bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnetic resonance imaging: a reliable method for measuring pancreatic volume in Type 1 diabetes
Authors: Williams A. J. K. , Chau W. , Callaway M. P. , Dayan C. M. 
Published: January 2007

AbstractAim  To validate magnetic resonance imaging (MRI) for monitoring pancreatic atrophy in Type 1 diabetes.Methods  Twelve male patients with Type 1 diabetes of duration ≥ 10 years (median age 28, range 19–32 years) and 12 healthy controls (median age 30, range 22–36 years) were invited for two abdominal MRI scans, 14 days apart. Four sequences were used: standard T1‐weighted; standard T2‐weighted; volumetric interpolated breath‐hold examination (VIBE); and T1‐weighted breath hold with fat suppression (T1BHFS). The pancreas was identified on coded images by one observer and volumes estimated by interpolation.Results  Eleven patients and all controls were scanned twice. Visualization of the pancreas was best with VIBE and T1BHFS, allowing volume estimation from 47 and 46 scans, respectively. The pancreatic volume of patients estimated from these sequences were half those of controls (52.4 ml, ± 17.1 ml, mean ± sd) vs. (101 ml, ± 19.5 ml, P < 0.001) and estimates showed little bias between visits; mean difference 1.1 ml (95% CI; −3.1 to 5.3 ml, P = 0.61) using VIBE and −2.6 ml (−5.8 to 0.6 ml, P = 0.03) using T1BHFS. Both sequences gave similar precision; the standard deviation of the differences in volume estimates between visits was 9.7 ml for VIBE and 7.3 ml for T1BHFS, although mean volumes estimated from T1BHFS were 4.9 ml lower (−8.2 to −1.7 ml, P = 0.005).Conclusions  Pancreatic volume can be measured reliably using MRI and shows a 48% reduction in long‐standing Type 1 diabetes as compared with age‐matched normal subjects. MRI should prove useful in determining the natural history of pancreatic atrophy in diabetes.
Paradoxical HDL‐C reduction during rosiglitazone and fibrate treatment
Authors: Shetty C. , Balasubramani M. , Capps N. , Milles J. , Ramachandran S. 
Published: January 2007

AbstractAims  Dyslipidaemia in Type 2 diabetes mellitus (T2DM) is one of the major contributors in the pathogenesis of atherosclerosis. Thiazolidinediones (TZD), a class of drugs used in the treatment of T2DM, also modify lipids, especially lowering serum triglycerides and raising high‐density lipoprotein cholesterol (HDL‐C).Methods  We describe five patients taking rosiglitazone and a fibrate who showed a paradoxical fall in HDL‐C, which would have been missed if HDL‐C had not been routinely monitored. This could have had a major impact in increasing the cardiovascular risk in these patients.Results  Our five patients showed marked variation in both the decrease in serum HDL‐C (50–89%) and also in the time taken for recovery of HDL‐C after withdrawal of rosiglitazone (between 5 and 20 weeks). Apolipoprotein A1 mirrored the drop in HDL‐C in four of the five patients but in one subject this was not seen, suggesting the possibility of multiple mechanisms leading to the phenomenon described, perhaps involving HDL metabolism. Improvements in glycaemic control with rosiglitazone (absolute HbA1c reduction between 0.6 and 3.0%) were seen in four of our patients. This suggests that the peroxisomal proliferator‐activated receptor γ signalling pathways relevant to glucose homeostasis were intact.Conclusion  As atherosclerosis is associated with a decrease in the HDL‐C level, our observations reinforce the message that HDL‐C should be measured before and after the commencement of rosiglitazone and also on increasing the dosage
The extension of healthcare coverage and protection in relation to the labour market: Problems and policies in Latin America
Authors: Mesa‐Lago Carmelo 
Published: January 2007

Abstract In the past 25 years almost all 20 countries of Latin America have reformed their healthcare systems, but coverage by social insurance averages 53 per cent of the total population (less than the ILO minimum standard), ranges from 7 to 26 per cent in ten countries and has stagnated or decreased in at least eight, and access is insufficient. This article (1) analyses the transformation of the labour market and its impact on social insurance coverage; describes legal coverage of various groups; estimates statistical coverage/access and its trends in the three typical sectors (public, social insurance and private); documents the differences in coverage by income, geographical area and ethnic group; examines the difficulties in the incorporation of the informal economy, the rural population, indigenous peoples and the poor, as well as the causes of low coverage, and touches problems of access;(2) summarizes recommendations from international organizations on coverage and access; suggests specific policies to expand protection in general and to vulnerable groups, and identifies themes that require more statistics and research; and (3) summarizes findings and recommendations. A preliminary version of this article was presented at the ISSA Regional Conference for the Americas held in Belize City, 28‐31 May 2006. Based on the author's book Las Reformas de Saluden América Latina y el Caribe: Su Impacto en los Principios de la Seguridad Social (Santiago, ECLAC/GTZ, 2006), the article summarizes and restructures all pertinent sections of that book, with numerous changes and new data. Useful comments were provided by two anonymous referees.
Microsatellite markers for population studies of the rice blast fungus, Magnaporthe grisea
Authors: ADREIT H. , SANTOSO  , ANDRIANTSIMIALONA D. , UTAMI D. W. , NOTTEGHEM J. L. , LEBRUN M. H. , THARREAU D. 
Published: January 2007

AbstractWe developed nine new microsatellite markers for rice blast (Magnaporthe grisea) population studies. These markers were used in addition to nine microsatellite markers previously developed by our group for mapping purpose. Altogether, the 18 markers were used in multiplex PCR (polymerase chain reaction) to characterize six populations from different geographical origins. The average number of alleles per locus across populations ranged from 1.2 to 7 and the total number of alleles detected from 2 to 19. Based on this large range of polymorphism, this set of markers is expected to be useful for different kind of population studies at different geographical scales.
The Myth of International Delegation: Limits to and Suggestions for Democratic Theory in the Context of the European Union
Authors: Agné Hans 
Published: January 2007

AbstractThis paper presents an argument as to why democratic states are unable to delegate authority to international organizations. Influential attempts to justify democratically such international bodies as the European Union by means of delegation are found to be untenable. At a more general level of theorization, it argues that the theory of delegation as involving the recoverability of delegated authority leaves us unable to identify democratic reforms for international organizations. As a remedy to the latter problem, the article proposes an alternative theory of democratic ‘delegation’– one that applies equally well to national and to international politics.
A Double‐Blind Evaluation of Gabapentin on Alcohol Effects and Drinking in a Clinical Laboratory Paradigm
Authors: Myrick Hugh , Anton Raymond , Voronin Konstantin , Wang Wei , Henderson Scott 
Published: January 2007

Introduction: There has been increasing interest in the use of anticonvulsant agents in the treatment of alcoholism. Anticonvulsant agents have mostly been evaluated as an alternative to benzodiazepines in the treatment of alcohol withdrawal. Among the advantages of using anticonvulsant agents in this capacity is their purported lack of interaction with alcohol (i.e., interactions that could increase psychomotor deficits, cognitive impairment, and increase intoxication). This is particularly important in the treatment of alcohol withdrawal and relapse prevention in outpatients. Unfortunately, these untoward clinical interactions between anticonvulsants and alcohol in alcoholic patients have not been thoroughly assessed. The current clinical laboratory study was conducted to evaluate the safety and tolerability of the anticonvulsant gabapentin in alcoholic subjects. In addition, the ability of gabapentin to reduce alcohol craving and consumption was evaluated.Methods: Thirty‐five non‐treatment–seeking alcoholic subjects were enrolled in a subacute human laboratory study and received double‐blind treatment with up to 1,200 mg of gabapentin (n=18) or placebo (n=17) for 8 days. The safety and tolerability of gabapentin were monitored in the natural environment during the first 5 days of medication treatment and during a free‐choice limited access consumption paradigm following an initial drink of alcohol in a bar–lab setting on Day 7.Results: There was no overall effect of gabapentin on drinking or craving; however, it was tolerated (e.g., mood and sedation) as well as placebo over 5 days of natural drinking. During the bar–lab drinking session, there were no differences in subjective high or intoxication between subjects treated with gabapentin or placebo.Discussion: This study provides initial evidence that the anticonvulsant gabapentin is safe if used in conjunction with alcohol consumption in alcoholic individuals. Further study is needed with this and other lab models to determine the utility and safety of gabapentin in the treatment of alcoholism.
Age‐Dependent Variation in Behavior Following Acute Ethanol Administration in Male and Female Adolescent Rhesus Macaques (Macaca mulatta)
Authors: Schwandt Melanie L. , Barr Christina S. , Suomi Stephen J. , Higley James D. 
Published: January 2007

Background: There has been considerable focus on the adolescent stage of development in the study of alcohol use and the etiology of alcohol‐related problems. Because adolescence is a process of dynamic change rather than a discrete or static stage of development, it is important to consider ontogenetic changes in the response to ethanol within the adolescent time period. In rodents, levels of ethanol‐induced motor impairment have been shown to increase from early to late adolescence. This study investigated associations between behavior following acute ethanol administration and age, rearing condition (mother‐reared vs nursery‐reared), and serotonin transporter (rh5‐HTTLPR) genotype in a sample of alcohol‐naïve adolescent rhesus macaques.Methods: Rhesus macaques (n=97; 41 males, 56 females), ranging in age from 28 to 48 months, were administered intravenous (IV) doses of ethanol (2.2 g/kg for males, 2.0 g/kg for females) twice in 2 separate testing sessions. A saline/ethanol group (n=16; 8 males, 6 females) was administered saline in 1 testing session and ethanol in the second session. Following each IV injection, subjects underwent a 30‐minute general motor behavioral assessment. Behavior in the saline/ethanol group was compared between the saline and ethanol‐testing sessions using analysis of variance. Behavioral data for the larger study sample were averaged between the 2 testing sessions and summarized using factor analysis. Rotated factor scores were used as dependent variables in multiple regression analyses to test for relationships between behavior and age, rearing condition, and rh5‐HTTLPR genotype.Results: During the ethanol‐testing session, behaviors indicative of motor impairment (stumbles, falls, sways, bumping the wall, and unsuccessful jumps) were frequently observed in the saline/ethanol group, while they did not occur under the saline‐testing session. Factor analysis of behavior following ethanol administration in the larger study sample yielded 3 factors: Ataxia, Impaired Jumping Ability, and Stimulation. Significant negative correlations between age and Ataxia were found for both males and females. Females also exhibited positive correlations between age and Impaired Jumping Ability and age and Stimulation. No significant correlations were found with either rearing condition or rh5‐HTTLPR genotype.Conclusions: These findings suggest that ontogenetic changes during adolescence in the behavioral response to ethanol differ between rodents and primates. Furthermore, sex differences in the behavioral response to ethanol appear to develop during adolescence.
Controlling for Serum Albumin Level Improves the Correlation Between Serum Fatty Acid Ethyl Esters and Blood Ethanol Level
Authors: Morfin John‐Paul , Kulig Clark , Everson Gregory , Beresford Thomas 
Published: January 2007

Background: Fatty acid ethyl esters (FAEEs) are generated by the nonoxidative metabolism of alcohol and correlate positively with blood alcohol levels (BAL). As FAEEs are produced predominantly in the liver and bind to albumin in plasma, blood FAEE concentrations may be affected by serum albumin levels. The aim of this exploratory study was to define the relationship of FAEE levels with BAL after adjustment for serum albumin concentration.Methods: Fatty acid ethyl ester, BAL, and albumin concentrations were measured from de‐identified, ethanol‐containing serum samples (N=18). The assay focused on 3 FAEE species ethyl palmitate, ethyl stearate, and ethyl oleate. The relationships of individual and total FAEE concentrations with BAL using albumin as a covariate were analyzed. Values for Pearson's r between the BAL and the natural log‐transformed FAEE (ln FAEE) levels were calculated, and then compared with partial correlation coefficients when controlling for albumin. The impact of serum albumin levels on the relationship between ln FAEE and BAL was evaluated by simple linear regression analysis.Results: Concentrations of total FAEE ranged from 632 to 20,166 nM, and BAL ranged from 9 to 375 mg/dL. In the 18 samples, the Pearson correlation coefficient between BAL and total FAEE levels was 0.868, and increased to 0.909 when controlling for albumin (p<0.0001). Similar statistically significant increases in the partial correlation coefficient occurred for each of the individual species of FAEE when controlling for albumin. In simple linear regression, albumin significantly reduced the variability in the model correlating BAL and FAEE for each of the individual species, as well as for total FAEE.Conclusions: The association between FAEE levels and BAL is enhanced by consideration of serum albumin concentrations. Our findings suggest that serum albumin should be included in any model attempting to define the relationship between BAL and FAEE.
Alcohol Consumption During Pregnancy in Nonindigenous West Australian Women
Authors: Colvin Lyn , Payne Jan , Parsons Deborah , Kurinczuk Jennifer J , Bower Carol 
Published: January 2007

Background: High alcohol intake in pregnancy has been linked to abnormal fetal development. There are limited published data in Australia on standard drinks of alcohol consumed on a typical occasion during the periconceptional period or pregnancy.Methods: During 1995 to 1997, a 10% random sample of all nonindigenous women giving birth in Western Australia was surveyed 12 weeks after delivery (N=4,839). Women were asked questions about alcohol consumption in each of the 4 time periods: the 3 months before pregnancy and each trimester of pregnancy. Questions were framed to measure volume, frequency, and type of alcoholic beverage.Results: 46.7% of the women had not planned their pregnancy. Most women (79.8%) reported drinking alcohol in the 3 months before pregnancy, with 58.7% drinking alcohol in at least 1 trimester of pregnancy. The proportion of women consuming 1 to 2 drinks on a typical occasion did not change much during pregnancy, but the number of occasions declined. Although the proportion of women consuming more than 2 standard drinks on a typical occasion declined after the first trimester, 19.0% of women consumed this amount in at least 1 trimester of pregnancy and 4.3% of women consumed 5 or more standard drinks on a typical occasion in at least 1 trimester of pregnancy. In the first trimester of pregnancy, 14.8% of women drank outside the current Australian guideline for alcohol consumption in pregnancy, decreasing to 10% in the second and third trimesters.Conclusions: Women generally reduced their average alcohol consumption and the number of standard drinks on a typical occasion as their pregnancy progressed, although 10 to 14% were drinking outside current guidelines for pregnancy. It is important that all women of child‐bearing age are aware, well before they consider pregnancy, of the risks of drinking alcohol during pregnancy so they can make informed decisions about their alcohol consumption in pregnancy.
Initial Experience Using a Forward Directed, High‐Intensity Focused Ultrasound Balloon Catheter for Pulmonary Vein Antrum Isolation in Patients with Atrial Fibrillation
Authors: NAKAGAWA HIROSHI , ANTZ MATTHIAS , WONG TOM , SCHMIDT BORIS , ERNST SABINE , OUYANG FEIFAN , VOGTMANN THOMAS , WU RICHARD , YOKOYAMA KATSUAKI , LOCKWOOD DEBORAH , PO SUNNY S. , BECKMAN KAREN J. , DAVIES D. WYN , KUCK KARL‐HEINZ , JACKMAN WARREN M. 
Published: January 2007

Background: A high‐intensity‐focused ultrasound balloon catheter (HIFU‐BC) is designed to isolate pulmonary veins (PV) outside the ostia (PV antrum). This catheter uses a parabolic CO2 balloon (behind water balloon) to focus a 20‐, 25‐, or 30‐mm diameter ring of ultrasound forward of the balloon (parallel to catheter shaft). The purpose of this study is to test the safety and efficacy of the HIFU‐BC for PV antrum isolation in patients with atrial fibrillation (AF). Methods and Results: Twenty‐seven patients with paroxysmal (19 patients) or persistent (8 patients) AF were studied. Double transseptal puncture was performed for left atrial deployment of a Lasso catheter (for PV mapping) and the 14 Fr HIFU‐BC. The HIFU‐BC was positioned outside the PV orifice over a guidewire. HIFU energy (acoustic power 45 watts) was applied for 40 seconds with a 20‐mm sonicating ring and 40 or 60 seconds with a 25‐mm or 30‐mm sonicating ring. No other ablation system was utilized. PV antrum isolation was attempted using HIFU‐BC in 78 of 104 PVs (25/27 RSPVs, all 23 LSPVs, all 23 LIPVs, all four left common trunks and 3/27 RIPVs). HIFU‐BC successfully isolated 68 (87%) of the 78PV antra with 1–26 (median 3) HIFU applications. The complications include transient bleeding from a distal branch of the left superior PV resulting from guidewire manipulation in one patient and right phrenic nerve injury in another patient. No PV stenosis (>50% narrowing) and no LA‐esophageal fistula occurred. At the 12‐month follow‐up, 16 (59%) of the 27 patients were free of symptomatic episodes of AF (only 3 of the 16 patients were receiving antiarrhythmic medications). Conclusions: Forward‐focused HIFU applications isolated PVs outside the PV ostium with elimination of AF in 16 (59%) of the 27 patients at 12 months following the single ablation procedure.
A Novel Algorithm for Determining Endocardial VT Exit Site from 12‐Lead Surface ECG Characteristics in Human, Infarct‐Related Ventricular Tachycardia
Authors: SEGAL OLIVER R. , CHOW ANTHONY W.C. , WONG TOM , TREVISI NICOLA , LOWE MARTIN D. , DAVIES D. WYN , BELLA PAOLO DELLA , PACKER DOUGLAS L. , PETERS NICHOLAS S. 
Published: January 2007

Introduction: Characteristics of the 12‐lead ECG during VT are used to guide initial placement of mapping catheters in endocardial ventricular tachycardia (VT) ablation. Previously constructed algorithms for guidance in human infarct‐related VT are limited to patients known to have anterior or inferior infarcts only. We hypothesized that 12‐lead ECG characteristics could be used to determine VT exit site in patients with all types of infarction of unknown location. Methods and Results: From noncontact activation maps of 121 LV VT in 51 patients undergoing catheter ablation, VT exit sites were determined and correlated with ECG characteristics according to bundle branch block configuration, limb lead polarity and patterns of precordial R‐wave transition. Eight ECG patterns were identified that accounted for 71% of all VT and gave a positive predictive value (PPV) ≥70% using the first two criteria. No correlation was found with patterns of R‐wave transition. Using these criteria an algorithm was developed, which was then applied prospectively and blinded to a further 17 VT in 11 patients. Of the 15 VT (88%) to which the algorithm predicted an exit site location (with a PPV ≥70%), 14 VT (93%) were correctly predicted by the algorithm. Conclusion: This algorithm can be used to predict endocardial LV VT exit site location in patients undergoing catheter ablation of VT without knowledge of or reference to infarct location, and can be applied to patients with posterior and/or multiple sites of infarction.
Characterization of the Electroanatomical Substrate in Human Atrial Fibrillation: The Relationship between Changes in Atrial Volume, Refractoriness, Wavefront Propagation Velocities, and AF Burden
Authors: KOJODJOJO PIPIN , PETERS NICHOLAS S , DAVIES D. WYN , KANAGARATNAM PRAPA 
Published: January 2007

Introduction: Progressive remodeling occurs in experimental models of AF whereby slowing of conduction, shortening of refractoriness, and atrial dilatation are associated with an increased vulnerability to atrial fibrillation (AF). This study investigates the relative changes in atrial geometry and electrophysiology with increasing AF burden in humans. Methods and Results: Patients undergoing ablation of AF or left‐sided accessory pathways were recruited. Atrial volumes were determined by echocardiography. Wavefront propagation velocities (WPV), specifically in the direction of activation, were calculated from pre‐ablation activation (Carto™) maps of both atria. Dispersion, adaptation of, and effective refractoriness (ERP) were measured at 3 sites. A composite arrhythmogenic index (Atrial Volume/WPV × ERP) was derived to compare the degree of electroanatomical remodeling with AF burden. Fifty‐nine patients (22 paroxysmal AF, 19 recurrent persistent AF, and 18 controls) were recruited. AF subjects had slower right atrial WPV (P = 0.01), but no difference in left atrial WPV compared with controls. ERP was reduced globally (P < 0.05), with increased dispersion (P < 0.05). WPV and ERP did not distinguish between patients with paroxysmal or persistent AF. Biatrial volumes were greater only in patients with persistent AF (P < 0.01). There was a stepwise increase in the AI with increasing AF burden (P < 0.0001). Conclusion: An arrhythmogenic substrate exists in human AF, characterized by globally decreased refractoriness with greater dispersion, slower right atrial conduction, and atrial dilatation. Persistence of AF is not accompanied by any further electrical remodeling, but only atrial dilatation. The degree of electroanatomical remodeling is associated with the clinical pattern of AF.