Atypical Brain Activation of Reading Processes in Children with Developmental Dyslexia.

Brain activation differences of reading-related processes between dyslexic and normal reading children were localized with functional magnetic resonance imaging (MRI). The children performed tasks that varied in visuospatial, orthographic, phonologic, and semantic processing demands. Enhanced activation of the left extrastriate cortex was found during all tasks in the dyslexic group. During orthographic processing, dyslexic children predominantly showed activation in the right prefrontal cortex, as also occurred during the visuo-spatial task. Normal readers also showed activation in the left prefrontal cortex. Dyslexic readers showed less activation of both the temporal and the prefrontal cortex during phonologic processing. The results suggest that dyslexic readers fail to use brain areas that are normally specialized in language processing, but rather use areas that underlie visuospatial processing

Leukocyte Counts, Myeloperoxidase, and Pregnancy-Associated Plasma Protein A as Biomarkers for Cardiovascular Disease: Towards a Multi-Biomarker Approach

We evaluated leukocyte counts and levels of CRP, fibrinogen, MPO, and PAPP-A in patients with stable and unstable angina pectoris, acute myocardial infarction, and healthy controls. All biomarkers were analyzed again after 6 months. Leukocyte counts and concentrations of fibrinogen, CRP, MPO, and PAPP-A were significantly increased in patients with acute myocardial infarction. Leukocyte counts and concentrations of MPO were significantly increased in patients with unstable angina pectoris compared with controls. After 6 months, leukocyte counts and MPO concentrations were still increased in patients with acute myocardial infarction when compared to controls. Discriminant analysis showed that leukocyte counts, MPO, and PAPP-A concentrations classified study group designation for acute coronary events correctly in 83% of the cases. In conclusion, combined assessment of leukocyte counts, MPO, and PAPP-A was able to correctly classify acute coronary events, suggesting that this could be a promising panel for a multibiomarker approach to assess cardiovascular risk

Visualization of Coronary Wall Atherosclerosis in Asymptomatic Subjects and Patients with Coronary Artery Disease Using Magnetic Resonance Imaging

Background: Magnetic resonance imaging (MRI) is sensitive to early atherosclerotic changes such as positive remodeling in patients with coronary artery disease (CAD). We assessed prevalence, quality, and extent of coronary atherosclerosis in a group of healthy subjects compared to patients with confirmed CAD. Methodology: Twenty-two patients with confirmed CAD (15M, 7F, mean age 60.4±10.4 years) and 26 healthy subjects without history of CAD (11M, 15F, mean age 56.1±4.4 years) underwent MRI of the right coronary artery (RCA) and vessel wall (MR-CVW) on a clinical 1.5T MR-scanner. Wall thickness measurements of both groups were compared. Principal Findings: Stenoses of the RCA (both < and ≥50% on CAG) were present in all patients. In 21/22 patients, stenoses detected at MRI corresponded to stenoses detected with conventional angiography. In 19/26 asymptomatic subjects, there was visible luminal narrowing in the MR luminography images. Fourteen of these subjects demonstrated corresponding increase in vessel wall thickness. In 4/26 asymptomatic subjects, vessel wall thickening without luminal narrowing was present. Maximum and mean wall thicknesses in patients were significantly higher (2.16 vs 1.92 mm, and 1.38 vs 1.22 mm, both p<0.05). Conclusions: In this cohort of middle-aged individuals, both patients with stable angina and angiographically proven coronary artery disease, as well as age-matched asymptomatic subjects. exhibited coronary vessel wall thickening detectable with MR coronary vessel wall imaging. Maximum and mean wall thicknesses were significantly higher in patients. The vast majority of asymptomatic subjects had either positive remodeling without luminal narrowing, or non-significant stenosis. Trial registration ClinicalTrials.gov NCT00456950

Association between Carotid Plaque Characteristics and Cerebral White Matter Lesions: One-Year Follow-Up Study by MRI

Objective: To prospectively assess the relation between carotid plaque characteristics and the development of new cerebral white matter lesions (WMLs) at MRI. Methods: Fifty TIA/stroke patients with ipsilateral 30-69% carotid stenosis underwent MRI of the plaque at baseline. Total plaque volume and markers of vulnerability to thromboembolism (lipid-rich necrotic core [LRNC] volume, fibrous cap [FC] status, and presence of intraplaque hemorrhage [IPH]) were assessed. All patients also underwent brain MRI at baseline and after one year. Ipsilateral cerebral WMLs were quantified with a semiautomatic method. Results: Mean WML volume significantly increased over a one-year period (6.52 vs. 6.97 mm3, P = 0.005). WML volume at baseline and WML progression did not significantly differ (P>0.05) between patients with 30-49% and patients with 50-69% stenosis. There was a significant correlation between total plaque volume and baseline ipsilateral WML volume (Spearman ¿ = 0.393, P = 0.005). There was no significant correlation between total plaque volume and ipsilateral WML progression. There were no significant associations between LRNC volume and WML volume at baseline and WML progression. WML volume at baseline and WML progression did not significantly differ between patients with a thick and intact FC and patients with a thin and/or ruptured FC. WML volume at baseline and WML progression also did not significantly differ between patients with and without IPH. Conclusion: The results of this study indicate that carotid plaque burden is significantly associated with WML severity, but that there is no causal relationship between carotid plaque vulnerability and the occurrence of WMLs. © 2011 Kwee et al

Invloed van dagdosering en inhalatiesysteem op therapieontrouw bij astmapatiënten

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The role of motivation in relating green supply chain management to performance

Purpose - Not all companies deal with green supply chain management (GSCM) in the same way. The purpose of this paper is to understand a company's GSCM motivation and how this motivation is linked to stakeholder pressures, a company's GSCM practices and performance. Design/methodology/approach - The authors report the findings of a survey on GSCM motivations. Findings - Clear differences are seen in why companies are motivated to pursue GSCM. Based on these different motivations, this paper explains differences in perceived stakeholder pressure and performance. Research limitations/implications - GSCM motivation is a sensitive topic and as such might cause respondents to provide socially desired answers. However, the analyses show clear variances in the answers, indicating that the measures put forth by the authors are valid. Social implications - This study shows that to achieve sustainable GSCM, companies can be motivated in various ways. Also, stakeholders can learn from this study: they need to focus their attention toward companies whom they have the highest impact on. Originality/value - First, this study tests a framework for GSCM motivations and shows that motivation mediates the relationship between stakeholder pressures and performance. Second, this study shows that these differences in motivation impact performance outcomes

Invloed van dagdosering en inhalatiesysteem op therapieontrouw bij astmapatienten

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