bluuebunny/crossref_metadata_2025_split huggingface dataset:
O-026 Initial clinical experience with the web intrasaccular flow-diverter device for endovascular treatment of intracranial aneurysms
Authors: Lubicz B , Mine B , Collignon L , De Witte O , Brisbois D 
Published: July 2011

Background and PurposeFlow diversion is a new approach for the endovascular treatment (EVT) of intracranial aneurysms (IA). The woven endobridge aneurysm embolization device (WEB) is the first intrasaccular flow-diverter device dedicated to IA treatment. We report our preliminary experience with this device.MethodsThis report is part of an ongoing prospective study that was approved by the authors ethical committees. This prospective multicentric study was approved by our ethical committees. Five patients with 5 wide-necked, unruptured, and terminal-type aneurysms were included and treated by WEB placement alone. There were four women and one man with a mean age of 47 years old. Aneurysms were located on the middle cerebral artery bifurcation (n=2), on the basilar tip, on the vertebral artery, and on the carotid-ophtalmic artery. Technical issues, immediate findings, clinical and imaging follow-up at 3 months were assessed.ResultsEVT was successfully performed in all but one patient who presented with a tortuous carotid siphon. In this patient, the WEB could not be delivered because of high frictions within the delivery catheter. In four patients, the WEB could be placed within the aneurysm achieving immediate occlusion with a slight neck remnant in 2 cases and major flow reduction in 2 cases. In one of these latter two patients, imaging follow-up at 3 months (magnetic resonance and conventional angiographies) was obtained showing satisfying occlusion with a neck remnant. There was no morbidity and mortality related to the procedure. However, in one patient with a middle cerebral artery aneurysm, slowing of a bifurcation branch was observed without any clinical significance.ConclusionsIntrasaccular flow-diversion is an effective new therapeutic approach for EVT of IA.
O-003 Recanalization vs reperfusion as vascular end points in acute ischemic stroke endovascular intervention
Authors: Sugg R , Holloway W , Martin C , Akhtar N , Rymer M 
Published: July 2011

IntroductionThe relationship between the two angiographic parameters, recanalization and reperfusion, as they relate to clinical outcome of acute stroke patients undergoing endovascular intervention is not well defined. We sought to determine the relationship of recanalization of the primary arterial occlusive lesion (AOL) and global reperfusion of the distal vascular bed in patients treated with endovascular stroke rescue at our institution.HypothesisWe assessed the hypothesis that recanalization and reperfusion scores would comparably predict outcome.Methods96 angiograms were reanalyzed using recanalization and reperfusion scores by neurointerventionalists blinded to clinical outcome. The AOL score was defined as follows: 0=no recanalization of the primary occlusion; I=incomplete or partial recanalization of the primary occlusion with no distal flow; II=incomplete or partial recanalization of the primary occlusion with distal flow; or III=complete recanalization of the primary occlusion with distal flow. The Thrombolysis in Cerebral Infarction (TICI) Score was defined as follows: 0=no perfusion; 1= penetration, but no distal branch filling; 2a= perfusion with incomplete (<50%) distal branch filling; 2b=perfusion with incomplete (>50%) distal branch filling; and 3=full perfusion with filling of all distal branches. We compared these methods of assessment to one another and with good clinical outcome (modified Rankin Score 0 to 2).ResultsAOL and TICI scores showed moderate to substantial agreement (κ=0.660, 95% CI (0.518 to 0.801). Good clinical outcome was seen in 60% of patients with AOL II/III scores (p=0.462) and in 71% with TICI 2/3 scores (p=0.854). The two methods did not significantly differ in predicting outcome (p=0.52).ConclusionIn conclusion, TICI reperfusion scores and AOL recanalization scores comparably predicted clinical outcome in our patient population. However, further investigation should be performed, possibly with the aid of other imaging modalities, to further differentiate between these parameters and their relationship to clinical outcome.
P-005 Is bridging with intravenous thrombolysis of any benefit in endovascular therapy of acute ischemic stroke?
Authors: Kass-Hout T , Mokin M , Kass-Hout O , Darkhabani M , Orion D , Jahshan S , Yashar P , Levy E , Siddiqui A , Snyder K 
Published: July 2011

BackgroundLarge vessel occlusions with a high clot burden are less likely to improve with presently accepted and FDA-approved intravenous thrombolysis (IV) strategy. Endovascular therapy within the first 3 h of stroke symptom onset provides an effective alternative treatment in patients with large vessel occlusion. It is not clear if combination of IV thrombolysis and endovascular approach is superior to endovascular treatment alone.MethodsWe retrospectively reviewed all cases of acute ischemic stroke with large vessel occlusion treated within the first 3 h stroke onset during the 2005–2010 period. First group received endovascular therapy within the first 3 h of stroke onset. Second group consisted of patients who received IV thrombolysis within the first 3 h followed by endovascular therapy. We compared the following outcomes: revascularization rates, NIHSS score at discharge, modified Rankin Scale (mRS) score at discharge and 3 months, symptomatic hemorrhage rates and mortality.ResultsAmong 104 patients identified, 42 received combined therapy, and 62 received endovascular therapy only. The two groups had similar demographic (age and sex distribution) and vascular risk factors distribution, as well as NIHSS score on admission (14.8±4.7 and 16.0±5.3; p=0.23). We found no difference in TIMI recanalization rates (Thrombolysis in Myocardial Infarction scale score of 2 or 3) following combined or endovascular therapy alone (83.3% and 79.0%; p=0.59). A preferred outcome, defined as a mRS of 2 or less at 90 days also did not differ between the combined therapy group and the endovascular only group (37.5% and 34.5%; p=0.76). There was no difference in mortality rate (22.5% and 31.0%; p=0.36) and the rate of symptomatic intracranial hemorrhage (9.5% and 8.1%; p=0.73). There was a significant difference in mean time from symptom onset to endovascular treatment between the combined group (227±88 min) and endovascular only group (125±40 min; p<0.0001).ConclusionCombining IV thrombolysis and endovascular therapy achieves similar rates of clinical outcomes, revascularization rates, complications and mortality rates, when compared with endovascular treatment alone. The combined therapy, however, significantly delays initiation of endovascular treatment. A randomized prospective trial comparing both treatment strategies in acute ischemic stroke is warranted.
P-024 Preliminary experience with the percutaneous embolization of juvenile angiofibromas (JNAs) using only ethylene vinyl alcohol copolymer (EVOH) Onyx
Authors: Gemmete J , Chaudhary N , Pandey A , Marentette L , McKean E , Sullivan S 
Published: July 2011

BackgroundJNAs are hypervascular tumors that may benefit from pre-operative devascularization to reduce intra-operative blood loss. The optimal method for devascularization of these tumors is not known.MethodsA consecutive series of seven JNAs were treated with percutaneous embolization with EVOH as the sole embolic agent. 1—Fischer Type I, 1—Fischer Type II, 4—Fischer type IIIb, and 1 Fischer Type IVa tumors were treated.ResultsComplete devascularization of the seven JNAs was achieved in all cases percutaneously with only EVOH. There were no complications. The average intraoperative blood loss was 680 ml (range 10–1700 ml). Three of the type IIIb tumors were completely removed from only an endoscopic approach.ConclusionsOur preliminary experience suggests that EVOH may offer a higher degree of devascularization when compared with other embolic agents. This may facilitate an easier surgical resection with lower blood loss. EVOH seems to be safe when percutaneously injected as the sole embolic agent into a JNA.
P-028 First year results of merci embolectomy in Japan
Authors: Sakai N , Minematsu K , Hasegawa Y , Ogasawara K , Saito N , Taki W 
Published: July 2011

Background and SignificanceThe Merci Retriever has been used at US stroke centers for mechanical embolectomy in acute stroke since 2004. Until very recently, however, there were no approved devices in Japan for mechanical embolectomy in acute stroke. The Merci Retriever was the first device to obtain such approval and was introduced into clinical practice in late 2010.MethodsA condition of approval in Japan is that every patient treated with the Merci Retriever must be prospectively entered into a post-market study. Key data elements include baseline demographic and medical history, IV rt-PA received or not, procedural details, in-hospital follow-up and 90 days clinical status. Clinical outcomes at discharge and 90 days were obtained prospectively with good outcomes defined as modified Rankin Score ≤2. Recanalization was reported using the TICI classification, with 2a, 2b and 3 considered as success.Results110 patients submitted from 14 centers between July 2010 and February 2011. Median patient age and NIHSS were 72 and 18, respectively and 68% were male, similar to prior clinical studies of the Merci Retriever (MERCI, Multi MERCI, and Merci Registry). Median time from last seen at baseline to treatment onset was 4 h. IV lytic was used in 42%. Successful recanalization (TICI 2a/2b/3) was achieved in 74% of cases, with 48% achieving TICI 2b or 3. Symptomatic subarachnoid hemorrhage occurred in 3.8% and intracerebral hemorrhage in 2.9% of cases. In-hospital death is 13.5% and 25.8% of patients were discharged from the hospital with a good outcome (mRS=0–2). Data collection and entry is on-going and the latest data will be reported at the time of presentation, including 90 days clinical outcomes.ConclusionsMechanical embolectomy with the Merci Retriever is being rapidly adopted in Japan. This is the first report of procedural and clinical outcomes from mechanical embolectomy in Japan. The preliminary results are similar to those obtained in previous prospective pivotal and post-marketing studies in the USA. Our findings suggest that the rates of revascularization, good clinical outcomes and mortality in initial clinical practice in Japan are comparable to those observed in MERCI, Multi MERCI, and the post-marketing Merci Registry.
SHARP SPECTRAL ESTIMATES IN DOMAINS OF INFINITE VOLUME
Authors: GEISINGER LEANDER , WEIDL TIMO 
Published: July 2011

We consider the Dirichlet Laplace operator on open, quasi-bounded domains of infinite volume. For such domains semiclassical spectral estimates based on the phase-space volume — and therefore on the volume of the domain — must fail. Here we present a method on how one can nevertheless prove uniform bounds on eigenvalues and eigenvalue means which are sharp in the semiclassical limit.We give examples in horn-shaped regions and so-called spiny urchins. Some results are extended to Schrödinger operators defined on quasi-bounded domains with Dirichlet boundary conditions.
Fluoroestradiol Positron Emission Tomography Reveals Differences in Pharmacodynamics of Aromatase Inhibitors, Tamoxifen, and Fulvestrant in Patients with Metastatic Breast Cancer
Authors: Linden Hannah M. , Kurland Brenda F. , Peterson Lanell M. , Schubert Erin K. , Gralow Julie R. , Specht Jennifer M. , Ellis Georgiana K. , Lawton Thomas J. , Livingston Robert B. , Petra Philip H. , Link Jeanne M. , Krohn Kenneth A. , Mankoff David A. 
Published: July 2011

Abstract
Purpose: To determine, by molecular imaging, how in vivo pharmacodynamics of estrogen-estrogen receptor (ER) binding differ between types of standard endocrine therapy.
Experimental Design: The ER has been a highly successful target for breast cancer treatment. ER-directed treatments include lowering ligand concentration by using aromatase inhibitors (AI) and blocking the receptor with agents like tamoxifen (TAM) or fulvestrant (FUL). We measured regional estrogen-ER binding by using positron emission tomography with 18F-fluoroestradiol (FES PET) prior to and during treatment with AI, TAM, or FUL in a series of 30 metastatic breast cancer patients. FES PET measured in vivo estrogen binding at all tumor sites in heavily pretreated women with metastatic bone soft tissue–dominant breast cancer. In patients with uterus (n = 16) changes in uterine FES uptake were also measured.
Results: As expected, tumor FES uptake declined more markedly on ER blockers (TAM and FUL, average 54% decline) compared with a less than 15% average decline on estrogen-depleting AIs (P &lt; 0.001). The rate of complete tumor blockade [FES standardized uptake value (SUV) ≤1.5] following TAM (5/5 patients) was greater than the blockade rate following FUL (4/11; 2-sided mid P = 0.019). Percent FES SUV change in the uterus showed a strong association with tumoral change (ρ = 0.63, P = 0.01).
Conclusions: FES PET can assess the in vivo pharmacodynamics of ER-targeted agents and may give insight into the activity of established therapeutic agents. Imaging revealed significant differences between agents, including differences in the efficacy of blockade by different ER antagonists in current clinical use. Clin Cancer Res; 17(14); 4799–805. ©2011 AACR.
Implementing services for Early Infant Diagnosis (EID) of HIV: a comparative descriptive analysis of national programs in four countries
Authors: Chatterjee Anirban , Tripathi Sangeeta , Gass Robert , Hamunime Ndapewa , Panha Sok , Kiyaga Charles , Wade Abdoulaye , Barnhart Matthew , Luo Chewe , Ekpini Rene 
Published: July 2011

Abstract

Background
There is a significant increase in survival for HIV-infected children who have early access to diagnosis and treatment. The goal of this multi-country review was to examine when and where HIV-exposed infants and children are being diagnosed, and whether the EID service is being maximally utilized to improve health outcomes for HIV-exposed children.

Methods
In four countries across Africa and Asia existing documents and data were reviewed and key informant interviews were conducted. EID testing data was gathered from the central testing laboratories and was then complemented by health facility level data extraction which took place using a standardized and validated questionnaire

Results
In the four countries reviewed from 2006 to 2009 EID sample volumes rose dramatically to an average of >100 samples per quarter in Cambodia and Senegal, >7,000 samples per quarter in Uganda, and >2,000 samples per quarter in Namibia. Geographic coverage of sites also rapidly expanded to 525 sites in Uganda, 205 in Namibia, 48 in Senegal, and 26 in Cambodia in 2009. However, only a small proportion of testing was done at lower-level health facilities: in Uganda Health Center IIs and IIIs comprised 47% of the EID collection sites, but only 11% of the total tests, and in Namibia 15% of EID sites collected >93% of all samples. In all countries except for Namibia, more than 50% of the EID testing was done after 2 months of age. Few sites had robust referral mechanisms between EID and ART. In a sub-sample of children, we noted significant attrition of infants along the continuum of care post testing. Only 22% (Senegal), 37% (Uganda), and 38% (Cambodia) of infants testing positive by PCR were subsequently initiated onto treatment. In Namibia, which had almost universal EID coverage, more than 70% of PCR-positive infants initiated ART in 2008.

Conclusions
While EID testing has expanded dramatically, a large proportion of PCR- positive infants are initiated on treatment. As EID services continue to scale-up, more programmatic attention and support is needed to retain HIV-exposed infants in care and ensure that those testing positive initiate treatment in a timely manner. Namibia's experience demonstrates that it is feasible for a rural, low-income country to achieve high national coverage of infant testing and treatment.
Exchange protein directly activated by cAMP 1 (Epac1) is expressed in human neutrophils and mediates cAMP-dependent activation of the monomeric GTPase Rap1
Authors: Dash-Koney Madhuri , Deevi Ravi K , McFarlane Cheryl , Dib Karim 
Published: July 2011

ABSTRACTEpac1 and Epac2 bind cAMP and mediate cAMP-dependent activation of Rap1. cAMP is produced in neutrophils in response to many chemoattractants. This second messenger plays a key role in the regulation of the functions of neutrophils. However, it is still not known whether Epacs are expressed in human neutrophils. We found that stimulation of PLB-985 cells differentiated into neutrophil-like cells, human neutrophils with 8CPT-2Me-cAMP (a selective activator of Epacs), or FK (a diterpene that augments the intracellular level of cAMP) led to GTP-loading of Rap1. Epac1 mRNA was expressed in UND and DF PLB-985 cells, but Epac1 protein was only detected in DF PLB-985 cells. In human neutrophils, the Epac1 transcript was present, and Epac1 protein could be detected by Western blot analysis if the cells had been treated with the serine protease inhibitor PMSF. FK induced adhesion of PLB-985 cells and human neutrophils on fibrinogen, a ligand for β2 integrins. Interestingly, in DF PLB-985 cells, but not in human neutrophils, 8CPT-2Me-cAMP induced β2 integrin-dependent adhesion. The failure of 8CPT-2Me-cAMP to induce β2 integrin-dependent human neutrophil adhesion could be explained by the fact that this compound did not induce a switch of the β2 integrins from a low-affinity to a high-affinity ligand-binding conformation. We concluded that Epac1 is expressed in human neutrophils and is involved in cAMP-dependent regulation of Rap1. However, the loading of GTP on Rap1 per se is not sufficient to promote activation of β2 integrins.
Seasonal variation of long-term potentiation at a central synapse in the medicinal leech
Authors: Grey Kathryn B. , Burrell Brian D. 
Published: July 2011

SUMMARY
Long-term potentiation (LTP) is a persistent increase in synaptic transmission that is thought to contribute to a variety of adaptive processes including learning and memory. Although learning is known to undergo circannual variations, it is not known whether LTP undergoes similar changes despite the importance of LTP in learning and memory. Here we report that synapses in the CNS of the medicinal leech demonstrate seasonal variation in the capacity to undergo LTP following paired presynaptic and postsynaptic stimulation. LTP was observed during the April–October period, but no LTP was observed during the November–March period. Application of forskolin, a technique often used to produce chemical LTP, failed to elicit potentiation during the November–March period. Implementing stimulation patterns that normally result in long term depression (LTD) also failed to elicit any change in synaptic strength during the November–March period. These experiments indicate that LTP and LTD can be influenced by circannual rhythms and also suggest a seasonal influence on learning and memory.
Genetic Evidence That Synaptonemal Complex Axial Elements Govern Recombination Pathway Choice in Mice
Authors: Li Xin Chenglin , Bolcun-Filas Ewelina , Schimenti John C 
Published: July 2011

AbstractChiasmata resulting from interhomolog recombination are critical for proper chromosome segregation at meiotic metaphase I, thus preventing aneuploidy and consequent deleterious effects. Recombination in meiosis is driven by programmed induction of double strand breaks (DSBs), and the repair of these breaks occurs primarily by recombination between homologous chromosomes, not sister chromatids. Almost nothing is known about the basis for recombination partner choice in mammals. We addressed this problem using a genetic approach. Since meiotic recombination is coupled with synaptonemal complex (SC) morphogenesis, we explored the role of axial elements – precursors to the lateral element in the mature SC - in recombination partner choice, DSB repair pathways, and checkpoint control. Female mice lacking the SC axial element protein SYCP3 produce viable, but often aneuploid, oocytes. We describe genetic studies indicating that while DSB-containing Sycp3−/− oocytes can be eliminated efficiently, those that survive have completed repair before the execution of an intact DNA damage checkpoint. We find that the requirement for DMC1 and TRIP13, proteins normally essential for recombination repair of meiotic DSBs, is substantially bypassed in Sycp3 and Sycp2 mutants. This bypass requires RAD54, a functionally conserved protein that promotes intersister recombination in yeast meiosis and mammalian mitotic cells. Immunocytological and genetic studies indicated that the bypass in Sycp3−/− Dmc1−/− oocytes was linked to increased DSB repair. These experiments lead us to hypothesize that axial elements mediate the activities of recombination proteins to favor interhomolog, rather than intersister recombinational repair of genetically programmed DSBs in mice. The elimination of this activity in SYCP3- or SYCP2-deficient oocytes may underlie the aneuploidy in derivative mouse embryos and spontaneous abortions in women.
Integration of Competencies in an Ontology-Based Framework Supporting Teachers to Construct Learning Designs in the Domain of Sustainable Energy Education
Authors: Karetsos Sotirios , Haralambopoulos Dias 
Published: July 2011

Integration of Competencies in an Ontology-Based Framework Supporting Teachers to Construct Learning Designs in the Domain of Sustainable Energy Education
In previous work, a framework based on three ontologies (content, learning design and sustainable energy domain models) was introduced in order to support teachers to construct learning designs in the field of sustainable energy education. This paper is focusing on the integration of a competency model in the structure of this framework. This model actually interconnects the other three models by establishing connections between learning objects, learners, activities, learning objectives/competencies and knowledge in the sustainable energy domain. It enriches the description of learning resources enabling their search and retrieval via queries based on competency parameters and can also support competency-based reasoning in order for the competency gaps to be filled. The competency model came as an answer to a literature review triggered by some results of a Wizard of Oz experiment along with the aim to integrate into the framework sets of questions supporting learning in sustainable energy domain.
Les canards criminels et les limites de la violence dans la France de la première modernité
Authors: Beam Sara 
Published: July 2011

Les canards criminels demeurent une source historique relativement négligée bien qu’ils fournissent des informations importantes sur l’évolution des attitudes envers le crime et la violence masculine dans la France de l’époque moderne. Cet article compare ces pamphlets avec les récits de pardons et les mémoires judiciaires, en les abordant à partir de leur utilisation du mot « assassinat ». A la différence de ces derniers genres, les canards condamnaient le criminel et resituaient ses actes dans un contexte de pénitence chrétienne qui est généralement minoré dans les sources que les historiens utilisent habituellement pour comprendre la violence à cette période. Les canards définissent l’assassinat dans un sens bien plus large que le législation de l’époque moderne, et, ce faisant, ils dénonçaient les homicides et les attaques comme des crimes impardonnables. Alors que les récits de pardon tendaient à banaliser la violence masculine, surtout dans les élites, les canards étaient des anti-récits de pardon, qui les jugeaient violemment, et qui insistaient sur le fait que tous les crimes prémédités devaient être pleinement punis par la loi.