has arisen for a new systematics of finishing. The topical and the energic characterizations have been suggested for this purpose—the first is based on consideration of the site of the finish in the textile (interyarn-intrayarn, interfiber-intrafiber) ; the second on consideration of the forces acting between finish and fiber. The significance of the spatial and energic factors is discussed in relation to some finishing processes.
Photoelastic Study of Stresses in Fabrics and Fabric-Like Structures
Authors: Wacner J. Robert
Published: October 2007

Photoelastic techniques were used to evaluate an assortment of materials to determine stress trajectories in fabrics, embedded fabrics, and embedding media. Photoelastic compounds were evaluated and molds, pressure injector-molding apparatus, a method of measuring stiffness, and a polariscope were developed. Photoelastic color change of monofilament yarns in fabrics, due to stress, was found to be related to fiber thickness and the Michel-Levy scale of birefringence. A method was discovered for evaluating the condition of clamping devices with respect to stress distribution in the specimen tested.
Never-Dried Cotton Fibers
Authors: Ingram P. , Woods D.K. , Peterlin A. , Williams J.L.
Published: October 2007

New data are presented illustrating the high intrinsic mobility within never-dried cotton fibers. This is shown both from a morphological point of view where a unique form of necking is found on fracture, and from a molecular point of view where the transport properties (sorption and diffusion) are found to be irrecoverable once the first drying has occurred. Contrary to generally accepted ideas, never-dried fibers are found to be highly crystalline and on either drying or stretching interfibrillar hydrogen bonding takes place irreversibly.
Observation of the Internal Structure of the Human Hair Cuticle Cell by SEM
Authors: Hunter Leroy D. , Garcia Mario L. , Newman Walter , Cohen George L.
Published: October 2007

Direct observation with a. scanning electron microscope of some aspects of the internal structure of the human hair cuticte cell has been accomplished. Long-term exposure of hair to sun and atmosphere resulted in a breakdown of the cuticle cells on the surface of the hair. Cleavage of the cuticle cells was observed to have occurred within the endocuticle layer in many cases.

Remains of the endocuticle layer on the hair surface-gave the appearance of an amorphous globular material. A layer believed to he an under membrane that was readily observed on the sun- and atmosphere-exposed samples has also been found on many different hair samples subjected to "normal" wear.

Longitudinal striations originating within the cuticle cell similar to but less discernihle than those found in some types of. wool, were also observed on the human hair samples.