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EP
Terms modified by EP Selected AbstractsEthics Seminars: Withdrawal of Treatment in the Emergency Department,When and How?ACADEMIC EMERGENCY MEDICINE, Issue 12 2006Kelly Bookman MD Abstract Although increasing discussion has occurred within emergency medicine about indications for withholding cardiac life support and other resuscitative interventions, emergency physicians (EPs) may be less familiar with the ethical, legal, and practical issues surrounding withdrawal of life support that has already been initiated. Both physicians and out-of-hospital personnel must act rapidly in critical situations and must assume that the patient has the desire to be resuscitated, unless clear evidence exists to the contrary. Often, only after initial life-saving actions have stabilized the patient is there time to reflect and determine a patient's desires regarding such interventions. When the EP can clearly discern a patient's previously stated wishes during the emergency department (ED) stay, these wishes should be honored in the ED. Respecting a patient's request to avoid unwanted, invasive treatments near death may involve withdrawing interventions that could not be withheld during the first few minutes of care. In this article, the authors use a case of out-of-hospital stabilization of a patient as a springboard to review the ethical and legal framework for withdrawal of life-sustaining care, as well as the practical issues involved with withdrawal of such care in the ED. [source] Victimization: a newly recognized outcome of prematurityDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2004Line Nadeau PhD Victimization by peers affects 10 to 20% of school children under the age of 12 years. Physical, verbal, and psychological victimization (being pushed, hit, called names, teased, being the target of rumours, theft, extortion) is associated with short- and long-term adjustment problems, such as peer rejection, social withdrawal, low self-esteem, anxiety, loneliness, and depression, as well as academic problems and school drop-out. Research on populations of school children (primary and secondary) has associated victimization with personal risk factors (the victim's characteristics and behaviour) and interpersonal risk factors (social relationships between peers). Studies on the social adjustment of preterm children at school age show that, even in the absence of a major motor or cognitive disability, this population has several personal risk factors associated with victimization. The objective of this study was to compare the level of victimization experienced by a group of 96 seven-year-old children born extremely preterm (EP, <29 weeks of gestation; 49 females) against that experienced by a group of 63 term children (34 females) matched for age and sex, maternal level of education, and family socioeconomic status. The children born EP had a mean gestational age of 27.3 weeks (SD 1.2) and a mean birthweight of 1001.1g (SD 223) and normal birth weight children had a mean gestational age of 39.5 weeks (SD 1.5) and a mean birthweight of 3468.7g (SD 431). Physical and verbal victimization were assessed in a school setting by peers with individual sociometric interviews (Modified Peer Nomination Inventory). After controlling for physical growth (height and weight) at the age of 7 years, the data indicate two independent effects: males were more victimized than females, and children born preterm experienced more verbal victimization by their peers than their term classmates, even when participants with a visible motor, intellectual, or sensory disability were excluded. Several hypotheses are presented to account for the higher incidence of verbal victimization of preterm children. [source] Impact of Scribes on Performance Indicators in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 5 2010Rajiv Arya MD Abstract Objectives:, The objective was to quantify the effect of scribes on three measures of emergency physician (EP) productivity in an adult emergency department (ED). Methods:, For this retrospective study, 243 clinical shifts (of either 10 or 12 hours) worked by 13 EPs during an 18-month period were selected for evaluation. Payroll data sheets were examined to determine whether these shifts were covered, uncovered, or partially covered (for less than 4 hours) by a scribe; partially covered shifts were grouped with uncovered shifts for analysis. Covered shifts were compared to uncovered shifts in a clustered design, by physician. Hierarchical linear models were used to study the association between percentage of patients with which a scribe was used during a shift and EP productivity as measured by patients per hour, relative value units (RVUs) per hour, and turnaround time (TAT) to discharge. Results:, RVUs per hour increased by 0.24 units (95% confidence interval [CI] = 0.10 to 0.38, p = 0.0011) for every 10% increment in scribe usage during a shift. The number of patients per hour increased by 0.08 (95% CI = 0.04 to 0.12, p = 0.0024) for every 10% increment of scribe usage during a shift. TAT was not significantly associated with scribe use. These associations did not lose significance after accounting for physician assistant (PA) use. Conclusions:, In this retrospective study, EP use of a scribe was associated with improved overall productivity as measured by patients treated per hour (Pt/hr) and RVU generated per hour by EPs, but not as measured by TAT to discharge. ACADEMIC EMERGENCY MEDICINE 2010; 17:490,494 © 2010 by the Society for Academic Emergency Medicine [source] Hydrological connectivity in coastal inland systems: lessons from a Neotropical fish metacommunityECOLOGY OF FRESHWATER FISH, Issue 1 2010P. H. M. De Macedo-Soares de Macedo-Soares PHM, Petry AC, Farjalla VF, Caramaschi EP. Hydrological connectivity in coastal inland systems: lessons from a Neotropical fish metacommunity. Ecology of Freshwater Fish 2010: 19: 7,18. © 2009 John Wiley & Sons A/S Abstract,,, We assessed the influence of hydrological connectivity in structuring fish communities through seasonal samplings of environmental variables and fishes in a coastal lagoon and associated pools in the Restinga de Jurubatiba National Park, Brazil. Community structure attributes such as species richness, numerical density and biomass, Shannon,Wiener diversity index and evenness were compared between periods of the lowest and highest hydrological connectivity, while the environmental gradient and fish zonation were explored through ordination techniques. The greater hydrological connectivity established in the rainy season promoted the homogenisation of most environmental variables and fish species, which differed markedly from the arrangement observed in the dry season. Despite variation in fish species composition, community attributes showed non-significant differences between the dry and rainy seasons. The patterns of composition and numerical density in pools were strongly influenced by local factors, especially salinity, dissolved oxygen, total phosphorous concentration and water colour in the dry season, in addition to total nitrogen concentration and depth in the rainy season. Comparable to the role played by flood pulses in river-floodplain systems, the hydrological connectivity in these tropical coastal waterbodies seems to strongly influence fish community structure, and, therefore to determine regional biodiversity. [source] More power to the European Parliament?ECONOMIC POLICY, Issue 35 2002Abdul G. Noury SUMMARY Many observers have expressed scepticism about granting more power to the European Parliament. The sceptics believe that Members of the European Parliament (MEPs) do not vote in a disciplined way and that they vote more often with their country group than with their European Party. Using a unique database consisting of all roll call votes by each individual MEP between 1989 and 1999 (over 6000 votes by over 1000 different MEPs), we show that the sceptics are wrong. Our data shows clearly that MEPs vote more along party lines than along country lines. Party cohesion is comparable to that of the US Congress and is increasing over time whereas country cohesion is low and declining. In short, politics in the European Parliament generally follows the traditional left,right divide that one finds in all European nations. These findings are valid across issues, even on issues like the structural and cohesion funds where one would expect country rather than party cohesion. In votes where the EP has the most power , those held under the so-called co-decision procedure , MEPs participate more and are more party-cohesive. In our opinion, this unique empirical analysis provides grounds for justifying a generalization of the co-decision procedure. [source] Australasian emergency physicians: A learning and educational needs analysis.EMERGENCY MEDICINE AUSTRALASIA, Issue 2 2008Part Three: Participation by FACEM in available CPD: What do they do, do they like it? Abstract Objective: To determine the participation of Emergency Physicians (EP) in currently available continuing professional development opportunities (CPD), their perception of the usefulness of available CPD and their preferred format or method of CPD desired in the future. Method: A mailed survey of Fellows of the Australasian College for Emergency Medicine with 17 Likert type options on educational methods and qualitative analysis grouping volunteered free text responses. Results: The most frequent learning methods reported by EP are on the job contact with other clinicians, formal ED based teaching and reading journals, which were also perceived as useful or very useful learning methods by more than 90% of EP. Less than 15% often or always participate on hospital grand rounds, high fidelity simulation, computer programmes or commercially sponsored events. Increased exposure was desired to high-fidelity simulation center skills training by 58% of respondents with nearly 49% of fellows also wanting more participation in international conferences with around 44% of fellows also wanting more participation in international conferences with around 44% desiring more formal teaching in the ED, more formal feedback on performance, and more meetings with other hospital departments. Over 50% of EP want less or no exposure to commercially sponsored dinners or events. Conclusion: Whilst emergency physicians currently participate in a wide variety of learning methods, the results of this survey suggest EP most appreciate ED based teaching, would like more contact with other departments, along with increased opportunities for simulation based learning and attendance at international conferences. [source] Pattern-reversal Visual Evoked Potentials in Patients with Newly Diagnosed EpilepsyEPILEPSIA, Issue 8 2005Bülent O. Genç Summary:,Purpose: The possible occurence of evoked potential (EP) abnormalities in patients with newly diagnosed epilepsy has been little investigated. The main purpose of the present study was to investigate possible changes in pattern-reversal visual evoked potential (P-VEP) responses in newly diagnosed epilepsy patients. Methods: By using P-VEPs, latency values of the N75 and P100 together with amplitude values of P100 were recorded in newly diagnosed idiopathic epilepsy patients. The patients comprised two groups; nonphotosensitive (non-PS), and photosensitive (PS) patients. Results: Shortened N75 and normal P100 latencies of the P-VEP with higher than normal P100 amplitudes were detected in PS patients. In non-PS patients, N75 latencies of the P-VEPs were unaffected; however, P100 latencies were prolonged, and P100 amplitudes were unchanged. Conclusions: P-VEPs are different from those of controls in previously untreated idiopathic epilepsy patients. Results also indicate different P-VEP features in patients with and without photoparoxysmal responses. The changes might be the result of a disorder of one or more neurotransmitters or subtle morphologic damage such as microdysgenesis. [source] Inclusion Complexes for Use in Room-Temperature Gas-Sensor DesignEUROPEAN JOURNAL OF INORGANIC CHEMISTRY, Issue 33 2007Liwei Mi Abstract The inclusion complex [{Co(bpy)(H2O)4}·(fcds)]n (1), which has been constructed using the guest molecule ferrocene-1,1,-disulfonate (fcds), the bridging ligand 4,4,-bipyridine (bpy) and d7 Co2+, contains an infinite zigzag chain formed by the central CoII ion and the bridging bpy ligand. Guest fcds molecules lie between two adjacent zigzag chains. The highly conjugated structure of complex 1 means that it can be used as a metal-organic semiconductor, and it also shows a high response to liquefied petroleum gas (LPG) and ethanol/petroleum ether (EP) at room temperature. The inclusion complexes [{Co(bpp)2(H2O)2}·(fcds)·4H2O]n [2; bpp = 1,3-bis(4-pyridyl)propane] and [{Zn(bpy)(H2O)4}·(fcds)]n (3), on the other hand, cannot be employed as room-temperature gas sensors because they are insulators. The electrical resistivity of inclusion complex [{Ni(bpy)(H2O)4}·(fcds)]n (4) is 621 M,, whereas that of [{Co(bpy)(H2O)4}SO4·(4-abaH)2·3H2O]n (5) (4-abaH = 4-aminobenzoic acid) is only 137 M,. This means that the semi-conducting properties of such inclusion complexes depend on both the conjugated structure and the central metal ions. Furthermore, conjugated inclusion complexes with an odd number of electrons could be useful for the design of highly selective room-temperature gas sensors.(© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2007) [source] Chemical and Electrochemical Behaviours of a New Phenolato-Bridged Complex [(L)MnIIMnII(L)]2+.EUROPEAN JOURNAL OF INORGANIC CHEMISTRY, Issue 21 2006Dinuclear Mono-µ-Oxido [(L)MnIII(µ-O)MnIII/IV(L)]2+/3+ Species, Pathways to Mononuclear Chlorido [(L)MnII/III/IVCl]0/1/2+ Abstract The X-ray structure of a new dinuclear phenolato-bridged Mn2II complex abbreviated as [(L)MnMn(L)]2+ (1), where LH is the [N4O] phenol containing ligand N,N -bis(2-pyridylmethyl)- N, -salicylidene-ethane-1,2-diamine ligand, is reported. A J value of ,3.3 cm,1 (H = ,J,1·,2) was determined from the magnetic measurements and the 9.4 GHz EPR spectra of both powder and frozen acetonitrile solution samples were analyzed with temperature. The cyclic voltammetry of 1 displays a reversible anodic wave at E1/2 = 0.46 V vs. SCE associated with the two-electron oxidation of 1 yielding the dinuclear Mn2III complex [(L)MnMn(L)]4+ (2). The easy air oxidation of 1 gives the mono-,-oxido Mn2III complex [(L)Mn(, - O)Mn(L)]2+ (3). A rational route to the formation of the mixed-valence Mn2III,IV complex [(L)Mn(, - O)Mn(L)]3+ (4) starting from 1 by bulk electrolysis at EP = 0.75 V vs. SCE in the presence of one equiv. of base per manganese ion is also briefly reported. Addition of chloride ions to 1 led to the cleavage of the phenolato bridges to give the mononuclear MnII complex [(L)MnCl] (5). Cyclic voltammetry of 5 displays two reversible anodic waves at E1/2 = 0.21 and E1/2 = 1.15 V vs. SCE, assigned to the two successive one-electron abstractions giving the MnIII and MnIV species [(L)MnCl]+ (6) and [(L)MnCl]2+ (7), respectively. The electronic signatures from UV/Visible and EPR spectroscopy of the electrochemically prepared samples of 6 and 7 confirmed the respective oxidation states. For instance, 7 displays a broad and intense absorption band characteristic of a phenolato to MnIV charge-transfer transition at 690 nm (2000 M,1,cm,1) and its 9.4 GHz EPR spectrum shows a strong transition at g = 5.2 consistent with a rhombically distorted S = 3/2 system with a zero-field splitting dominating the Zeeman effect. (© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2006) [source] Thinking locally, acting supranationally: Niche party behaviour in the European ParliamentEUROPEAN JOURNAL OF POLITICAL RESEARCH, Issue 2 2010CHRISTIAN B. JENSEN Recent research on the European Parliament (EP) has neglected the idiosyncrasies of niche parties. Similarly, analyses of niche parties have not fully engaged the literature on the EP. This article builds on both literatures by analysing niche party behaviour in the EP as a distinct phenomenon. It is argued that niche parties will respond differently to institutional stimuli than parties more generally. To test this argument, Hix, Noury and Roland's work on EP party voting behaviour is replicated concentrating on niche parties only. It is found that participation in national government and institutional changes affect niche party legislators' voting behaviour, whereas they do not for legislators in the EP overall. These results have important implications for understanding both party behaviour in the EP and niche party behaviour more generally. [source] Fast computation evolutionary programming algorithm for the economic dispatch problemEUROPEAN TRANSACTIONS ON ELECTRICAL POWER, Issue 1 2006P. Somasundaram Abstract This paper essentially aims to propose a new EP based algorithm for solving the ED problem. The ED problem is solved using EP with system lambda as decision variable and power mismatch as fitness function. The algorithm is made fast through judicious modifications in initialization of the parent population, offspring generation and selection of the normal distribution curve. The proposed modifications reduce the search region progressively and generate only effective offsprings. The proposed algorithm is tested on a number of sample systems with quadratic cost function and also on a 10-unit system with piecewise quadratic cost function. The computational results reveal that the proposed algorithm has an excellent convergence characteristic and is superior to other EP based methods in many respects. Copyright © 2005 John Wiley & Sons, Ltd. [source] Transepidermal water loss reflects permeability barrier status: validation in human and rodent in vivo and ex vivo modelsEXPERIMENTAL DERMATOLOGY, Issue 7 2006Joachim W. Fluhr Abstract:, Permeability barrier function is measured with instruments that assess transepidermal water loss (TEWL), either with closed- or open-loop systems. Yet, the validity of TEWL as a measure of barrier status has been questioned recently. Hence, we tested the validity of this measure by comparing TEWL across a wide range of perturbations, with a variety of methods, and in a variety of models. TEWL rates with two closed-chamber systems (VapoMeter and H4300) and one closed-loop system (MEECO) under different experimental in vivo conditions were compared with data from four open-loop instruments, i.e. TM 210, TM 300, DermaLab and EP 1. The instruments were compared in vivo both in humans and hairless mice skin subjected to different degrees of acute barrier disruption. The values obtained with bioengineering systems were correlated with absolute water loss rates, determined gravimetrically. Measurements with both closed and open systems correlated not only with each other, but each method detected different degrees of barrier dysfunction. Although all instruments differentiated among gradations in TEWL in the mid-range of barrier disruption in vivo, differences in very low and very high levels of disruption were less accurately measured with the H4300 and DermaLab systems. Nevertheless, a high Pearson correlation coefficient (r) was calculated for data from all instruments vs. gravimetrically assessed TEWL. Together, these results verify the utility of TEWL as a measure of permeability barrier status. Moreover, all tested instruments are reliable tools for the assessment of variations in permeability barrier function. [source] Robustness of a 3 min all-out cycling test to manipulations of power profile and cadence in humansEXPERIMENTAL PHYSIOLOGY, Issue 3 2008Anni Vanhatalo The purpose of this study was to assess whether end-test power output (EP, synonymous with ,critical power') and the work done above EP (WEP) during a 3 min all-out cycling test against a fixed resistance were affected by the manipulation of cadence or pacing. Nine subjects performed a ramp test followed, in random order, by three cadence trials (in which flywheel resistance was manipulated to achieve end-test cadences which varied by ,20 r.p.m.) and two pacing trials (30 s at 100 or 130% of maximal ramp test power, followed by 2.5 min all-out effort against standard resistance). End-test power output was calculated as the mean power output over the final 30 s and the WEP as the power,time integral over 180 s for each trial. End-test power output was unaffected by reducing cadence below that of the ,standard test' but was reduced by ,10 W on the adoption of a higher cadence [244 ± 41 W for high cadence (at an end-test cadence of 95 ± 7 r.p.m.), 254 ± 40 W for the standard test (at 88 ± 6 r.p.m.) and 251 ± 38 W for low cadence (at 77 ± 5 r.p.m.)]. Pacing over the initial 30 s of the test had no effect on the EP or WEP estimates in comparison with the standard trial. The WEP was significantly higher in the low cadence trial (16.2 ± 4.4 kJ) and lower in the high cadence trial (12.9 ± 3.6 kJ) than in the standard test (14.2 ± 3.7 kJ). Thus, EP is robust to the manipulation of power profile but is reduced by adopting cadences higher than ,standard'. While the WEP is robust to initial pacing applied, it is sensitive to even relatively minor changes in cadence. [source] The European Parliament and the Commission Crisis: A New Assertiveness?GOVERNANCE, Issue 3 2002David Judge This article examines two claims made about the "Commission crisis" of 1999: first, that the accountability of the Commission to the European Parliament (EP) was significantly increased; and, second, that the model of parliamentary government in the European Union (EU) was advanced by events in 1999. In analyzing the crisis and its consequences, this article focuses upon the powers of dismissal and appointment, and what these powers reveal about the capacity of the EP both to hold the Commission responsible for its collective and individual actions and to influence its policy agenda. If a parliamentary model is to develop in the EU, the negative parliamentary powers of censure and dismissal have to be balanced by the positive powers of appointment and enhanced executive responsiveness. On both counts,dismissal and appointment,the 1999 "Commission crisis" did not point to the clear and unambiguous dawning of a "genuine European parliamentary democracy." [source] Co-decision and Inter-Committee Conflict in the European Parliament Post-Amsterdam1GOVERNMENT AND OPPOSITION, Issue 2 2006Charlotte Burns This article makes a two-fold contribution to the European Parliament (EP) literature. First, it challenges the dominant assumption that post-Amsterdam the EP has experienced an increase in its powers. Through analysis of the Socrates case the article shows that the EP is now potentially weaker under the post-Amsterdam co-decision procedure (co-decision II), than it was under the earlier variant, co-decision I. Second, the article uncovers a hitherto overlooked aspect of internal divisions within the parliament, by revealing that there is scope for inter-committee conflict in the EP over budgetary allocations for multi-annual programmes. It is argued that such conflict can weaken the parliament in co-decision negotiations with the council, and that the negotiation of the EU's new multi-annual budgetary framework provides the perfect conditions for such internecine conflict to occur once more. [source] A Case of Hemodialysis Patients with Encapsulating Peritoneal Sclerosis (EPS)-like FindingHEMODIALYSIS INTERNATIONAL, Issue 1 2003H Kawanishi Encapsulating peritoneal sclerosis (EPS) is recognized as a serious complication of peritoneal dialysis (PD). Involvement of the inflammation is indispensable as the EPS emission factor. We experienced the surgery of the EPS-like case that emits it to the hemodialysis (HD) patient without the PD. Patient: In November 1996 the patients, a 47-year old male developed end-stage renal failure due to chronic nephritis and started HD. Before and during HD, he complicated alcohol liver cirrhosis with ascites. In September 2001 he had intestinal obstructive symptoms and recovered with repeated puncture and drainage of ascites. Abdominal CT examination revealed the intestine oppression by the ascites with thick tunic formation. At May 2002, he underwent a laparotomy. Thick capsules formed surroundings to the ascites. This capsules covered parietal peritoneum and intestine surface and oppressed the intestine. The total ablation of small intestine was succeeded. Ascites examinations IL-6 20,350 pg/mL FDP 80 micro-g/mL TAT 1090 micro-g/L, was suspected to conjecture the involvement of inflammation and coagulate-fibrinolysis. Histology of peritoneum showed absence of mesothelium but not fibrosis and sclerosis. Discussion: EPS is caused by the inflammation on the deteriorated peritoneum, resulting in encapsulation after the accumulation of inflammatory products such as fibrin. Even if there is not the peritoneum deterioration, chronic inflammation and stimulation that continues for long-time causing EPS-like findings with encapsulation. The encapsulating ileus findings irrespective of the peritoneum deterioration should call with encapsulated peritonitis (EP). [source] Histomorphometric assessment of bone turnover in uraemic patients: comparison between activation frequency and bone formation rateHISTOPATHOLOGY, Issue 6 2001P Ballanti Histomorphometric assessment of bone turnover in uraemic patients: comparison between activation frequency and bone formation rate Aims:,The histomorphometric assessment of bone formation rate (BFR/BS) in bone biopsies from uraemic patients is of crucial importance in differentiating low from high turnover types of renal osteodystrophy. However, since BFR/BS relies on osteoblasts, activation frequency (Ac.f), encompassing all remodelling phases, has recently been preferred to BFR/BS. This study was carried out to consider whether estimation of Ac.f is superior, in practical terms, to that of BFR/BS in distinguishing between different rates of bone turnover in uraemic patients. Methods and results:,Bone biopsies from 27 patients in predialysis (20 men and seven women; mean age 53 ± 12 years) and 37 in haemodialysis (22 men and 15 women; mean age 53 ± 12 years) were examined. The types of renal osteodystrophy were classified on the basis of morphology. Bone formation rate and Ac.f were evaluated according to standardized procedures. The Ac.f was calculated both as a ratio between BFR/BS and wall thickness (W.Th) and as a reciprocal of erosion, formation and quiescent periods (EP, FP and QP). Patients were affected by renal osteodystrophy with predominant hyperparathyroidism (two predialysis and 16 dialysis), predominant osteomalacia (three predialysis and seven dialysis) or that of advanced (nine predialysis and five dialysis) or mild (seven predialysis and four dialysis) mixed type or adynamic type (six predialysis and five dialysis). Activation frequency, which with either formula requires the measurement of W.Th, i.e. the thickness of bone structural units (BSUs), was not calculated in three dialysis patients with severe hyperparathyroidism and in one predialysis and four dialysis patients with severe osteomalacia, because only incomplete BSUs were found. In dialysis, EP was higher in the adynamic than in the other types of osteodystrophy. During both predialysis and dialysis, FP was higher in osteomalacia than in the other forms of osteodystrophy, and in adynamic osteopathy than in hyperparathyroidism or in advanced and mild mixed osteodystrophy. During predialysis and dialysis, QP was higher in the adynamic than in the other forms of osteodystrophy. Correlations were found between BFR/BS and Ac.f, during predialysis (r=0.97) and dialysis (r=0.95). Conclusions:,The superiority of Ac.f in assessing bone turnover, in comparison to BFR/BS, is conceptual rather than practical. The highest values for FP in osteomalacia and for QP in adynamic bone allow a clearer characterization of these low turnover conditions. [source] Vaccination with xenogeneic tumor endothelial proteins isolated in situ inhibits tumor angiogenesis and spontaneous metastasisINTERNATIONAL JOURNAL OF CANCER, Issue 1 2009Wang Zhang Abstract Angiogenesis is critical for tumor growth and metastasis. Tumor tissues induce the expression of angiogenesis-associated proteins on endothelial surface that can be targeted for tumor immunotherapy. In our study, the rat tumor endothelial proteins (EP) were isolated in situvia biotinylation of tumor vascular endothelial luminal surface followed by streptavidin affinity chromatography. The isolated tumor EP contained numerous up-regulated angiogenesis-associated endothelial proteins. The administration of these tumor EP as a vaccine to mice reduced the microvessel density in subcutaneous primary LLC tumors, delayed spontaneous LLC tumor metastasis and prolonged post-surgery life span. T lymphocytes from tumor EP-vaccinated mice lysed human umbilical vascular endothelial cells, but not tumor cells in vitro, in a dose-dependent manner. Furthermore, adoptive transfer of antitumor EP antibodies in vivo targeted to tumor endothelium and inhibited spontaneous LLC tumor metastasis. This study provides a successful preclinical exploration of the active immunotherapy for tumor by targeting tumor angiogenesis. © 2009 UICC [source] Electroporation-mediated muscarinic M3 receptor gene transfer into rat urinary bladderINTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2004MASAYUKI OTANI Abstract Background: Muscarinic M3 (M3) receptor has been recognized as a major muscarinic receptor for smooth muscle contractions of the urinary bladder. Under the hypothesis that overexpression of M3 receptor in the urinary bladder would enhance urinary bladder contractions, we have transferred the M3 receptor gene into rat bladders using electroporation (EP) and evaluated the functional expression of the transferred gene. Methods: Plasmids expressing luciferase, a green fluorescence protein and M3 receptor were injected into the rat bladder and square-wave electric pulses were immediately applied. Two days after gene transfer, we analyzed gene expression. Immunohistochemical staining was performed and the contractile responses from isolated bladder strips, which were induced KCl, carbachol and electrical field stimulation (EFS), were evaluated. Results: The optimal conditions of electroporation were 8 pulses, 45 voltages, 50 milliseconds/pulses and 1 Hz. Under these conditions, luciferase gene expression was enhanced approximately 300-fold, compared to an injection of DNA only. Regarding immunohistochemistry with an anti-M3 receptor, an increase in immunoactivity was observed in the M3 receptor gene transferred rat bladder, compared to the bladder of the control rat. In rats with the transferred M3 receptor gene, carbachol- and EFS-induced maximum contractile responses of bladder smooth muscle strips significantly increased. Conclusions: These findings suggest that an in vivo EP procedure is an useful method for gene transfer into the bladder and that an overexpression of M3 receptor in the rat bladder enhances bladder contractility. This technique may become a new treatment modality for detrusor underactivity. [source] The Legislative Powers and Impact of the European ParliamentJCMS: JOURNAL OF COMMON MARKET STUDIES, Issue 2 2003Andreas Maurer This article investigates the impact of the legislative powers of the European Parliament (EP), particularly the co-decision procedure. After explaining the development of the legislative procedures, the article analyses the extent to which the different procedures have been used since their creation. It then considers how growing legislative power has affected the EP's internal development, how far the EP has been able to influence EU legislation, and whether EP involvement in legislation has enhanced or impeded the efficiency of the EU legislative process. The article concludes by considering possible areas for further reform of the EP's role in the EU's legislative system. [source] The assessment of the frequency of chews during rumination enables an estimation of rumination activity in hay-fed sheepJOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 3-4 2002M. KASKE The objective was to assess rumination behaviour and, more specifically, the intra-individual and inter-individual variation of the frequency of chews during rumination (per min) in five Blackhead sheep fed hay at a level of 100% maintenance (experimental period [EP] I), 50% maintenance (EP II) and ad libitum (EP III). Animals ruminated in EP II less (416 min/day) than in EP I and III (558 and 592 min/day, respectively). Mean inter-individual coefficents of variation (CV) of frequency (defined as number of chews/duration of chewing per cycle) were 12.5%, mean intra-individual CV were 2.5%. The respective CVs for the duration of rumination per day were 8.1 and 9.7%, respectively. The level of intake influenced the frequency of chews significantly. It is concluded that the frequency of chews has to be considered in studies investigating chewing behaviour of ruminants. Under the experimental conditions investigated, number of chews during rumination per day could be estimated by the frequency of chewing with nearly the same precision as by using the duration of rumination per day. [source] Preparation and sorption studies of ,-cyclodextrin/epichlorohydrin copolymersJOURNAL OF APPLIED POLYMER SCIENCE, Issue 5 2010Dawn Y. Pratt Abstract ,-Cyclodextrin (,-CD) copolymer materials were synthesized by reacting different mole ratios (1 : 15, 1 : 25 and 1 : 35) of ,-CD with epichlorohydrin (EP). The products were characterized using N2 porosimetry, Fourier Transform Infrared spectroscopy, 13C CP-MAS NMR spectroscopy, thermogravimetry analysis, elemental (C and H) analysis, and scanning electron microscopy. The sorption properties in aqueous solution were studied using p-nitrophenol (PNP) with UV,Vis spectrophotometry. Sorption isotherms were obtained at pH 4.6 and three temperatures (22, 35, and 45°C) and at pH 10.3 at 22°C. The isotherms were analyzed using the BET isotherm model and the sorption parameters provided estimates of the surface area, sorption capacity, and isosteric heats of sorption for each polymeric material. The estimated surface areas are as follows: 58.2, 52.1, and 90.1 m2/g at pH 4.6. At pH 10.3, the estimated surface areas are 44.2, 40.5, and 58.5 m2/g, respectively. The removal efficiency of PNP by the polymeric materials ranged between 4.5 and 58% for the conditions investigated whereas the isosteric heats ranged between ,24.5 and ,13.6 kJ/mol. Removal efficiencies were concluded to strongly depend on the sorption conditions such as pH, temperature, and the relative amounts of sorbent and dye in aqueous solution. © 2010 Wiley Periodicals, Inc. J Appl Polym Sci, 2010 [source] Effects of bivalve shell particles of hyriopsis cumingii on the performances of epoxy resin studied by positron annihilationJOURNAL OF APPLIED POLYMER SCIENCE, Issue 6 2008Xudong Sun Abstract Mussel shell particles sized in micrometer level have been prepared with a ball mill. The X-ray powder diffractrometer (XRD) and Fourier transform infrared (FTIR) results proved that the shell particles contained mainly CaCO3 in the form of aragonite, together with small amount of organic phase. EP modified with shell particles showed a much rougher fracture surface than unfilled EP. The mechanical properties have been improved obviously by adding the shell particles in EP from 1% to 5%. The particle would occupy a number of free volume holes of the EP matrix. This would lead to a decrease in the total free volume concentration of the composites. The particles acted as a bridge to make more molecules interconnected for the good interfacial adhesion, resulting in a reduction of the free volume hole size in the interfacial layers. I2 reached its highest value when 3% shell particles were added and then decreased as the shellparticles content increased. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2008 [source] Effects of SiO2 nanoparticles on the performance of carboxyl-randomized liquid butadiene,acrylonitrile rubber modified epoxy nanocompositesJOURNAL OF APPLIED POLYMER SCIENCE, Issue 2 2007Minfeng Zeng Abstract The effects of SiO2 nanoparticles on the performance of carboxyl-randomized liquid butadiene,acrylonitrile rubber (CRBN) modified epoxy resin (EP) nanocomposites were studied. With the addition of an appropriate amount of SiO2 (2%) to EP/CRBN (95/5), the nanocomposites could achieve the desired impact strength and modulus. The morphology of the nanocomposites was studied with scanning electron microscopy and transmission electron microscopy. The nanocomposites showed a three-phase system; both the rubber particles and SiO2 nanoparticles showed uniform dispersions in the EP matrix, with their phases all nanosized. A good correlation between the free-volume hole radius and mechanical properties was found. The introduction of a small amount of nanoparticles (both rubber and SiO2) into EP led to the formation of interactions between the EP and nanoparticles. The interactions restricted the segment motion and the mobilization of the EP chains and then reduced the free-volume concentration in the amorphous region of EP. The fact that the average free-volume hole radius of EP/CRBN was larger than that of pure EP was mainly attributed to the contribution of the larger size of the free-volume holes within the rubber phase. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci 2007 [source] Effect of Establishing Guidelines on Appropriate Urinary Catheter PlacementACADEMIC EMERGENCY MEDICINE, Issue 3 2010Mohamad G. Fakih MD Abstract Objectives:, Avoiding placement of unnecessary urinary catheters (UCs) in the emergency department (ED) affects UC utilization during hospitalization. The authors sought to evaluate the effect of establishing institutional guidelines for appropriate UC placement coupled with emergency physician (EP) education on UC utilization. Methods:, Urinary catheter utilization was measured before and after the establishment of guidelines and EP education. Data collected included the presence of a UC on ED arrival, placement of a UC in the ED, documentation of a physician order for UC placement, reasons for placement, and compliance with the guidelines. Chi-square analyses were used to study the association between pre- and postintervention time periods and catheter use. Results:, A total of 377 (15%) patients had UCs; only 151 (47%) UCs initially placed in the ED had a physician order documented. UC placement was appropriately indicated in 75.5% of patients with a documented physician order, but in only 52% of cases without a documented physician order (p < 0.001). The physician intervention was associated with an overall reduction in UC utilization from 16.4% to 13% (p = 0.018). Physicians ordered 40% fewer UCs postintervention compared to preintervention. Preintervention, a physician order for UC placement was found indicated in 72.6% patients, compared to 82.2% patients with UC placed postintervention (p = 0.21). Conclusions:, Establishing guidelines for UC placement and physician education in the ED were associated with a marked reduction in utilization. However, addressing appropriate UC utilization may require evaluating other factors such as nursing influence on utilization. ACADEMIC EMERGENCY MEDICINE 2010; 17:337,340 © 2010 by the Society for Academic Emergency Medicine [source] Idiopathic Left Ventricular Tachycardia Originating from the Mitral AnnulusJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 10 2005KOJI KUMAGAI M.D. Background: Radiofrequency catheter ablation (RFCA) can eliminate most idiopathic repetitive monomorphic ventricular tachycardias (RMVTs) originating from the right and left ventricular outflow tracts (RVOT, LVOT). Here, we describe the electrophysiological (EP) findings of a new variant of RMVT originating from the mitral annulus (MAVT). Methods and Results: MAVT was identified in 35 patients out of 72 consecutive left ventricular RMVTs from May 2000 to June 2004. All patients underwent an EP study and RFCA. The sites of origin of the MAVT were grouped into four groups according to the successful ablation sites around the mitral annulus. Group I included the anterior sites (n = 11), group II the anterolateral sites (n = 9), group III the lateral sites (n = 6), and group IV the posterior sites (n = 9). The MAVTs were a wide QRS tachycardia with a delta wave-like beginning of the QRS complex. The transitional zone of the R wave occurred between V1-V2 in all cases. The 12-lead electrocardiogram (ECG) pattern might reflect the site of the origin of MAVTs around the mitral annulus. We proposed an algorithm for predicting the site of the focus and the tactics needed for successful RFCA of the MAVT. Conclusions: We described the EP findings of the new variant of RMVT, MAVT. Most MAVTs could be eliminated by RF applications to the endocardial mitral annulus using our proposed tactics. [source] From Genes to Cell Therapy: Molecular Medicine Meets Clinical EPJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 5 2005Ph.D., SILVIA G. PRIORI M.D. No abstract is available for this article. [source] Influence of Gender on Arrhythmia Characteristics and Outcome in the Multicenter UnSustained Tachycardia TrialJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 9 2004ANDREA M. RUSSO M.D. Introduction: Previous studies have demonstrated gender differences in risk of sudden death in patients with ischemic heart disease. The Multicenter UnSustained Tachycardia Trial (MUSTT) evaluated the ability of therapy guided by electrophysiologic (EP) testing to reduce mortality in patients with coronary disease, ejection fraction ,40%, and spontaneous nonsustained ventricular tachycardia. Methods and Results: We analyzed the influence of gender on results of EP testing and outcome of patients enrolled in MUSTT. Women made up 14% of the overall MUSTT population and were less likely than men to have inducible sustained randomizable ventricular arrhythmias (24% vs 36%, P < 0.001). Baseline characteristics differed between men and women. In randomized patients, women were older, more likely to have had an infarction within 6 months, more likely to have a history of heart failure, and more likely to have recent angina prior to enrollment than men (P < 0.05). In the EP-guided therapy group, there was no difference in implantable cardioverter defibrillator implantation rate in men and women (45% vs 53%, P = 0.38). There also were no significant gender influences on risk of arrhythmic death or cardiac arrest (2-year event rate 9% in women and 12% in men, adjusted hazard ratio 0.88) or overall mortality (2-year event rate 32% in women vs 21% in men, adjusted hazard ratio 1.51). Conclusion: The outcome and benefit of EP-guided therapy in this trial did not appear to be influenced by gender. However, due to the small numbers of women in the trial, small differences in outcome may not be apparent. Plans for future primary prevention trials should include careful risk stratification of women who less often have inducible sustained ventricular arrhythmias and better left ventricular function despite more frequent heart failure. [source] Ventricular Flutter Induced During Electrophysiologic Studies in Patients with Old Myocardial Infarction:JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 9 2003Clinical, Electrophysiologic Predictors, Prognostic Significance Introduction: Induction of ventricular flutter during electrophysiologic (EP) studies (similar to that of ventricular fibrillation [VF]) often is viewed as a nonspecific response with limited prognostic significance. However, data supporting this dogma originate from patients without previously documented ventricular tachyarrhythmias. We examined the significance of ventricular flutter in patients with and without spontaneous ventricular arrhythmias. Methods and Results: We conducted a cohort study of all patients with myocardial infarction (MI) undergoing EP studies at our institution. Of 344 consecutive patients, 181 had previously documented spontaneous sustained ventricular arrhythmias, 61 had suspected ventricular arrhythmias, and 102 had neither. Ventricular flutter was induced in 65 (19%) of the patients. Left ventricular ejection fraction was highest among patients with inducible VF (35 ± 13), lowest for patients with inducible sustained monomorphic ventricular tachycardia (SMVT; 27 ± 9), and intermediate for patients with inducible ventricular flutter (30 ± 10). Similarly, the coupling intervals needed to induce the arrhythmia were shortest for VF (200 ± 28 msec), intermediate for ventricular flutter (209 ± 27 msec), and longest for SMVT (230 ± 35 msec). During 5 ± 8 years of follow-up, the risk for ventricular tachycardia/VF was high for patients with SMVT and ventricular flutter and low for patients with inducible VF and noninducible patients (46%, 34%, 17%, and 14%, P < 0.005). Conclusion: Patients with inducible ventricular flutter appear to be "intermediate" between patients with inducible VF and patients with SMVT in terms of clinical and electrophysiologic correlates. However, the prognostic value of inducible ventricular flutter is comparable to that of SMVT. (J Cardiovasc Electrophysiol, Vol. 14, pp. 913-919, September 2003) [source] Effects of Estrogen on Cardiac Electrophysiology in Female MiceJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 3 2002SAMIR SABA M.D. Estrogen and Cardiac Electrophysiology.Introduction: Understanding the molecular mechanisms that underlie gender- and hormonal-related differences in susceptibility to cardiac arrhythmias has been hampered by the lack of a suitable animal model. We examined the effect of hormonal status on the electrophysiologic (EP) properties of the mouse heart in an in vivo, closed chest model. Methods and Results: Fifty-three female C57/J mice aged 10 to 12 weeks were studied. Thirty-six mice underwent bilateral ovariectomies; 18 received estrogen (OVX + E) and 18 received placebo (OVX). Seventeen female mice underwent only sham surgery. All animals underwent in vivo EP studies. Select EP parameters were measured after quinidine treatment. Data were analyzed by a blinded observer. Compared with the intact female mice, the PR and AH intervals were significantly shorter in the OVX mice, and these parameters normalized with estrogen replacement (PR = 45.9 ± 4.5 msec in the intact mice, 42.1 ± 4.3 msec in the OVX group, and 46.9 ± 3.5 msec in the OVX + E group, P < 0.005; AH = 36.5 ± 4.9 msec in the intact mice, 34.4 ± 4.7 msec in the OVX group, and 38.8 ± 2.7 msec in the OVX + E group, P = 0.03). The right ventricular effective refractory period was significantly shorter in the OVX mice versus the intact mice, and this also normalized with estrogen replacement. Hormonal status did not significantly affect any other EP variable, including QT interval. Conclusion: In female mice, estrogen prolongs AV nodal conduction and the right ventricular effective refractory period. Taken together, these data suggest that hormonal status affects aspects of cardiac EP function. Future application of this mouse model will be helpful in determining the molecular pathways that mediate hormonal differences in cardiac EP. [source] | ||||||||||||||||||||||||||||||||||||||||||||||||||||