bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in nigro‐striatal impairment in clinical variants of early Parkinson’s disease: evidence from a FP‐CIT SPECT study
Authors: Rossi C. , Frosini D. , Volterrani D. , De Feo P. , Unti E. , Nicoletti V. , Kiferle L. , Bonuccelli U. , Ceravolo R. 
Published: December 2009

Introduction:  In idiopathic Parkinson’s disease (PD), two different clinical phenotypes are usually distinguished: a tremor dominant variant (TD) and an akinetic‐rigid type (ART). TD patients are characterized by a slower disease progression and a minor cognitive impairment. Striatal density of DAT, as quantified by FP‐CIT SPECT, has been reported to correlate with rigidity and akinesia but not with tremor.Objective:  To evaluate FP‐CIT uptake in TD and ART phenotypes.Methods:  We retrospectively evaluated from our database the pre‐synaptic nigro‐striatal function of 24 patients with TD‐PD and 38 patients with ART‐PD who underwent a FP‐CIT SPECT within 1 year from disease onset.Results:  Disease duration, age at the time of SPECT scan and disease severity as measured with Unified Parkinson’s Disease Rating scale part III (UPDRS III) were not statistically different between the two groups. Putamen contralateral to the most clinically affected side showed a lower FP‐CIT uptake in ART patients compared to TD patients. No statistically significant differences emerged when considering bilateral caudate and ipsilateral putaminal uptake, as well as asymmetry indices and caudate/putamen ratios. FP‐CIT contralateral putaminal uptake correlated with the severity of rigidity and hypokinesia but not with tremor.Conclusions:  These data suggest that other neurotransmitter systems apart from the nigro‐striatal dopaminergic system are involved in the generation of Parkinsonian tremor, and they are consistent with previous evidence of a lack of correlation between tremor severity and FP‐CIT uptake. Putaminal relative sparing in TD patients could partially explain the slower disease progression reported in this PD phenotype.
Neurologic complications of Churg–Strauss syndrome – a prospective monocentric study
Authors: Wolf J. , Bergner R. , Mutallib S. , Buggle F. , Grau A. J. 
Published: December 2009

Background:  Churg–Strauss syndrome (CSS) is a rare systemic vasculitis. Case series with a focus on neurologic involvement are not common. With this study, we intended to evaluate the frequency and types of neurologic manifestations and complications at time of diagnosis and during follow‐up of patients with CSS.Methods:  In this monocentric study, consecutive patients of our hospital with first diagnosis of CSS based on the criteria of the American College of Rheumatology were included between 2001 and 2007. Each patient underwent a periodic follow‐up with clinical and electrophysiologic examination. Data were obtained prospectively.Results:  Fourteen patients were included. All patients had a hypereosinophilia and a history of asthma. Twelve of 14 patients had a neurologic involvement, mainly as an acute or subacute multiplex mononeuropathy (eight patients) or an axonal polyneuropathy (three patients). Three patients suffered from a neuropathy of cranial nerves, and two patients had a cerebral infarct. Mean follow‐up period was 31 months. With immunosuppressive therapy, 13 patients had no additional neurologic complications, one patient suffered from a cerebral infarct. Initial neurologic symptoms as a result of peripheral neuropathy improved, but sequelae of axonal damage were persistently detectable.Conclusions:  Even at time of diagnosis of a CSS, neurologic manifestations are common, especially as a multiplex mononeuropathy. With a consequent immunosuppressive therapy, new neurologic complications can be avoided for the most part.
Cut‐off scores in MMSE: a moving target?
Authors: Morgado J. , Rocha C. S. , Maruta C. , Guerreiro M. , Martins I. P. 
Published: December 2009

Background:  Cognitive tests are known to be influenced by language, culture and education. In addition, there may be an impact of ‘epoch’ in cognition, because there is secular increase in scores of IQ tests in children. If we assume this is a long lasting process, then it should persist later in life.Methods:  To test this hypothesis, we compared the performance of two cohorts of individuals (≥50 years of age), evaluated 20 years apart using the Mini‐Mental State Examination (MMSE).Results:  Study population included 135 participants in 1988 and 411 in 2008. MMSE scores were higher in 2008 than in 1988 for literacy x age‐matched subgroups, the difference being significant for participants with lower literacy. Score variance was explained by literacy (β = 0.479, t = 14.598, P = 0.00), epoch (β = 0.34, t = 10.33, P = 0.00) and age (β = −0.142, t = −4.184, P = 0.00).Conclusion:  The present results are in accordance with a lifelong secular improvement in cognitive performance. The operational cut‐off values may change with time, which may have clinical impact in the diagnosis of disorders like mild cognitive impairment or dementia.
Epidural blood patch in Trendelenburg position pre‐medicated with acetazolamide to treat spontaneous intracranial hypotension
Authors: Ferrante E. , Arpino I. , Citterio A. , Wetzl R. , Savino A. 
Published: December 2009

Background:  Spontaneous intracranial hypotension (SIH) is characterized by orthostatic headache, diffuse pachymeningeal enhancement on brain magnetic resonance imaging (MRI) and low cerebrospinal fluid (CSF) pressure. Treatment ranges from conservative management, such as bed rest, overhydration and caffeine, to invasive procedures, such as the autologous epidural blood patch (EBP), computed tomography (CT)‐guided fibrin glue injection at the site of the leak and open surgical intervention. EBP has emerged as the treatment of choice for SIH when initial conservative measures fail to bring relief.Methods:  Forty‐two patients with SIH were treated with lumbar autologous EBP in Trendelenburg position preceded by pre‐medication with acetazolamide.Results:  A complete recovery was obtained in all patients after one (90%), two (5%) or three (5%) EBPs. After EBP, two patients (5%) also performed evacuation of bilateral chronic subdural hematoma with mass effect.Conclusions:  Spontaneous intracranial hypotension can be effectively cured by lumbar autologous EBP in Trendelenburg position pre‐medicated with acetazolamide.
Security Zones and New York City's Shrinking Public Space
Authors: NÉMETH JEREMY , HOLLANDER JUSTIN 
Published: December 2009

AbstractUrban scholars lament the loss of public space due to heightened security and behavioral controls borne of economic priorities and anti‐terror concerns after September 11th 2001. Owners and managers of government buildings, banks and courthouses have closed streets and fitted the surrounding space with concrete barriers, bollards and moat‐like structures to prevent potential terror attacks. These are reasonable protections in emergency situations, but, as threat levels fall, these zones fail to incorporate a diversity of users, privatizing the space for those with security clearance. The ubiquity of these zones encourages us to consider them as a new type of land use. To test this statement, we describe the results of site visits to two high‐profile New York City neighborhoods (one with numerous civic buildings, the other populated with corporate headquarters). Using a simple tool we developed, we find that 27% of aggregate non‐building area in the two districts is now in a security zone. Interestingly, the percentage of space within each district that can be classed as a security zone is reasonably similar, providing insight into the way in which terror targets are internally and externally defined and justified. We argue that this new type of land use is an important and permanent feature of twenty‐first century global cities.Résumé Les chercheurs en sciences urbaines regrettent la perte d’espace public, incriminant souvent les contrôles accrus de sécurité et de comportement suscités par des priorités économiques ou des préoccupations anti‐terroristes depuis le 11 septembre 2001. Propriétaires et gestionnaires de bâtiments publics, banques et tribunaux ont fermé des rues et équipé l’espace environnant d’obstacles en béton, de plots et de quasi‐fossés afin de parer aux attaques terroristes potentielles. Ces protections sont normales en situations d’urgence, mais lorsque la menace décroît, les zones concernées ne parviennent pas à diversifier leurs usagers, l’espace étant réservé aux détenteurs de droits d’accès. L’ubiquité de ces zones pousse à les considérer comme un nouveau type d’occupation des sols. Pour vérifier cette affirmation, nous présentons les résultats de visites dans deux quartiers éminents de New York, l’un regroupant de nombreux bâtiments publics, l’autre une multitude de sièges sociaux. Au moyen d’un outil simple développé par nos soins, nous constatons que 27% de la surface cumulée non bâtie dans les deux secteurs sont désormais dans une zone sécurisée. Il faut noter que, dans chaque secteur, la proportion de l’espace qui peut être classé en zone sécurisée est relativement similaire, donnant un éclairage sur la façon dont les cibles terroristes sont définies et justifiées sur les plans intérieur et extérieur. Selon nous, ce nouveau type d’occupation des sols constitue un caractère important et permanent des villes planétaires du xxie siècle.
History of Family Involvement with Child Protective Services as a Risk Factor for Bullying in Ontario Schools
Authors: Mohapatra Satya , Irving Hyacinth , Paglia‐Boak Angela , Wekerle Christine , Adlaf Edward , Rehm Jürgen 
Published: December 2009

Background:  The relationship between history of family involvement with child protective services (CPS) and bullying was examined.Method:  Data were obtained from 2,516 pupils aged 12–19 in the 2007 Ontario Student Drug Use and Health Survey. The association between self‐reported history of family involvement with CPS and bullying was estimated using negative binomial hurdle regression models.Results:  Females who reported family CPS involvement were more likely to have bullied and been bullied compared with females without CPS involvement. Among males, family CPS involvement was only significantly associated with bully victimisation.Conclusion:  A history of family CPS involvement was a risk factor for bullying victimisation and perpetration.
Identification of Hospital Catchment Areas Using Clustering: An Example from the NHS
Authors: Gilmour Stuart John 
Published: December 2009

Objective. To develop a method of hospital market area identification using multivariate data, and compare it with existing standard methods.Data Sources. Hospital Episode Statistics, a secondary dataset of admissions data from all hospitals in England, between April 2005 and March 2006.Study Design. Seven criteria for catchment area definition were proposed. K‐means clustering was used on several variables describing the relationship between hospitals and local authority districts (LADs) to enable the placement of every LAD into or out of the catchment area for every hospital. Principal component analysis confirmed the statistical robustness of the method, and the method was compared against existing methods using the seven criteria.Principal Findings. Existing methods for identifying catchment areas do not capture desirable properties of a hospital market area. Catchment areas identified using K‐means clustering are superior to those identified using existing Marginal methods against these criteria and are also statistically robust.Conclusions. K‐means clustering uses multivariate data on the relationship between hospitals and geographical units to define catchment areas that are both statistically robust and more informative than those obtained from existing methods.
Managing Care? Medicare Managed Care and Patient Use of Cardiologists
Authors: Huesch Marco D. 
Published: December 2009

Objective. To examine the impact of Medicare managed care (MMC) versus Medicare fee for service (MFFS) on stent patients' use of physicians with lower resource use and better outcomes.Data Sources/Study Setting. Retrospective secondary data from 2003 through 2006 for 67,476 patients without acute myocardial infarction, staying 2 or more days in hospital, and treated by 486 physicians in Florida performing 10 or more cases per quarter.Study Design. Analysis was at the patient level. Multivariate logistic models estimated the probability of an MMC patient using a physician with a particular risk‐adjusted profile rank with respect to hospital peers.Principal Findings. No differences were found in usage of physicians with shorter admissions. Compared with MFFS, MMC patients were significantly less likely to use physicians whose average mortality was the lowest/lowest quartiles/below median among facility peers, and more likely to use a physician ranked below median on live discharges directly home (not needing home health care, skilled nursing care, or a subacute hospital convalescence). Similar results were found with emergency admissions, and where physicians both attended and treated.Conclusions. Florida percutaneous coronary interventions patients insured by MMC used physicians with worse outcome profiles than those of MFFS patients. Results were not consistent with hospital care differences, physician–patient, or payor–physician selection, but they were consistent with selection of unobservably sicker members into MMC and concentration of MMC among physicians.
Falling into the Coverage Gap: Part D Drug Costs and Adherence for Medicare Advantage Prescription Drug Plan Beneficiaries with Diabetes
Authors: Fung Vicki , Mangione Carol M. , Huang Jie , Turk Norman , Quiter Elaine S. , Schmittdiel Julie A. , Hsu John 
Published: December 2009

Objective. To compare drug costs and adherence among Medicare beneficiaries with the standard Part D coverage gap versus supplemental gap coverage in 2006.Data Sources. Pharmacy data from Medicare Advantage Prescription Drug (MAPD) plans.Study Design. Parallel analyses comparing beneficiaries aged 65+ with diabetes in an integrated MAPD with a gap versus no gap (n=28,780); and in a network‐model MAPD with a gap versus generic‐only coverage during the gap (n=14,984).Principal Findings. Drug spending was 3 percent (95 percent confidence interval [CI]: 1–4 percent) and 4 percent (CI: 1–6 percent) lower among beneficiaries with a gap versus full or generic‐only gap coverage, respectively. Out‐of‐pocket expenditures were 189 percent higher (CI: 185–193 percent) and adherence to three chronic drug classes was lower among those with a gap versus no gap (e.g., odds ratio=0.83, CI: 0.79–0.88, for oral diabetes drugs). Annual out‐of‐pocket spending was 14 percent higher (CI: 10–17 percent) for beneficiaries with a gap versus generic‐only gap coverage, but levels of adherence were similar.Conclusions. Among Medicare beneficiaries with diabetes, having the Part D coverage gap resulted in lower total drug costs, but higher out‐of‐pocket spending and worse adherence compared with having no gap. Having generic‐only coverage during the gap appeared to confer limited benefits compared with having no gap coverage.
The Novel Electrophysiology of Complex Fractionated Atrial Electrograms: Insight from Noncontact Unipolar Electrograms
Authors: LO LI‐WEI , HIGA SATOSHI , LIN YENN‐JIANG , CHANG SHIH‐LIN , TUAN TA‐CHUAN , HU YU‐FENG , TSAI WEN‐CHIN , TSAO HSUAN‐MING , TAI CHING‐TAI , ISHIGAKI SUGAKO , OYAKAWA ASUKA , MAEDA MINETAKA , SUENARI KAZUYOSHI , CHEN SHIH‐ANN 
Published: December 2009

Unipolar Characteristics of CFAEs. Background: The noncontact mapping (NCM) system possesses the merit of global endocardial recording for unipolar and activation mapping.
Objective:
We aimed to evaluate the unipolar electrogram characteristics and activation pattern over the bipolar complex fractionated atrial electrogram (CFAE) sites during atrial fibrillation (AF).
Methods:
Twenty patients (age 55 ± 11 years old, 15 males) who underwent NCM and ablation of AF (paroxysmal/persistent = 13/7) were included. Both contact bipolar (32–300 Hz) and NCM virtual unipolar electrograms (0.5–300 Hz) were simultaneously recorded along with the activation pattern (total 223 sites, 11 ± 4 sites/patient). A CFAE was defined as a mean bipolar cycle length of ≤ 120 ms with an intervening isoelectric interval of more than 50 ms (Group 1A, n = 63, rapid repetitive CFAEs) or continuous fractionated activity (Group 1B, n = 59, continuous fractionated CFAEs), measured over a 7.2‐second duration. Group 2 consisted of those with a bipolar cycle length of more than 120 ms (n = 101).
Results:
The Group 1A CFAE sites exhibited a shorter unipolar electrogram cycle length (129 ± 11 vs 164 ± 20 ms, P < 0.001), and higher percentage of an S‐wave predominant pattern (QS or rS wave, 63 ± 13% vs 35 ± 13%, P < 0.001) than the Group 2 non‐CFAE sites. There was a linear correlation between the bipolar and unipolar cycle lengths (P < 0.001, R = 0.87). Most of the Group 1A CFAEs were located over arrhythmogenic pulmonary vein ostia or nonpulmonary vein ectopy with repetitive activations from those ectopies (62%) or the pivot points of the turning wavefronts (21%), whereas the Group 1B CFAEs exhibited a passive activation (44%) or slow conduction (31%).
Conclusions:
The bipolar repetitive and continuous fractionated CFAEs represented different activation patterns. The former was associated with an S wave predominant unipolar morphology which may represent an important focus for maintaining AF. (J Cardiovasc Electrophysiol, Vol. 21, pp. 640‐648, June 2010)
ORIGINAL ARTICLE: Role of Regulatory and Angiogenic Cytokines in Invasion of Trophoblastic Cells
Authors: Dubinsky Valeria , Poehlmann Tobias G. , Suman Pankaj , Gentile Teresa , Markert Udo R. , Gutierrez Gabriela 
Published: December 2009

Citation Dubinsky V, Poehlmann TG, Suman P, Gentile T, Markert UR, Gutierrez G. Role of regulatory and angiogenic cytokines in invasion of trophoblastic cells. Am J Reprod Immunol 2010; 63: 193–199Problem  Trophoblast invasion is a temporally and locally restricted process, which regulates implantation and oxygen arrival to the embryo through the dialog with spiral artery endothelium. Trophoblast factors with angiogenic potential are activated by hypoxia. Their capacities to induce proliferation, migration, and invasion of trophoblastic cells have been investigated.Method of study  The expression of interleukin (IL)‐6, CD126, CD130, vascular endothelial growth factor (VEGF), and hypoxia inducible factor‐1α (HIF‐1α) has been silenced in JEG‐3 choriocarcinoma cells by using siRNA. Silencing efficacy has been assessed by ELISA, PCR or Western blotting. Proliferation has been measured by flow cytometry, migration by a transwell assay, and invasion by a Matrigel assay.Results  Proliferation was significantly reduced by silencing of CD126 or CD130, migration by silencing of IL‐6, VEGF, or HIF‐1α, and invasion by silencing of IL‐6 and HIF‐1α.Conclusion  The expression of IL‐6, VEGF, and HIF‐1α in trophoblastic cells is involved in the control of trophoblast invasion and migration.
ORIGINAL ARTICLE: Leptin on Peritoneal Macrophages of Patients with Endometriosis
Authors: Wu Meng‐Hsing , Huang Mei‐Feng , Chang Fong‐Ming , Tsai Shaw‐Jenq 
Published: December 2009

Citation Wu M‐H, Huang M‐F, Chang F‐M, Tsai S‐J. Leptin on peritoneal macrophages of patients with endometriosis. Am J Reprod Immunol 2010; 63: 214–221Problem  The expression of cyclooxygenase (COX)‐2 is considered as a marker of macrophage activation and has been implicated in the development of endometriosis. Leptin is an immunomodulator, which may also affect the development of endometriosis. However, how leptin contributes to these pathological processes has not been completely understood. The aim of this study was to investigate the effects of leptin on peritoneal macrophages and its relationship with endometriosis.Methods of study  Peritoneal fluid from 60 women of reproductive age was obtained while they underwent laparoscopy. Forty patients had endometriosis and 20 patients did not have endometriosis. The concentration of leptin in the peritoneal fluid and prostaglandin F2α levels was measured by ELISA, and the other protein expression using Western blot when peritoneal macrophages were stimulated with leptin.Results  Concentration of leptin in peritoneal fluid was increased in patients with endometriosis compared with disease‐free normal control. Functional leptin receptor was present in peritoneal macrophages. Treatment of peritoneal macrophages with leptin induced COX‐2 expression. Production of prostaglandin F2α by peritoneal macrophages was increased after leptin stimulation in women with endometriosis.Conclusion  Elevated concentration of leptin in peritoneal fluid may contribute to the pathological process of endometriosis through activation of peritoneal macrophages.
ORIGINAL ARTICLE: Role of Inflammatory Cytokines and eNOS Gene Polymorphism in Pathophysiology of Pre‐Eclampsia
Authors: Singh Archana , Sharma Deepika , Raghunandan Chitra , Bhattacharjee Jayashree 
Published: December 2009

Citation Singh A, Sharma D, Raghunandan C, Bhattacharjee J. Role of inflammatory cytokines and eNOS gene polymorphism in pathophysiology of pre‐eclampsia. Am J Reprod Immunol 2010; 63: 244–251Problem  Pre‐eclampsia involves endothelial vascular dysfunction. The aim of this study was to test the hypothesis that (i) endothelial nitric oxide (NO) synthase Glu298Asp gene polymorphism limits constitutive NO production causing endothelial dysfunction and (ii) inflammatory cytokines impairs endothelium dependent relaxation in pre‐eclampsia.Method of study  This cross‐sectional study included 50 women with pre‐eclampsia and 50 healthy pregnant women. Their blood samples were analyzed for NO, inflammatory cytokines and endothelial NO synthase (eNOS) gene polymorphism.Result  Decreased NO levels whereas increased tumor necrosis factor‐α, interleukin (IL)‐6 and interleukin‐2 were found in pre‐eclampsia (P < 0.001). No significant differences were found in genotype/allele distribution between two groups. Significant negative correlation was observed between NO and IL‐6 in pre‐eclamptic group (P = 0.001).Conclusion  An IL‐6‐mediated endothelium dependent NO‐cyclic guanine monophosphate‐mediated relaxation pathway may be inhibited in systemic vessels in pre‐eclampsia. As observed in this study Glu298Asp eNOS gene polymorphism did not showed significant association with pre‐eclampsia.
OPINION: Some Severe Maternal Diseases Might be Caused by Fetal‐Versus‐Maternal Disease (FVMD)
Authors: Yan Lei , Zuo Changting , Wei Deying , Zhao Xingbo 
Published: December 2009

Citation Yan L, Zuo C, Wei D, Zhao X. Some severe maternal diseases might be caused by fetal‐versus‐maternal disease (FVMD). Am J Reprod Immunol 2010; 63: 189–192Pregnancy‐related disease is a common challenging clinical problem. From our review and clinical experience, we hypothesize that many severe pregnancy‐related complications might be caused by a fetal‐versus‐maternal disease (FVMD), based on the fact that maternal disease is related to immunity and that fetal cells are present in maternal blood. Fetus is a semi‐antigen and can be considered as a tumor or graft. The pathophysiology of FVMD must be complex. We speculate it to be a three‐step process: impaired maternal immunological function, fetal T‐cell activation and injury of target organs. More experiments and research will be needed to prove our hypothesis.