bluuebunny/crossref_metadata_2025 huggingface dataset:
Contrast Transcranial Doppler Can Diagnose Large Patent Foramen Ovale
Authors: Kobayashi Kazuto , Iguchi Yasuyuki , Kimura Kazumi , Okada Yoko , Terasawa Yuka , Matsumoto Noriko , Sakai Kenichirou , Aoki Jyunya , Shibazaki Kensaku
Published: January 2009

Background: Contrast transesophageal echocardiography (c-TEE) and contrast transcranial Doppler (c-TCD) are useful diagnostic tools for detecting right-to-left shunts (RLS). However, the diagnostic accuracy of c-TCD for patent foramen ovale (PFO) remains uncertain. We investigated the relationship between the size of PFO determined by c-TEE and c-TCD findings and assessed the detectable rate of RLS by c-TCD. Methods: We assessed RLS three times using simultaneous c-TCD and c-TEE in 107 patients (321 examinations). We classified all of ultrasound examinations into three groups by size according to microbubbles on c-TEE, such as no PFO (0 microbubble), small PFO (1–29 microbubbles) and large PFO (≥30 microbubbles). We also calculated the number of microembolic signals (MES) on c-TCD and evaluated the association between PFO size on c-TEE and MES count on c-TCD. Results: In the present study, c-TEE detected RLS in 105 (33%; small PFO, n = 78; large PFO, n = 27), and c-TCD detected RLS in 49 (15%) of 321 examinations. Among 78 examinations with small PFO, MES were found in only 19 (24%) on c-TCD. In contrast, of all 27 examinations with large PFO, MES were found on c-TCD. Also, c-TCD were able to detect MES in 3 of 216 examinations among the no-PFO group. When ≥2 MES on c-TCD was established as the cutoff to predict large PFO on c-TEE, the sensitivity, specificity and accuracy were 96.3, 96.8, and 96.9%, respectively. Conclusion: When two or more MES were determined by c-TCD, large PFO could be accurately diagnosed.
The Quality of Diabetes Care following Hospitalization for Ischemic Stroke
Authors: Pandhi Nancy , Smith Maureen A. , Kind Amy J.H. , Frytak Jennifer R. , Finch Michael D.
Published: January 2009

Background: Follow-up is critically important for stroke survivors with diabetes, yet there is limited research about the quality of diabetes care that these patients receive. We investigated performance on diabetes quality of care indicators for stroke survivors overall and by race. Methods: Claims data was extracted for 1,460 Medicare beneficiaries with preexisting diabetes who survived hospitalization for acute ischemic stroke in 2000. Adjusted probabilities of receiving HbA1c, LDL and dilated eye exams were estimated using logistic regression. Results: 53% had a dilated eye exam, 60% received an LDL check, 73% percent had their HbA1c checked at least once and only 51% received two or more HbA1c checks. In the unadjusted results, blacks were significantly less likely than whites to receive these tests. Conclusions:Care of stroke survivors, particularly blacks, shows gaps according to guidelines.
Associations of Inflammatory and Haemostatic Biomarkers with Poor Outcome in Acute Ischaemic Stroke
Authors: Welsh Paul , Barber Mark , Langhorne Peter , Rumley Ann , Lowe Gordon D.O. , Stott David J.
Published: January 2009

Background: Many inflammatory and haemostatic biomarkers show associations with acute ischaemic stroke outcome, but few studies compare a large range of markers. Methods: We assessed clinical status and 16 biomarkers within 24 h of onset in 180 consecutive acute ischaemic stroke patients. Results: A total of 94 patients had a poor outcome (dead or dependent at 30 days). C-reactive protein (CRP), IL-6, and fibrin D-dimer showed the strongest univariate associations with poor outcome (>2-fold increase; p < 0.01). When all biomarkers were included with clinical variables in a multivariable model, only D-dimer (OR 1.54; 95% CI 1.09–2.17), CRP (OR 1.31; 95% CI 1.03–1.68) and Scandinavian Stroke Scale (OR 0.91; 95% CI 0.88–0.95) were associated with poor outcome. Conclusions:D-dimer and CRP are independently associated with poor outcome in acute ischaemic stroke. More data is required to expand our understanding of these potential relationships with outcome.
Utilization of Intravenous Tissue Plasminogen Activator for Ischemic Stroke: Are There Sex Differences?
Authors: Allen Norrina B. , Myers Daniela , Watanabe Emi , Dostal Jackie , Sama Danny , Goldstein Larry B. , Lichtman Judith H.
Published: January 2009

Background: We evaluated whether there were sex-related differences in the administration of intravenous tissue plasminogen activator (IV-tPA) to patients with acute ischemic stroke admitted to US academic medical centers. Methods: Medical records were abstracted for consecutive ischemic stroke patients admitted to 32 academic medical centers from January through June, 2004, as part of the University HealthSystem Consortium Ischemic Stroke Benchmarking Project. Multivariate logistic models were used to test for sex-related differences in the receipt of IV-tPA with adjustment for demographic and clinical factors. Results: The study included 1,234 patients (49% women; mean age 66.6 years; 56% white). IV-tPA was given to 7% (6.5% of women versus 7.5% of men, p = 0.49). Women and men were equally likely to receive IV-tPA in risk-adjusted analyses (OR 1.02, 95% CI 0.64–1.64). Approximately 77% of women and men who did not receive IV-tPA did not meet the 3-hour treatment window or their time of onset was unknown. Conclusions: Women admitted to academic hospitals receive IV-tPA as often as men; however, a substantial percentage of both women and men are not arriving within the 3-hour time window required for diagnostic assessment and administration of intravenous thrombolytic therapy. Additional efforts are needed to improve the rapid identification, evaluation and treatment of stroke patients.
The Groningen Protocol – The Jewish Perspective
Authors: Gesundheit Benjamin , Steinberg Avraham , Blazer Shraga , Jotkowitz Alan
Published: January 2009

Despite significant advances in neonatology, there will always be newborns with serious life-threatening conditions creating most difficult bioethical dilemmas. Active euthanasia for adult patients is one of the most controversial bioethical questions; for severely ill neonates, the issue is even more complex, due to their inability to take part in any decision concerning their future. The Groningen Protocol introduced in 2005 by P.J. Sauer proposes criteria allowing active euthanasia for severely ill, not necessarily terminal, newborns with incurable conditions and poor quality of life in order to spare them unbearable suffering. We discuss the ethical dilemma and ideological foundations of the protocol, the opinions of its defenders and critics, and the dangers involved. The Jewish perspective relating to the subject is presented based on classical Jewish sources, which we trust may enrich modern bioethical debates. In Jewish law, the fetus acquires full legal status only after birth. However, while the lives of terminally ill neonates must in no way be actively destroyed or shortened, there is no obligation to make extraordinary efforts to prolong their lives. Accurate preimplantation or prenatal diagnosis might significantly reduce the incidence of nonviable births, but active killing of infants violates the basic foundations of Jewish law, and opens the ‘slippery slope’ for uncontrolled abuse. Therefore, we call upon the international medical and bioethical community to reject the Groningen Protocol that permits euthanization and to develop ethical guidelines for the optimal care of severely compromised neonates.
Treatment of Early Parkinson’s Disease
Authors: Simuni Tanya , Lyons Kelly E. , Pahwa Rajesh , Hauser Robert A. , Comella Cynthia , Elmer Lawrence , Weintraub Daniel
Published: January 2009

The management of early Parkinson’s disease (PD) involves the treatment of motor symptoms and, increasingly, non-motor symptoms. Given the fast pace of clinical research in PD, clinicians are faced with the challenge of integrating the latest findings into the ongoing care of individual PD patients. Part 1 of this 2-part article reviews motor symptom efficacy data for the newest PD treatment options, as well as for established therapies. Safety and tolerability data are also reviewed. Part 2 of the article reviews key findings relevant to the assessment of potential neuroprotective therapies and the treatment of non-motor symptoms.
Awareness and Knowledge of the Clinical Practice Guideline on Parkinson’s Disease among German Neurologists
Authors: Eggert Karla , Larisch Astrid , Dodel Richard , Bormann Cornelia , Oertel Wolfgang H.
Published: January 2009

Background/Aims: With increasing diagnostic and therapeutic options of Parkinsonian syndromes (PS), evidence-based medicine clinical practice guidelines for Parkinson’s disease and related disorders have been published. This study evaluates the awareness and the knowledge of the German practice guideline for Parkinson’s disease among neurologists. Methods: The cross-sectional questionnaire-based study was conducted in 2005 in Germany on a survey of 181 neurologists in private practice. Results: 53.1% (n = 95) of the participants specified to be aware of the guideline. A low level of knowledge was reported in diagnostic and therapeutic strategies for motor and nonmotor complications (including depression and dementia), and in the diagnostic features of atypical PS. Neurologists who were aware of the guideline had a significantly better knowledge of the different clinical features of idiopathic (94.7 vs. 84.3%; p = 0.023) versus nonidiopathic (88.3 vs. 77.1%; p = 0.048) PS in general, and specifically of multiple system atrophy (54.3 vs. 36.1%; p = 0.016) as well as of characteristics concerning increased daytime sleepiness (95.7 vs. 86.7%; p = 0.032). Conclusion: The awareness and the knowledge of the guideline in everyday medical practice are still limited. Future interventions for a better implementation must include strategies which are suitable to modify behavior patterns.
Efficacy and Safety of Levetiracetam (3,000 mg/Day) as an Adjunctive Therapy in Chinese Patients with Refractory Partial Seizures
Authors: Xiao Zheng , Li Jin-Mei , Wang Xue-Feng , Xiao Fei , Xi Zhi-Qin , Lv Yang , Sun Hong-Bin
Published: January 2009

Aim: To evaluate the efficacy and safety of 3,000 mg daily levetiracetam (LEV; Keppra) as an adjunctive therapy for Chinese patients with refractory partial seizures. Methods: This randomized, placebo-controlled trial consisted of an 8-week baseline period followed by a 4-week titration interval and a 12-week maintenance period, and concluded with a 4-week medication withdrawal period or entered an open-label study. LEV was compared with placebo. Results: The 50% responder rate (the proportion of patients with a minimum of 50% reduction in partial seizure frequency) occurred in 46.4% of the LEV group, compared with 39.3% of the placebo group (p = 0.590). The median of the absolute weekly frequency reduction from baseline of partial seizures was 0.66 per week for LEV versus 0.48 per week for placebo (p = 0.187). The most common treatment-emergent adverse events, mostly mild to moderate in severity, were somnolence, dizziness and agitation. Conclusion: In this study, adjunctive therapy with LEV 3,000 mg daily was well tolerated but not as effective as expected in controlling partial seizures in this study population. Considering the lower mean weight of this study population, we suggest the dosage of LEV 3,000 mg daily may contribute to the results.
Efficacy of Vitrectomy and Internal Limiting Membrane Removal for Macular Edema Associated with Branch Retinal Vein Occlusion
Authors: Arai Miyuki , Yamamoto Shuichi , Mitamura Yoshinori , Sato Eiju , Sugawara Takeshi , Mizunoya Satoshi
Published: January 2009

Aim: To compare the results of vitrectomy with internal limiting membrane (ILM) peeling to that without ILM peeling for macular edema associated with branch retinal vein occlusion (BRVO). Methods: The medical records of 47 eyes of 47 patients with BRVO-associated macular edema were examined. To treat the macular edema, a posterior vitreous detachment (PVD) was created, and the ILM was removed in 13 eyes (ILM-removed group), whereas a PVD was created and the ILM was not removed in 34 eyes (ILM-preserved group). The best-corrected visual acuity (BCVA) and the optical-coherence-tomography-determined foveal thickness were obtained preoperatively and at 6 months postoperatively. Results: The mean postoperative BCVA was significantly better than the preoperative BCVA in both the ILM-removed and in the ILM-preserved groups (p = 0.0017 and p = 0.0002, respectively). The fovea was significantly thinner at 1 month after surgery in both groups (p = 0.0007 and p < 0.0001, respectively). The postoperative improvement of the mean BCVA and the foveal thickness were not significantly different for the two groups at any postoperative period. Conclusions: Because there was no significant difference in the improvement of BCVA between the two groups at 6 months postoperatively, there may be no additional benefit in removing the ILM for BRVO-associated macular edema.
Score for Neonatal Acute Physiology and Perinatal Extension II as a Predictor of Retinopathy of Prematurity: Study in 304 Very-Low-Birth-Weight Preterm Infants
Authors: Fortes Filho J.B. , Dill J.C. , Ishizaki A. , Aguiar W.W.S. , Silveira R.C. , Procianoy R.S.
Published: January 2009

Aim: To evaluate the use of the Score for Neonatal Acute Physiology and Perinatal Extension (SNAPPE-II) at admission to predict the development of retinopathy of prematurity (ROP) among very-low-birth-weight preterm babies. Methods: A prospective cohort study included 304 infants screened for ROP from July 2004 to October 2007. The main outcomes were the development of any stage ROP and severe ROP. The main variable was the SNAPPE-II obtained at admission. Seventeen risk factors for ROP were studied by univariate analysis (χ2 and Student’s t test). A simple descriptive analysis was used for the SNAPPE-II (mean, median, standard deviation and interquartile range: p25–p75). Logistic regression and receiver-operating characteristic (ROC) curve were calculated for SNAPPE-II. Ophthalmological examinations started at the 6th week of life and were repeated until the 45th week of corrected gestational age (GA). Results: The mean GA and mean birth weight of the whole cohort were 30.3 weeks (±2.2) and 1,209.2 g (±277.7), respectively. The median SNAPPE-II among non-ROP and ROP patients were 6.0 and 15.0, respectively (p = 0.001). When compared with severe ROP patients (25.0) there was also a significant difference (p = 0.003). After logistic regression, the SNAPPE-II adjusted odds ratio for ROP was 1.024. The area under the ROC curve was 0.62 (95% confidence interval: 0.55–0.70, p < 0.001). The best discriminative cutoff value was 8.5 (sensitivity: 68%; specificity: 54%; positive predictive value: 37.3%; negative predictive value: 80.6%). Conclusions: The SNAPPE-II values at admission were significantly higher among babies with ROP, suggesting a positive association between higher scores with the development of ROP, but after adjusted logistic regression and ROC curve results, the SNAPPE-II scores at admission did not enhance the assessment of risk for ROP.
Maxillary Sinus Grafting with a Nano-Structured Biomaterial: Preliminary Clinical and Histological Results
Authors: Stübinger S. , Ghanaati S. , Orth C. , Hilbig U. , Saldamli B. , Biesterfeld S. , Kirkpatrick C.J. , Sader R.A.
Published: January 2009

Background: In this study the potential of a new and entirely synthetic, nano-structured hydroxyapatite-based biomaterial for sinus floor augmentation is evaluated. Methods: 20 sinus floor elevations were carried out in a total of 20 patients. After a healing period of 6 months, in 10 cases cylinder-shaped bone biopsies were taken from the augmented maxillary region using trephine burs. Results: The healing period progressed without any complications. General and specific histological analysis of the bone biopsies showed a high osteoclast activity at the margin of the biomaterial which was well integrated into the newly formed bone. Conclusion: This study demonstrates that new trabecular bone is formed after grafting with the nanocrystalline bone substitute after 6 months. Ongoing histomorphological studies are necessary to quantify the biomaterial-bone ratio and the exact amount of newly built bone in the augmented cavity after 6 months.
Phosphate – The Silent Stealthy Cardiorenal Culprit in All Stages of Chronic Kidney Disease
Authors: Kanbay Mehmet , Goldsmith David , Akcay Ali , Covic Adrian
Published: January 2009

Background and Aim: Due to increasing evidence suggesting a link between hyperphosphatemia and cardiovascular disease (CVD), mediated through vascular calcification in patients on dialysis, the following question arises: At what stage of chronic kidney disease (CKD) does the relationship between elevated phosphate levels, vascular calcification and increased cardiovascular mortality begin? Therefore, the purpose of the current study was to critically review the current literature regarding this issue. Methods: We performed a systematic search of the National Library of Medicine and the Cochrane Library databases from January 1985 to February 2008 to identify clinical studies examining the effects of plasma phosphate on cardiovascular outcome, mortality and progression of kidney disease in subjects with and without CKD who have not yet received dialysis. The primary outcome measure was the development of CVD, mortality and progression of kidney disease. Results: Twelve clinical trials investigated the role of serum phosphate levels and adverse outcome (9 studies examining CVD outcome and 3 examining progression of kidney disease). After adjustment for risk factors for mortality, adverse cardiovascular outcome and progression of kidney disease, all studies found a graded independent significant association between phosphate levels and mortality, development of CVD and progression of kidney disease. There was no such association with plasma calcium levels. Conclusions: There is a graded independent association between serum phosphate levels and mortality, mainly cardiovascular events, and the progression of renal disease in subjects with and without definable (loss of glomerular filtration rate) CKD.
Renal Artery Stenosis and Renal Parenchymal Damage in Patients with Abdominal Aortic Aneurysm Proven by Autopsy
Authors: Nakamura Satoko , Ishibashi-Ueda Hatsue , Suzuki Chigure , Nakata Hiroto , Yoshihara Fumiki , Nakahama Hajime , Kawano Yuhei
Published: January 2009

Background: Chronic kidney disease is a major risk factor for patients with cardiovascular diseases (CVD). The aim of this study is to evaluate the relationship between clinical characteristics and renal histology in patients with abdominal aortic aneurysm (AAA). Methods: We studied 79 cases with AAA autopsied at the National Cardiovascular Center. They were classified into two groups: 14 subjects with renal artery stenosis (RAS) (group A) and 65 subjects without RAS (group B). Proteinuria, elevated serum creatinine and decreased estimated glomerular filtration rate had been recorded. We evaluated renal parenchymal damage using a semiquantitative histological score (score 0–3; normal to severe) for glomerulosclerosis, interstitial fibrosis, tubular atrophy, and arteriolar hyalinosis (maximal score = 12). Results: Total histological score was 8.2 ± 2.4 and significantly higher in the stenosed kidneys of group A than in the non-stenosed kidneys of group B (8.9 ± 2.6 vs. 8.0 ± 2.3). The histological score had a significant association with RAS, smoking, kidney function, proteinuria, kidney weight and the presence of other CVD. Conclusion: We demonstrated that renal parenchymal damage and deteriorated kidney function are closely associated in the patients with AAA. Treatment of these patients in view of protection of the kidney is thus relevant.
Salivary Gland Homogenates of Lutzomyia longipalpis and Its Vasodilatory Peptide Maxadilan Cause Plasma Leakage via PAC1 Receptor Activation
Authors: Svensjö Erik , Saraiva Elvira M. , Bozza Marcelo T. , Oliveira Sandra M.P. , Lerner Ethan A. , Scharfstein Julio
Published: January 2009

Objectives: Experiments were designed to determine if salivary gland homogenates (SGH) of the sand fly Lutzomyia longipalpis, the vasodilatory peptides maxadilan and pituitary adenylate cyclase-activating peptide (PACAP-38) may cause plasma leakage and to what extent these effects could be due to PAC1 receptor stimulation. Methods: Using FITC-dextran as a plasma marker, intravital microscopy of the hamster cheek pouch (HCP) and a digital camera were used to assess arteriolar diameter and fluorescence of a selected area (5 mm2) representative of the HCP microcirculation. Results: Cheek pouches prepared for intravital microscopy and exposed to topical application of SGH, maxadilan or PACAP-38 developed maximal dilation of arterioles in the range of 20–60 μm within 10 min, and this effect lasted for 30–90 min. The increase in fluorescence intensity induced by each of these compounds was due to plasma leakage from postcapillary venules. The mutant peptide of maxadilan (M-65), a PAC1 receptor antagonist, inhibited both dilation and plasma leakage induced by SGH or maxadilan. Plasma leakage induced by SGH was modestly inhibited by the bradykinin B2 receptor antagonist HOE-140, but not by the antihistamine mepyramine or the nitric oxide synthase inhibitor L-NA. Conclusions: SGH of L. longipalpis and its vasodilatory peptide maxadilan caused long-lasting arteriolar dilation and plasma leakage in the cheek pouch via PAC1 receptor activation.
Changes in Cortical Activation during Retrieval of Clock Time Representations in Patients with Mild Cognitive Impairment and Early Alzheimer’s Disease
Authors: Leyhe Thomas , Erb Michael , Milian Monika , Eschweiler Gerhard W. , Ethofer Thomas , Grodd Wolfgang , Saur Ralf
Published: January 2009

Objective: We investigated healthy controls (HCs), and patients with mild cognitive impairment (MCI) and early Alzheimer’s disease (AD) to identify neuronal correlates of clock time representation and changes resulting from neurodegenerative processes using functional magnetic resonance imaging. Methods: Two clock-specific tasks demanding conceptual knowledge of clock hands, i.e. a minute hand and an hour hand task, were compared with a semantic control task. Results: We observed that the minute hand task provoked a stronger activation of areas in the parietal lobes known to be involved in spatial mental imagery, while the semantic task primarily activated regions of the superior temporal lobes associated with verbal conceptual knowledge. The performance of the MCI group did not differ from that of the HC group, but additional activation was found in several brain regions. Decreased activation was detected during the minute hand task in the right middle temporal gyrus. Patients with early AD showed deteriorated performance in both clock tasks along with reduced activation in the occipital lobes and the left fusiform gyrus. Additional activation was detected in the precuneus. Conclusions: The fusiform gyrus might be crucial for the visual-semantic retrieval of clock time representation. In patients with early AD, access to this visual-semantic knowledge appears to be reduced.
Thrombospondin in Renal Disease
Authors: Hugo Christian , Daniel Christoph
Published: January 2009

Thrombospondins (TSPs) are multifunctional matricellular glycoproteins which are involved in the regulation of angiogenesis, proliferation, apoptosis, the NO-cGMP-dependent protein kinase pathway and transforming growth factor (TGF) β activation. The TSP family consists of 5 members, but currently only data on effects of TSP-1 and TSP-2 in renal disease are available. Both TSPs are hardly expressed within the healthy renal cortex and can be upregulated during renal disease. Using different animal models for renal disease, TSP-1 and -2 were found to be important regulators of pathophysiological changes during renal disease with similar and contrary effects. TSP-1 is a major activator for TGF-β resulting in profibrotic effects in the injured kidney. In contrast, TSP-2 lacks the ability for its activation. Proapoptotic actions of TSP-1 were found during renal ischemia/reperfusion injury. While TSP-1 exerts proinflammatory actions, the currently available data for TSP-2 propose anti-inflammatory effects for this molecule. Both TSPs are known angiogenesis inhibitors, which could be proved for TSP-2, but antiangiogenic effects for TSP-1 were only evident by treatment with TSP-1 peptides in renal disease. In addition, TSP-2 can inhibit cell proliferation and matrix metalloproteinase 2 activity.
Blood Pressure in Renal Transplant Recipients: Are There Independent Predictors for Achieving Target Blood Pressure?
Authors: Mason J. , Kleemann F. , Bankart J. , Medcalf J. , Carr S.
Published: January 2009

Background: Post-transplant hypertension is a major modifiable risk factor for graft and patient survival. The aim of this study was to establish independent predictors for achieving systolic, diastolic and overall blood pressure target [Kidney Disease Outcome Quality Initiative (K/DOQI) target blood pressure <130/80 mm Hg] in renal-transplant recipients (RTRs) and to consider whether current management strategies are adequate to achieve this aim. Methods: The most recent office blood pressure readings were collected for 513 RTRs at least 6 months after transplantation. In addition, demographic data, comorbidities, medications prescribed, weight, duration of transplantation, and laboratory parameters were recorded. Logistic regression analysis was used to determine whether any covariables were significant (p < 0.05) independent predictors of controlled blood pressure (<130/80 mm Hg). Results: Approximately 50% of the RTRs had blood pressures <130/80. There was a marked terminal digit preference demonstrated. Subjects who were female, had diabetes, did not have heart disease or had a lower albumin:creatinine ratio had a higher probability to achieve good blood pressure control. Diabetics were more likely to be prescribed 3 or more antihypertensive agents. Conclusions: This study shows that improvements in blood pressure control can be achieved. People with diabetes were 2.1 times more likely to meet target blood pressure. Further improvements in blood pressure control may require different treatment strategies in addition to the current pharmacological approach.
Richard Bright and His Neurological Studies
Authors: Pearce J.M.S.
Published: January 2009

Richard Bright was one of the famous triumvirate of Guy’s Hospital physicians in the Victorian era. Remembered for his account of glomerulonephritis (Bright’s disease) he also made many important and original contributions to medicine and neurology. These included his work on cortical epileptogenesis, descriptions of simple partial (Jacksonian) seizures, infantile convulsions, and a variety of nervous diseases. Most notable were his reports of neurological studies including papers on traumatic tetanus, syringomyelia, arteries of the brain, contractures of spinal origin, tumours of the base of the brain, and narcolepsy. His career and these contributions are outlined.
Different Expression of Vascular Endothelial Growth Factor and Pigment Epithelium-Derived Factor between Diabetic and Non-Diabetic Epiretinal Membranes
Authors: Nam Dong Heun , Oh Jaeryung , Roh Joon Ho , Huh Kuhl
Published: January 2009

Purpose: To determine whether there is a difference in protein levels of expression of vascular endothelial growth factor (VEGF), pigment epithelium-derived factor (PEDF), platelet-derived growth factor (PDGF) and transforming growth factor β1 (TGF-β1) between diabetic and non-diabetic epiretinal membranes (ERMs). Methods: ERMs and vitreous were surgically removed from the eyes of 8 patients with proliferative diabetic retinopathy and from 6 patients with proliferative vitreoretinopathy. Concentrations of VEGF, PEDF, PDGF and TGF-β1 were investigated by an enzyme-linked immunosorbent assay. Results: The concentrations of VEGF were higher in ERMs from patients with diabetes (9.2 ± 8.0 pg/μg protein) compared to those without diabetes (1.2 ± 3.0 pg/μg protein; p = 0.026), while the concentrations of PEDF were higher in ERMs from patients without diabetes (7.5 ± 1.5 ng/μg protein) compared to those with diabetes (3.5 ± 1.5 ng/μg protein; p = 0.002). In addition, the VEGF-to-PEDF ratio was higher in diabetic ERMs (2.80 ± 1.83) than in non-diabetic ones (0.17 ± 0.09; p = 0.019). However, the concentrations of PDGF and TGF-β1 in membranes were not different between patients with diabetes and those without diabetes. Conclusion: This study found the difference in protein levels of expression of VEGF and PEDF between diabetic and non-diabetic ERMs. These results suggest that a disturbance in the balance between angiogenic and anti-angiogenic factors may play an important role in angiogenesis in diabetic ERMs.
Frontal Assessment Battery and Brain Perfusion Imaging in Early Dementia
Authors: Yoshida Hidenori , Terada Seishi , Sato Shuhei , Kishimoto Yuki , Ata Toshie , Ohshima Etsuko , Honda Hajime , Ishihara Takeshi , Kuroda Shigetoshi
Published: January 2009

Background/Aims: The frontal assessment battery (FAB) is reported to be a useful tool for screening frontal function. However, the neural substrates involved remain to be elucidated. The aim of the present study was to identify the brain regions responsible for FAB performance in patients with early dementia. We sought a correlation between FAB scores and brain perfusion. Methods: A total of 117 subjects participated in this study (Alzheimer’s disease = 51, frontotemporal dementia = 14, vascular dementia = 13, dementia with Lewy bodies = 7, psychiatric disease = 7, mild cognitive impairment = 11, controls = 14). They underwent brain single photon emission computed tomography with 99mTc-ethylcisteinate dimer, and we analyzed the data, using a regional cerebral blood flow (rCBF) quantification software program, 3DSRT (3-dimensional stereotaxic region of interest template). Results: FAB scores had a moderately positive correlation with left callosomarginal and precentral rCBF. Comparison of rCBF between high- and low-scoring FAB groups revealed that the latter showed significantly lower rCBF in the bilateral callosomarginal and left precentral regions. Conclusion: The results in this study suggest that the FAB mainly reflects the function of the callosomarginal and precentral segments, especially the left side, and that it might be a valid frontal lobe function test.
Risk Factors for Falls in Community-Dwelling Patients with Alzheimer’s Disease and Dementia with Lewy Bodies: Walking with Visuocognitive Impairment May Cause a Fall
Authors: Kudo Yuri , Imamura Toru , Sato Atsushi , Endo Naoto
Published: January 2009

Background/Aims: To identify risk factors for falls in community-dwelling patients with Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB). Patients: 78 consecutive patients (51 AD, 27 DLB) were recruited from the Niigata Rehabilitation Hospital memory clinic. Methods: We assessed the number of falls each patient had had in the previous 4 months. The data for DLB patients without motor parkinsonism were analyzed both as part of the whole DLB group and separately to determine the effect of parkinsonism alone on falls. Results: Of 78 patients, 17 (21.8%) reported at least 1 fall during the period. A diagnosis of DLB, visual hallucinations, parkinsonism and cognitive fluctuation were significant predictors, but none of them was significant in the stepwise multivariate analysis. After excluding patients with parkinsonism, the use of hypnotics-anxiolytics and a worse score on the constructional task were significant and independent predictors of falling. Conclusion: Parkinsonism was a major risk factor for falls. When AD or DLB patients walk with incongruent visual information, they may increase their postural sway or instability, because of their executive dysfunction. If elementary and/or higher-order visuocognitive impairment in AD or DLB patients alters visual information sufficiently, they may fall when walking.
Education Attenuates the Association between Dietary Patterns and Cognition
Authors: Akbaraly Tasnime N. , Singh-Manoux Archana , Marmot Michael G. , Brunner Eric J.
Published: January 2009

Background/Aims: Various foods have been shown to be associated with cognitive outcomes. As individual food items are not consumed in isolation, we examined the association between dietary patternsand cognitive function, with special attention to the role of education in this association. Methods: Analyses were carried out on 4,693 stroke-free white European participants of the Whitehall II study. Two dietary patterns were determined using principal component analysis: a ‘whole food’ and a ‘processed food’ pattern. Cognitive function was assessed using a battery of 5 tests. Results: After adjustment for demographic, behavioral and health measures, higher intake of ‘whole food’ diet was associated with lower and high consumption of ‘processed food’ with higher odds of cognitive deficit. However, adjustment for education significantly attenuated most of these associations. Conclusions: Education, through its role as a powerful confounder, shapes the relationship between dietary patterns and cognitive deficit in a healthy middle-aged UK cohort.
The response of American robins (Turdus migratorius) to aerial alarms
Authors: Vanderhoff E. Natasha , Eason Perri
Published: February 2009

Alarm calls are important signals that allow individuals to convey information about both predator type and risk level. How individuals respond to these calls may depend on both the intensity of the call as well as the age of the responder. We investigated an aerial alarm call of the American robin and specifically examined how call rate (reflecting intensity) and age affect the anti-predator behaviors of responders. Both juveniles and adults significantly altered their behavior upon hearing playbacks of seet calls; they foraged less and increased vigilance and other anti-predator behaviors. Adult robins were also able to distinguish between low intensity and high intensity calls; skygazing, an important behaviour that allows robins to scan for raptors, increased with call rate. Juveniles, on the other hand, skygazed less and there was a trend for juveniles to spend more time alert than adults suggesting that some learning may be involved.
The Southern Ocean Overturning: Parameterized versus Permitted Eddies
Authors: Spence Paul , Saenko Oleg A. , Eby Michael , Weaver Andrew J.
Published: February 2009

Four versions of the same global climate model, with horizontal resolution ranging from 1.8° × 3.6° to 0.2° × 0.4°, are employed to evaluate the resolution dependence of the Southern Ocean meridional overturning circulation. At coarse resolutions North Atlantic Deep Water tends to upwell diabatically at low latitudes, so that the Southern Ocean is weakly coupled with the rest of the ocean. As resolution increases and eddy effects become less parameterized the interior circulation becomes more adiabatic and deep water increasingly upwells by flowing along isopycnals in the Southern Ocean, despite each model having the same vertical diffusivity profile. Separating the overturning circulation into mean and eddy-induced components demonstrates that both the permitted and the parameterized eddies induce overturning cells in the Southern Ocean with mass fluxes across mean isopycnals. It is found that for some density classes the transformation rate derived from surface buoyancy fluxes can provide a proxy for the net meridional transport in the upper Southern Ocean. Changes in the Southern Ocean overturning in response to poleward-intensifying Southern Hemisphere winds concomitant with increasing atmospheric CO2 through the twenty-first century are also investigated. Results suggest that the circulation associated with the formation of Antarctic Intermediate Water is likely to strengthen, or stay essentially unchanged, rather than to slow down.
Simulation of Coherent Radar Imaging Using Continuous Wave Noise Radar
Authors: Xu Jing , Hoffman M. W. , Cheong B. L. , Palmer R. D.
Published: February 2009

A computationally simple cross-correlation model for multiple backscattering from a continuous wave (CW) noise radar is developed and verified with theoretical analysis and brute-force time-domain simulations. Based on this cross-correlation model, a modification of an existing numerical method originally developed by Holdsworth and Reid for spaced antenna (SA) pulsed radar is used to simulate the estimated cross correlation corresponding to atmospheric backscattering using a coherent CW noise radar. Subsequently, coherent radar imaging (CRI) processing comparisons between the CW noise radar and a conventional pulsed radar are presented that verify the potential of CW noise radar for atmospheric imaging.
Risks and Redistribution
Authors: Rehm Philipp
Published: January 2009

Much of the disagreement in the debate about globalization and its present or absent effects on the welfare state stems from competing assumptions about the individual-level determinants of redistributional preferences. This article calls for and provides testing of these causal mechanisms at the individual level. Traditional accounts suggest that risks at the industry level are important determinants of redistributional preferences. This article argues that risks at the occupational level should also be considered. A comprehensive new data set is used to test whether and what types of risks in the labor market play an important role in shaping preferences. Statistical analyses of public opinion surveys (European Social Survey) show strong evidence for the assumed causal mechanism. Contrary to much of the literature, but in line with this article's claims, it is the occupational, rather than the industry level, that is most important. The article lays out implications of these findings.
Importing the Bomb
Authors: Kroenig Matthew
Published: January 2009

Why do nuclear weapons spread? Using new data on sensitive nuclear transfers, this article analyzes the determinants of nuclear proliferation. The author first describes a simple logic of the technical and strategic advantages that potential nuclear proliferators can gain by importing nuclear materials and technology from more advanced nuclear states. The author then shows that sensitive nuclear transfers are an important determinant of nuclear proliferation. In broader terms, the author find strong support for a supply-side approach to nuclear proliferation. States that are better able to produce nuclear weapons, due to either international assistance or domestic capacity, are more likely to do so.
Taking a Walk on the Supply Side
Authors: Fuhrmann Matthew
Published: January 2009

When and why do states transfer nuclear technology, materials, and knowledge to other states for peaceful purposes? This question is important given the recent finding that countries receiving nuclear aid are more likely to pursue and acquire nuclear weapons. I argue that countries provide civil nuclear assistance for three strategic reasons: to strengthen their allies and alliances, to strengthen their relationship with enemies of enemies, and to strengthen existing democracies and bilateral relationships with these countries (if the supplier is also a democracy). I test these arguments using statistical analysis and a new data set on more than 2,000 bilateral civilian nuclear cooperation agreements signed between 1950 and 2000. The findings offer robust empirical support for my argument and very little support for the competing explanation rooted in norms and nonproliferation. This article enhances scholarly understanding of how and why nuclear weapons spread and encourages further research on the supply side of nuclear proliferation. It also has broad implications for the literatures on norms and international cooperation.
Bargaining, Nuclear Proliferation, and Interstate Disputes
Authors: Gartzke Erik , Jo Dong-Joon
Published: January 2009

Contrasting claims about the consequences of nuclear weapons rely on different interpretations about how leaders respond to risk, uncertainty, and the balance of power. Nuclear optimists use deterrence theory to argue that proliferation can promote stability and inhibit the use of force. Pessimists argue that proliferation precipitates nuclear hubris, accident, or anger that heightens the risk of war. It is also possible that nuclear weapons have no net effect on dispute propensity. Since states fashion their own bargains, nuclear status is bound to influence the distribution of influence. Proliferation also reflects existing tensions, biasing upward the apparent impact of nuclear weapons on conventional conflict. Instrumenting for the decision to proliferate, the authors find that nuclear weapons increase diplomatic status without much affecting whether states fight.
Winning with the Bomb
Authors: Beardsley Kyle , Asal Victor
Published: January 2009

Nuclear weapons' effects on an actor's success in coercive diplomacy are in part a function of how nuclear weapons change the perceived costs of conflict. The authors argue that states can improve their allotment of a good or convince an opponent to back down and have shorter crises if their opponents have greater expected costs of crisis. Noting that nuclear weapons increase the costs of full-escalation scenarios but decrease their probability, it is uncertain what impact nuclear weapons should have on expected costs of conflict. The authors assess crisis outcomes from 1945 to 2000 using the International Crisis Behavior data set. The evidence confirms that nuclear actors are more likely to prevail when facing a nonnuclear state. The expected duration of crisis in such asymmetric directed dyads is substantially smaller than the duration of crisis for actors in nonnuclear dyads. Nuclear actors in asymmetric dyads are also more likely to prevail than states in symmetric nuclear dyads.
Predicting Employment Outcomes of Consumers of State-Operated Comprehensive Rehabilitation Centers
Authors: Beach David Thomas
Published: January 2009

This study used records from a state-operated comprehensive rehabilitation center to investigate possible predictive factors related to completing comprehensive rehabilitation center programs and successful vocational rehabilitation (VR) case closure. An analysis of demographic data of randomly selected comprehensive rehabilitation center participants served between fiscal year (FY) 1998-1999 and FY 2003-2004 indicated that participants were by and large younger than participants in the general VR program, with many center participants having psychological or cognitive primary disabilities. A binary logistic regression identified completing a comprehensive rehabilitation center program as a predictor of successful VR case closure, whereas receiving psychological services, being from a rural area, and receiving public assistance were negative predictors of successful VR case closure.
Small-Business Owners' Knowledge and Rural Tourism Establishment Performance in Spain
Authors: Hernández-Maestro Rosa M. , Muñoz-Gallego Pablo A. , Santos-Requejo Libia
Published: January 2009

A review of the literature reveals that the entrepreneur's knowledge is a source of competitive advantage within the firm. This investigation assesses the relationships among small-business owners' knowledge and service quality performance in rural tourism in Spain by considering two measures of service quality: objective and perceived quality. Data from a paired sample of tourists and small-business owners were analyzed with an overall model that contains different types of variables (including dichotomic) and constructs (formative and reflective). Consequently, the partial least squares approach was used. The results reveal the positive and strong influence of small-business owners' education on objective quality, but small-business owners' experience does not seem to play any role for service quality. In addition, objective quality precedes perceived quality. Implications for the sector are derived from the findings.
Children's appraisal of moderately stressful situations
Authors: Hood Brianne , Power Thomas , Hill Laura
Published: January 2009

This study investigated 2 questions: (1) do children show consistent styles of appraisal across a range of moderately stressful events?, and (2) what are the adjustment and parenting correlates of individual differences in children's appraisal style? Ninety-nine 3rd though 5th grade children and their mothers participated. For each of 6 vignettes involving moderately stressful situations, children responded to 10 items assessing children's appraisal of these events. Mothers completed a self-report measure of parenting practices and children reported on their psychological adjustment. Participants showed moderate levels of consistency in their appraisal of the events across situations, and 6 appraisal styles were identified that reflected the nature of appraisal aggregated across situations. These styles showed meaningful patterns of association with child psychological symptoms and parenting practices. Children showing the victim appraisal style reported the highest levels of anxiety and school dislike, whereas children showing the inconvenience and take responsibility styles reported the lowest level of conduct problems. Parenting style was associated with the appraisal style of boys but not girls. Specifically, boys of authoritative mothers were more likely than other boys to show the inconvenience and take responsibility appraisal styles and less likely to show the victim style.
Links between children's attachment behavior at early school-age, their attachment-related representations, and behavior problems in middle childhood
Authors: Moss Ellen , Bureau Jean-François , Béliveau Marie-Julie , Zdebik Magdalena , Lépine Suzanne
Published: January 2009

The objective of the present study was to examine associations between children's attachment behavior at early school-age, dimensions of narrative performance, and behavior problems as assessed in middle childhood. Children's attachment patterns with mother were assessed at age 6 ( N = 127) using the Main and Cassidy (1988) separation—reunion classification system. Two years later, these children ( N = 109) completed the Narrative Story Stem Battery (Bretherton, Oppenheim, Buchsbaum, Emde, & The MacArthur Narrative Group, 1990), and teachers rated their level of behavior problems using the Social Behavior Questionnaire (Tremblay, Vitaro, Gagnon, Piché, & Royer, 1992). Results indicated that secure children depicted fewer conflict themes in their narratives than did disorganized/controlling children, produced more discipline themes than avoidant children, and had higher coherence scores than ambivalent children. Avoidant children also depicted fewer conflict themes than disorganized/controlling children. Finally, children's narrative conflict themes significantly predicted both level of externalizing and total behavior problems, even after controlling for variance explained by gender and disorganized/controlling attachment behavior. Girls' narratives were more likely to evoke discipline and affection/affiliation themes, and to be more coherent than boys' narratives.