bluuebunny/crossref_metadata_2025 huggingface dataset:
How Comparable Can 'Comparable Corpora' Be?
Authors: Laviosa Sara
Published: January 2011

The development of a coherent methodology for corpus-based work in translation studies is essential for the evolution of this newfield of research into a fully-fledged paradigm within the discipline. The design of a monolingual, multi-source-language comparable corpus of English as a resource for the systematic study of the nature of translated text can be regarded as an important step towards the development of such a methodology. This paper deals with a crucial and problematic aspect of the design of a monolingual comparable corpus, namely the achievement of an adequate level of comparability between its translational and non-translational components.
Red Clover HCT2, a Hydroxycinnamoyl-Coenzyme A:Malate Hydroxycinnamoyl Transferase, Plays a Crucial Role in Biosynthesis of Phaselic Acid and Other Hydroxycinnamoyl-Malate Esters in Vivo
Authors: Sullivan Michael L. , Zarnowski Robert
Published: January 2011

In red clover (Trifolium pratense) leaves, phaselic acid (2-O-caffeoyl-l-malate) accumulates to several mmol kg−1 fresh weight and is a crucial component of a natural system that prevents protein breakdown during harvest and storage of this forage crop. Previously, we identified HCT2, a red clover gene encoding a hydroxycinnamoyl-Coenzyme A (CoA) hydroxycinnamoyl transferase capable of transferring p-coumaroyl and caffeoyl moieties from their CoA derivatives to malic acid to form the corresponding hydroxycinnamoyl-malate esters in vitro. Here, we carried out a detailed kinetic analysis of the enzyme and examined its in vivo function in red clover via reverse genetics. The kinetic analysis indicates that in vitro, despite similar K  m values for the tested hydroxycinnamoyl-CoA derivatives, HCT2 favors transfer to malate of p-coumaroyl and feruloyl moieties over caffeoyl moieties by greater than 5-fold. Reverse reaction (transfer of hydroxycinnamoyl moieties from malate to CoA) by HCT2 was observed with p-coumaroyl-malate but not phaselic acid. Analysis of red clover plants down-regulated for HCT2 expression via RNA interference showed a significant and substantial correlation between HCT2 mRNA levels and phaselic acid accumulation (P < 0.005). In several of the HCT2-silenced plants, phaselic acid and p-coumaroyl-malate levels were reduced to <5% that of wild-type controls. These reductions resulted in easily observable phenotypes including reduced polyphenol oxidase-mediated browning and a reduction in blue epidermal fluorescence under ultraviolet light. These results demonstrate a crucial role for HCT2 in phaselic acid accumulation in red clover and define a previously undescribed pathway for the biosynthesis of hydroxycinnamoyl-malate esters in plants.
Use of the AST to platelet ratio index in HCV/HIV co‐infected patients
Authors: Singal A. G. , Thomassen L. V. , Gretch D. R. , Shuhart M. C.
Published: January 2011

Aliment Pharmacol Ther 2011; 33: 566–577

Background  The AST to platelet ratio index (APRI), a non‐invasive marker of liver fibrosis, has not been well studied in HCV/HIV (hepatitis C virus/human immunodeficiency virus) co‐infected patients with advanced HIV.

Aim  To compare the accuracy of APRI in HCV/HIV co‐infected patients to that in HCV mono‐infected patients and to determine the impact of CD4+ T‐cell counts on its performance.

Methods  We identified 106 consecutive HCV/HIV co‐infected patients and 105 matched HCV mono‐infected patients who underwent liver biopsy at Harborview Medical Center over a 5‐year period. Performance characteristics were calculated and receiver operating characteristic (ROC) analysis conducted.

Results  The area under the ROC curve (AUROC) of APRI for predicting significant fibrosis was similar when comparing those with and without HIV co‐infection (0.77 vs. 0.86, P = 0.18), but was lower in HIV co‐infected patients with CD4 counts <250 cells/mm3 (0.64 vs. 0.86, P = 0.05). In HIV co‐infected patients with CD4 counts ≥250, APRI had higher negative predictive value (93% vs. 88%, P = 0.57), positive predictive value (63% vs. 40%, P = 0.43) and specificity (95% vs. 88%, P = 0.05) than in those with lower CD4 counts.

Conclusions  The AST to platelet ratio index (APRI) performance characteristics appear to be suboptimal in HCV/HIV co‐infected patients with CD4 counts <250 and they require further study in this population at increased risk for advanced liver disease.
The changing face of hospitalisation due to gastrointestinal bleeding and perforation
Authors: Lanas A. , García‐Rodríguez L. A. , Polo‐Tomás M. , Ponce M. , Quintero E. , Perez‐Aisa M. A. , Gisbert J. P. , Bujanda L. , Castro M. , Muñoz M. , Del‐Pino M. D. , Garcia S. , Calvet X.
Published: January 2011

Aliment Pharmacol Ther 2011; 33: 585–591

Background  Temporal changes in the incidence of cause‐specific gastrointestinal (GI) complications may be one of the factors underlying changing medical practice patterns.

Aim  To report temporal changes in the incidence of five major causes of specific gastrointestinal (GI) complication events.

Methodology  Population‐based study of patients hospitalised due to GI bleeding and perforation from 1996 to 2005 in Spain. We report crude rates, and estimate regression coefficients of temporal trends, severity and recorded drug use for five frequent GI events. GI hospitalisation charts were validated by independent review of large random samples.

Results  The incidence per 100 000 person‐years of hospitalisations due to upper GI ulcer bleeding and perforation decreased over time [from 54.6 and 3.9 in 1996 (R2 = 0.944) to 25.8 and 2.9 in 2005 (R2 = 0.410) respectively]. On the contrary, the incidence per 100 000 person‐years of colonic diverticular and angiodysplasia bleeding increased over time [3.3 and 0.9 in 1996 (R2 = 0.443) and 8.0 and 2.6 in 2005 (R2 = 0.715) respectively]. A small increasing trend was observed for the incidence per 100 000 person‐years of intestinal perforations (from 1.5 to 2.3 events). Based on data extracted from the validation process, recent recorded drug intake showed an increased frequency of anticoagulants with colonic diverticular and angiodysplasia bleeding, whereas NSAID and low‐dose aspirin use were more prevalent in peptic ulcer bleeding and colonic diverticular bleeding respectively.

Conclusions  From 1996 to 2005, hospitalisations due to peptic ulcer bleeding and perforation have decreased significantly, whereas the number of cases of colonic diverticular and angiodysplasia bleeding have increased.
Estimating medical expenditures spent on rule‐out diagnoses in Japan
Authors: Tanihara Shinichi , Okamoto Etsuji , Une Hiroshi
Published: January 2011

Background  According to the regulations concerning reimbursement rules for the uniform coverage scheme in Japan's health insurance system, rule‐out diagnoses must be included in a health insurance claim (HIC) to ensure reimbursement for clinical procedures whose results show that a suspected disease is not present. However, estimations of disease‐specific medical expenditure by conventional methods have not considered the information on rule‐out diagnoses.

Objectives  To estimate disease‐specific medical expenditure for rule‐out diagnoses.

Methods  Data were obtained from 169 622 outpatient HICs in May 2006 from corporate health insurance societies. We used the proportional distribution method to estimate medical expenditure for each of the major disease categories defined by the Classification of Diseases for the use of Social Insurance, which is based on the International Statistical Classification of Diseases and Related Health Problems, 10th Revision.

Results  There were 442 010 diagnoses on the HICs, of which 20 330 (4.60%) were rule‐out diagnoses. Rule‐out diagnoses accounted for 8.5% of total medical expenditure. The proportion of medical expenditure spent on rule‐out diagnoses varied across the major diseases categories, and it was estimated that more than one‐third (36.9%) of the medical expenditure on neoplasm is spent on rule‐out diagnoses.

Conclusions  The existence of rule‐out diagnoses affects the estimation of disease‐specific medical expenditure. Therefore, the estimation of disease‐specific medical expenditure and evaluation of prevention and treatment programmes should be improved by utilizing information on rule‐out diagnoses.
Prevalence and associations of anxiety disorders in adults with intellectual disabilities
Authors: Reid K. A. , Smiley E. , Cooper S.‐A.
Published: January 2011

Background  Anxiety disorders are known to be common in the general population. Previous studies with adults with intellectual disabilities (IDs) report a prevalence of general anxiety disorder ranging from <2% to 17.4%. Little is known about associated factors in this population. This study investigates point prevalence of anxiety disorders and determines the factors independently associated with them.

Methods  Information was collected with 1023 adults with IDs who participated in a large‐scale, population‐based study. All had a comprehensive physical and mental health assessment. The point prevalence of anxiety disorders according to different diagnostic criteria was determined, as were independently associated factors by using logistic regression analysis.

Results  Three point eight per cent (95% CI = 2.7–5.2%) of the cohort had an anxiety disorder at the time of assessment. Generalised anxiety disorder was the most common (1.7%), then agoraphobia (0.7%). Factors independently associated with having an anxiety disorder were not having any daytime employment, and having a recent history of life events. Having previously been a long‐term hospital resident was independently associated with not having an anxiety disorder.

Conclusions  Anxiety disorders are common in the ID population. At times of significant life events, it might be sensible for carers to consider proactively providing additional support and being vigilant to seek early health‐care interventions should there be any suggestion of emerging mental ill‐health. The study further highlights the range of mental ill‐health that is experienced by the population with IDs, and therefore the need for appropriate care, supports and development of effective interventions.
Behavioural features of Italian infants and young adults with Williams–Beuren syndrome
Authors: Gagliardi C. , Martelli S. , Tavano A. , Borgatti R.
Published: January 2011

Background  The increased interest in social interaction in Williams–Beuren syndrome (WBS) is evident from infancy onwards, together not only with increased empathy, positive interpersonal bias, but also with social disinhibition. Previous studies have described behavioural and emotional problems as being widely represented in WBS. There is limited scope for comparisons between literature data because of the variety of instruments used to assess behaviour.

Method  Forty‐one children and young adults with WBS were enrolled and underwent general cognitive assessment. In order to compare our data with the literature, we used standardised questionnaires used in previous studies (Developmental Behaviour Checklist: DBC‐P). General cognitive abilities, gender and age were included in the analysis.

Results  Behavioural problems were more relevant than expected according to intellectual impairment. Some features were present at any age: inattention, anxiety, disruptive behaviours. Antisocial conduct was almost absent; perseverative conduct, a poor sense of danger and, more generally, self‐absorbed behaviours tended to diminish along with age and to be linked to more pronounced cognitive impairment.

Conclusion  As previously described for other countries, behaviour disturbances occur frequently in the Italian WBS population. Our data could support the existence of some ‘intrinsic’ behavioural characteristics in WBS such as inattention and anxiety, which are detectable and important at any age; both learning and social exposure to a structured context such as school could help diminish self‐absorbed behaviour.
So what exactly is nursing knowledge?
Authors: CLARKE L.
Published: January 2011

Accessible summary

Definitions of nursing knowledge are ill thought through and confusing.

That which adds uniqueness to nursing is typically confused in argument to the extent that argument is presented.

The persistence of a medical base for theory, although highly prevalent, albeit justified via a linguistic turn, as in ‘advanced practitioner’.

Implicit, in my argument, is that there exist, among journals and their authors, denials of what (practically) nursing is, forcing instead a counterfeit nursing language that stems from either medical or unworkable, non‐propositional, philosophical sources.

This paper aims to present a discussion about intrinsic nursing knowledge. The paper stems from the author's study of knowledge claims enshrined in nursing journal articles, books and conference speeches. It is argued that claims by academic nurses have largely depended on principles drawn from continental and not Analytic (British‐American) philosophy. Thus, claims are credible only insofar as they defer propositional logic. This is problematic inasmuch as nursing is a practice‐based activity usually carried out in medical settings. Transpersonal nursing models are particularly criticizable in respect of their unworldly character as are also concepts based on shallow usages of physics or mathematics. I argue that sensible measurements of the ‘real world’ are possible – without endorsing positivism – and that nursing requires little recourse to logically unsustainable claims. The paper concludes with an analysis of a recent review of nursing knowledge, which analysis indicates the circularity that attends many discussions on the topic.
Papillation in Bacillus anthracis colonies: a tool for finding new mutators
Authors: Yang Hanjing , Sikavi Cameron , Tran Katherine , McGillivray Shauna M. , Nizet Victor , Yung Madeline , Chang Aileen , Miller Jeffrey H.
Published: January 2011

Colonies of Bacillus anthracis Sterne allow the growth of papillation after 6 days of incubation at 30°C on Luria–Bertani medium. The papillae are due to mutations that allow the cells to overcome the barriers to continued growth. Cells isolated from papillae display two distinct gross phenotypes (group A and group B). We determined that group A mutants have mutations in the nprR gene including frameshifts, deletions, duplications and base substitutions. We used papillation as a tool for finding new mutators as the mutators generate elevated levels of papillation. We discovered that disruption of yycJ or recJ leads to a spontaneous mutator phenotype. We defined the nprR/papillation system as a new mutational analysis system for B. anthracis. The mutational specificity of the new mutator yycJ is similar to that of mismatch repair‐deficient strains (MMR‐) such as those with mutations in mutL or mutS. Deficiency in recJ results in a unique specificity, generating only tandem duplications.
YopK regulates the Yersinia pestis type III secretion system from within host cells
Authors: Dewoody Rebecca , Merritt Peter M. , Houppert Andrew S. , Marketon Melanie M.
Published: January 2011

The pathogenic Yersinia species share a conserved type III secretion system, which delivers cytotoxic effectors known as Yops into target mammalian cells. In all three species, YopK (also called YopQ) plays an important role in regulating this process. In cell culture infections, yopK mutants inject higher levels of Yops, leading to increase cytotoxicity; however, in vivo the same mutants are highly attenuated. In this work, we investigate the mechanism behind this paradox. Using a β‐lactamase reporter assay to directly measure the effect of YopK on translocation, we demonstrated that YopK controls the rate of Yop injection. Furthermore, we find that YopK cannot regulate effector Yop translocation from within the bacterial cytosol. YopE is also injected into host cells and was previously shown to contribute to regulation of the injectisome. In this work we show that YopK and YopE work at different steps to regulate Yop injection, with YopK functioning independently of YopE. Finally, by expressing YopK within tissue culture cells, we confirm that YopK regulates translocation from inside the host cell, and we show that cells pre‐loaded with YopK are resistant to Yop injection. These results suggest a novel role for YopK in controlling the Yersinia type III secretion system.
Differing spectrum of HIV‐associated ophthalmic disease among patients starting antiretroviral therapy in India and South Africa
Authors: Pathai Sophia , Gilbert Clare , Weiss Helen A. , McNally Matthew , Lawn Stephen D.
Published: January 2011

Differences in the prevalence and spectrum of HIV‐associated ophthalmic disease in Africa and Asia are not well documented. We studied two comparable cohorts of patients initiating antiretroviral therapy in Mumbai, India, and Cape Town, South Africa. The prevalence of HIV‐associated ophthalmic disease was higher in the Indian population (17.5%) than in the South African population (12.1%). This was largely because of vitreo‐retinal opportunistic infections (11.4%vs. 2.6%, respectively), notably cytomegalovirus retinitis. This difference persisted after adjusting for confounding factors (adjusted odds ratio = 11.32, 95% confidence interval: 2.67–48.13), confirming a marked geographical difference in the prevalence of HIV‐associated retinal disease.
Performance of an algorithm based on WHO recommendations for the diagnosis of smear‐negative pulmonary tuberculosis in patients without HIV infection
Authors: Soto Alonso , Solari Lely , Gotuzzo Eduardo , Acinelli Roberto , Vargas Dante , Van der Stuyft Patrick
Published: January 2011

Objective  To evaluate the performance of an algorithm based on WHO recommendations for diagnosis of smear‐negative pulmonary tuberculosis in HIV‐negative patients.

Methods  We recruited HIV‐negative patients with clinical suspicion of tuberculosis who had had three negative sputum smears in Lima, Peru. All included subjects underwent a complete anamnesis, physical examination and chest X‐ray, and had a sputum specimen cultured in Ogawa, Middlebrook 7H9 media and MGIT®. We applied an algorithm based on WHO recommendations to classify patients as having tuberculosis or not. The diagnostic performance of the algorithm was evaluated comparing its results against the reference standard of a positive culture for M. tuberculosis in either of the media used.

Results  A total of 264 of the 285 patients included (92.6%) completed evaluation and follow up. Of these, 70 (26.5%) had a positive culture for M. tuberculosis. Clinical response to a broad spectrum course of antibiotics was good in 32 of these 70 patients (45.7; 95%CI 34.0–57.4%). Overall, the algorithm attained a sensitivity of 22.9% (95% CI 13.1–32.7%) and a specificity of 95.4 % (95% CI 92.4–98.3%) compared to culture results. The positive likelihood ratio was 4.93 and the negative likelihood ratio was 0.81.

Conclusions  The sensitivity and negative likelihood ratio of the algorithm is poor. It should be re‐evaluated, and possibly adapted to local circumstances before further use. The clinical response to an antibiotic trial is the most important component to reassess. We also suggest considering performing chest X‐ray earlier in the diagnostic work‐up.
Clinical measurement of addictions
Authors: CLOUTIER RICHARD , LESAGE ALAIN , LANDRY MICHEL , KAIROUZ SYLVIA , MÉNARD JEAN‐MARC
Published: January 2011

Introduction and Aims. To conduct a systematic review of instruments for the clinical measurement of addictive behaviours and to determine whether substance addictive behaviours (SAB) and non‐substance addictive behaviours (NSAB) are similarly conceptualised in clinical research.

Design and Methods. The analytic strategy employed comprised three steps: (i) major search engines were used to take stock of available clinical instruments for assessing addictive behaviours; (ii) an analysis grid was developed and validated, covering 21 parameters under four heuristic categories: dependence, temperament, social handicap and cognitive behaviour; and (iii) all instruments were analysed and compared via the grid.

Results. The search yielded 157 questionnaires covering 14 addictive behaviours. The analysis grid allowed rating all questionnaire items on one parameter only; very good interrater agreement was maintained throughout. The categories most evaluated by the questionnaires were dependence and cognitive behaviour; temperament and social handicap were much less frequently considered. Patterns were generally similar in terms of categories, whether questionnaires concerned SAB or NSAB; however, differences within categories indicated a greater frequency of psychologically oriented parameters for NSAB.

Conclusions. The measurement of addictive behaviours appears clinically cohesive, as determined by a validated analysis grid applied to an exhaustive set of questionnaires identified through a systematic literature review.[Cloutier R, Lesage A, Landry M, Kairouz S, Ménard J‐M. Clinical measurement of addictions. Drug Alcohol Rev 2012;31:33–39]
Factors associated with continued solvent use in Indigenous petrol sniffers following treatment
Authors: DINGWALL KYLIE M. , MARUFF PAUL , CLOUGH ALAN R. , CAIRNEY SHEREE
Published: January 2011

Introduction and Aims. While petrol sniffing afflicts several isolated Indigenous groups internationally, few studies have examined the factors contributing to continued sniffing following treatment. This study aims to describe those factors in a group of Aboriginal Australian users.

Design and Methods. During residential treatment, 56 petrol sniffers completed baseline demographic and substance use questionnaires and cognitive and psychological assessments. Eighty per cent were reassessed and interviewed an average of 9 months (SD = 4) later. Cognitive, psychological, substance use and sociocultural factors were compared between those who relapsed at follow up and those who maintained abstinence.

Results. More males (n = 44) than females (n = 12) were studied. Of the 45 individuals followed up, 58% (n = 26) relapsed. Significant risk factors for relapse included the ready availability of petrol, living in urban centres, being unmarried and living with fewer people (P < 0.05). Other potential risk factors, indicated by P‐values < 0.10, included younger age of first petrol use, having sniffed within 14 days prior to treatment, poly substance use, sniffing in response to negative emotions, and feeling lonely at baseline and having sleep problems at follow up.

Discussion and Conclusion. This study identified psychosocial factors that may be associated with continued petrol sniffing among Aboriginal Australians post treatment. Future research, interventions and policy relating to petrol sniffing should consider these factors. [Dingwall KM, Maruff P, Clough AR, Cairney S. Factors associated with continued solvent use in Indigenous petrol sniffers following treatment. Drug Alcohol Rev 2012;31:40–46]
RESEARCH UNIVERSITIES AND REGIONAL HIGH‐TECH FIRM START‐UP AND EXIT
Authors: DE SILVA DAKSHINA G. , MCCOMB ROBERT
Published: January 2011

If localized knowledge spillovers are present in the university setting, higher rates of both start‐up and/or survival would be observed in areas that are geographically proximate to the university. Using a detailed industry data set for Texas for 1999:3–2005:2, we analyze start‐up and exit rates for high‐tech firms. Based on a Poisson quasi‐maximum likelihood estimation, we find evidence that the level of R&D and proximity of a research institution positively affects the likelihood of technology start‐ups. However, using both the Cox proportional hazards model and Kaplan–Meier approach, our results suggest that geographic proximity to knowledge centers does not reduce hazard rates. (JEL R12, R53, O18)
The Historical Constitution of the Political Forms of Capitalism
Authors: Gerstenberger Heide
Published: January 2011

Abstract: This article provides a general overview and critique of approaches to state theory, from the Marxist “state derivation“ debate of the 1970s, through to regulation and world‐systems perspectives, to theories which encompass imperialism. It proposes that a theory of the political forms of capitalism should have three elements: it should be based on analysis of the different historical processes by which capitalist states have been and are constituted; it should elucidate the specificities of the various political forms of capitalism; and it should explain the continuing existence of a plurality of states and imperialist relations.
International Transformations of the Capitalist State1
Authors: Picciotto Sol
Published: January 2011

Abstract:  There has not been a retreat but a transformation of the state, involving significant changes in both the public sphere of politics and the so‐called private sphere of economic activity, and in their modes of interaction, especially law. The privatization of state‐owned assets and the reduction of direct state economic intervention have not led to a reduced role of the state but to changes in its form, involving new types of formalized regulation, the fragmentation of the public sphere, the decentering of the state and the emergence of multi‐level governance. This has been complemented by the increased salience of “private” regulation, so that in many ways the apparently private sphere of economic activity has become more public. In fact, there has been a complex process of interaction with a blurring of the divisions between apparently private and public regulation. Despite talk of deregulation there has been extensive reregulation, or formalization of regulation, and the emergence of global regulatory networks, intermingling the public and the private. The transition from government to governance means a lack of a clear hierarchy of norms, a blurring of distinctions between hard and soft law, and a fragmentation of public functions entailing a resurgence of technocracy.
Social Conflict and Competing State Projects in the Semi‐Periphery: A Strategic‐Relational Analysis of the Transformation of the Mexican State into an Internationalized Competition State
Authors: Heigl Miriam C.
Published: January 2011

Abstract:  This article draws on the strategic‐relational approach in state theory and examines the transformation of the Mexican state into internationalized competition state. It does so by analyzing the rise of the neoliberal forces and the neoliberal state project inside Mexico during the 1970s while taking into account the important modifications in the international division of labor and the evolving international regulation. These developments resulted in the transformation of the Mexican state into an internationalized competition state which adopts a Ricardian strategy of competition and is characterized by the tendencies towards the denationalization of statehood and the internationalization of policy regimes.
Fathering in the first few months
Authors: Thomas Jan E. , Bonér Ann‐Kathrine , Hildingsson Ingegerd
Published: January 2011

Scand J Caring Sci; 2011; 25; 499–509
 
Fathering in the first few months

Becoming a parent is a major event in life. Pregnancy is a time when both physical and emotional changes affect the lives of expectant parents as they prepare for parenthood. The aim of this study was to focus on fathers during and shortly after pregnancy. A prospective longitudinal study was conducted in all hospital prenatal clinics in the county council of Västernorrland, Sweden. Participating were 827 partners of women who had been pregnant and given birth during the period of June 2007 to June 2008. Data were collected using three questionnaires. Regression analysis showed that fathers who were most concerned about their new role were those that were university educated, first‐time fathers, and those with financial worries. Support from the midwife or others close to the father did not impact fathers’ thoughts about the difficulties of being a parent during pregnancy, but lack of support from the partners after the birth increased fathers’ concern. This study suggests that more research is needed on fathers’ own needs for support in parenting.
Oral health‐related quality of life in older Swedish people with pain problems
Authors: Östberg Anna‐Lena , Hall‐Lord Marie‐Louise
Published: January 2011

Scand J Caring Sci; 2011; 25; 510–516
 
Oral health‐related quality of life in older Swedish people with pain problems

Objectives:  The aim of the present paper was to explore the oral health‐related quality of life in old Swedish people with pain problems, with special reference to demography, socio‐economic factors, health, and general health‐related quality of life.

Method:  Individuals ≥80 years (n = 186) who earlier reported pain problems answered two multi‐item instruments on oral health‐related quality of life (Oral Health Impact Profile, OHIP‐14) and general health‐related quality of life (Short Form Health Survey, SF‐12), respectively. Socio‐demographic and health questions were also inquired.

Results:  Both the oral and general health‐related quality of life were rated very low. Two thirds (67.2%) reported at least one of the aspects in the OHIP‐14 fairly often, very often or all the time. The mean additive score of the OHIP‐14 was 14.6 (SD 10.5). The mean value of the physical component scale (PCS) of SF‐12 was 25.9 (SD 6.2) and of the mental component scale (MCS) 44.1 (SD 11.5). The OHIP‐14 was consistently and significantly correlated with self‐rated general and oral health, chewing ability and MCS. The associations between self‐rated general and oral health in relation to the OHIP‐14 were independent of possible confounders: OR 3.63 (95% CI 1.58–8.32) and OR 2.68 (95% CI 1.44–4.99), respectively.

Conclusion:  Old people with pain problems experienced very low oral and general health‐related quality of life. Personnel caring for the oldest with pain problems should be aware that oral health problems can contribute to a low quality of life and that oral care should be included in the general care.
Long‐Term Mortality and Pacing Outcomes of Patients with Permanent Pacemaker Implantation after Cardiac Surgery
Authors: RAZA SYED S. , LI JIAN‐MING , JOHN RANJIT , CHEN LIN Y. , THOLAKANAHALLI VENKATAKRISHNA N. , MBAI MACKENZIE , ADABAG A. SELCUK
Published: January 2011

Background: Approximately 20,000 permanent pacemakers (PPMs) are implanted annually for bradycardia or atrioventricular (AV) block after cardiac surgery. Little is known about the long‐term pacing and mortality outcomes and the temporal trends of these patients.

Methods: We examined 6,268 consecutive patients who underwent cardiac surgery at the Minneapolis Veterans Administration Medical Center between 1987 and 2010. Patients who had a PPM within 30 days of cardiac surgery were identified. Pacemaker interrogation records were retrospectively reviewed and mortality was ascertained.

Results: Overall, 141 (2.2%) patients underwent PPM implantation for high‐degree AV block (55%) and bradycardia (45%), 9 ± 6 days after surgery. Age, diuretic use, cardiopulmonary bypass time (CPBT), and valve surgery were independent predictors of PPM requirement. After 5.6 ± 4.2 years of follow‐up, 40% of the patients were PPM dependent. Longer CPBT (P = 0.03), PR interval >200 ms (P = 0.03), and QRS interval > 120 ms (P = 0.04) on baseline electrocardiogram predicted PPM dependency
. In univariable analysis, PPM patients had a higher long‐term mortality than those without PPM (45% vs 36%; P = 0.02). However, after adjusting for age, sex, type of surgery, and CPBT, PPM requirement was not associated with long‐term mortality (hazard ratio 1.3; 95% confidence interval 0.9–1.9; P = 0.17). Compared to before, incidence of PPM implantation increased after the year 2000 (1.9% vs 2.6%; P = 0.04).

Conclusion: The majority of patients who require PPM after cardiac surgery are not PPM dependent in the long term. Requiring a PPM after surgery is not associated with long‐term mortality after adjustment for patient‐related risk factors and cardiac surgical procedure. (PACE 2011; 34:331–338)
Atrial Fibrillation Ablation: “Perpetual Motion” of Open Irrigated Tip Catheters at 50 W Is Safe and Improves Outcomes
Authors: WINKLE ROGER A. , MEAD R. HARDWIN , ENGEL GREGORY , PATRAWALA ROB A.
Published: January 2011

Background: Point‐by‐point use of open irrigated tip catheters (OITCs) at 50 W increases atrial fibrillation (AF) ablation cure rates but also increases complications. We determined if constantly moving the OITC (perpetual motion) when using 50 W increases ablation cure rates without increasing complications.

Methods: We evaluated procedural data, complications, and individual procedure cure rates (IPCRs) for AF ablation using closed tip catheters (CTC) versus OITC at 40, 45, and 50 W in 1,122 ablations. We used “perpetual motion” to move the OITC at 50 W every 3–10 seconds.

Results: The OITC showed higher IPCR than CTC at 45 W (P = 0.012) and 50 W (P < 0.0005). For the OITC, IPCR increased from 44.6% to 60.7% as power increased from 40 to 50 W (P = 0.008). The OITC appeared superior to the CTC for all types of AF. For paroxysmal AF, increasing OITC power from 40 to 50 W provided no increase in IPCR (70.6% vs 71.2%, P = 0.827). For persistent AF, increasing power from 40 to 50 W increased IPCR from 34.5% to 59.5% (P = 0.001). Complications were similar for the CTC and the OITC at any power. The OITC at 50 W had shorter procedure, left atrial, and fluoroscopy times (P < 0.0005).

Conclusions: Increasing OITC power from 40 to 50 W increases IPCR with no increase in complications as long as the 50 W setting is done using “perpetual motion.” The OITC 50 W power setting results in shorter procedure and fluoroscopy times and should be considered for AF ablations. (PACE 2011; 34:531–539)
Frequency Domain and Time Complex Analyses Manifest Low Correlation and Temporal Variability When Calculating Activation Rates in Atrial Fibrillation Patients
Authors: BIVIANO ANGELO B. , COROMILAS JAMES , CIACCIO EDWARD J. , WHANG WILLIAM , HICKEY KATHLEEN , GARAN HASAN
Published: January 2011

Background: Atrial fibrillation (AF) activation rates have been calculated using both frequency domain and time complex analyses. Direct comparisons of these methods are limited. We report: (1) their correlation when measuring AF activation rates, (2) comparisons of recording durations required to minimize variability, and (3) differences in the temporal reproducibility.

Methods: AF activation rates were calculated using domain frequency (DF) (via fast Fourier transform) and time complex (TC) (via beat‐to‐beat activation measurements) analyses. We compared: (1) AF frequencies derived from each method; (2) successively longer subinterval durations to their 16‐second reference intervals, and (3) the correlation between consecutively collected 8‐second segments and segments collected 10 minutes apart.

Results: There was low intraclass correlation coefficient (ICC = 0.234) when comparing AF activation rates derived using DF versus TC analysis. There was no difference in the frequencies between any of the subintervals compared to their 16‐second reference intervals, but variability of measurements was higher for intervals <8 seconds (P < 0.01). Correlations between successive segments and segments taken 10 minutes apart were 0.92 and 0.75 using DF analysis (P < 0.001), and 0.72 and 0.49 using TC analysis (P < 0.001).

Conclusions: There is low correlation between the DF and TC methods of analyzing AF activation rates. While AF rates do not differ between subintervals and 16‐second reference electrograms, the variability of measurements is dependent upon the subinterval duration, and increases for durations less than 8 seconds. AF rates were prone to change over a 10‐minute time period. These results point out existing clinical limitations of measuring atrial activation rates in AF patients. (PACE 2011; 34:540–548)
Successful Epicardial Catheter Ablation of a Septal Ventricular Tachycardia after Myocardial Infarction
Authors: YAMADA TAKUMI , DOPPALAPUDI HARISH , McELDERRY H. THOMAS , PLUMB VANCE J. , KAY G. NEAL
Published: January 2011

A 55‐year‐old man underwent catheter ablation of ventricular tachycardia (VT) after anterior myocardial infarction. Although electrophysiological study suggested that the VT originated from the septum, biventricular endocardial irrigated radiofrequency ablation failed to interrupt the VT. Epicardial ablation at the site located halfway between the lesions in the right and left ventricles via a pericardial approach eliminated the VT, suggesting that the VT likely originated from the top of the septum. When VTs originating from the upper septum are refractory to endocardial ablation, epicardial mapping and ablation may be considered because only that site may be accessible with an epicardial approach. (PACE 2012; 35:e116–e119)
Coexistent Brugada Syndrome and Wolff‐Parkinson‐White Syndrome: What Is the First Clinical Presentation?
Authors: HASDEMIR HAKAN , ALPER AHMET T. , GÜVENÇ TOLGA S. , ARSLAN YÜCESIN , AKSU HÜSEYIN , POYRAZ ESRA , NURKALEM ZEKERIYA , ORHAN AHMET L. , ÇAKMAK NAZMIYE
Published: January 2011

The coexistence of Brugada syndrome and Wolff‐Parkinson‐White (WPW) syndrome is a very rare phenomenon. We describe a 31‐year‐old patient without any previous cardiac disorder admitted to our hospital due to palpitations and concomitantly diagnosed as WPW syndrome and treated with radiofrequency catheter ablation. He was later diagnosed with Brugada syndrome and followed‐up 2 years without any symptoms. We discuss other previously reported cases in literature, in which these two conditions exist simultaneously. (PACE 2011; 760–763)
Initial Single‐Center Experience of a Quadripolar Pacing Lead for Cardiac Resynchronization Therapy
Authors: SHETTY ANOOP K. , DUCKETT SIMON G. , BOSTOCK JULIAN , ROY DEBASHIS , GINKS MATTHEW , HAMID SHOAIB , ROSENTHAL ERIC , RAZAVI REZA , RINALDI CHRISTOPHER ALDO
Published: January 2011

Background: The Quartet model 1458Q (St. Jude Medical, Sylmar, CA, USA) lead is a quadripolar left ventricular (LV) lead with pace/sense capability from four electrodes (tip and three rings). The lead is capable of pacing in 10 different configurations rather than the three that are available in conventional bipolar pacing leads. We describe a single‐center initial experience of the use of this lead in patients undergoing cardiac resynchronization therapy (CRT).

Methods: Twenty‐eight patients for a CRT with cardiac defibrillator were implanted between October 2009 and May 2010 with a Quartet lead
. Lead position, pacing parameters, stability, complications, and presence of phrenic nerve stimulation (PNS) data were collected at implant and predischarge. Follow‐up data were collected at 15 ± 8 weeks for all patients.

Results: A Quartet lead was successfully implanted in 96% (27/28) of patients (age 61 ± 15 years; 82% male; ischemic etiology 50%; mean left ventricular [LV] ejection fraction 25 ± 7%; left bundle branch block 68%). PNS was seen at implant in 11 patients (41%) with at least one vector. In eight of these cases (72%), the need for lead repositioning was averted by programming LV pacing utilizing the additional vectors available with the Quartet lead.

Conclusion: These initial data suggest that pacing with the Quartet lead is associated with a high implant success rate and stable pacing parameters acutely and at short‐term follow‐up. The 10 LV pacing vectors available with this lead may allow PNS and capture threshold problems to be easily overcome. (PACE 2011; 34:484–489)
Pathogenesis of pruritus
Authors: Ständer Sonja , Raap Ulrike , Weisshaar Elke , Schmelz Martin , Mettang Thomas , Handwerker Hermann , Luger Thomas A.
Published: January 2011

The pathogenesis of acute and chronic (> 6 weeks duration) pruritus is complex and involves in the skin a network of resident cells (e. g., mast cells, keratinocytes, sensory neurons) and transient inflammatory cells (e. g., eosinophils). Though pruritus and pain show overlapping mechanisms, recent studies have provided evidence that pruritus and pain pathogenesis differ in important points. In the skin, the sensory C‐nerve fibers have been investigated intensively. Several classes of histamine‐sensitive or histamine‐insensitve C‐fibers have been described. Epidermal and dermal sensory nerve fibres are now assumed to be of major importance in pruritus induction. They interact with keratinocytes, inflammatory cells such as T lymphocytes, eosinophils and basophils which have been shown to release multiple pruritogenic mediators (e.g., nerve growth factor, interleukin‐31) which lead to activation, sensitization and sprouting of skin nerves. Specific receptors have been discovered on cutaneous and spinal neurons to be exclusively involved in the processing of pruritic signals. Just recently, the gastrin‐releasing peptide receptor (GRPR) was identified on spinal neurons that are crucially involved in pruritus but not pain processing. Chronic pruritus is notoriously difficult to treat. Newer insights into the underlying pathogenesis of pruritus have enabled novel treatment approaches that target the pruritus‐specific pathophysiological mechanism. For example, kappa‐opioid receptor agonists and neurokinin‐1 antagonists have been found to relieve chronic pruritus.
IMPROVING POSTHARVEST QUALITY OF TABLE GRAPE CV. “RISH BABA” USING THYMUS KOTSCHYANUS AND CARUM COPTICUM ESSENTIAL OILS
Authors: MARANDI RASUL JALILI , HASSANI ABBAS , GHOSTA YOUBERT , ABDOLLAHI ALI , PIRZAD ALIREZA , SEFIDKON FATEMEH
Published: January 2011

The antifungal activity of different concentrations of Thymus kotschyanus and Carum copticum essential oils (0, 100, 200, 300, 400 and 500 µL/L) on mycelial growth of Botrytis cinerea and Penicillium digitatum under in vitro condition were investigated. Also, the preservative property of various concentrations of these essential oils (0, 250 and 500 µL/L) to maintenance quality parameters of “Rish Baba” table grape were studied. Chemical compositions of the essential oils were also determined by gas chromatography–mass spectrometry analysis. Major compounds found in essential oils from T. kotschyanus and C. copticum were carvacrol (28.54%) and thymol (63.18%), respectively. The results of in vitro assay showed that T. kotschyanus and C. copticum essential oils in 300–500 µL/L concentration completely inhibited the mycelial growth of B. cinerea and P. digitatum. Also, at the end of the storage period, all the applied concentration of essential oils reduced disease severity compared to control fruit. The application of essential oil did not affect the berry shrinkage and rachis browning. However, essential oil treatment showed high preservative effect on weight loss, appearance, flavor, berry browning, total soluble solids (TSS), titrable acidity (TA) and TSS/TA of treated fruits. Therefore, essential oils may be used as an alternative for the synthetic chemicals for control of postharvest phytopathogenic fungi, and in turn to fulfill consumer requirements for more natural and healthy fruits.

PRACTICAL APPLICATIONS

Postharvest disease of perishable fruits such as table grape renders heavy losses during transit and storage. Use of chemical fungicides such as SO2 generator pads are basic means of controlling postharvest diseases of table grape. Public awareness about chemical residues in food and interest to use of organic crops intended search to find a new safe alternatives to synthetic fungicides. The main reason for examine the possibility use of essential oils are they plant origins, safe, no side‐effect and their acceptability for consumers. Consequently, recently the interest to use of essential oils to preserve of fruits and vegetables has increased. The goal of this research was to examine the possibility use of T. kotschyanus, C. copticum essential oils to maintain postharvest quality of table grapes.
Commercializing Human Rights: Trademarks in Europe AfterAnheuser‐Busch v Portugal
Authors: Reiss Jennifer W.
Published: January 2011

This article uses the European Court of Human Rights decision inAnheuser‐Busch v Portugal(2007) to explore the intersection between intellectual property—specifically trademarks—and human rights. It applies the three possible paradigms of intellectual property—human rights jurisprudence identified by Laurence Helfer—“rule of law”, “enforcement” and “balancing”—toAnheuser‐Buschand then critiques the court's lack of engagement with the intellectual property elements of the case, particularly the theoretical underpinnings of trademark law as distinctly commercial property. It concludes that this makes trademarks especially unsuitable for treatment in a human rights context. Agreeing with Helfer's prescription for the “rule of law” paradigm when taking such cases in the future, this article emphasizes that an additional sensitivity to the special nature of the subject matter must be involved if the court were to take intellectual property cases in the future. This is particularly important given that court's oversight may enable the proliferation of the concept of “corporate human rights”—potentially leading to corrosive effects on the integrity of the human rights law it seeks to protect.
Healthcare-Associated Infections in Acute Ischaemic Stroke Patients from 36 Japanese Hospitals: Risk-Adjusted Economic and Clinical Outcomes
Authors: Lee Jason , Imanaka Yuichi , Sekimoto Miho , Ikai Hiroshi , Otsubo Tetsuya
Published: January 2011

Background

Healthcare-associated infections are a major cause for worsening in ischaemic stroke patients. In addition to increased morbidity and mortality, healthcare-associated infections also result in a potentially preventable increase in economic costs.

Aims

The aim of this study was to identify healthcare-associated infection incidence in ischaemic stroke patients in Japanese hospitals, and to conduct a risk-adjusted analysis of the associated economic and clinical outcomes.

Methods

Healthcare-associated infections were identified in 36 Japanese hospitals using an administrative database. Identification was carried out using a combination of International Classification of Diseases-10 codes and antibiotic utilisation patterns that indicated the presence of an infection. Risk-adjusted hospital charges and length of stay were calculated using multiple linear regression analyses correcting for patient and hospital factors. A logistic regression model was used to analyse the association between healthcare-associated infection infection and mortality.

Results

There was an overall healthcare-associated infection incidence of 16·4 %, with an interhospital range of 4·7–28·3%. After risk-adjustment, infected cases paid an additional US$3 067 per admission (interhospital range US$434–US$7 151) and were hospitalised for an additional 16·3-days (interhospital range: 5·1–25·1-days) when compared with uninfected patients. Healthcare-associated infections also had a strongly significant association with increased mortality (odds ratio=23·2, 95% confidence intervals: 12·5–43·2).

Conclusions

We observed a wide range of healthcare-associated infection incidence between the hospitals. Healthcare-associated infections were found to be significantly associated with increased hospital charges, length of stay, and mortality. Furthermore, the use of risk-adjusted multi-institutional comparisons allowed us to analyse individual performance levels in both infection and cost control.