bluuebunny/crossref_metadata_2025 huggingface dataset:
Anthrax: a disease in waiting?
Authors: Dognany L , Welsby P D
Published: November 2006

Anthrax was a relatively unknown disease in the Western world until 2001, when spores were maliciously mailed in the US, causing five deaths. The mortality of the disease, the stability of its spores and the subsequent lack of person-to-person spread make anthrax an attractive biological weapon for terrorists with a desire for targeted mass destruction.
The role of research training during higher medical education in the promotion of academic medicine in the UK
Authors: Myint P K , MacLullich A M J , Witham M D
Published: November 2006

Objectives

To examine the research activities and perceived barriers to research among higher specialist trainees in geriatric medicine and to show how trainees active in research might have a role in assisting their peers in getting started in research.

Design

Cross-sectional questionnaire survey on research activities, attitudes to doing research and perceived difficulties in doing research.

Setting and participants

Trainee members of the British Geriatrics Society (BGS) in the UK.

Results

A total of 122 responses (30% response rate) were received after a single mailing and a follow-up questionnaire to trainees attending the BGS national conference. Although 64% (67/104) of respondents would like to undertake a period of research, many perceived barriers preventing them from planning, funding and executing a research project. Among those who had not undertaken research, the majority (70%, 42/60) indicated that they have no clear idea of a topic to research, 64% (39/61) did not know how to develop an idea and 62% (38/61) indicated that they did not know how to get funding. Trainees motivated to do research were faced with particular difficulties with regards to funding and selection of a project topic.

Conclusions

One useful method would be systematically to provide basic information to trainees on how to enter into the early stages of research. This would help to overcome some of the unnecessary uncertainty that many trainees keen to do research seem to have.
Acute mountain sickness: medical problems associated with acute and subacute exposure to hypobaric hypoxia
Authors: Clarke C
Published: November 2006

This article summarises the medical problems of travel to altitudes above 3000 m. These are caused by chronic hypoxia. Acute mountain sickness (AMS), a self limiting common illness is almost part of normal acclimatisation—a transient condition lasting for several days. However, in <2% of people staying above 4000 m, serious illnesses related to hypoxia develop – high altitude pulmonary oedema and cerebral oedema. These are potentially fatal but can be largely avoided by gradual ascent. Short vacations, pressure from travel companies and peer groups often encourage ascent to 4000 m more rapidly than is prudent. Sensible guidelines for ascent are outlined, clinical features, management and treatment of these conditions.
Study to outline the efficacy and illustrate techniques for steroid injection for trigger finger and thumb
Authors: Akhtar S , Burke F D
Published: November 2006

Aim

To outline the efficacy of a steroid injection in treating trigger finger. Our study defines the anatomy of the A1 pulley, and suggests methods for simple and safe flexor sheath injection for trigger finger and thumb.

Method

Systematic review of published literature on trigger finger and thumb and its treatment, particularly steroid injection. The use of the knowledge of the superficial landmarks of the A1 pulley with the techniques described were combined to provide a comprehensive guide to injecting steroids in patients with trigger finger and thumb.

Results

Several studies are outlined, which provided evidence to suggest that a steroid injection into the flexor sheath of the affected digit is successful in treating most of the patients. Methods of identifying the superficial landmarks of the A1 pulley and of approaching the pulley without injury to surrounding structures are also outlined in the literature. Two different techniques used to infiltrate the flexor sheath were described.

Conclusion

Steroid injection in the flexor sheath at the level of the A1 pulley is an effective method of treating patients with trigger finger and should be considered as the preferred treatment. Specific anatomical landmarks and methods allow the procedure to be carried out without fear of inadvertent damage to surrounding structures.
Predicting outcome of acute non-variceal upper gastrointestinal haemorrhage without endoscopy using the clinical Rockall Score
Authors: Tham T C K , James C , Kelly M
Published: November 2006

Background

The Rockall risk scoring system uses clinical criteria and endoscopy to identify patients at risk of adverse outcomes after acute upper gastrointestinal haemorrhage. A clinical Rockall score obtained using only the clinical criteria may be able to predict outcome without endoscopy.

Aim

To validate the clinical Rockall Score in predicting outcome after acute non-variceal upper gastrointestinal haemorrhage.

Methods

A retrospective observational study of consecutive patients who were admitted with non-variceal acute upper gastrointestinal haemorrhage was undertaken. Medical records were abstracted using a standardised form.

Results

102 cases were identified (51 men and 51 women; mean age 59 years). 38 (37%) patients considered to be at low risk of adverse outcomes (clinical Rockall Score 0) had no adverse outcomes and did not require transfusion. Patients with a clinical Rockall Score of 1–3 had no adverse outcomes, although 13 of 45 (29%) patients required blood transfusions. Clinical Rockall Scores >3 (n = 19) were associated with adverse outcomes (rebleeding in 4 (21%), surgery in 1 (5%) and death in 2 (10%)).

Conclusions

The clinical Rockall Score without endoscopy may be a useful prognostic indicator in this cohort of patients with acute non-variceal upper gastrointestinal haemorrhage. This score may reduce the need for urgent endoscopy in low-risk patients, which can instead be carried out on a more elective outpatient basis.
Falsely raised TSH levels due to human anti-mouse antibody interfering with thyrotropin assay
Authors: Krishnan S G S , Pathalapati R , Kaplan L , Cobbs R K
Published: November 2006

The case of a 39-year-old woman who was referred for weight gain and amenorrhoea is reported. Laboratory evaluation showed high levels of thyroid-stimulating hormone (TSH). The patient was started on increasing doses of levothyroxine for subclinical hypothyroidism. TSH remained persistently raised and the patient became thyrotoxic. Evaluation at another laboratory showed normal levels of TSH, raising the possibility of interfering substances. TSH levels were normalised with the addition of mouse serum to the patient's sample, confirming the presence of human anti-mouse antibodies as the interfering substance in the TSH assay.
NON-TRIVIAL REALIZATIONS OF VIRTUAL LINK DIAGRAMS
Authors: DYE H. A.
Published: November 2006

A realization of a virtual link diagram is obtained by choosing over/under markings for each virtual crossing. Any realization can also be obtained from some representation of the virtual link. (A representation of a virtual link is a link diagram on an oriented 2-dimensional surface.) We prove that if a minimal genus representation meets certain criteria then there is a minimal genus representation resulting in a knotted realization.
SOME RESULTS ABOUT THE KAUFFMAN BRACKET SKEIN MODULE OF THE TWIST KNOT EXTERIOR
Authors: GELCA RĂZVAN , NAGASATO FUMIKAZU
Published: November 2006

In this paper, we list in explicit form the factoring relations of the Kauffman bracket skein module (KBSM for short) of a twist knot exterior. This is done using curves decorated by characters of irreducible SL(2, ℂ)-representations. In the process, we exhibit a relation which holds in the KBSM of the knot exterior, called the minimal relation. In the final section we prove that, when specializing the variable of the Kauffman bracket at t = -1, the minimal relation becomes the defining polynomial of the SL(2, ℂ)-character variety of the twist knot.
SOCIAL AND INTELLECTUAL CAPITAL FORMATION IN LEADING INDIAN PHARMACEUTICAL COMPANIES
Authors: BOWER D. JANE , SULEJ JULIAN
Published: November 2006

A number of Indian pharmaceutical firms have achieved high levels of success globally in product and process development. They are competing effectively in the generic pharmaceutical markets of the USA and Europe. They have progressively accumulated process development and manufacturing capabilities which meet the stringent criteria of the US and European Union regulators, and have also acquired drug "discovery" skills to a level which has gained some recognition from major Western pharmaceutical companies. This paper analyses evidence from a range of documentary sources in order to elucidate how two of the leading Indian companies have accumulated the intellectual and social capital which has enabled this degree of innovative success. It finds evidence that environmental factors have opened up opportunities which drew on the firms' early capabilities, while requiring additional skills. In response, these firms have invested in expanding their initial internal competences through a number of routes, including hiring Indian-born, Western-trained scientists and industry executives, membership of an internationally oriented industry association, etc. As their profits and reputations have grown, they have also been able to access external knowledge through Western alliances and acquisitions. It concludes that they have built a broad business and technical knowledge-base and very wide networks, which have been effectively integrated thus far in pursuit of business objectives, but raises the question of whether they should now adopt a more focused approach.
Highly Fluorescent Noble-Metal Quantum Dots
Authors: Zheng Jie , Nicovich Philip R. , Dickson Robert M.
Published: November 2006

Highly fluorescent, water-soluble, few-atom noble-metal quantum dots have been created that behave as multielectron artificial atoms with discrete, size-tunable electronic transitions throughout the visible and near infrared. These molecular metals exhibit highly polarizable transitions and scale in size according to the simple relation EFermi/N1/3, predicted by the free-electron model of metallic behavior. This simple scaling indicates that fluorescence arises from intraband transitions of free electrons, and these conduction-electron transitions are the low-number limit of the plasmon—the collective dipole oscillations occurring when a continuous density of states is reached. Providing the missing link between atomic and nanoparticle behavior in noble metals, these emissive, water-soluble Au nanoclusters open new opportunities for biological labels, energy-transfer pairs, and light-emitting sources in nanoscale optoelectronics.
State-to-State Dynamics of Elementary Bimolecular Reactions
Authors: Yang Xueming
Published: November 2006

The study of state-to-state dynamics of elementary bimolecular reactions has provided remarkable insights into chemical reactivity at the most fundamental level. This review covers exciting developments in this important field in the past decade. I focus on recent studies of quantum-state-resolved molecular-beam reactive-scattering studies of elementary chemical reactions, from triatomic to polyatomic systems. Researchers have made great advances in the fundamental understanding of many elementary chemical reactions through state-to-state dynamics studies. The strong interaction between theory and experiment has significantly enhanced our understanding of the dynamics of these reactions. I hope this review provides a glimpse of this exciting research field to both experts and beginners.
Propagation of calcium waves along endothelium of hamster feed arteries
Authors: Uhrenholt Torben R. , Domeier Timothy L. , Segal Steven S.
Published: November 2006

An increase in tissue blood flow requires relaxation of smooth muscle cells along entire branches of the resistance vasculature. Whereas the spread of hyperpolarization along the endothelium can coordinate smooth muscle cell relaxation, complementary signaling events have been implicated in the conduction of vasodilation. We tested the hypothesis that Ca2+ waves propagate from cell to cell along the endothelium of feed arteries exhibiting spontaneous vasomotor tone. Feed arteries of the hamster retractor muscle were isolated, pressurized to 75 mmHg at 37°C, and developed myogenic tone spontaneously. Smooth muscle cells and endothelial cells were loaded with the Ca2+ indicator Fluo-4. An acetylcholine stimulus was delivered locally using microiontophoresis (1-μm pipette tip, 1 μA, 1 s), and Ca2+ signaling within and along respective cell layers was determined using laser-scanning confocal microscopy. Acetylcholine triggered an increase in intracellular Ca2+ concentration ([Ca2+]i) of endothelial cells at the site of stimulation that preceded two distinct events: 1) a rapid synchronous decrease in smooth muscle [Ca2+]i along the entire vessel and 2) an ensuing Ca2+ wave that propagated bidirectionally along the endothelium at ∼111 μm/s for distances exceeding 1 mm. Maximal dilation of vessels with either nifedipine (1 μM) or sodium nitroprusside (SNP, 100 μM) reduced the distance that Ca2+ waves traveled to ∼300 μm ( P < 0.05). Thus Ca2+ waves propagate along the endothelium of resistance vessels with vasomotor tone, and this signaling pathway is compromised during maximal dilation with nifedipine or SNP.
Expression of cathepsin K is regulated by shear stress in cultured endothelial cells and is increased in endothelium in human atherosclerosis
Authors: Platt Manu O. , Ankeny Randall F. , Shi Guo-Ping , Weiss Daiana , Vega J. D. , Taylor W. R. , Jo Hanjoong
Published: November 2006

Cathepsins, the lysosomal cysteine proteases, are involved in vascular remodeling and atherosclerosis. Genetic knockout of cathepsins S and K in mice has shown to reduce atherosclerosis, although the molecular mechanisms remain unclear. Because atherosclerosis preferentially occurs in arteries exposed to disturbed flow conditions, we hypothesized that shear stress would regulate cathepsin K expression and activity in endothelial cells. Mouse aortic endothelial cells (MAEC) exposed to proatherogenic oscillatory shear (OS, ± 5 dyn/cm2for 1 day) showed significantly higher cathepsin K expression and activity than that of atheroprotective, unidirectional laminar shear stress (LS, 15 dyn/cm2for 1 day). Western blot and active-site labeling studies showed an active, mature form of cathepsin K in the conditioned medium of MAEC exposed to OS but not in that of LS. Functionally, MAEC exposed to OS significantly increased elastase and gelatinase activity above that of LS. The OS-dependent elastase and gelatinase activities were significantly reduced by knocking down cathepsin K with small-interfering (si) RNA, but not by a nonsilencing siRNA control, suggesting that cathepsin K is a shear-sensitive protease. In addition, immunohistochemical analysis of atherosclerotic human coronary arteries showed a positive correlation between the cathepsin K expression levels in endothelium and elastic lamina integrity. These findings suggest that cathepsin K is a mechanosensitive, extracellular matrix protease that, in turn, may be involved in arterial wall remodeling and atherosclerosis.
Inhibition of PPAR-α activity in mice with cardiac-restricted expression of tumor necrosis factor: potential role of TGF-β/Smad3
Authors: Sekiguchi Kenichi , Tian Qi , Ishiyama Masakuni , Burchfield Jana , Gao Feng , Mann Douglas L. , Barger Philip M.
Published: November 2006

A shift in energy substrate utilization from fatty acids to glucose has been reported in failing hearts, resulting in improved oxygen efficiency yet perhaps also contributing to a state of energy deficiency. Peroxisome proliferator-activated receptor (PPAR)-α, the principal transcriptional regulator of cardiac fatty acid β-oxidation (FAO) genes, is downregulated in heart failure, and this may contribute to reduced fatty acid utilization. Cardiomyopathic states are also accompanied by elevated levels of circulating cytokines, such as tumor necrosis factor (TNF), as well as increased local production of cytokines and profibrotic factors, such as transforming growth factor (TGF)-β. However, whether these molecular pathways directly modulate cardiac energy metabolism and PPAR-α activity is not known. Therefore, FAO capacity and FAO gene expression were determined in mice with cardiac-restricted overexpression of TNF (MHCsTNF3). MHCsTNF3 hearts had significantly lower FAO capacity and decreased expression of PPAR-α and FAO target genes compared with control hearts. Surprisingly, TNF had little effect on PPAR-α activity and FAO rates in cultured ventricular myocytes, suggesting that TNF acts indirectly on myocyte FAO in vivo. We found that TGF-β expression was upregulated in MHCsTNF3 hearts and that treatment of cultured myocytes with TGF-β significantly suppressed FAO rates and directly impaired PPAR-α activity, a result reproduced by Smad3 overexpression. This work demonstrates that TGF-β signaling pathways directly suppress PPAR-α activity and reduce FAO in cardiac myocytes, perhaps in response to locally elevated TNF. Although speculative, TGF-β-driven repair mechanisms may also include the additional benefit of limiting FAO in injured myocardium.
Atrioventricular plane displacement is the major contributor to left ventricular pumping in healthy adults, athletes, and patients with dilated cardiomyopathy
Authors: Carlsson Marcus , Ugander Martin , Mosén Henrik , Buhre Torsten , Arheden Hakan
Published: November 2006

Previous studies using echocardiography in healthy subjects have reported conflicting data regarding the percentage of the stroke volume (SV) of the left ventricle (LV) resulting from longitudinal and radial function, respectively. Therefore, the aim was to quantify the percentage of SV explained by longitudinal atrioventricular plane displacement (AVPD) in controls, athletes, and patients with decreased LV function due to dilated cardiomyopathy (DCM). Twelve healthy subjects, 12 elite triathletes, and 12 patients with DCM and ejection fraction below 30% were examined by cine magnetic resonance imaging. AVPD and SV were measured in long- and short-axis images, respectively. The percentage of the SV explained by longitudinal function (SVAVPD%) was calculated as the mean epicardial area of the largest short-axis slices in end diastole multiplied by the AVPD and divided by the SV. SV was higher in athletes [140 ± 4 ml (mean ± SE), P = 0.009] and lower in patients (72 ± 7 ml, P < 0.001) when compared with controls (116 ± 6 ml). AVPD was similar in athletes (17 ± 1 mm, P = 0.45) and lower in patients (7 ± 1 mm, P < 0.001) when compared with controls (16 ± 0 mm). SVAVPD%was similar both in athletes (57 ± 2%, P = 0.51) and in patients (67 ± 4%, P = 0.24) when compared with controls (60 ± 2%). In conclusion, longitudinal AVPD is the primary contributor to LV pumping and accounts for ∼60% of the SV. Although AVPD is less than half in patients with DCM when compared with controls and athletes, the contribution of AVPD to LV function is maintained, which can be explained by the larger short-axis area in DCM.
A search for genes that may confer divergent morphology and function in the carotid body between two strains of mice
Authors: Balbir Alexander , Lee Hannah , Okumura Mariko , Biswal Shyam , Fitzgerald Robert S. , Shirahata Machiko
Published: November 2006

The carotid body (CB) is the primary hypoxic chemosensory organ. Its hypoxic response appears to be genetically controlled. We have hypothesized that: 1) genes related to CB function are expressed less in the A/J mice (low responder to hypoxia) compared with DBA/2J mice (high responder to hypoxia); and 2) gene expression levels of morphogenic and trophic factors of the CB are significantly lower in the A/J mice than DBA/2J mice. This study utilizes microarray analysis to test these hypotheses. Three sets of CBs were harvested from both strains. RNA was isolated and used for global gene expression profiling (Affymetrix Mouse 430 v2.0 array). Statistically significant gene expression was determined as a minimum six counts of nine pairwise comparisons, a minimum 1.5-fold change, and P ≤ 0.05. Our results demonstrated that 793 genes were expressed less and that 568 genes were expressed more in the A/J strain vs. the DBA/2J strain. Analysis of individual genes indicates that genes encoding ion channels are differentially expressed between the two strains. Genes related to neurotransmitter metabolism, synaptic vesicles, and the development of neural crest-derived cells are expressed less in the A/J CB vs. the DBA/2J CB. Through pathway analysis, we have constructed a model that shows gene interactions and offers a roadmap to investigate CB development and hypoxic chemosensing/chemotransduction processes. Particularly, Gdnf, Bmp2, Kcnmb2, Tph1, Hif1a, and Arnt2 may contribute to the functional differences in the CB between the two strains. Bmp2, Phox2b, Dlx2, and Msx2 may be important for the morphological differences.
Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson’s Disease Without Orthostatic Hypotension
Authors: Barbic Franca , Perego Francesca , Canesi Margherita , Gianni Michela , Biagiotti Sara , Costantino Giorgio , Pezzoli Giovanni , Porta Alberto , Malliani Alberto , Furlan Raffaello
Published: November 2006

Cardiac autonomic abnormalities have been described in Parkinson’s disease. Little is known about possible alterations of vascular sympathetic regulatory activity in patients without orthostatic hypotension or symptoms of orthostatic intolerance. Nineteen patients with Parkinson’s disease without orthostatic hypotension (PD), 21 with orthostatic hypotension (PDOH), and 20 healthy controls underwent ECG, beat-to-beat arterial pressure, and respiration recordings while recumbent and during a 75° head-up tilt. Spectrum analysis of RR interval and systolic arterial pressure (SAP) variability provided indices of cardiac sympathovagal interaction (low frequency [LF]/high frequency [HF]) to the sinoatrial node and sympathetic vasomotor control (LF
SAP
). Arterial baroreceptor mechanisms were assessed by the spontaneous sequences technique and bivariate spectrum analysis (α index). Plasma catecholamines provided the neurohormonal profile. At rest, hemodynamics and spectral markers of autonomic function were similar in PD and control subjects. Norepinephrine was lower in PD and PDOH than in control subjects. In PDOH, SAP was higher, whereas LF/HF ratio and LF
SAP
were lower compared with control subjects. During tilt, SAP was unchanged in PD; however, similar to PDOH, the increase of heart rate, LF/HF ratio, and LF
SAP
was blunted compared with control subjects. Baroreflex indices were unmodified in PD and PDOH compared with control subjects. Initial alterations in both cardiac and vascular sympathetic modulatory activity were found in PD and revealed by a gravitational stimulus. Prompt recognition of sympathetic abnormalities might result in earlier therapeutic intervention, reduced orthostatic intolerance, and increased quality of life.
Prolyl Hydroxylase Domain 2 Protein Suppresses Hypoxia-Induced Endothelial Cell Proliferation
Authors: Takeda Kotaro , Fong Guo-Hua
Published: November 2006

Prolyl hydroxylase domain 2 protein (PHD2) signals the degradation of hypoxia-inducible factor (HIF)-1α by hydroxylating specific prolyl residues located within oxygen-dependent degradation domains. As expected, endothelial cells (ECs) overexpressing PHD2 had reduced HIF-1α and vascular endothelial growth factor-A expression and failed to accelerate their proliferation in response to hypoxia. Surprisingly, although these cells displayed further reductions in HIF-1α and vascular endothelial growth factor-A expression when cultured under normoxia, there was no further reduction in EC proliferation. Thus, there seemed to be no consistent correlation between PHD2 hydroxylase–mediated suppression of HIF-1α expression and inhibition of EC growth. Indeed, overexpression of a mutant PHD2 lacking hydroxylase activity also greatly diminished EC response to hypoxia-induced increase in proliferation, in spite of the fact that hypoxia-induced HIF-1α accumulation was not affected by mutant PHD2. These data strongly suggest the existence of a hydroxylase-independent mechanism for PHD2-mediated inhibition of EC proliferation under hypoxia. In support of a physiological relevance of PHD2 overexpression, we found that endogenous PHD2 expression was significantly upregulated by hypoxia and that silencing of the
Phd2
gene by RNA interference significantly enhanced hypoxia-induced EC proliferation. In conclusion, this study demonstrates that PHD2 may act as a negative feedback regulator to antagonize hypoxia-induced EC proliferation.
X-Ray Fused With Magnetic Resonance Imaging (XFM) to Target Endomyocardial Injections
Authors: de Silva Ranil , Gutiérrez Luis F. , Raval Amish N. , McVeigh Elliot R. , Ozturk Cengizhan , Lederman Robert J.
Published: November 2006

Background—

Magnetic resonance imaging (MRI) permits 3-dimensional (3D) cardiac imaging with high soft tissue contrast. X-ray fluoroscopy provides high-resolution, 2-dimensional (2D) projection imaging. We have developed real-time x-ray fused with MRI (XFM) to guide invasive procedures that combines the best features of both imaging modalities. We tested the accuracy of XFM using external fiducial markers to guide endomyocardial cell injections in infarcted swine hearts.

Methods and Results—

Endomyocardial injections of iron-labeled mesenchymal stromal cells admixed with tissue dye were performed in previously infarcted hearts of 12 Yucatan miniswine (weight, 33 to 67 kg). Features from cardiac MRI were displayed combined with x-ray in real time to guide injections. During 130 injections, operators were provided with 3D surfaces of endocardium, epicardium, myocardial wall thickness (range, 2.6 to 17.7 mm), and infarct registered with live x-ray images to facilitate device navigation and choice of injection location. XFM-guided injections were compared with postinjection MRI and with necropsy specimens obtained 24 hours later. Visual inspection of the pattern of dye staining on 2,3,5-triphenyltetrazolium chloride–stained heart slices agreed (κ=0.69) with XFM-derived injection locations mapped onto delayed hyperenhancement MRI and the susceptibility artifacts seen on the postinjection T2*-weighted gradient echo MRI. The distance between the predicted and actual injection locations in vivo was 3.2±2.6 mm (n=64), and 75% of injections were within 4.1 mm of the predicted location.

Conclusions—

Three-dimensional to two-dimensional registration of x-ray and MR images with the use of external fiducial markers accurately targets endomyocardial injection in a swine model of myocardial infarction.
Genetic Variation Is Associated With C-Reactive Protein Levels in the Third National Health and Nutrition Examination Survey
Authors: Crawford Dana C. , Sanders Christopher L. , Qin Xiaoting , Smith Joshua D. , Shephard Cynthia , Wong Michelle , Witrak Laura , Rieder Mark J. , Nickerson Deborah A.
Published: November 2006

Background—

Increased serum C-reactive protein (CRP) is an independent risk factor for cardiovascular disease. Previous studies have suggested that genetic variation within the
CRP
gene is associated with serum CRP.

Methods and Results—

We genotyped
CRP
genetic variants in 7159 individuals from the Third National Health and Nutrition Examination Survey (NHANES III). NHANES III is American population-based sample linked to hundreds of phenotypes, including CRP; however, the CRP assay used in this survey is not a high-sensitivity CRP assay, and 65% of participants (n=4679) had CRP measurements at or below the level of detection. Despite these limitations, we identified specific
CRP
single-nucleotide polymorphisms (SNPs) and haplotypes associated with serum CRP levels in the general population. Two variants were associated with increased levels of serum CRP: SNP rs3093058 (in linkage disequilibrium with a
CRP
promoter SNP rs3093062) in the non-Hispanic black sample and the triallelic promoter SNP rs3091244 in the non-Hispanic black and Mexican American samples. Two other SNPs were associated with decreased levels of serum CRP in either the non-Hispanic black (rs1205 and rs2808630) or Mexican American (rs1205) samples. Three haplotypes inferred from 7 SNPs (ATTGCGA, TTAGCGA, and AAAGAGA) were associated (
P
≤0.01) with increased levels of serum CRP in the non-Hispanic black sample; 2 haplotypes (ATTGCGA and AAAGCGA) were associated (
P
<0.05) with increased levels in the Mexican American sample; and 1 haplotype (AAAGCGA) was associated (
P
<0.03) with increased levels in the non-Hispanic white sample. Post hoc analysis suggests that the AA genotype of the triallelic SNP rs3091244, after adjustment for covariates, was associated with prevalent coronary heart disease in the non-Hispanic white population sample.

Conclusions—

Genetic variation within
CRP
is associated with serum CRP levels in the general population and may be associated with prevalent coronary heart disease.
Ventricular Septal Defects
Authors: Minette Mary S. , Sahn David J.
Published: November 2006

Ventricular septal defects are the most common congenital heart defect. They vary greatly in location, clinical presentation, associated lesions, and natural history. The present article describes the clinical aspects of ventricular septal defects and current management strategies.
Long-Term Survival in Patients Presenting With Type B Acute Aortic Dissection
Authors: Tsai Thomas T. , Fattori Rossella , Trimarchi Santi , Isselbacher Eric , Myrmel Truls , Evangelista Arturo , Hutchison Stuart , Sechtem Udo , Cooper Jeanna V. , Smith Dean E. , Pape Linda , Froehlich James , Raghupathy Arun , Januzzi James L. , Eagle Kim A. , Nienaber Christoph A.
Published: November 2006

Background—

Follow-up survival studies in patients with acute type B aortic dissection have been restricted to a small number of patients in single centers. We used data from a contemporary registry of acute type B aortic dissection to better understand factors associated with adverse long-term survival.

Methods and Results—

We examined 242 consecutive patients discharged alive with acute type B aortic dissection enrolled in the International Registry of Acute Aortic Dissection (IRAD) between 1996 and 2003. Kaplan-Meier survival curves were constructed, and Cox proportional hazards analysis was performed to identify independent predictors of follow-up mortality. Three-year survival for patients treated medically, surgically, or with endovascular therapy was 77.6±6.6%, 82.8±18.9%, and 76.2±25.2%, respectively (median follow-up 2.3 years, log-rank
P
=0.61). Independent predictors of follow-up mortality included female gender (hazard ratio [HR],1.99; 95% confidence interval [CI], 1.07 to 3.71;
P
=0.03), a history of prior aortic aneurysm (HR, 2.17; 95% CI, 1.03 to 4.59;
P
=0.04), a history of atherosclerosis (HR, 2.48; 95% CI, 1.32 to 4.66;
P
<0.01), in-hospital renal failure (HR, 2.55; 95% CI, 1.15 to 5.63;
P
=0.02), pleural effusion on chest radiograph (HR, 2.56; 95% CI, 1.18 to 5.58;
P
=0.02), and in-hospital hypotension/shock (HR, 12.5; 95% CI, 3.24 to 48.21;
P
<0.01).

Conclusions—

Contemporary follow-up mortality in patients who survive to hospital discharge with acute type B aortic dissection is high, approaching 1 in every 4 patients at 3 years. Current treatment and follow-up surveillance require further study to better understand and optimize care for patients with this complex disease.
Prevention of High-Dose Chemotherapy–Induced Cardiotoxicity in High-Risk Patients by Angiotensin-Converting Enzyme Inhibition
Authors: Cardinale Daniela , Colombo Alessandro , Sandri Maria T. , Lamantia Giuseppina , Colombo Nicola , Civelli Maurizio , Martinelli Giovanni , Veglia Fabrizio , Fiorentini Cesare , Cipolla Carlo M.
Published: November 2006

Background—

An increase in troponin I soon after high-dose chemotherapy (HDC) is a strong predictor of poor cardiological outcome in cancer patients. This finding has important clinical implications and provides a rationale for the development of prophylactic strategies for preventing cardiotoxicity. Angiotensin-converting enzyme inhibitors slow the progression of left ventricular dysfunction in different clinical settings, but their role in the prevention of cardiotoxicity has never been investigated.

Methods and Results—

Of the 473 cancer patients evaluated, 114 (72 women; mean age, 45±12 years) who showed a troponin I increase soon after HDC were randomized to receive (angiotensin-converting enzyme inhibitor group; 20 mg/d; n=56) or not to receive (control subjects; n=58) enalapril. Treatment was started 1 month after HDC and continued for 1 year. Cardiological evaluation was performed at baseline and at 1, 3, 6, and 12 months after HDC. The primary end point was an absolute decrease >10 percent units in left ventricular ejection fraction, with a decline below the normal limit value. A significant reduction in left ventricular ejection fraction and an increase in end-diastolic and end-systolic volumes were observed only in untreated patients. According to the Kaplan-Meier analysis, the incidence of the primary end point was significantly higher in control subjects than in the angiotensin-converting enzyme inhibitor group (43% versus 0%;
P
<0.001).

Conclusions—

In high-risk, HDC-treated patients, defined by an increased troponin I value, early treatment with enalapril seems to prevent the development of late cardiotoxicity.
Myocardial Injury and Ventricular Dysfunction Related to Training Levels Among Nonelite Participants in the Boston Marathon
Authors: Neilan Tomas G. , Januzzi James L. , Lee-Lewandrowski Elizabeth , Ton-Nu Thanh-Thao , Yoerger Danita M. , Jassal Davinder S. , Lewandrowski Kent B. , Siegel Arthur J. , Marshall Jane E. , Douglas Pamela S. , Lawlor David , Picard Michael H. , Wood Malissa J.
Published: November 2006

Background—

Multiple studies have individually documented cardiac dysfunction and biochemical evidence of cardiac injury after endurance sports; however, convincing associations between the two are lacking. We aimed to determine the associations between the observed transient cardiac dysfunction and biochemical evidence of cardiac injury in amateur participants in endurance sports and to elicit the risk factors for the observed injury and dysfunction.

Methods and Results—

We screened 60 nonelite participants, before and after the 2004 and 2005 Boston Marathons, with echocardiography and serum biomarkers. Echocardiography included conventional measures as well as tissue Doppler–derived strain and strain rate imaging. Biomarkers included cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP). All subjects completed the race. Echocardiographic abnormalities after the race included altered diastolic filling, increased pulmonary pressures and right ventricular dimensions, and decreased right ventricular systolic function. At baseline, all had unmeasurable troponin. After the race, >60% of participants had increased cTnT >99th percentile of normal (>0.01 ng/mL), whereas 40% had a cTnT level at or above the decision limit for acute myocardial necrosis (≥0.03 ng/mL). After the race, NT-proBNP concentrations increased from 63 (interquartile range [IQR] 21 to 81) pg/mL to 131 (IQR 82 to 193) pg/mL (
P
<0.001). The increase in biomarkers correlated with post-race diastolic dysfunction, increased pulmonary pressures, and right ventricular dysfunction (right ventricular mid strain,
r
=−0.70,
P
<0.001) and inversely with training mileage (
r
=−0.71,
P
<0.001). Compared with athletes training >45 miles/wk, athletes who trained ≤35 miles/wk demonstrated increased pulmonary pressures, right ventricular dysfunction (mid strain 16±5% versus 25±4%,
P
<0.001), myocyte injury (cTnT 0.09 versus <0.01 ng/mL,
P
<0.001), and stress (NT-proBNP 182 versus 106 pg/mL,
P
<0.001).

Conclusions—

Completion of a marathon is associated with correlative biochemical and echocardiographic evidence of cardiac dysfunction and injury, and this risk is increased in those participants with less training.
Novel Nanocomposite Actuator Based on Sulfonated Poly(styrene-b-ethylene-co-butylene-b-styrene) Polymer
Authors: Jung Jin-Young , Oh Il-Kwon
Published: November 2006

Ionic polymer metal composite (IPMC) actuators were developed with multi-walled carbon nanotubes (MWNT) and sulfonated poly(styrene-b-ethylene-co-butylene-b-styrene) (SSEBS) ionic polymers. MWNT with the diameter of 10 ∼ 15 nm and length of 10 ∼ 20 μm was used to enhance
the mechanical and electrical performances of IPMC actuators. Ultrasonic treatment and high speed mixing were employed to disperse MWNTs homogeneously in SSEBS solution. The electroless plating method was used to make electrodes on the both side of the composite membrane. Scanning electron
microscope (SEM) and transmission electron microscope (TEM) images were taken to characterize the surface and micro-structures of the composite actuators. In this study, novel nano-composite actuators were fabricated with different weight ratio of the MWNT 0.5%, 1.5% and the bending actuation
performance and electrical power consumptions were investigated.
Aqueous-Phase Synthesis of Ultra-Stable Small CdSe Nanoparticles
Authors: Park Yeon-Su , Dmytruk Andriy , Dmitruk Igor , Yasuto Noda , Kasuya Atsuo , Takeda Motohiro , Ohuchi Noriaki
Published: November 2006

Very stable and small CdSe nanoparticles (NPs) were synthesized from the aqueous solutions containing L-cysteine (Cys) at room temperature. The Cys-capped CdSe NPs showed a very sharp excitonic peak at 420 nm. Its very small full width at half maximum (18 nm) indicates very high quality
of the CdSe NPs. Their absorption features experienced little change over a month, implying an excellent stability of the CdSe NPs. The synthesis conditions were very critical to the optical property and stability of the CdSe NPs: only those prepared at specific conditions (nSe-precursor/nCd-precursor
= 0.25–0.5, nCys/nCd-precursor = ∼9, pH = ∼12) showed very sharp absorption peaks and maintained an excellent stability against time. Under these conditions, the peaks always appear at nearly the same wavelength, indicating that these NPs are selectively
stable and grow at a particular size and structure.
Fabrication and Characterization of Directly-Assembled ZnO Nanowire Field Effect Transistors with Polymer Gate Dielectrics
Authors: Yoon Ahnsook , Hong Woong-Ki , Lee Takhee
Published: November 2006

We report the fabrication and electrical characterization of ZnO nanowire field effect transistors (FETs). Dielectrophoresis technique was used to directly align ZnO nanowires between lithographically prepatterned source and drain electrodes, and spin-coated polyvinylphenol (PVP) polymer
thin layer was used as a gate dielectric layer in "top-gate" FET device configuration. The electrical characteristics of the top-gate ZnO nanowire FETs were found to be comparable to the conventional "bottom-gate" nanowire FETs with a SiO2 gate dielectric layer, suggesting the directly-assembled
nanowire FET with a polymer gate dielectric layer is a useful device structure of nanowire FETs.
Electrothermal Properties of Porous Ceramic Fiber Media Containing Carbon Materials
Authors: Park Sung , Kwon Young Pil , Kwon Hyuck Chon , Lee Ju-Hyeon , Lee Hae-Weon , Lee Jae Chun
Published: November 2006

Electrically regenerable porous ceramic fiber media containing nanoporous carbon from 2.5% to 19.2% have been prepared for adsorption/regeneration system. An experimental apparatus was built for in situ measurement of the sample weight during adsorption and electrothermal desorption
of gaseous adsorbates. Adsorption and electrothermal desorption behavior of gaseous adsorbates on carbon contained porous ceramic fiber media was explained by physical and electrothermal properties of these materials measured in this work. In situ thermal desorption and adsorption experiments
showthat a considerable amount of water vapor is adsorbed on the carbon contained media exposed to ambient air.
Unique Mechanical Properties of Nanostructured Metals
Authors: Tsuji Nobuhiro
Published: November 2006

Recently, it becomes possible to fabricate bulk metals having ultrafine grained or nanocrystalline structures of which grain size is in nano-meter dimensions. One of the promising ways to realize bulk nanostructured metals is severe plastic deformation (SPD) above logarithmic equivalent
strain of 4. We have developed an original SPD process, named Accumulative Roll Bonding (ARB) using rolling deformation in principle, and have succeeded in fabricating bulk nanostructured sheets of various kinds of metals and alloys. The ARB process and the nanostructured metals fabricated
by the ARB are introduced in this paper. The nanostructured metals sometimes perform quite unique mechanical properties, that is rather surprising compared with conventionally coarse grained materials. The unique properties seem to be attributed to the characteristic structures of the nano-metals
full of grain boundaries.
Land Surface Microwave Emissivities over the Globe for a Decade
Authors: Prigent Catherine , Aires Filipe , Rossow William B.
Published: November 2006

Microwave land surface emissivities have been calculated over the globe for ~10 yr between 19 and 85 GHz at 53° incidence angle for both orthogonal polarizations, using satellite observations from the Special Sensor Microwave Imager (SSM/I). Ancillary data (IR satellite observations and meteorological reanalysis) help remove the contribution from the atmosphere, clouds, and rain from the measured satellite signal and separate surface temperature from emissivity variations. The method to calculate the emissivity is general and can be applied to other sensors. The monthly mean emissivities are available for the community, with a 0.25° × 0.25° spatial resolution.

The emissivities are sensitive to variations of the vegetation density, the soil moisture, the presence of standing water at the surface, or the snow behavior, and can help characterize the land surface properties.

These emissivities (not illustrated in this paper) also allow for improved atmospheric retrieval over land and can help evaluate land surface emissivity models at global scales.
Surprising Trends in Land Invasions in Metropolitan Lima and Quito
Authors: Dosh Paul , Lerager James
Published: November 2006

Study of land invasion organizations in Lima and Quito reveals six surprising trends that differ by metropolitan context. Specifically, invasion organizations tend to differ with respect to building materials, original land ownership, the difficulty and consequences of acquiring land titles, strategies for acquiring electricity, and types of neighborhood regimes. A more general contrast also emerges: Lima organizations are more likely to encounter quick initial success followed by gradual decline, while the success of Quito organizations is often more gradual, resulting in long-term organizational survival. These citywide trends can be explained by three factors—public policy, local democratization, and geography and climate—that are often neglected in favor of neighborhood-level explanations.
Export Agriculture and Agrarian Crisis
Authors: Ripton John
Published: November 2006

Integration of El Salvador's agrarian resources into the global economy has contributed to periodic agrarian crises, including the 1932 massacre of 10,000 peasants and the civil war of the 1980s, in which 75,000 perished. The formation of the state, the emergence of an oligarchy, the role of the military, and the poverty of the peasants are shaped by commercial agricultural production for the global market. Recent neoliberal and “free-trade” policies are a neglected part of this history. Whereas coffee exports dominated the Salvadoran economy throughout much of the twentieth century, emigration of rural people is now the nation's main export, and there are significant problems with remittances as a development strategy. Liberal theory generally fails to recognize that integrating resources of a poor country into the global economy is as much a political project as it is an economic one.
Community-Centered Globalization
Authors: Jackiewicz Edward L.
Published: November 2006

The retreat of the state from the development process throughout Latin America has placed added responsibility on local communities to improve local living conditions. Research on the impacts of globalization and tourism has tended to highlight the negative repercussions of such engagements, often portraying the hosts as helpless victims of savage capitalism and overbearing tourists. Examination of the introduction of small-scale development initiatives into a small rural community in Costa Rica reveals that the local community is anything but a passive recipient and may actively manage the very modest inclusion of tourism into its overall development strategy. Drawing on the theoretical contributions of Max-Neef, Escobar, and others, this research provides further evidence that integrated small-scale rural development initiatives can achieve modest success by capitalizing on existing resources, gradually broadening the economic mix and collaborating with similarly situated communities.
Migration and Class as Constraints in Battered Women's Attempts to Escape Violence in Lima Peru
Authors: Alcalde M. Cristina
Published: November 2006

The impact of migration on women's experiences of intimate violence and on their efforts to leave abusive relationships in Latin American states is an important area that has yet to be sufficiently explored. A case study reveals many of the external obstacles that migrant battered women in Lima face in attempting to leave abusive relationships. The experience of Daisy, a 29-year-old indigenous woman and mother of four boys who migrated to Lima with her abusive partner and their children in 1997, shows that migration and class can play an important role in battered women's vulnerability to isolation and poverty, thereby prolonging the violence they experience.
Insulin Treatment and the Problem of Weight Gain in Type 2 Diabetes
Authors: Carver Catherine
Published: November 2006

Purpose

Insulin therapy has been shown to benefit the prognosis in patients with type 2 diabetes, but its initiation and intensification is often delayed through concerns about hypoglycemia and weight gain. In addition, weight gain is linked to the pathophysiology of type 2 diabetes and contributes to the overall risk for adverse cardiovascular outcomes. This article attempts to summarize this issue and examine the options available for weight management.

Methods

A broad range of literature has been reviewed to distil important, consistent facts about insulin and weight gain and the options available for limiting the problem.

Results

Unfortunately, the great benefits of insulin therapy may be potentially undermined by weight gain. Weight gain is physiologically and psychologically undesirable, especially in patients with diabetes who are already overweight. The fear of weight gain with some medications contributes to psychological insulin resistance, which may discourage patients from commencing or following insulin regimens. However, new diabetes treatments and lifestyle interventions can be used to mitigate these problems.

Conclusions

The exact choice of insulin and oral medications and weight loss interventions are important considerations in the overall management of patients with type 2 diabetes. Changes in a patient’s lifestyle, such as modifications to diet and implementing an exercise program, are first-line treatments for type 2 diabetes and can also counteract insulin-induced weight gain.