G R 1322/2006) The area is also characterized in great part (∼5

G.R. 1322/2006). The area is also characterized in great part (∼50%) by soils with a high runoff potential (C/D according to the USDA Hydrological Group definition), that in natural condition would have a high water table, but that are drained to keep the seasonal high water table at least 60 cm below the surface. Due to the geomorphic settings, with slopes almost equal to zero and lands below sea level, and due to the settings of the Selleckchem KRX0401 drainage system, this floodplain presents numerous

areas at flooding risk. The local authorities underline how, aside from the risk connected to the main rivers, the major concerns derive mainly from failures of the agricultural ditch network that often results unsufficient to drain rather frequent rainfall events that are not necessarily associated with extreme meteorological condition (Piani Territoriali di Coordinamento Provinciale, 2009). The study site was C59 wnt selected as representative of the land-use

changes that the Veneto floodplain faced during the last half-century (Fig. 3a and b), and of the above mentioned hydro-geomorphological conditions that characterize the Padova province (Fig. 3c–e). The area was deemed critical because here the local authorities often suspend the operations of the water pumps, with the consequent flooding of the territories (Salvan, 2013). The problems have been underlined also by local witnesses and authorities that described the more frequent flood events as being mainly caused by the failures of the minor drainage system, that is

not able to properly drain the incoming rainfall, rather than by the collapsing of the major river system. The study area was also selected because of the availability of different types of data coming from official sources: (1) Historical images of the years 1954, 1981 and 2006; (2) Historical rainfall datasets retrieved from a nearby station (Este) starting from the 1950s; (3) A lidar DTM at 1 m resolution, with a horizontal accuracy selleck chemicals of about ±0.3 m, and a vertical accuracy of ±0.15 m (RMSE estimated using DGPS ground truth control points). For the purpose of this work, we divided the study area in sub-areas of 0.25 km2. This, to speed up the computation time and, at the same time, to provide spatially distributed measures. For the year 1954 and 1981, we based the analysis on the available historical images, and by manual interpretation of the images we identified the drainage network system. In order to avoid as much as possible misleading identifications, local authorities, such as the Adige-Euganeo Land Reclamation Consortium, and local farmers were interviewed, to validate the network maps. For the evaluation of the storage capacity, we estimated the network widths by interviewing local authorities and landowners. We generally found that this information is lacking, and we were able to collect only some indications on a range of average section widths for the whole area (∼0.

, 2013 and Pellissier et al , 2013) These processes have been ex

, 2013 and Pellissier et al., 2013). These processes have been exacerbated as a consequence of the abandonment of agricultural and pastoral activities (Piussi and Farrell, 2000, Chauchard et al., 2007 and Zimmermann et al., 2010) and changes in traditional fire uses (Borghesio, 2009, Ascoli and Bovio, 2010, Conedera and Krebs, 2010 and Pellissier Autophagy signaling inhibitors et al., 2013), combined with intensified tourism pressure (Arndt et al., 2013). Many studies show how land-use abandonment and the following tree and shrub encroachment have negative consequences on biodiversity maintenance in the Alps, e.g., Laiolo et al. (2004), Fischer et al. (2008), Cocca et al. (2012), Dainese and Poldini (2012).

Under the second fire regime conditions, landscape opening favoured the creation of new habitats and niches with an increase in plant species richness (Carcaillet, 1998, Tinner et al., 1999, Colombaroli et al., 2010 and Berthel et al., 2012) and evenness, e.g., less dominant taxa (Colombaroli

et al., 2013). Such positive effects of fire on taxonomic and functional diversity are usually highest at intermediate fire disturbance level for both the plant (Delarze et al., 1992, Tinner et al., 2000, Beghin et al., 2010, Ascoli et al., 2013a and Vacchiano et al., 2014a) and invertebrate community (Moretti et al., 2004, Querner et al., 2010 and Wohlgemuth et al., 2010). In some cases fire favours the maintenance of habitats suitable for endangered click here SPTLC1 communities (Borghesio, 2009) or rare species (Moretti et al., 2006, Wohlgemuth et al., 2010 and Lonati et al., 2013). However, prolonged and frequent fire disturbance can lead to floristic impoverishment.

On the fire-prone southern slopes of the Alps the high frequency of anthropogenic ignitions during the second fire epoch (see also Fig. 2 and Fig. 3 for details) caused a strong decrease or even the local extinction at low altitudes of several forest taxa such as Abies alba, Tilia spp, Fraxinus excelsior and Ulmus spp. ( Tinner et al., 1999, Favilli et al., 2010 and Kaltenrieder et al., 2010) and animal communities, e.g., Blant et al. (2010). In recent times however, opening through fire results also in an increased susceptibility of the burnt ecosystems towards the colonization of invasive alien species ( Grund et al., 2005, Lonati et al., 2009 and Maringer et al., 2012) or animal communities, e.g., Lyet et al. (2009) and Blant et al. (2010). Similar to what is reported for the Mediterranean ( Arianoutsou and Vilà, 2012) or other fire prone ecosystems ( Franklin, 2010 and Monty et al., 2013), also in the Alpine environments fire may represent an unrequested spread channel for alien invasive species with pioneer character, what reinforce the selective pressure of fire in favour of disturbance adapted species of both native ( Delarze et al., 1992; Tinner et al., 2000 and Moser et al., 2010) and alien origin ( Lonati et al., 2009 and Maringer et al., 2012) ( Fig. 7).

The Kinh were mainly involved in administration, tourism, and edu

The Kinh were mainly involved in administration, tourism, and education and settled in the district’s capital, while selleckchem most of the other ethnic groups practiced different types of subsistence agriculture mostly in the form of shifting

cultivation (Tugault-Lafleur, 2007). Apart from the shifting cultivation, ethnic minorities also used to cultivate opium and collect forest products for their survival (Michaud and Turner, 2000, Sowerwine, 2004b and Turner, 2012), which could have contributed to past forest clearance. Today, the ethnic groups cultivate water rice on permanent terraced paddy fields; maize and other crops on upland fields (Leisz et al., 2004 and Turner, 2011). Terraced paddy fields were first introduced by the Hmong and Yao who migrated from southern China to northern Vietnam during the late 19th and early

20th centuries (Michaud, 1997). Additionally, many households cultivate cardamom (Amomum aromaticum) under forest cover as a substitute cash crop, after the ban on opium in 1992 ( Tugault-Lafleur and Turner, 2009 and Turner, 2011). Because of its scenic landscape and presence of five ethnic groups with their traditional way of living, Sa Pa is considered as one of the most attractive tourism areas in Vietnam. The Hoang Lien Mountains MDV3100 cost comprise probably the last remnants of native forest of the northern Vietnamese highlands. It became one of the first areas recognized as a ‘special use forest’ in Vietnam, and it was converted into the Hoang Lien National Park (HLNP) in July 2002 following the Prime Minister’s Decision 90/2002/QD-TTg to protect biodiversity by preserving the subtropical and temperate forest ecosystems (Le, 2004 and Jadin et al., 2013). Already under the French Regime (1887–1940), Sa Pa district was a well-known holiday and relaxation resort (Michaud and Turner, 2006). Northern Vietnam suffered a lot under Unoprostone the first Indochina war (1945–1954). The town sunk into oblivion, as a large part of the population of Sa Pa town fled

away from the hostilities. In the early 1960s, in the framework of the New Economic Zones Policy, migration schemes were designed by the new socialist regime that stimulated the Vietnamese Kinh from the lowlands to populate the northern Vietnamese Highlands (Hardy, 2005). The decision of the national government to open Sa Pa district for international tourism in 1993 had a large impact on daily life in Sa Pa town and its surrounding communities. The number of domestic and international visitors increased exponentially from 16,100 in 1995 to 405,000 in 2009 (GSO, 1995 and GSO, 2010) (Fig. 1). Tourism is now the most important economic activity in the area, and it generated 58% of Sa Pa district’s GDP in 2010 (GSO, 2010). The poverty rate in Sa Pa district decreased gradually from 36% in 2000 to 21% in 2009 (GSO, 2000 and GSO, 2010).

Goblet cells are the main mucus-producing cell type within the ai

Goblet cells are the main mucus-producing cell type within the airway epithelium and goblet cell hyperplasia is a common pathology

of asthma [7]. IL-13 has been implicated as a key pathogenic cytokine in allergic asthma and Kondo and colleagues have suggested that it contributes to the differentiation of ciliated cells into goblet cells in asthmatic epithelium [8] and [9]. In addition it has been previously reported that both paediatric and adult epithelium exposed to IL-13 expressed increased goblet cell number and levels of MUC5AC, the major mucus forming mucin, in both healthy and asthmatic epithelium [10], [11], [12], [13] and [14]. IL-13 has been studied in detail using a number of Venetoclax solubility dmso different models in an attempt to re-create the asthmatic phenotype. Early

studies included experiments using mice sensitised with ovalbumin, which then receive see more a further allergic ‘hit’ resulting in an increase in MUC5AC expression and goblet cell number [15] and [16]. The effects of IL-13 have also been assessed using in vitro adult normal human bronchial epithelial cell cultures and it has been shown to increase goblet cell density by ten times as well as increasing MUC5AC expression, indicating a central role for IL-13 in allergic asthma [17]. IL-31 is produced by activated CD4+ T cells, mainly from the Th2 subset [6] and may work synergistically with IL-13 to modulate bronchial epithelial cell function. IL-31 over-expression has been well documented as having pathogenic effects in atopic dermatitis (AD) including skin inflammation, pruritis and severe dermatitis [6] and [18] and IL-31 levels in serum or at mRNA level may be a valuable indicator of allergic asthma [19]. IL-31 is known to act through a hetero-dimeric Chlormezanone receptor composed of IL-31 receptor A (IL-31RA) and oncostatin M receptor (OSMR), which has been shown to activate signal transducer and activator of transcription factor 3 (STAT-3) in alveolar epithelial cells transfected with IL-31-RA, a pathway shared

by IL-9 which has also been implicated in goblet cell hyperplasia and airways remodelling [20], [21] and [22]. IL-31 activates STAT-1 and STAT-5 to a lesser extent [23] and [24], a similarity shared with IL-9. IL-31 has been shown to significantly increase epidermal growth factor (EGF) in a transformed human bronchial epithelial cell line which is linked with up-regulation of mucin transcription [25] and [26]. Human bronchial epithelial cells have been shown to express IL-31-RA and are thought to be direct targets for IL-31 [20]. It is important therefore to study IL-31 further, in a human paediatric epithelial cell model [27] to identify its effect on paediatric airways.

More in-depth information and a review of evidence for each recom

More in-depth information and a review of evidence for each recommendation can be found in the complete recommended practices (RP) document.5 The new “Recommended practices for sharps safety” supersedes the “AORN guidance statement: Sharps injury prevention in the perioperative setting,”6 developed in 2005. The intent of the guidance statement was to assist perioperative RNs in developing sharps injury prevention programs and overcoming obstacles to compliance with the suggested

and mandated practices. Federal regulations and strong research evidence provided support for a stronger position on sharps safety, so the RP document was developed to replace the guidance statement. Although many of the responsibilities and risk-reduction strategies from the guidance statement have been carried over into the RP document, the new PD98059 document provides the format of recommendations followed by evidence-based

rationales, evidence-rated intervention statements, and supporting UMI-77 activity statements. The evidence supporting the recommendations is derived from regulatory controls, randomized controlled trials, and Cochrane systematic reviews. Approximately 500,000 health care workers each year experience percutaneous injuries.3 and 7 Percutaneous injuries are associated with occupational transmission of hepatitis B virus, hepatitis C virus, and HIV, which can result in lifelong health concerns.4 Percutaneous injuries also present a risk to patients; a health care provider who is infected with a bloodborne pathogen and who then receives a percutaneous injury can inadvertently infect Rebamipide a patient through contact with the contaminated sharp or contact with the health care provider’s blood through an unnoticed glove perforation. Between 1991 and 2005, 132 cases of health care provider-to-patient transmission of hepatitis B, hepatitis C, or HIV were documented.8 Anyone who has experienced an occupational exposure to bloodborne pathogens knows the emotional burden of fear, worry, and concern that follows, which may be far greater than the actual physical injury. The real or potential

economic burdens also can cause additional stress. Costs to the health care worker are any expenses incurred because of missed work days. Potential economic burdens include the inability to continue working because of an illness that results from the occupational exposure. Costs to the employer include the postexposure management, the laboratory tests and follow-up testing, and any necessary prophylaxis, as well as loss of productivity of the health care worker. The annual cost of percutaneous sharps injuries has been estimated at $65 million.9 The cost for a health care facility to manage an occupational exposure can range from $71 to $4,838 per exposure.10 Two significant pieces of legislation, the Bloodborne Pathogens Standard 29 CFR §1910.

1 and 2) There were no external compression or emphysema Bronch

1 and 2). There were no external compression or emphysema. Bronchoscopy revealed a generally swollen and inflamed mucosa with visually poorly defined tracheal and bronchial cartilage

in both patients. There was a fixed airway narrowing affecting the trachea and main bronchi, with no apparent dynamic changes throughout the respiratory cycle. After a period of medical treatment, repeated bronchoscopy showed reduced inflammatory changes but was otherwise similar. There was no growth of mycobacteria, other bacteria or vira in lavage fluid from the airways. Bronchial biopsies revealed chronic unspecific inflammation. There were no signs of granulomatous inflammation, vasculitis or amyloidosis in a Congo red staining. Unfortunately there was no cartilage in the bronchial biopsies. Additional biopsies from auricular cartilage, SCH772984 solubility dmso conchae and costosternal cartilage were normal. All biopsies Buparlisib mw obtained from the siblings were compared, and deemed identical. Electron microscopic evaluation of the biopsies has not been performed. We have not performed biopsies of subcutaneous fat or rectal mucosa. Positron-emission

tomography of patient no 2 whilst receiving both cyclophosphamide and prednisolon, did not show any activity in trachea, bronchi or lung parenchyma. CT of the sinuses were normal apart from minor edema in the right maxillar sinus of patient no 2. Serologic testing was negative for CMV and Mycoplasma pneumoniae, Bordetella pertussis, ANA, ANCA and RF. Skin testing for aspergillus was negative, and the total IgE was normal. Renal function was normal, and there was no proteinuria or signs of nephritis. Serum-electrophoresis showed non-specific inflammation.

Both patients have received immunosuppressive therapy with prednisolone, AZD9291 manufacturer and cyclophosphamide was added. Patient no 1 received azithromycin as immunomodulation, and patient no 2 has received azathioprine, without any effect on symptoms. They also received inhalations with budesonide/formoterol, salbutamol and ipratriopium bromide ad libitum, with uncertain effect. Initially the condition deteriorated for both patients with progressive worsening of symptoms, inspiratory stridor and declining spirometric values. The condition of patient no 1 has been stable during the last two years with FVC 2.8 l (63%) and FEV1 0.9 l (26%). Cyclophosphamide has been replaced by azathioprine, and he still receives prednisolone and azathioprine, 5 years after the initial presentation. The rapid deterioration of patient no 2 was initially halted when treatment was instituted. After a time she progressed, though, and eventually received rituximab, without any significant effect. There is, however, still a minor effect of large doses of steroids. She still suffers from considerable obstruction of the central airways, resembling what is seen in patient no 1, her latest spirometry values being FVC 2.7 l (83%), FEV1 0.8 l (29%) (Fig. 3).

6%, agreeing with the results reported by Manda et al (2009), wh

6%, agreeing with the results reported by Manda et al. (2009), which amounted to 91%. In coffee, a fermented product similar to cocoa, the reduction reported by Ferraz et al. (2010) ranged from 8.2% to 98.9%, according PD0332991 purchase to the time and

temperature of exposure. In wheat the variation observed was between 2% and 94% (Boudra et al., 1995). In general, the cocoa processing steps can reduce ochratoxin A contamination by destroying the molecule, as occurs in thermal treatments such as roasting; physically removing the contamination, as observed during shelling; or diluting the concentration, by adding other non-contaminated ingredients. They will therefore influence the contamination found in the finished products. Because the cocoa processing is not capable of eliminating all the ochratoxin A coming with the raw material, the best protection would be to prevent toxin formation in the cocoa producing chain. Consequently, the lower the initial contamination selleck inhibitor of cocoa beans the safer the manufactured chocolate will be. If the amounts of ochratoxin A found in cocoa by-products is considered and the usually low amounts of these products employed in the formulation of chocolate

powders, cakes, biscuits and similar products, it is concluded that cocoa does not represent a major source of ochratoxin A in the diet. However, one concern is the fact that chocolate-containing products are widely consumed by children who are more sensitive to the effects of mycotoxins. Thus, it is important that constant monitoring next should be carried

out of their occurrence and also to find ways to prevent the contamination in the cocoa production chain. “
“Mycotoxins are toxic contaminants produced by fungi via their secondary metabolism. Despite efforts to control fungal contamination, toxigenic fungi are ubiquitous in nature and occur worldwide in food supplies due to mould infestation of susceptible agricultural products, such as cereal grains, nuts and fruits. The natural fungal flora associated with foods is dominated by the Aspergillus, Fusarium, and Penicillium species ( Murphy, Hendrich, Landgren, & Bryant, 2006). Aflatoxins (AFs) are potent mycotoxins produced by some strains of Aspergillus flavus, Aspergillus parasiticus and Aspergillus nomius. These fungal metabolites induce mutagenic, teratogenic and carcinogenic effects ( Rustom, 1997). Aflatoxins may contaminate many crops, including peanuts, corn, cottonseed, pistachios and other nuts, with widespread contamination in hot and humid regions of the world ( Murphy et al., 2006). Aflatoxin B1 (AFB1) is the most toxic for mammals and induces cell injury, free radical liberation and lipid peroxidation. AFB1 is metabolised by the liver through the cytochrome P450 enzyme system to generate the major carcinogenic metabolite AFB1-8,9-epoxide or other less mutagenic forms ( Biehl and Buck, 1987 and Murphy et al., 2006).

This table shows 30 out of 49 attributes were found to be signifi

This table shows 30 out of 49 attributes were found to be significantly different (3 nearly significantly different) between the four samples. A highly significant effect of assessor for all attributes was also found. This suggested that the assessors were using the scales differently;

however, only a few attributes (mainly after-effects attributes) had a significant assessor × sample interaction, thus indicating that the assessors were ranking the samples in a similar way. As shown in Table 3, sweet aroma, floral aroma and honey aroma were found to be significantly higher in mMSL, hence confirming the GC–MS Rigosertib results, where the levels of esters (acetates and non-acetate esters) were higher in these samples. These attributes were highly positively correlated with the sum of acetate and non-acetate esters, having correlation coefficients of more than 0.8 (data

not shown). Brown orchard fruit aroma was also significantly higher in mMSL fruit. On the contrary, green and cucumber odour and taste/flavour attributes were scored significantly higher in iMSL fruit followed by iLSL fruit. This is also confirmed by both the GC-O and the GC–MS results which showed (Z)-6-nonenal (cucumber) was significantly higher in the immature check details fruit of both genotypes. Sweet and syrupy taste/flavour, as well as sweet aftertaste, were significantly higher in both maturity stages of LSL genotype and in mMSL fruit. This also agrees with the results for sucrose (Table 1). Principal component analysis was carried out on the correlation matrix of all samples and all attributes (Fig. 2). The difference in maturity stage was the predominant distinguishing factor in the sensory analysis, with principal component 1 separating the immature from mature MSL fruit and principal component 2 separating the immature from the mature LSL and MSL fruits.

Desirable sweet (o01), floral (o02), honey (o03), strawberries (o04) and ripe tropical fruit (o12) odour attributes, as well as floral (tf06), honey (tf07), strawberries (tf09) and ripe tropical fruit (tf19) taste/flavour attributes were associated with the mMSL fruit. On the other hand, cucumber odour (o07), cucumber taste/flavour (tf12), green odour Epothilone B (EPO906, Patupilone) (o08), green taste/flavour (tf13), acidic taste (tf04) and aftertaste (ae04), and savoury taste/flavour (tf02) were highly correlated with the iMSL fruit. Regarding the LSL genotype, earthy (o09-tf16) and musty (o10-tf17) odour and taste/flavour, and salty (tf03) taste/flavour attributes were associated with the iLSL fruit, whereas taste/flavour attributes like sweet (tf01), syrupy (tf08), brown orchard fruit (tf18), as well as sweet (ae01) aftertaste, were associated with the mLSL fruit. Similar results were reported by Beaulieu et al. (2004) who studied the effect of harvest maturity on the sensory characteristics of fresh-cut cantaloupe.

The total terpene concentrations in the musts treated with GO wer

The total terpene concentrations in the musts treated with GO were even lower than that of the controls, an explanation click here for this could be the absorption of volatile compounds on hydrophobic regions of the protein. In contrast to the experiments described in Section 3.1, only low enzyme concentrations were used in these vinification experiments, causing an expectedly low release of terpenes. Nevertheless, with increasing dose of GO the

total terpene concentrations increased as well, suggesting that GO was not completely inactive, although the detected changes were at a low level (see Table 5 and Fig. S3). Interestingly, both samples treated with GO/AO and AO displayed terpene concentrations equal to those of the controls. In tests with the Traminer extract, it was shown that AO could release only low levels of terpenes compared to the control without the presence of the glucosidase (21 ppm total compared to the controls). Considering the fact that it was

reported that grape glucosidases mainly hydrolyse primary terpenols ( Maicas & Mateo, 2005), and further regarding the differences in the release of primary/tertiary terpenols by different enzyme preparations as discussed in Section 3.2, it could be expected that different enzyme treatments would Cilengitide result in recognisably distinct terpene profiles in the musts. However, such an observation cannot be confirmed. The analysis of terpenes after the alcoholic fermentation (Table 5, see also Supplementary

Figs. S3 and S4) shows that the differences in terpene concentrations between the treatments are less distinct than before the alcoholic fermentation. Further, the total terpene concentrations in the wines were lower than in the musts. However, it is interesting to observe that the overall trends observed in the musts are still recognisable after alcoholic fermentation, which is evident when comparing the results in the Supplementary Figs. S3 and S4. This indicates that dependent on the glycosidase activity HSP90 profile of the yeast involved, enzyme treatment at an early stage of winemaking, as presented here, may indeed affect the sensory properties of the final product. The results of the sensory evaluation are shown in Fig. 2. “Riesling HBLA” was included as a further control for the sensory tests. This wine was produced from the same harvest of grapes without cold maceration but otherwise the same fermentation conditions. Interestingly, in the aroma intensity ranking (Fig. 2a), the highest intensity was recognised in the wines treated with AO only, while wines treated with GO/AO received the lowest rating (except “Riesling HBLA”). This is remarkable as treatment with AO and GO/AO did not result in analytically distinct terpene concentrations compared to the controls.

A numerical scheme, i e the shooting method was adopted to calcu

A numerical scheme, i.e. the shooting method was adopted to calculate the morphology of the vesicle-substrate system, the phase diagram, the relationship between BIBW2992 manufacturer the free energy and the substrate rigidity, and the opening angle of the substrate. Finally, the adhesion of a vesicle adhered to a rigid substrate was investigated. The obtained results can provide some illustrations of the cell movement regulated by the substrate rigidity, and can be analogous

to the droplet wrapped by a membrane controlled by the voltage. The relationship between the free energy and the work of adhesion has implications on designing special substrates with different surface energies to govern the cell movement. Although the surface tension of AZD2281 datasheet the substrate, the three-dimensional case and the roughness of the substrate haven’t been considered, the presented model is beneficial to understanding the mechanism of cell motility, and paves a new way to engineer devices to manipulate cells. This project is supported by the National Natural Science Foundation of China (11102140 and 11272357), the Doctoral

Fund of Ministry of Education of China (20110141120024), and the Fundamental Research Funds for the Central Universities (14CX02044A). “
“Implantable cardioverter-defibrillator (ICD) therapy prevents sudden cardiac death and prolongs survival in patients who undergo implantation for primary and secondary prevention of sudden cardiac death 1, 2, 3 and 4. The benefits of the therapy and the expansion of indications for ICDs since their introduction have led to a significant increase in the number of ICD recipients

and in lives saved by ICD therapy (5). However, (-)-p-Bromotetramisole Oxalate inappropriate therapies, most commonly caused by supraventricular tachyarrhythmias (SVTs), remain a significant adverse effect of ICD therapy, affecting up to 40% of patients during long-term follow-up 6, 7, 8, 9 and 10. Besides the pain and discomfort caused by inappropriate shocks, they are also associated with anxiety, depression, impaired quality of life, proarrhythmia, low treatment satisfaction, and possibly mortality 11, 12 and 13. Important efforts have been made in defining optimal programming methods for accurate rhythm detection and minimizing inappropriate ICD interventions. However, so far, there is no consensus on the most appropriate programming methodology 14, 15, 16 and 17. Likewise, the question of whether dual-chamber ICD therapy with dual-chamber settings can reduce the risk for inappropriate shocks in comparison with single-chamber therapy with single-chamber settings remains unanswered. Several investigators have reported a trend toward fewer inappropriate shocks with dual-chamber setting (18), whereas others have reported no differences between the therapies 19, 20, 21 and 22.