bluuebunny/crossref_metadata_2025_split huggingface dataset:
Taser‐Induced Rapid Ventricular Myocardial Capture Demonstrated by Pacemaker Intracardiac Electrograms
Authors: CAO MICHAEL , SHINBANE JEROLD S. , GILLBERG JEFFREY M. , SAXON LESLIE A. 
Published: June 2007

Introduction: A Taser weapon is designed to incapacitate violent individuals by causing temporary neuromuscular paralysis due to current application. We report the first case of a Taser application in a person with a dual‐chamber pacemaker demonstrating evidence of Taser‐induced myocardial capture. Methods and Results: Device interrogation was performed in a 53‐year‐old man with a dual‐chamber pacemaker who had received a Taser shot consisting of two barbs delivered simultaneously. Assessment of pacemaker function after Taser application demonstrated normal sensing, pacing thresholds, and lead impedances. Stored event data revealed two high ventricular rate episodes corresponding to the exact time of the Taser application. Conclusions: This report describes the first human case of ventricular myocardial capture at a rapid rate resulting from a Taser application. This raises the issue as to whether conducted energy devices can cause primary myocardial capture or capture only in association with cardiac devices providing a preferential pathway of conduction to the myocardium.
New Insights into Long‐Term Follow‐Up of Atrial Fibrillation Ablation: Full Disclosure by an Implantable Pacemaker Device
Authors: MARTINEK MARTIN , AICHINGER JOSEF , NESSER HANS‐JOACHIM , ZIEGLER PAUL D. , PURERFELLNER HELMUT 
Published: June 2007

Introduction: Long‐term outcome of radiofrequency ablation (RFA) for atrial fibrillation (AF) is difficult to assess. This study sought to evaluate various aspects of very long‐term follow‐up (FU) by the properties of an implantable device. Methods: Fourteen patients with an implanted pacemaker device (Medtronic AT500) were selected for RFA, due to drug‐refractory and highly symptomatic AF despite antibradycardic pacing. Results: With a mean FU of 41.4 ± 15.1 months, we could achieve continuous monitoring for more than 400,000 hours after RFA. Based on symptomatic episodes, simulated 24‐hour, 48‐hour, or 7‐day Holter, 57% to 71% of the patients were classified as RFA responders. With permanent FU provided by the implanted device, 43% of the patients exhibited a positive treatment effect and only 21% had no tachyarrhythmic episode at all in long‐term FU. With a mean of 1.7 ± 0.7 RFA per subject, atrial tachyarrhythmia burden (ATB) was significantly reduced from a median of 3.6 to 0.3 hours per day (P < 0.001). Two out of 14 patients developed AF recurrences after a tachyarrhythmia‐free period of more than 12 months. Conclusion: Continuous monitoring provided by an implantable device is able to detect significantly more AF episodes than routine FU. ATB is decreased significantly by (repeated) RFA over a very long‐term FU. AF may reoccur very late after long‐lasting (>1 year) episode‐free intervals. A subgroup of patients with drug‐aggravated bradycardia in brady‐tachy syndrome might be considered for PV isolation rather than pacemaker implantation.
Political Decentralization and Technological Innovation: Testing the Innovative Advantages of Decentralized States
Authors: Taylor Mark Zachary 
Published: June 2007

AbstractAre politically decentralized states better at fostering long‐run technological innovation than centralized states? Societies with decentralized governments are widely seen as agile, competitive, and well structured to adapt to innovation's gale of creative destruction. Meanwhile, centralized states, even when democratic, have come to be viewed as rigid and thus hostile to the risks, costs, and change associated with new technology, or prone to cling too long to foolhardy or outdated technological projects. Therefore government decentralization is often perceived as a necessary institutional foundation for encouraging long‐run technological innovation. However, in this article, I analyze data on international patent activity, scientific publications, and high‐technology exports, and show that there exists little evidence for an aggregate relationship between government structure and technological innovation.
The Technology Trap and the Role of Political and Cultural Variables: A Critical Analysis of the E‐Government Policies
Authors: Bolgherini Silvia 
Published: June 2007

AbstractMore than a decade after the first introduction of the e‐government policies, early enthusiasms on its immediate benefits on the quality of democracy have undergone critical review. E‐government implementation worldwide has proved that technology alone does not necessarily provide more access and more participation. Massive technological intervention is not enough for reinventing government online. Hence, other variables should be taken into consideration. Factors concerning political culture, cognitive frames and mentality, administrative traditions, as well as the country‐specific peculiarities play a relevant role in determining if and how e‐gov initiatives can succeed or fail. In this article, it will be argued that any opportunity and push for change and actual influence on administrations, governments, and societies, prompted by the new technologies, should endure important variables of political, social, and cultural nature. The political and socio‐cultural variables then overcome the technological one and we can state that politics (still) determines (e‐)policy.
Impact of glucose levels on advanced glycation end products in hemodialysis
Authors: GODFREY Amy Ruth 
Published: June 2007

AbstractThe current obesity epidemic throughout the western world has resulted in a considerable increase in the condition Type II diabetes mellitus. Recently, the World Health Organization has predicted that the global prevalence of Type II will increase from 175 million patients in 2003 to over 350 million by 2030. One of the major consequences of this disorder is renal failure, which presents itself as chronic kidney disease, and can progress to end‐stage renal disease. Once diagnosed, patients are generally treated using dialysis due to a shortage of kidney donors. The fundamental process of dialysis still requires improvement because the survival rate of these patients is relatively poor. This has resulted in considerable research into improvements in hemodialysis membranes, and the challenge to find more suitable marker(s) in assessing the efficacy of the dialysis process. A class of compounds highlighted as a possible accumulative toxin is advanced glycation end products or AGEs. This is an article regarding the impact of hemodialysis and hemodiafiltration on glucose and AGE levels within the body and the consequences of a chronic hyperglycemic condition. It also highlights the negative aspects of using dextrose in conventional dialysis solutions (an area that has already been identified by peritoneal dialysis clinicians as problematic). The review concludes by suggesting several possible topics of future research.
Fever of unknown origin in a hemodialysis patient with a failed allograft
Authors: YAZICI Halil , SEVER Mehmet Sukru 
Published: June 2007

AbstractFever of unknown origin (FUO) in hemodialysis (HD) patients represents a diagnostic challenge because differential diagnosis includes diverse etiologies. Causes of FUO in the general population can be classified into 3 diagnostic categories: infections, tumors, and noninfectious inflammatory diseases. Also, chronic HD patients may have additional problems such as infections, the risk for which may be increased by the immunosuppression associated with uremia, vascular access‐related infections, and nosocomial infections. Moreover, patients with chronically failed kidney transplants can have low‐grade fever and abdominal pain, and if inflammation of the allograft is severe enough, it may result in a spontaneous rupture. Hence, it is important to rapidly recognize, diagnose, and manage these complications. In the present study, we report a case of FUO in an HD patient with a failed graft and discuss clinical approach and management of these patients.
Monckeberg's calciphylaxis with necrosis of the glans penis: A case presentation
Authors: SORENSEN Mathew D. , LONG Layron O. , WESSELLS Hunter , KUAN James K. 
Published: June 2007

AbstractMonckeberg's calcific sclerosis of the media of the small‐sized and medium‐sized arteries is a well described and potentially life‐threatening condition seen almost exclusively in patients with end‐stage renal disease (ESRD) and with hyperparathyroidism. Penile gangrene resulting from this entity is associated with a mortality as high as 64%. A 65‐year‐old man with ESRD on dialysis for 6 years was referred to Harborview Medical Center with severe penile pain and partial necrosis of his glans penis, which progressed despite medical management. The patient had previously undergone amputations on all four extremities. After intraoperative biopsies of the proximal corpora cavernosa and spongiosum demonstrated viable tissue, he underwent partial penectomy. Pathologic evaluation revealed calciphylaxis within the media of the penile vessels. Two months later the patient had persistent wound‐healing issues with intractable pain and thus underwent a complete penectomy with ultimate resolution of his severe pain.
Prevalence of 25(OH) vitamin D insufficiency and deficiency in chronic kidney disease stage 5 patients on hemodialysis
Authors: VALLE Elisa DEL , NEGRI Armando L. , AGUIRRE Cristina , FRADINGER Erich , ZANCHETTA Jose R. 
Published: June 2007

AbstractLittle is known about the magnitude of vitamin D deficiency in patients with stage 5 chronic kidney disease (CKD‐5) on hemodialysis (HD). In the present study, we examined the prevalence of vitamin D deficiency in patients with CKD‐5 undergoing HD, evaluating the relationship between calcidiol levels with other parameters of mineral metabolism, nutrition/inflammation, functional capacity (FC), and sunlight exposure. Serum 25(OH) vitamin D levels were evaluated in 84 stable patients on chronic HD not receiving vitamin D supplements, with a mean age 58.9±16.6 years, during the month of September (end of winter in the southern hemisphere). 25(OH) vitamin D serum levels, intact PTH (iPTH), as well as serum albumin, calcium, phosphorus, and alkaline phosphatase were analyzed in fasting samples. Similarly, protein catabolic rate (PCR) and body mass index (BMI) were determined as nutritional parameters. Functional capacity according to the Karnofsky index, and sunlight exposure were also analyzed. In this study, we considered adequate vitamin D levels those above 30 ng/mL (U.S.A. National Kidney Foundation DOQI Guidelines), vitamin D insufficiency when levels were between 15 and 30 ng/mL, and vitamin D deficiency when levels were below 15 ng/mL. The mean 25(OH) D levels were significantly higher in men than in women (28.6 vs. 18.9 ng/mL; p=0.001). Vitamin D insufficiency was found in 53.5% of the patients (n=45) and vitamin D deficiency in 22.6% (n=19). In the univariate analysis, there were no correlations between 25(OH) D levels with age, iPTH, calcium, or phosphorus. There were positive correlations between serum 25(OH) D levels and degrees of sunlight exposure (R=0.55; p<0.0001), serum creatinine (r=0.38; p<0.001), serum albumin (r=0.22; p=0.04), and a negative correlation with BMI (r=−0.26; p=0.01). In the multiple regression analysis, only sunlight exposure (B=0.361), BMI (B=−0.23), and gender (B=−0.27) were significantly associated with 25(OH) D levels. Patients with FC 1 to FC 2 (n: 70%, 83.3%) had significantly higher 25(OH) D serum levels compared with FC 3 to FC 4 patients (n: 14%, 16.6%): 25.9 vs. 17.1 ng/mL (p=0.03). These results indicate that vitamin D insufficiency/deficiency is highly prevalent (76.1%) at the end of winter, in stage 5 CKD patients on HD, and lower values seem to be related to decreased sunlight exposure, female gender, increased BMI, and worse functional class.
Less‐oxidative hemodialysis solution rendered by cathode‐side application of electrolyzed water
Authors: NAKAYAMA Masaaki , KABAYAMA Shigeru , TERAWAKI Hiroyuki , NAKAYAMA Keisuke , KATO Kiyoshi , SATO Toshinobu , ITO Sadayoshi 
Published: June 2007

AbstractElectrolyzed water (EW) generated on the cathode side reportedly displays anti‐oxidative properties, and application of EW to hemodialysis (HD) systems supposedly suppresses oxidative markers in patients on HD. However, most of the chemical properties and biological effects of such solutions remain unclear. This study aimed to examine those issues to clarify the scientific background for the clinical use of EW solution. Reverse osmosis water comprising EW from the cathode side (e‐RO) was prepared and used to process a test HD solution (e‐HD). Chemical and biological properties of these solutions were compared with controls. Redox properties were examined by chemiluminescence (CL) of the luminol‐H2O2 system. Biological effects of e‐RO on human polymorphonuclear leukocytes (PMNs) were tested with respect to the cellular protection against methylglyoxal, and with respect to the preservation of cellular function as to radical generation. Control HD solution presented the highest CL, followed by e‐HD, control RO, suggesting a lower oxidative capacity for EW‐based solutions. Increased levels of dissolved hydrogen were characteristic of e‐RO and e‐HD. Application of e‐RO tended to be associated with less injury of PMNs by methylglyoxal, and with significantly higher levels of radical generation compared with the control. Compared with control HD, e‐RO‐based HD solution displays less‐oxidative capacity in chemical terms, and may at least partly facilitate preservation of PMN viability. These results appear to offer a scientific basis for supporting the clinical challenge of applying this technology to HD treatment.
Association of mineral metabolism factors with all‐cause and cardiovascular mortality in hemodialysis patients: The Japan dialysis outcomes and practice patterns study
Authors: KIMATA Naoki , ALBERT Justin M. , AKIBA Takashi , YAMAZAKI Shin , KAWAGUCHI Yoshindo , FUKUHARA Shunichi , AKIZAWA Tadao , SAITO Akira , ASANO Yasushi , KUROKAWA Kiyoshi , PISONI Ronald L. , PORT Friedrich K. 
Published: June 2007

AbstractAbnormalities in mineral metabolism have been linked to mortality in hemodialysis (HD) patients. We postulated that these abnormalities would have a particularly large deleterious impact on deaths due to cardiovascular causes in Japan. This study describes the recent status of abnormal mineral metabolism, significant predictors, and potential consequences in the Dialysis Outcomes and Practice Patterns Study (DOPPS), Phases 1 and 2, in Japan. Major predictor variables were patient demographics, comorbidities, and laboratory markers of mineral metabolism such as albumin‐adjusted serum calcium (calciumAlb), phosphorus, and intact PTH (iPTH). In a cross section of 3973 Japanese HD patients in DOPPS I and II, a large faction had laboratory values outside of the recommended Kidney Disease Outcomes Quality Initiative (K/DOQI) guideline range for serum concentrations of phosphorus (51% of patients above upper target range), calciumAlb (43.7% above), calcium‐phosphorus (Ca × P) product (41.1% above), and iPTH (18.6% above). All‐cause mortality was significantly and independently associated with calciumAlb (relative risk [RR]=1.22 per 1 mg/dL, p=0.0005) and iPTH (RR=1.04 per 100 pg/mL, p=0.04). Cardiovascular mortality was significantly associated with calciumAlb (RR=1.28, p=0.02), phosphorus (RR=1.13 per 1 mg/dL, p=0.008), Ca × P product (RR=1.07 per 2 mg2/dL2, p=0.002), and PTH (RR=1.08, p=0.0001). This study expands our understanding of the relationship between altered mineral metabolism and mortality outcomes, showing slightly stronger associations with cardiovascular causes than observed for all‐cause mortality. These findings have important therapeutic implications for Japanese HD patients.
Barriers to access before initiation of hemodialysis: A single‐center review
Authors: BHAN Vineet , SOROKA Stephen , CONSTANTINE Charles , KIBERD Bryce A. 
Published: June 2007

AbstractGuidelines recommend that ≥50% of patients starting dialysis have a fistula. We reviewed our experience in consecutive incident patients over a 1‐year period. Only 30 of the 93 patients starting hemodialysis had a fistula that was accessed. Late referral (nephrology contact <90 days) was a significant issue in 48% (30/63) of the patients without a fistula. Most (n=21) of the late referrals were acute disease; only 9 were late referrals of chronic disease. Nephrology follow‐up exceeded 200 days in the remaining (33/63) without this access. In the cohort with sufficient nephrology referral, we explored variables associated with a fistula (n=30) compared with those without one (n=33). In multivariate logistic regression analysis, peripheral vascular disease (odds ratio [OR] 0.026, 95% confidence interval [CI] 0.002–0.286) and rapid loss of estimated glomerular filtration rate (eGFR) (OR 0.745 per mL/min/1.73 m2/year, 95% CI 0.625–0.888) in the year preceding dialysis were significant negative predictors for a fistula. Patients without access experienced faster declines in GFR in the year preceding dialysis (12.1±9.9 vs. 4.7±3.5 mL/min 1.73 m2 with access, p<0.001). Glomerular filtration rate loss in the 2 years before starting dialysis was the same between the 2 groups (−0.54±10.4 vs. 1.42±3.9 mL/min 1.73 m2). Age, sex, diabetes, other comorbidity, length of nephrology follow‐up, eGFR at dialysis start, hemoglobin, and albumin were not significant. At our center, rapid loss of renal function in otherwise stable chronic kidney disease (CKD) patients is more important than late referral of CKD for the lack of access. Improvements in rapid referral for access creation could help reduce this barrier.
Hepatitis C in dialysis units: The Saudi experience
Authors: KARKAR Ayman 
Published: June 2007

AbstractHepatitis C virus (HCV) infection is a significant health problem, as it can lead to chronic active hepatitis, liver cirrhosis, and hepatic carcinoma. Patients undergoing hemodialysis treatment are at increased risk of contracting HCV and other viral infections. This is primarily due to their impaired cellular immunity, underlying diseases, and blood exposure for a prolonged period. Transmission of viral hepatitis, and in particular HCV in dialysis units, has been showing a progressive increase worldwide, ranging between 5% in some western countries and up to 70% in some developing countries. The annual rate of HCV seroconversion in Saudi Arabia is 7% to 9%, while its prevalence is variable between 15% and 80%. This prevalence remained at almost 50% in recent years, despite the further increase in number of patients with end‐stage renal disease and the expansion of dialysis services. The most prevalent genotypes in Saudi Arabia are genotype 4 followed by genotypes 1a and 1b, whereas genotypes 2a/2b, 3, 5, and 6 are rare. Genotypes 1 and 4 were associated with different histological grades of liver disease. Mixed infections with more than one genotype were observed in some studies. Isolation of dialysis machines and infected patients, together with strict application of infection‐control policies and procedures and continuous education and training of nursing staff, remain the cornerstone in prevention and control of the spread of HCV infection in dialysis units. Interferon (INF)‐α or pegylated INF, alone or in combination with ribavirin, have shown great promise in the treatment of chronic HCV in dialysis patients.
Use of odours by Cycloneda sanguinea to assess patch quality
Authors: Sarmento Renato Almeida , Venzon Madelaine , Pallini Angelo , Oliveira Eugenio Eduardo , Janssen Arne 
Published: June 2007

AbstractAdult ladybirds are likely to encounter various species of prey when foraging for oviposition sites. Optimal oviposition theory predicts that females should lay eggs in those sites that are the most suitable for offspring development. Therefore, factors that directly affect offspring mortality, such as the presence of predators and food, are expected to play an important role in the assessment of patch profitability by ladybird predators. Using a Y‐tube olfactometer, we tested whether the predatory ladybird Cycloneda sanguinea L. (Coleoptera: Coccinellidae) can use volatile cues to assess patch profitability and avoid predator‐rich patches. We assessed the foraging behaviour of C. sanguinea in response to odours associated with tomato plants infested with a superior prey, Macrosiphum euphorbiae Thomas (Homoptera: Aphididae), and with an inferior prey, Tetranychus evansi Baker and Pritchard (Acari: Tetranychidae), in the presence or absence of the heterospecific predator Eriopis connexa Mulsant (Coleoptera: Coccinellidae). Females of C. sanguinea significantly preferred plants infested by M. euphorbiae to plants infested by T. evansi and avoided odours emanating from plants on which E. connexa females were present. Our results show that C. sanguinea use volatile cues to assess patch profitability and to avoid patches with heterospecific competitors or intraguild predators.
Potassium chloride deters Lygus hesperus feeding behavior
Authors: Hagler James R. , Blackmer Jacquelyn L. 
Published: June 2007

AbstractA series of bioassays were conducted to determine the response of adult western tarnished plant bugs, Lygus hesperus Knight (Heteroptera: Miridae), to artificial diets containing potassium chloride (KCl). We first examined the feeding behavior of L. hesperus by direct observation in a no‐choice diet feeding arena. We observed a total of 22 Lygus feeding events lasting an average of 411 ± 64 s on the control artificial diet and only three feeding events lasting an average of 11 ± 3 s on the KCl‐treated diet. We then conducted several multiple diet choice bioassays to determine the feeding response of L. hesperus when exposed simultaneously to five artificial diet treatments containing different amounts of KCl. For the first bioassay, we used standard clear parafilm diet packets and for the second bioassay we used dark green parafilm diet packets to hold the various diet treatments. Regardless of the diet packet color, L. hesperus overwhelmingly selected the 0% KCl diet treatment over diets containing 3, 6, 9, or 12% KCl. The third and fourth multiple diet choice bioassays were identical to the first bioassay, except that concentrations of the KCl‐treated diets were reduced. Lygus hesperus consistently selected the control diet over all diets containing more than 0.5% KCl. However, when the concentration of KCl in the diet was reduced to ≤0.4%, there were no significant differences in feeding activity exhibited by L. hesperus. Finally, to determine if the addition of KCl to the diet influenced their upwind response, we examined the responses of L. hesperus that were simultaneously exposed to a control artificial diet and a diet containing 12% KCl in a Y‐tube olfactometer bioassay. Of the 95 adults tested, 47 selected the arm containing the normal diet and 48 selected the arm containing KCl‐treated diet, indicating that dietary constituents did not preferentially attract or repel L. hesperus. The results from these studies strongly suggest that KCl negatively affects L. hesperus feeding behavior by functioning as a strong gustatory deterrent when concentrations exceed 0.5%. Visual and volatile cues appeared to have no role in mediating orientation or feeding behavior under these test conditions.