bluuebunny/crossref_metadata_2025 huggingface dataset:
Low Incidence of Left Atrial or Left Atrial Appendage Thrombus in Patients with Paroxysmal Atrial Fibrillation and Normal EF Who Present for Pulmonary Vein Antrum Isolation Procedure
Authors: KHAN MOHAMMED N. , USMANI ALI , NOOR SAIRA , ELAYI SAMY , CHING CHI KEONG , BIASE LUIGI DI , PATEL DIMPI , BURKHARDT J. DAVID , CUMMINGS JENNIFER , SCHWEIKERT ROBERT , SALIBA WALID , NATALE ANDREA
Published: February 2008

Introduction:
The incidence of left atrial appendage (LAA) thrombus in patients with paroxysmal atrial fibrillation (PAF) who present for pulmonary vein antrum isolation procedure (PVAI) is unknown.

Methods and Results:
All consecutive patients from January 2000 to June 2004 who underwent a PVAI received a computed tomography (CT) to evaluate LAA thrombus before the procedure and 3 months post‐PVAI. All patients were followed prospectively. One thousand two hundred twenty‐one patients received a PVAI during the study dates. All patients received a CT pre‐PVAI at 3 months, and 601 (49%) received a transesophageal echocardiography (TEE) pre‐PVAI. Per protocol, all patients who had CT scans that were positive for LAA thrombus received a TEE. There were 9 patients who had LAA thrombus on CT scan, but only 3 had LAA thrombus on TEE. Using TEE as the gold standard, only 3 patients had an LAA thrombus before PVAI; of these patients, 2 had chronic AF with average ejection fraction (EF) of 48% and 1 patient had PAF with EF 25%. No patients with PAF and normal EF had LAA thrombus. Patients with LAA thrombus pre‐PVAI had lower EF than patients without LAA thrombus (40% vs. 53%, P = 0.007) but had similar LA size (5.0 vs. 4.5 cm, P = 0.77). No other differences in baseline characteristics were noted.

Conclusions:
In this registry of 1,221 patients, we did not observe LA thrombus in PAF patients with normal EF who present for PVAI. Prescreening CT alone is likely to be sufficient in paroxysmal AF patients with normal EF, and the use of TEE may not be needed.
Periprocedural Anticoagulation for Atrial Fibrillation Ablation
Authors: MORTADA M. EYMAN , CHANDRASEKARAN K. , NANGIA VIKRAM , DHALA ANWER , BLANCK ZALMEN , COOLEY RYAN , BHATIA ATUL , GILBERT CAROL , AKHTAR MASOOD , SRA JASBIR
Published: February 2008

Background: Catheter ablation for atrial fibrillation (AF) can increase risk of left atrial (LA) thrombi and stroke. Optimal periprocedural anticoagulation has not been determined.

Objective: We report the role of administering warfarin and aspirin without low molecular weight heparin in patients undergoing AF ablation.

Methods: A total of 207 patients underwent ablation for AF. Transesophageal echocardiography (TEE) guided transseptal puncture and ruled out clot in the LA. After first puncture, the sheath was flushed with heparin (5,000 Units/mL). After second puncture, a bolus of 80 units/kg of heparin was given, followed by an infusion to maintain activated clotting time (ACT) around 300–350 seconds. Warfarin was stopped and aspirin was started (325 mg/day) 3 days preprocedure. Warfarin was restarted on the day of the procedure. Both medications were continued for 6 weeks postablation. Warfarin was continued for 6 months in patients with prior history of persistent or recurrent AF. Thirty‐seven patients who showed smoke in the LA on TEE were given low molecular weight heparin postprocedure until international normalized ratio (INR) was therapeutic.

Results: Thirty‐two patients had persistent and 175 had paroxysmal AF; 87 were cardioverted during ablation. Two patients had transient ischemic attack (TIA) on the sixth and eighth days, respectively, following ablation, with complete recovery. Both had subtherapeutic INRs.

Conclusion: In patients without demonstrable clot or smoke in the LA, starting aspirin 3 days prior and warfarin immediately post‐radiofrequency ablation, without low molecular weight heparin, with meticulous anticoagulation during the procedure, appears to be a safe mode of anticoagulation.
Effects of Pacing Modes on Cardiac Baroreflex Function in Permanently Paced Patients with Sinus Node Dysfunction
Authors: TSURUGI TAKUO , ABE HARUHIKO , OGINOSAWA YASUSHI , KOHNO RITSUKO , YASUMASU TOMIYA , NAGATOMO TOSHIHISA , OTSUJI YUTAKA
Published: February 2008

Objectives: We compared, in patients with sick sinus syndrome, the effects of various pacing modes on baroreceptor (BR)‐stroke volume (SV) reflex sensitivity, a method we have closely correlated with BR‐heart rate (HR) reflex sensitivity.

Background: Impaired autonomic nervous function, such as decreased BR‐HR reflex sensitivity, predicts sudden cardiac death. However, in patients with sick sinus syndrome, the effects of various pacing modes on autonomic function are unknown, since chronotropic incompetence precludes its evaluation by measurements of BR‐HR reflex sensitivity.

Methods: We studied 12 recipients of dual‐chamber pacemakers with sick sinus syndrome (mean age = 73 ± 8 years; 8 men). Beat‐by‐beat blood pressure (BP) and SV were measured during 5‐minute runs of AAI, DDD, and VVI pacing, and spectrally analyzed to assess BR‐SV reflex sensitivity.

Results: Systolic BP was significantly lower (P < 0.01) during VVI (109 ± 24 mmHg) than during DDD (124 ± 22 mmHg) or AAI (125 ± 41 mmHg) pacing. SV was significantly smaller during VVI (36 ± 23 mL) than during DDD (49 ± 31 mL) pacing (P < 0.05). BR‐SV reflex sensitivity was significantly lower (P < 0.05) during VVI (9.3 ± 5.7% per mmHg) than during DDD (15.0 ± 6.5% per mmHg) or AAI (15.5 ± 6.2% per mmHg) pacing.

Conclusions: BR‐SV reflex sensitivity was significantly lower during VVI than during AAI or DDD pacing. Atrioventricular synchrony plays an important role in the preservation of BR‐SV reflex sensitivity in pacemaker recipients.
Effect of Alkali Metal Oxide Addition on the Sinterability of MgO–B2O3–Al2O3 Glass–Al2O3 Filler Composites
Authors: Okamoto Masahide , Kodama Hironori , Shinozaki Kazuo
Published: February 2008

The sintering of a composite of MgO–B2O3–Al2O3 glass and Al2O3 filler is terminated due to the crystallization of Al4B2O9 in the glass. The densification of a composite of MgO–B2O3–Al2O3 glass and Al2O3 filler using pressureless sintering was accomplished by lowering the sintering temperature of the composite. The sintering temperature was lowered by the addition of small amounts of alkali metal oxides to the MgO–B2O3–Al2O3 glass system. The resultant composite has a four‐point bending strength of 280 MPa, a coefficient of thermal expansion (RT—200°C) of 4.4 × 10−6 K−1, a dielectric constant of 6.0 at 1 MHz, porosity of approximately 1%, and moisture resistance.
Subretinal surgery and transplantation of autologous pigment epithelial cells in retinal angiomatous proliferation
Authors: Krebs Ilse , Binder Susanne , Stolba Ulrike , Kellner Lukas , Glittenberg Carl , Goll Alexandra
Published: February 2008

Purpose:  The aim of this study was to examine whether the presence of retinal angiomatous proliferation (RAP) is a prognostic factor in subretinal surgery with transplantation of a suspension of autologous retinal pigment epithelial (RPE) cells.

Methods:  Eyes that had been followed for at least 12 months after subretinal surgery were reviewed retrospectively and assigned to group 1 (presence of RAP) or group 2 (lesions without RAP). Main outcome measures were logMAR distance acuity and lesion size at 12 months.

Results:  A total of 68 eyes of 68 patients were included; 28 were assigned to group 1 and 40 to group 2. A total of 43% of patients were male and 57% were female. Their mean age was 77.8 years. Mean distance acuity was 1.02 logMAR at baseline and 1.06 logMAR at month 12. Mean lesion size was 27.9 mm2 at baseline and 29.9 mm2 at month 12. The differences between the groups were not significant.

Conclusions:  The presence of RAP did not significantly influence the outcome after subretinal surgery with transplantation of autologous RPE cells. Other than age, preoperative lesion size and distance acuity were the only predictive factors for postoperative results.
Gender‐related differences in cataract surgery outcome: a 5‐year follow‐up
Authors: Lundqvist Britta , Mönestam Eva
Published: February 2008

Purpose:  A prospective, longitudinal, population‐based cohort study was performed to analyse gender‐related differences in subjective and objective visual function 5 years after cataract surgery.

Methods:  All patients (n = 810) who underwent cataract surgery during a 1‐year period (1997–98) at Norrlands University Hospital in Umeå, Sweden, were studied with visual acuity (VA) data and questionnaires (VF‐14) before and after surgery, as well as 5 years later.

Five hundred and thirty patients (177 men, 353 women) answered the questionnaire, constituting 90% (530/590) of the survivors. Four hundred and sixty‐seven (156 men, 311 women) also underwent an eye examination.

Results:  The women were significantly older (P = 0.009) and were more often operated on both eyes (P = 0.005). Before surgery and postoperatively, the women had a significantly lower age‐ and VA‐adjusted VF‐14 score (P = 0.000 and P = 0.036, respectively). This difference was not significant 5 years after surgery (P = 0.16).

Five years after surgery, a significantly larger proportion of women had a decline of more than 0.1 logarithm of the minimum angle of resolution of the better‐seeing eye (P = 0.013). There were no significant gender‐related differences in the operated eye.

Conclusion:  Female cataract surgery patients assess their visual function worse than males after adjustment for age and VA preoperatively and postoperatively. These differences were not significant 5 years after surgery although the men had better best‐corrected visual acuity (BCVA) of their better eye. It is important to be aware of gender‐related differences in perception when performing questionnaire‐based outcome studies.
Allergic axillary dermatitis due to hydrogenated castor oil in a deodorant
Authors: Taghipour Kathy , Tatnall Frances , Orton David
Published: February 2008

We present a case of axillary dermatitis caused by hydrogenated castor oil (HCO) in a commercially available deodorant. Patch testing with constituents obtained from the manufacturer showed allergic reaction to HCO ‘as is’, whereas there was no reaction to HCO 30% in pet. Testing 10 controls with HCO ‘as is’ did not cause irritant contact dermatitis. Allergic contact dermatitis to non‐HCO in cosmetics has been described previously but sensitization to HCO seems to be rare. Most common allergens identified in deodorants are fragrances, and this case illustrates that HCO is another possible allergen found in this group of personal care products. It is important that it is tested ‘as is’ to avoid false‐negative results.
Enhancement of visual scoring of skin irritant reactions using cross‐polarized light and parallel‐polarized light
Authors: Farage Miranda A
Published: February 2008

Background/purpose:  Polarized light has been used as an aid in visualizing various skin conditions, including acne vulgaris, rosacea, photoageing, lentigo simplex, and basal cell carcinoma. The use of parallel‐polarized and cross‐polarized light was evaluated in mild irritant reactions to determine, if this increases the ability to detect very early stages or low levels of irritation.

Methods:  Low concentrations of sodium lauryl sulfate (0.01% and 0.1%) were patched on human volunteers for 2, 6, and 24 hr, daily for 2–3 days in a modification of the standard patch test. Feminine protection products were evaluated in the behind‐the‐knee (BTK) test. Erythema reactions were scored by unaided visual assessment and using a polarized light visualization system.

Results:  In the 24‐hr patch test, mean erythema assessed with polarized light was consistent with results of unaided visual scoring. Under milder conditions (2‐ and 6‐hr patches), and in the BTK, significant differences from pretreatment levels of erythema were apparent earlier in the series of treatments compared with unaided scoring. In addition, subsurface scoring demonstrated that changes were still present under the skin surface even after unaided visual scoring indicated recovery.

Conclusion:  Low (subclinical) levels of irritation can be detected using enhanced visual scoring, indicating this non‐invasive method has the potential to increase the sensitivity of our clinical studies.
Frequency of and trends in fragrance allergy over a 15‐year period
Authors: Nardelli Andrea , Carbonez An , Ottoy Winfried , Drieghe Jacques , Goossens An
Published: February 2008

Background:  The widespread use of fragrance‐containing products is probably the most important reason for its high impact in allergic contact dermatitis.

Objectives:  To describe the frequency of contact allergy to fragrance allergens as tested in the standard series, in relation to age, sex and lesion locations. To determine trends in frequency over the years and to study the association between positive tests observed with the different fragrance‐allergy markers as well as between specific fragrance allergens and locations of the lesions.

Patients/Methods:  10 128 patients underwent patch testing between January 1990 and December 2005 at the Dermatology department in Leuven.

Results:  1463 (14.5%), that is, 380 (26%) males and 1083 (74%) females, reacted positively to at least 1 fragrance‐allergy marker in the standard series: 9% to fragrance mix I, 6% to Myroxylon pereirae, and 4.8% to colophonium (often in association), 2.1% to hydroxyisohexyl 3‐cyclohexene carboxaldehyde and 2.1% to fragrance mix II, the latter 2 allergens having been introduced more recently. Over the years, fragrance contact allergy has shown a fluctuating trend. Hands and face were the most commonly affected body sites. Moreover, a significant association was found between specific fragrance allergens and certain locations.

Conclusions:  This study illustrates that fragrance contact allergy is common in patients suffering from contact dermatitis.
Reduced allergy rates in atopic eczema to contact allergens used in both skin products and foods: atopy and the ‘hapten‐atopy hypothesis’
Authors: McFadden John P. , White Jonathan M. L. , Basketter David A. , Kimber Ian
Published: February 2008

Background:  Food allergy is strongly associated with atopy. This retrospective study investigates whether atopic status affects responses to contact allergens also found in food. We compared incidences of atopic dermatitis/eczema (AD) in subjects who were patch‐test positive (PT+) to diallyl disulfide from handling garlic and parabens used as a skin cream/ointment and food preservative with the incidence in those subjects who were PT+ to chemicals encountered at skin surfaces (lanolin and nickel).

Results:  36 658 patients with eczema/dermatitis were patch tested (1980–2006). 10 326 (28.2%) had AD. 13/83 (15.6%) PT+ subjects to diallyl disulfide/garlic had AD (AD/total population versus AD/diallyl disulfide PT+, P = 0.011). 54/239 parabens PT+ had AD (22.6%), while 181/608 lanolin PT+ had AD (29.8%) (P < 0.05).

Conclusions:  Contact allergy to haptens with oral and skin exposure is reduced in AD compared with non‐AD, unlike food protein hypersensitivity. Lanolin frequency was not decreased. Possible explanations include (i) confounding factors, e.g. AD subjects handle garlic less than non‐AD subjects, or (ii) AD patients tolerate haptens efficiently, secondary to their atopic status, or (iii) oral tolerance of haptens antagonizes tolerance of food proteins, contributing to development of atopy (hapten‐atopy hypothesis). The recent upsurge of atopy took place when gut exposure to haptens in processed foods increased dramatically.
Biological and clinical relevance of matrix metalloproteinases 2 and 9 in acute myeloid leukaemias and myelodysplastic syndromes
Authors: Travaglino Erica , Benatti Chiara , Malcovati Luca , Porta Matteo Giovanni Della , Gallì Anna , Bonetti Elisa , Rosti Vittorio , Cazzola Mario , Invernizzi Rosangela
Published: February 2008

We analysed by immunocytochemistry metalloproteinase (MMP)‐2 and MMP‐9 expression in bone marrow cells from 54 acute myeloid leukaemia (AML) patients, 153 myelodysplastic syndrome (MDS) patients, and 52 non‐haemopathic subjects, in order to evaluate whether MMP expression abnormalities were associated with relevant laboratory or clinical findings. In normal samples MMP‐2 was detected in rare myeloid cells, MMP‐9 in most maturing myeloid cells. In MDS MMP‐2 myeloid levels were higher than in controls (P < 0.0001); MMP‐2 and MMP‐9 were often co‐expressed. Also many erythroblasts expressed MMP‐2. There was a positive correlation between MMP‐2 erythroblast expression and erythroid dysplasia (P = 0.002) and an inverse correlation between MMP‐2 or MMP‐9 myeloid expression and blast cell percentage (P = 0.05 and P = 0.04 respectively). High MMP levels in myeloid cells were associated with longer overall survival (P = 0.03) and evolution‐free survival (P = 0.04). In AML MMP‐2 levels were lower than in MDS (P < 0.0001) and MMP‐9 levels lower than in MDS and controls (P < 0.0001). MMP levels did not predict response to therapy. The release of active MMPs was detected by colorimetric analysis in cell cultures from representative MDS and AML cases. In conclusion, we have demonstrated an abnormal MMP expression in AML as well as in MDS. The production and release of these enzymes may influence haematopoietic cell behaviour. In MDS, the detection of MMP deregulated expression may be important also from the clinical point of view: it may provide a useful tool for diagnosis, prognosis and a possible target for experimental treatments.
Dose‐escalated CHOP and tailored intensification with IFE according to early response and followed by BEAM/autologous stem‐cell transplantation in poor‐risk aggressive B‐cell lymphoma: a prospective study from the GEL–TAMO Study Group
Authors: Arranz Reyes , Conde Eulogio , Grande Carlos , Mateos Maria Victoria , Gandarillas Marco , Albo Carmen , Lahuerta Juan J. , Fernández‐Rañada José M. , Hernández Miguel T. , Alonso Natalia , García Vela José A. , Garzón Sebastián , Rodríguez José , Caballero Dolores ,   the Grupo Español de Linfomas/Trasplante Autólogo de Médula Ósea (GEL–TAMO)
Published: February 2008

Objectives:  The role of high‐dose therapy and autologous stem‐cell transplantation (HDT/ASCT) in the up‐front treatment of poor‐risk aggressive lymphoma is still unknown. We conducted a prospective multi‐centre trial with dose‐escalated CHOP (MegaCHOP) and tailored intensification prior to HDT/ASCT according to early response assessed by CT and gallium scan (Ga67S).

Patients and methods:  Eighty‐six patients with newly diagnosed and Ga‐67 avid aggressive B‐cell lymphoma received MegaCHOP for three courses and were evaluated for response by CT and Ga67S. Patients with CT response and negative Ga67S received another MegaCHOP cycle followed by BEAM and ASCT. Those patients with positive Ga67S or without CT response received salvage treatment with two courses of ifosfamide and etoposide (IFE) followed, whenever response had been achieved, by BEAM and ASCT.

Results:  Response rate before HDT/ASCT was 85% and, with 34 months of median follow‐up, progression‐free survival (PFS), overall survival (OS) and treatment‐related mortality were 56%, 64% and 7%, respectively. For transplanted patients (81% of the whole series), PFS and OS were 67% and 74%, respectively. No different outcomes were observed between patients achieving an early negative Ga67S response treated with MegaCHOP and BEAM/ASCT and patients with mid‐treatment positive Ga67S who received IFE prior BEAM/ASCT.

Conclusions:  This response‐adapted strategy including early treatment modifications prior HDT/ASCT have yielded encouraging PFS and OS in patients with poor‐risk B aggressive non‐Hodgkin’s lymphoma.
A case of atypical POEMS syndrome without polyneuropathy
Authors: Morizane Ryuji , Sasamura Hiroyuki , Minakuchi Hitoshi , Takae Yujiro , Kikuchi Haruhito , Yoshiya Naomi , Hashiguchi Akinori , Konishi Konosuke , Okamoto Shinichiro , Itoh Hiroshi
Published: February 2008

POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, M‐protein, Skin changes) syndrome is a rare hematological disease associated with overproduction of pro‐inflammatory cytokines. Under the current nomenclature and diagnostic criteria for POEMS syndrome, the presence of characteristic polyneuropathy is required for diagnosis. We report a 43‐year‐old Japanese woman with organomegaly, endocrinopathy, M‐protein, skin lesions, as well as typical renal lesions and sclerotic bone lesions. Of note, neurological examinations and peripheral nerve conduction tests were normal in this patient. In view of the overwhelming number of otherwise characteristic signs and symptoms, we made a provisional diagnosis of ‘atypical POEMS syndrome without polyneuropathy’. If further similar cases are reported in the future, reconsideration of the nomenclature and/or diagnostic criteria for POEMS syndrome may be required.
Hematological manifestations of copper deficiency: a retrospective review
Authors: Halfdanarson Thorvardur R. , Kumar Neeraj , Li Chin‐Yang , Phyliky Robert L. , Hogan William J.
Published: February 2008

Copper deficiency is an established cause of hematological abnormalities but is frequently misdiagnosed. Copper deficiency can present as a combination of hematological and neurological abnormalities and it may masquerade as a myelodysplastic syndrome. We reviewed the records of patients with hypocupremia and hematologic abnormalities identified between 1970 and 2005. Patients with hypocupremia unrelated to copper deficiency (e.g. Wilson’s disease) were excluded. Forty patients with copper deficiency and hematological abnormalities were identified. Ten patients (25%) had undergone bariatric (weight reduction) surgery and an additional 14 patients (35%) had undergone surgery on the gastrointestinal tract, most commonly gastric resection. In 12 cases, no cause for copper deficiency was identified. Anemia and neutropenia were the most common hematologic abnormalities identified and the majority of the patients also had neurologic findings, most commonly due to myeloneuropathy. Abnormalities observed on bone marrow examination including vacuoles in myeloid precursors, iron‐containing plasma cells, a decrease in granulocyte precursors and ring sideroblasts may be valuable clues to the diagnosis. Copper deficiency is an uncommon but very treatable cause of hematologic abnormalities.
Early impairment of myocardial function in young patients with β‐thalassemia major
Authors: Magrì Damiano , Sciomer Susanna , Fedele Francesco , Gualdi Gianfranco , Casciani Emanuele , Pugliese Pellegrina , Losardo Anna , Ferrazza Giancarlo , Pasquazzi Eleonora , Schifano Erika , Mussino Eleonora , Quaglione Raffaele , Piccirillo Gianfranco
Published: February 2008

Background and objective:  One of the chief causes of death in patients with β‐thalassemia major (TM) remains heart failure due to iron overload. We investigated possible differences in myocardial function between a population of young asymptomatic patients with TM and healthy controls all of whom underwent an echocardiographic study, including tissue Doppler (TDI) and strain imaging (SI) analysis and cardiac magnetic resonance imaging (MRI).

Methods:  30 young asymptomatic patients with TM (16 taking deferoxamine and 14 taking deferiprone) and 30 healthy subjects underwent a cardiac MRI with T2* technique and an echocardiographic evaluation including systolic myocardial velocities (Sm), early (Em) and late (Am) diastolic velocities and systolic strain (S) at the level of basal segments of the lateral left ventricle (LV), interventricular septum (Septal) and lateral right ventricle (RV) wall. The differences in T2* values and echocardiographic parameters were also compared in patients with TM subgrouped according to iron chelation therapy.

Results:  The following TDI and SI measures were lower in patients than in controls: LV‐Sm (P < 0.05), S‐LV (P < 0.001), Septal‐Sm (P < 0.05), Septal‐Em (P < 0.001), S‐Septal (P < 0.001), RV‐Sm (P < 0.001), RV‐Em (P < 0.001), RV‐Em/Am (P < 0.05) and S‐RV (P < 0.05). Myocardial function was better in the patients receiving deferiprone than those receiving deferoxamine. T2* values were higher in controls than in patients with TM and in those treated with deferiprone than those treated with deferoxamine. MRI data well correlated with SI parameters.

Conclusions:  Study underlines that, even in a population of young, asymptomatic and well‐chelated patients with TM, there is an impairment of myocardial function and that this condition could be easily detected by more advanced ultrasound techniques such as TDI and SI. The better indices of myocardial function in patients treated with deferiprone clearly needs confirmation from larger prospective studies.
UVB induces a biphasic response of HIF‐1α in cultured human keratinocytes
Authors: Wunderlich Livius , Paragh György , Wikonkál Norbert M. , Bánhegyi Gábor , Kárpáti Sarolta , Mandl József
Published: February 2008

Abstract:  Hypoxia in the skin is important in chronic degenerative dermo‐epidermal changes, inflammation, photoageing and carcinogenesis. In these processes, vascular endothelial growth factor (VEGF) plays a crucial role and is known to be affected by ultraviolet radiation (UVR). Hypoxia‐inducible factor‐1 (HIF‐1) closely regulates the expression of VEGF in several experimental settings. We set out to study the impact of acute UVB irradiation on the level of HIF‐1 as a major regulator of hypoxia‐induced genes. Effects of UVB exposure on HIF‐1α expression were investigated in HaCaT cells after a single irradiation by Western blots. Downstream target gene expression was measured by quantitative real‐time polymerace chair reaction (PCR). UVB treatment resulted in an initial decrease of the HIF‐1α protein level followed by a subsequent prolonged increase. If cells were exposed to additional UVB irradiation, another decrease in HIF‐1α was provoked, similar to the original effect. The observed changes followed a strict timeline and were dose‐dependent. The role of the PI3K/AKT pathway was examined. No change in the total level of AKT after UVB treatment was seen; however, its phosphorylation level was found to be markedly higher. In accordance with these observations, wortmannin, an inhibitor of PI3‐kinase effectively blocked the UVB‐induced increase in HIF‐1α. In agreement with previous findings, UVB irradiation increased VEGF and haem oxygenase‐1 mRNA levels determined by quantitative real‐time PCR. It is concluded that changes in HIF‐1α expression underlie the alterations in expression of VEGF upon UVB irradiation. Our findings indicate the involvement of PI3K in UVB‐mediated HIF‐1α upregulation.
From Contract Manufacturing to Own Brand Management: The Role of Learning and Cultural Heritage Identity
Authors: Horng Ching , Chen Wayne
Published: February 2008

While the contract manufacturers in Taiwan take orders from their brand-name buyers, some of them have started to move up to own brand management (OBM). This study examined three factors contributing to the performance of OBM: learning from the key buyer, learning from the key subsidiary and the focal firm's own cultural heritage identity. We found learning from the key subsidiary and one's own cultural heritage identity related positively to OBM performance. Further, there is a counterintuitive negative moderating effect of identity on the relationship between learning from the key buyer and OBM performance. Although preliminary, our results suggest that partners with asymmetric power relationships are prime candidates for future studies to explore the role of identity and pride.
Ribonucleases with angiogenic and bactericidal activities from the Atlantic salmon
Authors: Pizzo Elio , Varcamonti Mario , Maro Antimo D. , Zanfardino Anna , Giancola Concetta , D’Alessio Giuseppe
Published: February 2008

The importance of fish in vertebrate evolution has been better recognized in recent years after the intense work carried out on fish genomics. The recent discovery that fish genomes comprise homologs of ribonucleases, studied before only in tetrapods, and the isolation of ribonucleases from zebrafish have suggested an experimental model for studying fish and vertebrate evolution. Thus, the cDNAs encoding the RNases from the Atlantic salmon were expressed, and the recombinant RNases (Ss‐RNase‐1 and Ss‐RNase‐2) were isolated and characterized as both proteins and for their biological activities. Salmon RNases are less active than RNase A in degrading RNA, but are both sensitive to the action of the human cytosolic RNase inhibitor. The two enzymes possess both angiogenic and bactericidal activities. However, catalytically inactivated Ss‐RNases do not exert any angiogenic activity, but preserve their full bactericidal activity, which is surprisingly preserved even when the enzyme proteins are fully denatured. Analyses of the conformational stability of the two RNases has revealed that they are as stable as typical RNases of the superfamily, and Ss‐RNase‐2, the most active as an enzyme, is also the most resistant to thermal and chemical denaturation. The implications of these findings in terms of the evolution of early RNases, in particular of the physiological significance of the angiogenic and bactericidal activities of fish RNases, are analyzed and discussed.
The Art and Science in Nursing Diagnosis Development
Authors: Avant Kay C.
Published: February 2008

There is both an art and a science to nursing diagnosis. Art is a creative force, whereas science is a systematic force. Each is necessary for diagnosis development. This paper examines issues confronting nurse clinicians, educators, and scientists interested in continued efforts to generate and validate diagnoses. It concludes with suggestions of tasks necessary for sound diagnosis development.
Effects of Guided Design and Lecture Teaching Strategies on Knowledge Recall and on Problem‐Solving Performance of Student Nurses
Authors: Newsome Grace G. , Tillman Murray H.
Published: February 2008

The purpose of this study was to compare the effect of guided design and lecture teaching strategies on the clinical problem‐solving performance of first quarter student nurses. The guided design treatment (written simulations and small group interaction) was selected especially with a view of developing new approaches to teaching nursing diagnosis. A total of 50 students, enrolled in Fundamentals of Nursing, were randomly assigned to two treatment groups: guided design and lecture. Each group received 10 hours of instruction. Treatment groups remained intact for 6 weeks of clinical practice following instruction. Recall knowledge of the nursing process was measured by an objective examination, and performance in problem solving was measured through the use of a care plan evaluation tool. Data were analyzed using analysis of variance and t‐tests. Students taught by guided design scored significantly higher than those taught by lecture in preparing a patient care plan for an actual patient and for a simulated patient. Knowledge of the nursing process as tested by an objective examination was not significantly different for the two treatment groups.
Evaluation of Admission Nursing Diagnoses
Authors: Minton Judy A. , Creason Nancy S.
Published: February 2008

Despite the interest and research in nursing diagnosis, few studies have examined the incidence and quality of the diagnoses. Specifically, a lack of knowledge exists regarding what nursing diagnoses are formulated on a patient's admission to the hospital Data from the charts of 33 adult orthopedic patients were evaluated for the type, frequency, and quality of admission nursing diagnoses. Of the 106 nursing diagnoses written, approximately two‐thirds were on the accepted list of the North American Nursing Diagnosis Association (NANDA) at the time of the study (1988). Alteration in comfort was the most prevalent diagnostic label. The quality of the diagnoses was evaluated using Ziegler's (1984) tool Only one diagnosis, potential alteration in skin integrity related to bedrest. met all 12 criteria. Nurses showed more difficulty in correctly identifying the etiology component than the response component of the diagnostic statement. Factors that affect the quality of nursing diagnoses and the need for tool refinement are discussed, and research recommendations are made.
A Synthesis of Selected Literature on Mobility: A Basis for Studying Impaired Mobility
Authors: Ouellet Louiselle L. , Rush Kathy L.
Published: February 2008

The concept of mobility can be found in the nursing diagnosis literature asimpaired physical mobility, which is generally defined as limitations of physical movement within the environment. In this context, mobility is viewed within the confines of the physical realm. This conceptualization is restrictive in scope and therefore does not provide much direction for the nurse clinician. The theoretical basis of mobility must be strengthened to generate the knowledge necessary to understandimpaired physical mobility.The purpose of this article is to present a consolidated review of the literature related to the concept of mobility. Studies from the social sciences are explored. Conceptual orientations from the health literature also are discussed. Finally, the nursing perspective is examined, including the measurement of the concept.
Concept Analysis of Anxiety
Authors: Whitley Georgia Griffith
Published: February 2008

Anxiety, a nursing diagnosis that impacts clients in all settings and nurses throughout the profession, is clarified through the technique of concept analysis. Uses of the concept of anxiety in prominent theories of human behavior and in nursing are reviewed. Four critical attributes occurring in all cases of anxiety are identified—model cases, a related case, a contrary case, and an illegitimate case are presented. Antecedents to anxiety are identified. Consequences of anxiety are discussed. Empirical referents that demonstrate occurrence of the concept of anxiety are determined, classified, and related to critical attributes. This concept analysis provides an essential conceptual base for instrument development and clinical research on anxiety.
Nursing Diagnosis and Depressive Illness
Authors: Zauszniewski Jaclene A.
Published: February 2008

In nursing practice, clinicians have identified specific nursing diagnoses that repeatedly emerge in depressed individuals. Specifically, chronic low self‐esteem, powerlessness, and hopelessness have been linked with depressive illness and reflect Beck's cognitive theory of depression, which postulates that depressive symptoms result from a negative view of self, world, and future. The purpose of this analysis was to validate defining characteristics of three nursing diagnoses while evaluating the usefulness of the Cognitive Triad Index for specifying critical and supporting indicators for these nursing diagnoses in a population of 63 depressed adult inpatients. A patient‐focused clinical diagnostic validation model was used. Results are discussed in light of previously specified defining characteristics for these diagnoses and directions for future research related to clinical validation of these diagnoses are recommended.
Coping With Urinary Incontinence: Development and Testing of a Scale
Authors: Talbot Laura A.
Published: February 2008

Using psychometric theory and Mitteness' theory of urinary incontinence, the author developed a 159‐item self‐report, interval level, and norm‐referenced scale to measure the effectiveness of coping with urinary incontinence. As a result of the expert evaluation, The Coping With Urinary Incontinence Scale was reduced from 159 items to 64 items. A pilot study determined initial internal consistency estimates for the scale. One hundred seventy‐three community‐residing, incontinent older adults participated in the major study. The Cronbach's Alpha for internal consistency reliability for the final version of 39 items was .9359 (standardized item alpha = .9526). Ten subscales were created: strengthening muscles, coping sexually, intimate moments, seeking health care strategies, controlling urge and loss of urine, rearranging physical environment, expressing emotions, concealing attempts, seeking social support/rearranging social environment, and managing in social situations.
High Frequency: Treatment Priority Nursing Diagnoses in Critical Care
Authors: Gordon Marjory , Hiltunen Elizabeth
Published: February 2008

The purpose of this study was to identify high frequency‐treatment priority nursing diagnoses in critical care nursing using survey research methods. Through a mailed survey the prevalence of 135 nursing diagnoses from the NANDA Diagnostic Taxonomy and other diagnoses was rated by a national, random sample of 678 critical care nurses. Six important diagnostic areas were: sleep‐rest, activity, nutritional‐metabolic, cognitive‐perceptual, self‐perception (mood state), and health management (risk) patterns. Twenty diagnoses were rated as nearly always or frequently present in their practice by 70% or more of the nurses. Findings can be used to focus clinical studies of the highly prevalent diagnoses.
The Congruence of Nursing Diagnoses and Supporting Clinical Evidence
Authors: Roberts Beverly L. , Madigan Elizabeth A. , Anthony Mary K. , Pabst Sharon L.
Published: February 2008

In this secondary analysis, 890 patients 40 years of age and older were assessed within 24 hours of transfer from intensive care to medical/surgical units. Nursing diagnoses documented in the hospital record were compared to supporting clinical evidence obtained from subjects, the hospital record, and interviews with subjects and nurse caregivers. The congruence, based on the kappa statistic, between the nursing diagnosis and clinical evidence ranged from 0.1% for altered thought processes to 10% for impaired gas exchange, impaired physical mobility, and potential for injury, while no diagnoses were made for self‐care deficits or sensory alterations, visual, when clinical evidence for them was available.
Use of Metacognition in Developing Diagnostic Reasoning Skills of Novice Nurses
Authors: Chartier Louise
Published: February 2008

PURPOSE. To discuss the assumptions of metacognition as it applies to reasoning skills in nursing and to explore one way to incorporate these principles into a teaching environment

SOURCES. Books, published articles, teaching experiences

DATA SYNTHESIS. When working with novice nurses, whether in a university or inservice setting, the conceptual basis of cognitive psychology is useful in helping develop diagnostic reasoning ability. An instrument to help nurses acknowledge the metacognitive skills used within their clinical judgment processes was designed and implemented

CONCLUSION. This instrument has proved useful to students and teachers alike over the last 6 years. Formal research needs to be done to substantiate empiric observation.

IMPLICATIONS FOR PRACTICE. An instrument such as this can help mentors, preceptors, and teachers guide novice nurses in documenting diagnostic decision making.
The effects of group structure and rearing strategy on personality in ChimpanzeesPan troglodytesat Chester, London ZSL and Twycross Zoos
Authors: MURRAY L. E.
Published: February 2008

Fifty‐nine ChimpanzeesPun troglodytes, maintained in groups, trios or pairs, were rated by multiple observers, including their keepers, on a seven‐point rating scale consisting of 28 behaviourally defined adjectives. To identify differences resulting from group size and mode of rearing, mean ratings on the 25 adjectives found to be reliable were subjected to analyses of variance and were correlated with actual group size and rearing strategy. These ratings formed the input for a Principal Components Analysis (PCA) which yielded three main components accounting for the greatest amount of variation among individuals: C1, Confident/Apprehensive; C2, SociablelSolitary; C3, Excitable/ Slow. Scores on these components were also correlated with group size. While the effects of rearing may reflect the tendency for many more of the adults to be hand‐reared, strong correlations between group size and both adjectives and component scores demonstrate that when Chimpanzees are maintained in larger groups, they are more Maternal/Paternal, Playful, Popular, Gentle, Protective, Sociable, Curious, Intelligent and Irritable, less Solitary and Slow, and have higher scores on both C2 and C3.
Differences in acoustic signals from Delphinids in the western North Atlantic and northern Gulf of Mexico
Authors: Baron Susan C. , Martinez Anthony , Garrison Lance P. , Keith Edward O.
Published: February 2008

Abstract

Whistle characteristics were quantitatively compared between both geographically separated and neighboring populations of Atlantic spotted dolphins (Stenella frontalis), bottlenose dolphins (Tursiops truncatus), and pilot whales (Globicephala spp.) in U.S. waters to evaluate if intraspecific acoustic differences exist between groups. We compared nine whistle characteristics between continental shelf and offshore Atlantic spotted dolphins in the western North Atlantic and between northern Gulf of Mexico and western North Atlantic bottlenose dolphins and pilot whales using discriminant analysis. Offshore Atlantic spotted dolphin whistles were significantly different (Hotelling's T2, P= 0.0003) from continental shelf whistles in high frequency, bandwidth, duration, number of steps, and number of inflection points. Atlantic bottlenose dolphin whistles were significantly different (Hotelling's T2, P < 0.0001) from those in the Gulf of Mexico in duration, number of steps, and number of inflection points. There was no significant difference between pilot whale whistles in the two basins. The whistle differences indicate acoustic divergence between groups in different areas that may arise from geographic isolation or habitat separation between neighboring but genetically distinct populations of dolphins. This study supports the premise that acoustic differences can be a tool to evaluate the ecological separation between marine mammal groups in field studies.
Temporal variation in dwarf sperm whale (Kogia sima) habitat use and group size off Great Abaco Island, Bahamas
Authors: Dunphy‐Daly Meagan M. , Heithaus Michael R. , Claridge Diane E.
Published: February 2008

Abstract

Dwarf sperm whales (Kogia sima) are among the most commonly stranded yet least known pelagic cetaceans. Few studies have occurred at sea, and none have quantified temporal and spatial variation in dwarf sperm whale abundance and group size. We assessed seasonal and spatial variation in dwarf sperm whale group size and abundance off Great Abaco Island, Bahamas using surveys within a 126 km2study area with depths between 2 and 1,600 m. After correcting for survey effort and variation in sighting efficiency among sea states, we found that dwarf sperm whale group size and habitat use varied seasonally. In summer, dwarf sperm whale groups were small (median = 2.5, range = 1–8) and were found only in the two deep habitats within the study area (slope 400–900 m, deep 900–1,600 m). In winter, group sizes increased (median = 4, range = 1–12) and sightings were almost six times higher in the slope habitat, where vertical relief is highest, than other habitats. Our results suggest that studies of pelagic cetaceans and conservation plans must explicitly account for seasonal variation in group size and habitat use.
Does China have Inflationary Effects on the USA and Japan?
Authors: Feyzioglu Necmettin Tarhan , Willard Luke Byrne
Published: February 2008

With China's share in global trade increasing rapidly, some argued in 2002‐2003 that China was exporting deflation to other countries as it was dumping cheap goods in mature markets. Later, others argued that China was causing sharp increases in global prices. This paper uses several econometric techniques to assess the extent of the link between inflation rates between China and the USA and Japan. Only limited empirical evidence at the aggregate level is found for consumer price inflation in China leading to price changes in the USA and Japan. However, there is some evidence that inflation in the USA has an impact on Chinese inflation. The results seem consistent with the Federal Reserve and the Bank of Japan being concerned about inflation and, hence, adjusting policy such that inflation shocks have no significant effect on overall inflation. Recent Chinese price rises are unlikely to have a material effect on the USA or Japan.
China's Trade Acceleration and the Deepening of an East Asian Regional Production Network
Authors: Tong Sarah Y. , Zheng Yi
Published: February 2008

China's recent surge in trade has been associated with its deepening but contrasting trade relations with its two groups of key trading partners. On the one hand, China's trade surpluses with the USA and the EU have risen rapidly, reaching US$144bn and US$91bn in 2006, respectively. On the other hand, China is importing heavily from its Asian neighbors. This diverging pattern of trade relations between China and its main trading partners reflects the continuous expansion and intensification of a complex cross‐border production network in Asia, particularly for consumer electronics. In the process of deepening manufacturing sharing, China serves as an essential export platform for firms headquartered in the more advanced economies. These firms export intermediate goods from the relatively more advanced Asian economies to their affiliates in China where these inputs are assembled and then shipped to key export markets, including primarily the USA and the EU. One apparent outcome of the growing processing and assembly trade is the increased interdependency among Asian economies, which are now more dependent on each other than ever. It has also led to substantial structural changes and technological upgrading in China's traded goods.
Ultraviolet Resonance Raman Microprobe Spectroscopy of Photosystem II
Authors: Chen Jun , Barry Bridgette A.
Published: February 2008

Photosystem II (PSII) carries out photosynthetic oxygen production and is responsible for the maintenance of aerobic, heterotrophic life. In PSII, protein amino acid residues play an important role in the light‐driven electron transfer reactions. Here, we describe an approach to enhancing vibrational signals from PSII proteins through ultraviolet resonance Raman (UVRR) and a microprobe jet flow technique. Our work shows that pump‐probe UVRR can be used to monitor intermediates during photosynthetic oxygen evolution.
Serum cytochrome c to indicate the extent of ongoing tumor cell death
Authors: OSAKA A. , HASEGAWA H. , TSURUDA K. , INOKUCHI N. , YANAGIHARA K. , YAMADA Y. , AOYAMA M. , SAWADA T. , KAMIHIRA S.
Published: February 2008

Despite the significant implication of apoptosis in tumorigenesis, there is no biomarker to assess the extent of ongoing apoptosis in vivo for hematological malignancies. We investigated the potential of serum cytochrome c (cyto‐c) as a biomarker for apoptosis. Cyto‐c and lactate dehydrogenase (LD) were released into the culture medium from apoptotic cells induced by tumor necrosis factor‐related apoptosis‐inducing ligand in a time‐dependent manner in vitro, with different kinetic patterns. Only one‐third of 153 patients with hematological malignancies showed high levels of serum cyto‐c (>20 ng/ml). Although serum cyto‐c level was roughly correlated to serum LD activity, their different kinetic patterns from serial measurements indicated that serum cyto‐c rather than LD is a more sensitive indicator for tracking changes of tumor status. Furthermore, serum cyto‐c level stratified patients with acute adult T‐cell leukemia into favorable and unfavorable subgroups with 5‐year survival rates of 67%vs. 11%. In conclusion, serum cyto‐c may provide a fast real‐time biomarker for tracking changes of tumor status involved in apoptotic cell death, but lacking disease or cell‐type specificity.