bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metamorphic phase relations in orthopyroxene‐bearing granitoids: implication for high‐pressure metamorphism and prograde melting in the continental crust
Authors: BHOWMIK S. K. , SAHA L. , DASGUPTA S. , FUKUOKA M. 
Published: April 2009

AbstractIn this work, the factors controlling the formation and preservation of high‐pressure mineral assemblages in the metamorphosed orthopyroxene‐bearing metagranitoids of the Sandmata Complex, Aravalli‐Delhi Mobile Belt (ADMB), northwestern India have been modelled. The rocks range in composition from farsundite through quartz mangerite to opdalite, and with varying K2O, Ca/(Ca + Na)rock and FeOtot + MgO contents. A two stage metamorphic evolution has been recorded in these rocks.An early hydration event stabilized biotite with or without epidote at the expense of magmatic orthopyroxene and plagioclase. Subsequent high‐pressure granulite facies metamorphism (∼15 kbar, ∼800 °C) of these hydrated rocks produced two rock types with contrasting mineralogy and textures. In the non‐migmatitic metagranitoids, spectacular garnet ± K‐feldspar ± quartz corona was formed around reacting biotite, plagioclase, quartz and/or pyroxene. In contrast, biotite ± epidote melting produced migmatites, containing porphyroblastic garnet incongruent solids and leucosomes.Applying NCKFMASHTO T–M(H2O) and P–T pseudosection modelling techniques, it is demonstrated that the differential response of these magmatic rocks to high‐pressure metamorphism is primarily controlled by the scale of initial hydration. Rocks, which were pervasively hydrated, produced garnetiferous migmatites, while for limited hydration, the same metamorphism formed sub‐solidus garnet‐bearing coronae. Based on the sequence of mineral assemblage evolution and the mineral compositional zoning features in the two metagranitoids, a clockwise metamorphic P–T path is constrained for the high‐pressure metamorphic event. The finding has major implications in formulating geodynamic model of crustal amalgamation in the ADMB.
Correlates of Community Health Service Utilization for Menopausal Symptoms among Urban Japanese Women
Authors: Matsui Noriko , Sakane Ayako , Omori Yukiko , Kimoto Satoko , Kadota Naoko , Moriya Michiko 
Published: April 2009

ABSTRACT
Objectives: This study aims to identify the factors associated with community health service utilization for menopausal symptoms among Japanese women in urban areas by using Andersen's behavioral model of health service use.Design: A cross‐sectional study was conducted.Sample: The sample comprised 350 women aged 40–60 years living in a community in Japan.Measurements: The independent variables were predisposing (demographics, social status, and health beliefs), enabling (family and community resources), and need factors (perceived health status and the need for community health services). The dependent variable was community health service utilization. A logistic regression model was used.Results: 8 of the women were categorized in “treatment required” by simplified menopausal index score, and 103 women said that they would use the services. Knowledge regarding the services, OR: 1.814 (1.084–3.036); the absence of a negative attitude toward menopausal syndromes, OR: 0.605 (0.367–0.998); and the presence of a positive attitude, OR: 2.203 (1.070–4.536); influenced community health service utilization.Conclusions: An appropriate attitude toward menopausal symptoms was observed to be more relevant to community health service utilization than the experience or acuity of the menopausal symptoms themselves. Therefore, community‐dwelling, middle‐aged women should be provided with sufficient education regarding menopausal symptoms to encourage their utilization of community health services.
The Effects of a Walking Program on Older Chinese American Immigrants With Hypertension: A Pretest and Posttest Quasi‐Experimental Design
Authors: Chiang Chun‐Ying , Sun Fan‐Ko 
Published: April 2009

ABSTRACT
Objective: Hypertension is known to have high rates among Chinese Americans. Identifying culturally specific interventions to reduce sedentary behavior may be effective in reducing hypertension. This study examines the effects of an 8‐week walking program with and without cultural modification.Design: The study used a 2‐group, pretest and posttest, quasi‐experimental design.Sample: A total sample of 128 Chinese American immigrants with hypertension were assigned to walking groups.Results: The results showed that the walking program had no significant effects upon participant blood pressure or walking endurance. The results also revealed that individuals in the maintenance stage walked longer than those in the preparation stage. A comparison of demographic data showed that subjects with a lower level of education walked more minutes per week, which contributed to lower systolic blood pressures among this group as compared with those with a higher level of education.Conclusions: These results suggest that this walking protocol, when translated into Chinese and when accompanied by a weekly telephone reminder and other interactions with a Chinese‐speaking nurse, is appropriate to use without additional cultural modification. Future research should examine other components of Chinese culture or should apply this protocol for a longer period of time.
Assessment of Depressive Symptoms and Cognitive Impairment in Elders From Rural Areas of the Brazilian State of Rio Grande do Sul
Authors: Morais Eliane P. , Rodrigues Rosalina A. P. , Sousa Valmi D. 
Published: April 2009

ABSTRACT
Objective: The main objective of this study was to examine the relationships among demographic characteristics, depressive symptoms, and cognitive impairment in oldest‐old elders from rural areas of the Brazilian State of Rio Grande do Sul.Design: A cross‐sectional, descriptive correlational design was used to conduct the study.Sample: 137 Brazilian elders age 80 years or over.Measurements: A target population data form, a county data form, a demographic questionnaire, the Mini‐Mental State Examination, and the Depressive Cognition Scale were used to collect the data.Results: A significant difference was found between males and females in regard to cognitive impairment. In addition, educational level and depressive symptoms were correlated with cognitive impairment. Depressive symptoms were a weak but significant predictor of cognitive impairment after controlling for the effect of age, gender, and educational level of the oldest‐old elders.Conclusions: The findings need to be interpreted cautiously since the sample scored above the cutoff points for cognitive impairment, and had low scores on depressive symptoms. Despite several limitations, findings from this study can be a foundation for further studies, and well‐designed correlational or experimental approaches, are warranted.
Social Aspects of Epilepsy in Childhood
Authors: HAAS A. M. LORENTZ DE 
Published: April 2009

SUMMARYThere is a generally known interaction between epilepsy and social environment. The influence of this interaction on the epileptic child can become manifest in behaviour and adjustment, and in the frequency of seizures.In this connection, family and school are discussed as the main constituents of the background of childhood epilepsy.A few remarks are made on the organization of management and treatment.RÉSUMÉIl y a une action réciproque bien connue entre l'épilepsie et le milieu social. L'influence de cette action réciproque sur l'enfant épileptique peut devenir manifeste dans le comportement et l'adaptation, et dans la fréquence des crises.La discussion porte sur la famille et l'école, principaux constituants de l'arrièreplan de l'épilepsie chez l'enfant. On émet quelques considérations sur l'organisation du maniement de ces enfants et sur leur traitement.
The Effect of Chlordiazepoxide on the Electroencephalogram
Authors: Jeavons P. M. 
Published: April 2009

SUMMARYChlordiazepoxide was given to 41 patients suffering from epilepsy of various types and electroencephalograms were taken before and after treatment. Paroxysmal discharges in the EEG were reduced in 17 cases, and in 18 there was an increase in normal alpha activity. The most unusual finding was a reduction in abnormal background slow activity. Fast activity was induced in more than half the cases. The clinical effects were unpredictable, but there was reduction in infantile spasms and petit mal attacks. The effect on other forms of epilepsy was equivocal. Behaviour improved in some cases and worsened in others.RÉSUMÉIl a été administré du chlordiazépoxide à 41 malades atteints d'épilepsie de types variés; des électroencéphalogrammes avaient été enregistrés avant et après le traitement. Des décharges paroxysmales dans l'EEG ont diminué en 17caset l'on a constaté en 18 cas une augmentation de l'activité alpha normale. La découverte la plus rare a été celle d'une réduction de l'activité lente anormale de l'arrière plan. Il y a eu induction d'une activité rapide dans plus de la moitié des cas. Les effets cliniques ont été imprévisibles mais il y a eu diminution des spasmes infantiles et des crises de petit mal. L'effet obtenu sur d'autres formes d'épilepsie a été douteux. Le com‐portement a été amélioré en certains cas et aggravé en d'autres.
Pacing and Defibrillation Lead Exchange Without Vein Puncture
Authors: ANTONELLI DANTE , FREEDBERG NAHUM A. , TURGEMAN YOAV 
Published: April 2009

Background: During lead implantation, venous access is generally achieved by puncturing the subclavian or axillary vein. Sometimes, although rarely, after lead positioning, the lead must be changed because of its inadequate mechanical stability or poor pacing parameters. This report concerns a technique of lead exchange that avoids an additional vein puncture.
Method: The tip of the lead, that has to be replaced, is retracted from the right atrium or ventricle into the superior vena cava; the lead insulation is lanced along a few millimeters; the straight flexible tip of the guide wire is inserted between the insulation layer and the conductor of the lead. Then the lead is advanced, while the guide wire is driven in, until the tip of the guide wire is in the superior vena cava. At this point, the tip of the guide wire, gently retracted from its position, is released in the vein lumen. Subsequently, the lead is completely extracted from the vein but the guide wire is maintained inside it. A dilator with a mounted peel‐away sheath is advanced over the guide wire. The lead positioning follows in the usual manner.
Results: Three (2.2%) of the 139 implanted defibrillator leads and 13 (3.3%) of the 391 pacing leads were replaced. All the procedures were successful; their mean time was 2 ± 1 minutes.
Conclusion: This technique is successful and safe in providing vein access using the previously implanted lead, thus avoiding the need to repeat the puncturing of a vein.
Pacemaker‐Based Analysis of Atrioventricular Conduction and Atrial Tachyarrhythmias in Patients with Primary Sinus Node Dysfunction
Authors: STOCKBURGER MARTIN , TRAUTMANN FREDERIKE , NITARDY AISCHA , MARTIN‐JUST‐TEETZMANN   M.D.  , SCHADE STEFAN , CELEBI OEZLEM , KREBS ALICE , DIETZ RAINER 
Published: April 2009

Background: Most patients with symptomatic sinus node disease (SND) receive DDDR pacemakers (PM) in order to cover SND and atrioventricular (AV) block from the outset. But the concern about adverse effects of right ventricular pacing (RVP) is increasing. So far, data on the incidence of AV block in SND are based on clinical events. The study undertakes to assess and appraise AV block and atrial tachyarrhythmias (AT) from memory and electrograms of a dual‐chamber PM set to an AAIR‐DDDR switch mode (AAISafeR).
Methods: A dual‐chamber PM incorporating the AAISafeR mode was implanted in 58 patients (70 ± 10 years, 28 males) with SND, but without AV block >I. AV block and AT episodes were retrieved from the PM memory and validated from electrograms. AV block episodes were classified potentially relevant while comprising AV block III or AV block I/II during exercise.
Results: The patients experienced a median of 90 (interquartile range 7–1,084) commutations. Possibly relevant AV block occurred in 32 patients (55%). Validation revealed high‐quality PM‐based categorization. The RVP prevalence was 0% (0–16%). The median AT prevalence was 0.03 (0–26) min/day. RVP was the only multivariate predictor of AT (P = 0.001).
Conclusions: Potentially relevant AV block occurs frequently in patients with SND. Nonetheless, the RVP prevalence is kept low through the AAISafeR mode. The protection of SND patients with demand‐actuated ventricular pacing appears reasonable. The AT prevalence is low in SND patients treated by the AAISafeR mode. Even low RVP proportions appear to favor AT. Prospective evaluation is needed.
Effect of Noise on T‐Wave Alternans Measurement in Ambulatory ECGs Using Modified Moving Average versus Spectral Method
Authors: SELVARAJ RAJA J. , CHAUHAN VIJAY S. 
Published: April 2009

Background: The modified moving average (MMA) and spectral method (SM) are commonly used to measure T‐wave alternans (TWA), but their accuracy has not been compared in ambulatory electrocardiograms (ECGs) where TWA signal‐to‐noise ratio is low. Our objective was to compare the effect of noise and signal nonstationarity on the accuracy of TWA measurement using MMA versus SM when applied to synthetic and ambulatory ECGs.
Methods: Periodic and nonperiodic noise were added to noiseless synthetic ECGs. Simulated TWA (0–20 μV) was added to synthetic ECGs and ambulatory ECG recordings. TWA was measured using SM and MMA, and the measurement error relative to added TWA was compared. An MMA ratio was used to discriminate TWA signal from noise. Signal nonstationarity was simulated by changing heart rate, TWA magnitude, and TWA phase.
Results: With no added TWA, MMA falsely measured TWA in synthetic and ambulatory ECGs, while false measurement was not seen with SM. An MMA ratio > 1.2 eliminated false TWA detection. In the presence of low TWA magnitude (<10 μV), TWA was overestimated by MMA and underestimated by SM in proportion to the noise level. In synthetic ECGs with periodic noise and 10‐μV added TWA, MMA was less accurate than SM. The effects of simulated signal nonstationarity on the TWA magnitude measured with MMA versus SM were similar using a 64‐beat analysis window.
Conclusions: In the presence of noise, MMA falsely detects or overestimates simulated TWA in ambulatory ECG recordings. In this setting, the proposed MMA ratio improves the specificity of MMA.
Atrial Fibrillation and CHADS2 Risk Factors are Associated with Highly Sensitive C‐Reactive Protein Incrementally and Independently
Authors: CRANDALL MARK A. , HORNE BENJAMIN D. , DAY JOHN D. , ANDERSON JEFFREY L. , MUHLESTEIN JOSEPH B. , CRANDALL BRIAN G. , WEISS J. PETER , LAPPÉ DONALD L. , BUNCH T. JARED 
Published: April 2009

Background: Inflammation has been shown to have a direct role in the initiation, maintenance, and recurrence of atrial fibrillation (AF) although the underlying mechanisms are unknown. Similarly, it is unclear if inflammatory markers are elevated due to the AF alone or the coexisting cardiovascular diseases that increase the risk of AF.
Methods: Consecutive patients who underwent angiography for suspicion of coronary artery disease, but without a myocardial infarction, were studied. Serum was analyzed to determine high‐sensitivity C‐reactive protein (hs‐CRP) level. Patients’ AF status was determined through ICD‐9 codes, review of hospital discharge summaries, clinical evaluations, and electrocardiograms.
Results: A total of 2,340 patients were studied (64±12 years). Comorbid diseases included 1,438 (61%) coronary artery disease, 1,309 (56%) hypertension, 433 (19%) diabetes, 345 (15%) congestive heart failure, and 43 (2%) a prior stroke. The hs‐CRP level was significantly higher in patients with AF (n = 238) compared to those without (14.0 mg/L vs 9.1 mg/L, P < 0.001). Greater CHADS2 score was also significantly associated with higher hs‐CRP in a linear fashion (medians [mg/L], 0: 1.99, 1: 2.91, 2: 3.49, 3: 3.89, 4–5: 4.82, P <0.001). The presence of AF was associated with higher hs‐CRP level across all scores (medians [mg/L], 0: 2.22 vs 1.98, P = 0.83, 1: 3.85 vs 2.86, P = 0.057, 2: 4.96 vs 3.29, P = 0.021, 3: 6.29 vs 3.17, P = 0.09, 4–5: 4.82 vs 4.50, P = 0.87).
Conclusion: Risks factors associated with AF were associated with higher hs‐CRP in an incremental manner. The presence of AF increased hs‐CRP across the CHADS2 score strata is supportive of the concept that AF is an inflammatory process and may convey independent risk.
Angiographic Markers of Restenosis after Drug‐Eluting Stent Implantation: Surrogates for Late Clinical Outcomes?
Authors: POPMA JEFFREY J. , ALMONACID ALEXANDRA 
Published: April 2009

Introduction:

Although angiographic measures of restenosis, including late lumen loss, binary angiographic restenosis, and follow‐up percent diameter stenosis have value in determining the efficacy of new drug‐eluting stents (DES) designs, their ability to predict clinical events, including death, myocardial infarction, and target lesion revascularization (TLR) has been questioned.
Methods:

We reviewed the available literature and recent DES clinical trials to determine the relationship between clinical and angiographic markers of restenosis and late clinical outcomes after stent use.
Results:

Angiographic markers are useful surrogates for predicting differences in TLR between bare metal and DES. Due to the curvilinear relationship between late lumen loss and TLR and the skewedness of the late lumen loss distribution, late lumen loss as a single index has been less effective at predicting clinical differences between different DES when the absolute values of late lumen loss are low. Beyond predicting clinical restenosis, follow‐up angiographic indices have been less predictive of other late clinical events, such as very late stent thrombosis or aneurysm formation.
Conclusions:

Angiographic markers of restenosis may be a useful surrogate for TLR in pilot studies of patients treated with DES, but their use as a surrogate marker for all clinical events after stent placement, including death, myocardial infarction, and stent thrombosis, may be confounded by the progression of atherosclerosis at remote sites and vagaries of the distribution of late lumen loss in patients treated with DES.
Choice of DES: A European Clinician's Perspective
Authors: SASTRY SANJAY , MORICE MARIE‐CLAUDE 
Published: April 2009

The introduction of the first generation of drug‐eluting stents (DES) in 2002 revolutionized interventional cardiology by minimizing restenosis. Reports of increased late stent thrombosis with these stents compared with bare metal stents, probably due to delayed endothelialization, emerged late in 2006. These studies contained serious methodological flaws, however. Subsequent meta‐analyses clearly showed only a small incremental risk of late stent thrombosis across all patient groups. Importantly, a significant and sustained benefit of DES due to reduced restenosis and thus repeat revascularization was also shown. Several “real‐world” registries have confirmed these results, as well as suggesting that use in more complex situations is not associated with adverse outcomes. Stent thrombosis is a multifactorial problem, in which the stent is only one element. Further research is required to determine optimal procedural technique and antiplatelet regimes. Second‐generation DES, with different antiproliferative drugs and more biocompatible polymers, have shown promising results in comparative studies with the first generation. Current follow‐up data for these stents is only up to 3 years, however. DES are safe and effective in the long term, though intensive research continues into ways to reduce the risk of stent thrombosis in the next generation.
Sequence of Electrocardiographic and Acoustic Cardiographic Changes and Angina during Coronary Occlusion and Reperfusion in Patients Undergoing Percutaneous Coronary Intervention
Authors: Lee Eunyoung , Drew Barbara J. , Selvester Ronald H. , Michaels Andrew D. 
Published: April 2009

Background: Previous studies have suggested that ventricular function may be impaired without or prior to electrocardiographic changes or angina during ischemia. Understanding of temporal sequence of electrical and functional ischemic events may improve the detection of myocardial ischemia. Methods: A prospective study was performed in 21 subjects undergoing percutaneous coronary intervention (PCI) who had both ST amplitude changes >2 standard deviations above baseline on 12‐lead electrocardiography (ECG), and new or increased third or fourth heart sound (S3 or S4) intensity measured by computerized acoustic cardiography. The sequence of the onset and resolution of these signs of ischemia were examined following coronary balloon inflation and deflation. Results: Electrocardiographic ST amplitude and diastolic heart sound changes occurred contemporaneously, shortly after coronary occlusion (mean onset from balloon inflation; ST changes, 21 ± 17 seconds; S4, 25 ± 26 seconds; S3, 45 ± 43 seconds). In 40% of patients, a new or increased S3 or S4 developed earlier than ST changes. Anginal symptoms occurred in only 2 of the 21 subjects during ischemia with a mean onset time of 68 seconds. ST‐segment changes resolved earliest (33 seconds after balloon deflation) while diastolic heart sounds (89 ± 146 seconds) and angina (586 ± 653 seconds) resolved later. Conclusion: A new or intensified S3 and/or S4 occurred contemporaneously with electrocardiographic changes during ischemia. These diastolic heart sounds persisted longer than ST changes following coronary reperfusion. Acoustic cardiographic assessment of diastolic heart sounds may aid in the early detection of myocardial ischemia, particularly in those patients with an uninterpretable ECG.
The Measurement of the QT and QTc on the Neonatal and Infant Electrocardiogram: A Comprehensive Reliability Assessment
Authors: Gow Robert M. , Ewald Benjamin , Lai Lillian , Gardin Letizia , Lougheed Jane 
Published: April 2009

Background: An electrocardiogram has been proposed to screen for prolonged QT interval that may predispose infants to sudden death in the first year of life. Understanding the reliability of QT interval measurement will inform the design of a screening program. Methods: Three pediatric cardiologists measured the QT/RR intervals on 60 infant electrocardiograms (median age 46 days), from leads II, V5 and V6 on three separate occasions, 7 days apart, according to a standard protocol. The QTc was corrected by Bazett's (QTcB), Fridericia's (QTCFrid), and Hodges' (QTcH) formulae. Intraobserver and interobserver reliability were assessed by intraclass correlation coefficients (ICC), limits of agreement and repeatability coefficients for single, average of two and average of three measures. Agreement for QTc prolongation (> 440 msec) was assessed by kappa coefficients. Results: QT interval intraobserver ICC was 0.86 and repeatability coefficient was 25.9 msec; interobserver ICC increased from 0.88 for single observations to 0.94 for the average of 3 measurements and repeatability coefficients decreased from 22.5 to 16.7 msec. For QTcB, intraobserver ICC was 0.67, and repeatability was 39.6 msec. Best interobserver reliability for QTcB was for the average of three measurements (ICC 0.83, reproducibility coefficient 25.8 msec), with further improvement for QTcH (ICC 0.92, reproducibility coefficient 16.69 msec). Maximum interobserver kappa for prolonged QTc was 0.77. Misclassification around specific cut points occurs because of the repeatability coefficients. Conclusions: Uncorrected QT measures are more reliable than QTcB and QTCFrid. An average of three independent measures provides the most reliable QT and QTc measurements, with QTcH better than QTcB.