Fourth Paragraph Research Articles

Insomnia and Hypertension

We would like to respond to the 2 letters to the editor,1,2 which were published in SLEEP, August 2009, in regard to our study, “Insomnia with objective short sleep duration is associated with a high risk for hypertension.”3 The objective of our study was to assess the cross-sectional association of two prevalent conditions, i.e., insomnia and hypertension, in a general-population sample. Our study demonstrated a strong and significant association between insomnia with objective short sleep and hypertension. Given the high prevalence of hypertension in the general population, we did not intend to imply that the odds ratio is a reliable estimate of the relative risk for this condition in insomniacs with short sleep, versus the reference group. In less technical terms, our odds ratios indicate that the odds or the likelihood of having hypertension is 5-fold higher in the insomnia–short sleep-duration group versus the control group. Thus, we agree with Sainani et al., that the phrase “a risk for hypertension 500% or 350% higher,” although commonly used, is grammatically incorrect and may lead to misinterpretation. Dr. Krakow suggests that, in our study, we underestimated the severity of obstructive sleep apnea because we used only thermocouple technology. In our study, in contrast with many previous reports, subjects were evaluated for sleep apnea, the prevalence of which was the primary goal of our project, with technology very similar to other large epidemiology cohorts, i.e., Sleep Heart Health Study and Wisconsin cohort. In our analysis, for the association of insomnia with hypertension, we controlled even for mild forms of apnea, i.e., an apnea-hypopnea index of 5 or less, which usually are not treated in most clinical settings. Dr. Krakow also suggests that we did not assess for other forms of the apnea spectrum disorder, such as upper airway resistance syndrome. This syndrome is usually associated with sleep fragmentation but not with apneas or hypopneas based on standard definition. In our study, we controlled for indices of sleep fragmentation, i.e., number of awakenings, number of sleep-stage changes, and percentage of stage 1 sleep, and the results remained significant and strong (see results section, fourth paragraph). Further, the author states that upper airway resistance syndrome occurs more frequently in subjects with short sleep duration. We do not know of any evidence supporting such a claim. However, even if we accept such a claim, how can we explain that the adjusted odds ratio for subjects with short sleep duration, i.e., less than 5 hours, is lowest in those with no sleep complaint (1.13, 95% confidence interval 0.79-1.62), intermediate in those with “poor sleep” (a milder form of insomnia) (2.43, 95% confidence interval 1.36-4.35), and highest in those with chronic insomnia (5.12, 95% confidence interval 2.22-11.79)? This strong dose-response association between the joint effect of insomnia with short sleep duration and hypertension can only be explained by the difference in the severity or chronicity of the insomnia complaint and not by the “underestimation of the severity of sleep apnea” and the lack of detection of upper airway resistance syndrome that should be equally distributed, based on the author's argument, in these 3 groups. Notably, our new study on the same population showed a similar pattern on the association between insomnia–short sleep duration and diabetes.4 The difficulties in treating mild or moderate sleep apnea (apnea-hypopnea index < 30) are well recognized, whereas the effects of current standard treatment, i.e., continuous positive airway pressure, on hypertension in this population are very doubtful, albeit very costly.5,6 Effective treatment for a large group of insomniacs with short sleep duration may be crucial to protect them from the significant cardiometabolic problems associated with this very prevalent disorder.

Erratum to: Analyzing and dating the structure of the Phaistos Disk

The original version of this article unfortunately contains mistakes in the second section concerning the disk sides. The first line in the fourth paragraph should read: The spiral of both sides has 18 boxes with a small but important box on side A right after the 18th box counted from the center. The sixth paragraph should read: This structure is not visible on first glance, e.g., both box groups, the inner spiral and the outer rim, were often identified as one contiguous group, as can be seen in the literature, where the side A’s box names ranged from A01not stopping at A18—to A30; obviously, the short break at A18 is overlooked, and the possibility to identify a Saros cycle is missed.

Recurrent acute biliary pancreatitis: the protective role of cholecystectomy and endoscopic sphincterotomy

1. Table 1 has only two studies comparing recurrent acute biliary pancreatitis (RABP) after cholecystectomy and endoscopic sphinctrotomy (ES).The total number of these patients was 81. Accordingly, the power of the conclusion from these two studies would be low. 2. One of the important points is the time from the acute cholecystitis to the cholecystectomy. A number of patients will experience RABP while they are awaiting cholecystectomy. This study had no time specification, so these vital data have not been explored in the literature, as the authors mentioned. 3. In the fourth paragraph on page 953, the authors said ‘‘an additional cholecystectomy resulted in a lower death rate (7.9 vs. 14.1%).’’ Although there is no doubt about this, we were nevertheless surprised at the high mortality rate of 7.9%. In our experience, the number of patients who experienced RABP after ES and cholecystectomy was negligible, and we reported only one death over the last 10 years with a work load exceeding 2,000 laparoscopic cholecystectomies. 4. The number of patients in each group shows constant variation. The study compares different numbers of patients. For example Hammarstrom et al. [2] compared 49 patients with RABP after ES and 16 patients who had RABP after cholecystectomy. Consequently, it would be difficult to have a sound conclusion from such nonmatched data. 5. Our practice is to perform laparoscopic cholecystectomy at the same admission whether the attack of pancreatitis was mild or severe provided there is no radiologic stigmata of common bile duct stone and the liver function test results are normal. However, for patients who have a recurrent attack of biliary pancreatitis, we certainly perform ES before proceeding with cholecystectomy. If the cholecystectomy was performed previously, the postoperative ES is our choice even if there is no radiologic evidence of common bile duct stones.

Misstated Identity in Gaskell's 'The Old Nurse's Story'

ELIZABETH GASKELL’s ‘The Old Nurse's Story’, already well-known to aficionados of the ghost story, is likely to become the primary work by which Gaskell is known to a much wider audience thanks to its inclusion in recent editions of the Norton Anthology of English Literature and the Broadview Anthology of British Literature, as well as in various collections of Gothic and ghost story literature, such as the Oxford Book of Victorian Ghost Stories. It has not yet been remarked, however, that there is an error of identity in this important story. This error involves matters of lineage and generational relationship, for it mis-states the relationship between Grace Furnivall and the ‘present Lord Furnivall’, a notable mistake given this story's close concern with matters of class and family heritage. The story's present Lord Furnivall (the one who sends Rosamund and her nurse to live in Furnivall Manor) is a grandson of the old Lord Furnivall (he of the ghostly organ playing). We are told that the old Lord had a son who ‘was with the army in America’ (18) and it is this son who is also identified as ‘the present Lord Furnivall's father’. This clearly makes the present Lord Furnivall the grandson of the old Lord Furnivall, yet the Nurse identifies Grace as ‘a great-aunt of my lord's’ (12). It is inescapable that ‘my lord's’ here refers to the present Lord Furnivall, since it is his disposition of Rosamund that the Nurse is discussing when she makes the above reference to Grace Furnivall. This identification unintentionally inserts an additional (non-existent) generation between the present Lord Furnivall and Grace, who as the sister of the present Lord's father would simply be the present Lord's aunt, not his great-aunt. Gaskell herself affirms this when, at the end of the story's fourth paragraph, she writes of the present Lord Furnivall's plan to send Rosamund to live at Furnivall Manor that ‘my lord had thought that it would suit Miss Rosamond very well for a few years, and that her being there might perhaps amuse his old aunt’ (12).

Comment on: Analgesic effects of treatments for non-specific low back pain: a meta-analysis of placebo-controlled randomized trials: reply

SIR, We would like to thank Dr Sweetman for his valuable comments [1] on our meta-analysis [2]. The key message from his letter can be summarized by his comment: ‘Furthermore the best outcome criteria will also depend on the type of back pain and also the type of treatment’ (fourth paragraph, last sentence). While we share Dr Sweetman’s interest in identifying effective interventions for low back pain [3, 4] we feel that his suggestion to use different outcomes for different types of back pain and different types of treatment is not the direction to pursue. As an illustration, let us think of a trial comparing two different treatments for low back pain, which is in fact the most frequently used trial design in back pain research. In a trial like that, measuring outcomes differently in the two groups would ensure that the treatment which provided the best outcomes could not be determined. We would have numbers, but their comparison would be meaningless because they have been measured on different scales. Therefore, we feel that it makes more sense to use a common yardstick when measuring treatment outcomes in clinical trials. Additionally, as highlighted in the discussion of our paper, it is likely that a measure of pain intensity will show larger responses in trials than any other outcome measure regardless of the type of treatment being evaluated [2]. Furthermore, our present understanding (or lack of understanding) on how to identify truly distinguishable subgroups of non-specific low back pain is another important barrier for Dr Sweetman’s suggestion about choosing different outcome measures for different types of back pain. For example, he suggests that the count of painful back movements should be used to identify patients in the back strain subgroup who respond to traction therapy. In our paper, we listed five randomized controlled trials [5–9] reporting conflicting evidence on clinician’s ability to identify subgroups of non-specific low back pain with differential responses to treatment. These findings indicate that research on classification systems and clinical prediction rules developed to identify such subgroups is still in its infancy.

Valutare i fondi interprofessionali per la formazione continua. Il modello Obr Fondimpresa Lombardia

- This article is about a model proposed by OBR Fondimpresa Lombardia for the evaluation of concerted training plan. Usually, in Italy the term "evaluation" is perceived as a negative word which reminds critics and judgment. In this investigation job, which is characterized by a participated and shared process, the meaning of evaluation gains a completely opposite sense: it is meant as a "giving value", as a way to bring into light the different aspects that build the Fondimpresa system, aiming to scout and to create some possible improvement spaces. The article is divided into six sections. First paragraph is about the beginning and the characteristics of inter-professional funds which support life long learning. Second paragraph describes the action plan followed by the promotion and evaluation team (the so-called professionals) of Obr Fondimpresa Lombardia. In the third paragraph shall be disclosed the specifics of the evaluation of the concerted training. In the fourth and fifth paragraph are presented, respectively, the path to building the model for assessing Fondimpresa in Lombardy and the results so far emerged. The last paragraph outline the future prospects of intervention, from a critical analysis of the path taken so far.Key words: evaluation model, evaluation brainstorming, inter-professional funds, education, action researchParole chiave: modello di valutazione, brainstorming valutativo, fondi interprofessionali, formazione, ricerca - intervento

Correction: A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant

Chong, K. & Dhatariya, K. A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant. Nat. Rev. Endocrinol. 5, 285–288 (2009). In the May issue of Nature Reviews Endocrinology, the dosage of erythromycin in the first sentence of the fourth paragraph of The Case section should have read “low-dose erythromycin (0.

Correction

In a recent article,[1][1] a parenthetical sentence in the fourth paragraph of the Interpretation section contained a misplaced percentage and reference citation. It should have read “To obtain this factor, we multiplied Ferrando's estimate by the proportion of induced abortions in Latin America

Governance multilivello e partecipazione politica: una introduzione

- The introduction draws a picture of the link between multi-level governance and transnational social movement. The Authors moves from the description of governance polity as a system of political opportunities to social mobilization, then they describe both local and global dimensions, regarding as a field of conflict and legitimacy. The fourth paragraph develops a comparative analysis on two alternative Europe, the one from above (the institutional building suffering a democratic deficit), the latter from below (the process of collective learning built up by Social Forums). In the end, the last paragraph describes the guidelines of the whole Issue. Keywords: Multilevel Governance; Social Movements; Europe; Globalization; Public Sphere

Correction to [“Meeting Report: Ocean Carbon Cycling and Climate Impacts on Marine Ecosystems”

In the 18 November 2008 issue (Eos, 89(47), 472), a sentence in the fourth paragraph of the meeting report entitled “Ocean Carbon Cycling and Climate Impacts on Marine Ecosystems” was incorrect.

Inspiratory Increases in Systolic Blood Pressure (“Delta-up”) and Pulse Pressure Are Not Equivalent

Inspiratory Increases in Systolic Blood Pressure (“Delta-up”) and Pulse Pressure Are Not Equivalent

Reply to Skoyles: Natural selection does appear to explain some cultural rates of change

With reference to the letter from Skoyles (1), our article (2) tested the hypothesis that those aspects of culture that may affect outcomes of survival and reproduction would evolve at a rate different from that of those that will not. We showed that, in the case of functional versus symbolic design traits for oceanic canoes, the former evolved more slowly. This is a commonly accepted signal of negative (purifying) selection for genetic evolution and when interpreting the fossil record. Although it does not prove that natural selection was at work, it certainly supports that inference. We do not attribute rates of symbolic trait evolution to positive natural selection; we explicitly rule out this possibility in the fourth paragraph of our article. We propose instead that symbolic traits may be subject to cultural selection—a different process.

Erratum: Improved nanofabrication through guided transient liquefaction

Nature Nanotechnology 3, 295–300 (2008) There was an error in the fourth paragraph of the section “Applying SPEL to metals and semiconductors”. The first sentence should read: “In guided-SPEL, local spacers are used to keep a plate fixed above the nanostructures (Fig. 1), and the molten nanostructures rise up against surface tension until they reach the plate.

Correction: Resisting Immune Exhaustion in HIV-1 Infection

Correction for: Rowland-Jones S, de Silva T (2008) Resisting immune exhaustion in HIV-1 infection. PLoS Med 5(5): e103. doi:10.1371/journal.pmed.0050103 In the fourth paragraph of the section entitled “Can Early ART Affect Risk of Future Disease Progression?”, the text that reads “25% of treated patients remained aviraemic (more than 50 copies/ml)” should be replaced with “25% of treated patients remained aviraemic (less than 50 copies/ml)”.

Kamma and Forgiveness with some Thoughts on Cambodia

AbstractIn this article, I give some notes on kamma and forgiveness. The doctrines of kamma and forgiveness or grace are central notions in Buddhism and Christianity, and contrary to what looks different at first sight, they may show similarities in terms of 'salvation'. In the first paragraph, I explain, to a very limited extent, the concept of kamma in Theravada Buddhist tradition. In the second paragraph, I maintain that comparing kamma and grace is not correct, but that a comparison between meditation and grace could be more promising. In the third paragraph, narratives from the Pali canon illustrate Buddhist notions that show similarity to forgiveness. The possibility of a royal pardon is the theme of the fourth paragraph. The last paragraph hints at the possible relevance of the thoughts developed in this article for the Khmer Rouge Tribunal and gives some additional food for further thinking.

Why does electron sharing lead to covalent bonding? A variational analysis

Please note the following corrections to the above article: Page 391, left column, line 10 from the bottom: “(1810)” should read “(1811)”. Page 392, left column, line 9: The comma after the first word should be deleted. Page 403, right column, equation (4.19b): The entire expression should be preceded by an equal sign “=”. Page 404, right column, last word before equation (4.21): The word “orbit.” should be replaced by “orbital”. Page 406, right column, third paragraph, lines 9 and 10: The text “lags behind… . .atomic functional.” should be in italic font. Page 407, left column, line before equation (4.29): “x, y and z” should read “x and y”. Page 407, left column, third paragraph: The last word in this paragraph (“bitter”) should be capitalized. Page 408, right column, fourth paragraph, line 4: Between the words “additional influences.” and the words “In general, too”, the following sentence should be inserted: “This expectation has in fact been confirmed through the momentum density studies of a series of diatomic molecules by Rozendahl and Baerends.42” Page 408, right column, last paragraph: Add the following sentence to the Acknowledgments: “The present work was supported by the Division of Chemical Sciences, Office of Basic Energy Sciences, U.S. Department of Energy under Contract No. W-7405-Eng-82 with Iowa State University through the Ames Laboratory.”

Correction

HomeCirculationVol. 115, No. 10Correction Free AccessCorrectionPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessCorrectionPDF/EPUBCorrection Originally published13 Mar 2007https://doi.org/10.1161/CIRCULATIONAHA.107.181837Circulation. 2007;115:e324This article corrects the followingCarotid Intima-Media Thickness Is Associated With Premature Parental Coronary Heart DiseaseThe article, “Carotid Intima-Media Thickness Is Associated With Premature Parental Coronary Heart Disease: The Framingham Heart Study” by Wang et al that appeared in the August 5, 2003, issue (Circulation. 2003;108:572–576) contained an error. Because of a programming error, the age cutoff used to define premature coronary heart disease was 70 years, rather than 60 years as stated in the Methods (fourth paragraph) and the title of Table 2. The corrected title for Table 2 should read, “Table 2: Mean Internal Carotid IMT in mm (Standard Error), by Parental Premature (Age <70) CHD Status.”If age 60 years is used rather than 70 years, the results do not change in men (age-adjusted internal carotid intima-media thickness [IMT] in those with versus without premature parental coronary heart disease [CHD], 1.17 vs. 1.05 mm, P=0.003) but are slightly attenuated in women (age-adjusted internal carotid IMT in those with versus without premature parental CHD, 0.92 vs. 0.86 mm, P=0.13).The authors regret this error and any confusion it may have caused. Previous Back to top Next FiguresReferencesRelatedDetailsRelated articlesCarotid Intima-Media Thickness Is Associated With Premature Parental Coronary Heart DiseaseThomas J. Wang, et al. Circulation. 2003;108:572-576 March 13, 2007Vol 115, Issue 10 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCULATIONAHA.107.181837 Originally publishedMarch 13, 2007 PDF download Advertisement

Condiciones de vida, socializaci&amp;#243;n y actividad f&amp;#237;sica en la vejez

The present article approaches the relations between the conditions of life and the processes of socialization with the practice of physical activity in the oldness. After checking the literature on the Socialization and the conditions of life in the Social Modern Theories and of the specific investigations in Socialization and Physical Activity, there appears the methodological design of the effected survey. In the third and fourth paragraph there are exposed and discuss the obtained results, which seem to indicate the existence of significant relations between the conditions of life, the processes of socialization and the physical activity of the older studied

Erratum: "The Effects of Metallicity and Grain Size on Gravitational Instabilities in Protoplanetary Disks" ([URL ADDRESS="/cgi-bin/resolve?2006ApJ...636L.149C" STATUS="OKAY"]ApJ 636, L149 [2006][/URL

We have found that the total cumulative radiative energy losses shown in Figure 2 of the above-mentioned Letter were computed for only half the disk. This caused the final global cooling times tcool in the eighth column of the original Table 1 to be too large by a factor of 2. Proper values of tcool are given in the revised Table 1 below. To be more consistent with what the Letter states, we now use instantaneous values for both the total internal energy and the final total net cooling rates to compute final tcool’s, instead of averaging the loss rates over an interval of time at the end of the calculations before dividing, as was done in the Letter. We also take this opportunity to make a few other inconsequential corrections to the fourth column of the table. In addition to the changes to Table 1, the approximate initial tcool relation in the fourth paragraph of § 3.2 becomes to within tens t ∼ Z/Z cool , of percent. Despite the corrections, our conclusions in the Letter remain unchanged. Most importantly, the final tcool’s vary with metallicity and are still too long for disk fragmentation to occur with our equation of state over the range of Z examined. We regret any inconvenience our errors may have caused.

Corrigendum

CORRIGENDACorrigendumPublished Online:01 May 2006https://doi.org/10.1152/ajpcell.00054.2006Original articleMoreSectionsPDF (39 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations Volume 290, February 2006 Volume 59, February 2006 Pages C539–C553. Zhou J, Yi J, Royer L, Launikonis BS, González A, García J, and Ríos E. “A probable role of dihydropyridine receptors in repression of Ca2+ sparks demonstrated in cultured mammalian muscle” ( http://ajpcell.physiology.org/cgi/content/full/290/2/C539; doi:10.1152/ajpcell.00592.2004). In the article by Zhou et al., several items were incorrectly presented. The following sentences show how the these items should have appeared in the online and print version. The correct items are underlined here for emphasis.introduction: The fourth paragraph should begin with “According to Felder and Franzini-Armstrong (17), βRyRs form separate arrays of channels, placed parajunctionally, on the sides of the triadic junction.”discussion: In the subsection titled DHPRs are necessary for basal suppression of Ca2+ sparks, the fourth paragraph should begin with “In an attempt to compare wild-type and mdg cells under similar conditions of load, the normal myotubes were imaged in high Ca2+, with the addition of 50 μM nifedipine to block Ca2+ entry through L-type Ca2+ channels.”Also in the discussion, the legend to Figure 10 should begin with “The evolution of SR luminal Ca2+]. A: image F33 of rhod-2 fluorescence in anmdgculture dish, 1 min after being immersed in permeabilizing solution.”This article has no references to display. Download PDF Previous Back to Top FiguresReferencesRelatedInformation Related ArticlesA probable role of dihydropyridine receptors in repression of Ca2+ sparks demonstrated in cultured mammalian muscle 01 Feb 2006American Journal of Physiology-Cell Physiology More from this issue > Volume 290Issue 5May 2006Pages C1459-C1459 Copyright & PermissionsCopyright © 2006 the American Physiological Societyhttps://doi.org/10.1152/ajpcell.00054.2006History Published online 1 May 2006 Published in print 1 May 2006 Metrics