bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel Formulations of an Organic Acid Herbicide
Authors: Penner Donald , Coleman Robert , Michael Jan
Published: May 2011

Herbicides sold commercially to producers of organic crops have low specific activity. The potential exists to increase the herbicidal activity of the more active candidate herbicides with appropriate and acceptable adjuvants and emulsifiers. The naturally occurring organic acid chosen for this study was caprylic acid (C8). Caprylic disrupts the integrity of the plasmalemma of plant cells, causing desiccation. Both the spread and penetration of a spray solution become important in maximizing herbicidal or desiccant activity. The addition of an emulsification system is necessary to facilitate microemulsion stability when formulations are diluted in water. In greenhouse studies, a natural emulsifier from naturally occurring sources was found to be as effective as a phosphate ester emulsifier for enhancing caprylic acid activity on velvetleaf (Abutilon theophrasti), giant foxtail (Setaria faberi), and common lambsquarters (Chenopodium album). Citric acid, when used as an adjuvant in C8 product formulations, increased herbicidal activity on the weed species tested. Desiccation obtained with organic herbicide formulations were observed to be much greater than that obtained with a currently available herbicide formulation such as MATRAN.
Reproducibility of Probing Depth Measurement by an Experimental Periodontal Probe Incorporating Optical Fiber Sensor
Authors: Ishihata Kazuki , Wakabayashi Noriyuki , Wadachi Juro , Akizuki Tatsuya , Izumi Yuichi , Takakuda Kazuo , Igarashi Yoshimasa
Published: May 2011

Background: An experimental periodontal sensor probe (SP) equipped with an optical fiber for recording function was developed. The aim was to test the intraexaminer reproducibility of probing using the SP and to assess the consistency with the manual probe (MP).

Methods: The SP was assembled with an external sheath covering the probe tip of an MP. The sheath was slid backward by the free gingival margin while probing and the sliding distance was detected by the sensor. The probing was conducted with the walking stroke at six sites for four first molar teeth in six maintenance patients with the SP and the MP at a 1‐hour interval. The deepest reading in the vicinity of each site was recorded. The measurements were rerecorded 1 week later.

Results: The mean depth was 3.03 and 3.08 mm recorded by the MP and SP, respectively. Although no significant difference was found between the probes (P >0.05) in all measurement sites, the mean depth at the lingual site of the upper left first molar was noticeably lower with the SP. For sites ≥7 mm, significantly lower depth was recorded by the SP (P <0.05). Zero discrepancy in duplicate measurements was found in 76% of all sites with MP and 92% with SP.

Conclusions: The reproducibility of the SP was comparable to that of the MP. The results indicate that for sites of maintenance patients with probing depth <7 mm there was excellent agreement obtained by a single examiner using the SP compared to the MP.
Making Measures Count
Authors: Friedman Allon N. , Fadem Stephen Z.
Published: May 2011

An abundance of available laboratory information has led in part to the establishment of quantitative performance goals that use serum albumin, hemoglobin, Kt/V, and bone mineral indices to track quality of medical care and even physician reimbursement. As we look to the future, the next generation of measures should should more specifically reflect efforts to improve more fundamental outcomes, such as mortality, hospitalization, and quality of life. In this essay we address the important question of how clinicians can translate rich sources of quantitative data into a service that makes a difference in our patients' lives; a way to distinguish exemplary from ordinary care; a means to support continuous improvement in our care patterns individually and as part of larger, integrated health care systems all while avoiding prematurely advocating flawed quality measures. We also offer a pathway for how future quality measures can be developed. Our ultimate goal is to individualize quantitative assessments and by doing so encourage more meaningful, patient-oriented care that will lead to improved outcomes, greater physician job satisfaction, and wiser allocation of scarce resources.
Physical Correlates of College Students' Body Image Satisfaction Levels
Authors: Çatikkaş Fatih
Published: May 2011

Whether or not the association between physical characteristics and body image satisfaction varies by gender was investigated. The sample included 148 male and 104 female college students aged 19-27 years. To assess body image satisfaction, the Body Image Satisfaction Questionnaire
(Berscheid, Walster, & Bohrnstedt, 1973) was used. Body fat, waist to hip, chest to shoulder ratio, weight, and height were measured. The results indicate that males had significantly greater body image satisfaction than did females. There was a small but significant correlation between
physical characteristics and body image satisfaction for females but not for males. The regression model, consisting of bodily measures, predicted a significant variance in female body image satisfaction. The same model failed to explain male body image satisfaction.
Morningness-Eveningness Personality and Creative Thinking Among Young People Who Play Recreational Sport
Authors: Cavallera Guido M. , Boari Giuseppe , Labbrozzi Dina , Bello Emilia Del
Published: May 2011

Morningness-eveningness personality and creative thinking were investigated in a sample of young people who play recreational sports. Results showed that male participants were more eveningness-oriented than females; evening types had lower scores in creative thinking, although these
were not statistically significant; the elaboration factor of the Torrance Test of Creative Thinking (Torrance, 1989) was positively correlated with taking part in sport activities in the whole sample; and the elaboration and fluidity factors were negatively correlated with intermediate and
morningness dispositions. The relationship between the number of hours per week of sport activity, morningness-eveningness personality, and creative thinking was also explored.
Self-esteem and Body Image of Turkish Adolescent Girls
Authors: Dorak Ferudun
Published: May 2011

The aim in this study was to examine the relationship between self-esteem and body image in female adolescents who are athletes or nonathletes. Adolescent girls (N = 477) between the ages of 12 and 14 participated in the research in İzmir, Turkey. The self-esteem survey
developed by Coopersmith (1967) and the Body Cathexis Scale developed by Secord and Jourard (1953) were used in the study. The findings obtained show that there is a significantly stronger relationship between self-esteem and body image in the athletic adolescent girls compared with the sedentary
girls (p < 0.05).
Identification and phylogeny of some species of the genera Sporidiobolus and Rhodotorula using analysis of the 5.8s rDNA gene and two ribosomal internal transcribed spacers
Authors: Mokhtari M. , Etebarian H.R. , Mirhendi S.H. , Razavi M.
Published: May 2011

Due to the problems encountered in routine morphological and physiological
procedures that are used in yeast identification, DNA-based methods have
recently been developed. In the present study, l66 yeast strains were
isolated from several apple and citrus cultivars. After analysis by basic
morphological methods, the ITS1 and ITS2 regions of the isolates were
amplified separately, and the isolates were grouped based on fragment size
polymorphism (FSP) of the amplicons. By comparing the electrophoretic
patterns of the PCR products with Rhodotorula mucilaginosa, species were
identified as Rhodotorula. For precise and final identification, the ITS-PCR
products were subjected to sequencing followed by Blast analysis. As a
result, eight isolates were identified as belonging to the Rhodotorula genus,
of which five were identified as R. mucilaginosa and three as R. glutinis,
and one as a Sporidiobolus. We conclude that the method PCR-FSP, in
combination with other approaches, is useful for the identification of yeast
species.
Feature diagram formalization based on directed hypergraphs
Authors: Laguna Miguel , Marqués José , Rodríguez-Cano Guillermo
Published: May 2011

Feature models are used to represent the variability and commonality of
software product lines (SPL), and to decide on the configuration of specific
applications. Several variants based on tree or graph hierarchical
structures have been proposed. These structures are completed with
additional constraints, generally expressed in parallel with the feature
diagram. This paper proposes the use of hypergraphs to integrate both
concepts in a unique characterization. Therefore, the definition, validation
and selection of feature configurations can be internally based on the
hypergraph properties and well-known algorithms, while the concrete visual
syntax remains unchanged for domain engineers. The implemented hypergraph
algorithms have been tested using a complete set of feature diagrams.
Finally a feature meta-model can be derived directly from the formal
definitions, providing the foundations for building feature modeling tools.
Domain-specific language for coordination patterns
Authors: Oliveira Nuno , Rodrigues Nuno , Henriques Rangel
Published: May 2011

The integration and composition of software systems requires a good
architectural design phase to speed up communications between (remote)
components. However, during implementation phase, the code to coordinate such
components often ends up mixed in the main business code. This leads to
maintenance problems, raising the need for, on the one hand, separating the
coordination code from the business code, and on the other hand, providing
mechanisms for analysis and comprehension of the architectural decisions once
made. In this context our aim is at developing a domain-specific language,
CoordL, to describe typical coordination patterns. From our point of view,
coordination patterns are abstractions, in a graph form, over the composition
of coordination statements from the system code. These patterns would allow
us to identify, by means of pattern-based graph search strategies, the code
responsible for the coordination of the several components in a system. The
recovering and separation of the architectural decisions for a better
comprehension of the software is the main purpose of this pattern language.
A DSL for PIM specifications: Design and attribute grammar based implementation
Authors: Lukovic Ivan , Pereira Varanda , Oliveira Nuno , da Cruz , Henriques Rangel
Published: May 2011

IIS
The isolation, analytical characterization by HPLC-UV and NMR spectroscopy, cytotoxic and antioxidant activities of baeomycesic acid from Thamnolia vermicularis var. subuliformis
Authors: Manojlovic Nedeljko , Vasiljevic Perica , Nikolic Dragan , Bogdanovic-Dusanovic Gordana , Markovic Zoran , Najman Stevo
Published: May 2011

The aim of this work was the analytical characterization of the ?-orcinol
depside, baeomycesic acid in lichens extracts. The extract of Thamnolia
vermicularis var. subuliformis was analyzed by the two different methods,
namely HPLC-UV and 1H NMR analysis. The results showed that baeomycesic acid
was the most abundant depside in the lichens. These results could be of use
for rapid identification of this metabolite in other lichen species. Besides
baeomycesic acid, three depsides and one monocyclic phenolic compound were
isolated from the lichen extract on the chromatographic column. The structure
of baeomycesic acid was confirmed by HPLC-UV and spectroscopic methods. In
addition, antioxidant and cytotoxic activities of baeomycesic acid were
determined. The result of the testing showed that baeomycesic acid exhibited
a moderate radical scavenging activity (IC50 = 602.10 ? 0.54 ?g/mL) and good
cytotoxic activity. This is the first report of detailed analytical
characterization, isolation, as well as antioxidant and cytotoxic activities
of baeomycesic acid from Thamnolia vermicularis. These results may be helpful
in future industrial production of herbal medicines that include this
important natural product.
Neo-Liberalism in Crisis? Educational Dimensions
Authors: Small David
Published: May 2011

Until the global financial crisis, neo-liberalism had appeared invincible. This article examines the global rise of neo-liberalism and its impact on education, particularly its treatment of the social democratic ideal of equality. Drawing on examples from education and other socio-political factors, it considers whether the financial crisis is putting neo-liberalism's dominant position at threat. It argues that despite the existence of some elements of a crisis in neo-liberalism, the conditions do not exist for the changes of the magnitude of those that emerged either at the time of the birth of social democracy or when neo-liberalism replaced it.
Prevalence of echinococcosis in humans, livestock and dogs in northern Italy
Authors: Manfredi M. , Cerbo A. , Zanzani S. , Moriggia A. , Fattori D. , Siboni A. , Bonazza V. , Filice C. , Brunetti E.
Published: May 2011

The presence of Echinococcus sp. cysts was investigated in 822 sheep, 123 goats and 112,521 cattle from Lombardy region, North Italy. Faecal samples from 40 sheepdogs were also analyzed, with 9 samples containing taeniid eggs (22.5 %), 8 samples being coproantigen-positive (20 %), and one dog from a northern province (Lecco) positively confirmed by PCR. Cystic Echinococcosis (CE) was detected in 0.36 % of sheep and in 0.29 % of cattle in 2004. No goat resulted to be infected. Data from CE patients treated in Lombardy were collected by inspecting hospital discharge records. In 2004, 156 CE-related admissions (62 % male and 38 % female) were reported in Lombardy. Total hospital stay was 1,372 days (1,286 for inpatients, 86 for outpatients). Most patients (72.4 %) were residents in Lombardy and 1.9 % were from Piedmont; the remaining patients were from central and southern Italy. According to acquired data CE resulted hypoendemic in animals in Lombardy. Prevalence rates in humans were higher than expected in this region, usually considered as non-endemic. Assessment of the prevalence of CE in humans remains a difficult, costly, time-consuming and labourintensive task. The present study suggests establishing a National Registry of Cystic Echinococcosis with the aim to highlight regional risk factors and to benefit from its matching both clinical and epidemiological data.
Optimization of Power System Development Using Acceleration Factor for Power Flow Calculation
Authors: Obusev A. , Oleinikova I. , Krishans Z.
Published: May 2011

Optimization of Power System Development Using Acceleration Factor for Power Flow Calculation

The dynamic optimization process is analyzed from the viewpoint of simplifying the power flow calculations. The aim of the work was to reduce the calculation time using all admissible algorithms. Although the conventional iteration methods are simple and fast enough, the use of the so-called relaxation principle leads to increased calculation time. The paper exemplifies the power flow calculation based on the iteration method using acceleration factor. Proposals concerning the modelling of a power system are put forward in the aspect of its future development.
Distant Determination of Bilirubin Distribution in Skin by Multi-Spectral Imaging
Authors: Saknite I. , Jakovels D. , Spigulis J.
Published: May 2011

Distant Determination of Bilirubin Distribution in Skin by Multi-Spectral Imaging

For mapping the bilirubin distribution in bruised skin the multi-spectral imaging technique was employed, which made it possible to observe temporal changes of the bilirubin content in skin photo-types II and III. The obtained results confirm the clinical potential of this technique for skin bilirubin diagnostics.
Transformations of the Employment Structure as an Expression of the Transformation of Polish Industry Against the Background of the European Union
Authors: Rachwał Tomasz
Published: May 2011

Transformations of the Employment Structure as an Expression of the Transformation of Polish Industry Against the Background of the European Union

Global social and economic changes, connected mainly with globalization processes, have an impact on changes both in present spatial and division structures of the industry and in its functions in the economic development of various spatial systems. The aim of the paper is to analyze changes in the industry's role in the Polish economy during the period of economic transformation and European integration based on its share in the employment structure. These changes are set against transformations in other EU countries, diversification and transformations of the division structure of employment in Polish industry and the similarity of the Polish employment structures to the EU countries as an expression of transformation processes. The analyzed processes are stimulated by the international environment and a change in national conditions for the socio-economic development.
Immigrants and Immigration Policy in Ageing Finland
Authors: Łobodzińska Anna
Published: May 2011

Immigrants and Immigration Policy in Ageing Finland

The paper addresses the issue of current immigration to Finland in the context of population ageing. It is estimated that about 40% of the present labour force will have withdrawn from the Finnish labour market by the year 2020. The government of this rapidly ageing country is seeking possible remedies to the problem of a shrinking labour force. The necessity of attracting a new workforce as well as the growing number of immigrants in the ethnically homogeneous Finnish society create a need for more detailed and creative immigration policy. The paper analyzes the age and economic structure of the immigrant population, its participation in the labour market as well as the importance of immigration in contemporary demographic changes in Finland. Another aim of this paper is to outline major issues concerning Finnish immigration policy.
Electoral Geography as a New Mean of Analyzing Social Change. Kraków City and Małopolskie Voivodship Case Study
Authors: Haydukiewicz Lech
Published: May 2011

Electoral Geography as a New Mean of Analyzing Social Change. Kraków City and Małopolskie Voivodship Case Study

The paper describes political support for Polish political parties as aggregated into four principal options (left-wing, liberal, populist, and right-wing) as well as flux in the electorate in Małopolskie voivodship in the last two decades in order to show regions of electoral stability that tend to do favour the four principal social and political options. Stabilization of cultural and political identity and gradual changes therein are shown by comparing dominant political options with selected social and economic data. The comparison should also allow for a reasonable prediction of future gains and losses for each political option.
Ventricular catheter exchange using a peel-away outer catheter
Authors: Omahen David A. , Hentschel Stephen J. , Cameron G. Stuart
Published: May 2011

Ventricular catheter replacement can be challenging, especially in patients with small ventricles. Shunt malfunction due to ventricular catheter obstruction can occur without ventricular enlargement, such as in the setting of slit-ventricle syndrome or benign intracranial hypertension. The authors describe a simple technique for ventricular catheter exchange using a peel-away catheter. In the limited initial experience of the senior author (G.S.C.), this technique appears to be safe and effective. To the authors' knowledge, this method has not been described in the neurosurgical literature before.
Rupture of anterior communicating artery aneurysms during computed tomography angiography: description of the pathway for intraseptal and intraventricular hemorrhage
Authors: Scholtes Felix , Signorelli Francesco , Bojanowski Michel W.
Published: May 2011

Intraventricular hemorrhage is common after the rupture of anterior communicating artery (ACoA) aneurysms, although the anatomical pathway has not been described. Knowledge of the mechanism of hemorrhage may enhance understanding of its prognosis. Using CT angiography, the authors analyzed this pathway in 2 cases of ACoA aneurysm rupture associated with intraventricular hemorrhage. The initial hemorrhages created a hyperdense ventriculographic image on which the subsequent contrast medium ejection could be followed. The contrast medium entered the subarachnoid space of the anterior interhemispheric fissure and broke through the lamina rostralis into the septum pellucidum and into the frontal horns of the lateral ventricles. Thus, the authors provide an explanation for bleeding from ACoA aneurysms into the ventricular system in the presence of an intact lamina terminalis. The septum pellucidum may act as a buffer before extension of the bleeding into the ventricular system.
Critical Care Medicine in Bangladesh: Evolution and Challenges
Authors: Faruque Mohammad Omar
Published: May 2011

DOI: 10.3329/jcmcta.v21i1.7661 Journal of Chittagong Medical College Teachers' Association 2010: 21(1):3-5
Effects of Probiotics on Necrotizing Enterocolitis in Very Low Birth Weight Infants
Authors: Mannan MA , Shaidullah Md , Barua Chowdhury Chiranjib , Nahar Zakia , Barua Sarmila
Published: May 2011

DOI: 10.3329/jcmcta.v21i1.7667 Journal of Chittagong Medical College Teachers' Association 2010: 21(1):30-33
Treatment with Short Wave Diathermy on Chronic Low Back Pain
Authors: Shakoor Md Abdus , Al Hasan Suzon , Moyeenuzzaman Md , Deb Arun Kumar
Published: May 2011

DOI: 10.3329/jcmcta.v21i1.7669 Journal of Chittagong Medical College Teachers' Association 2010: 21(1):40-44
Prevalence of Oedematous Malnutrition in Early Infancy
Authors: Begum Ayesha , Sharma Jhulan Das , Azad Abul Kalam , Mahmud Nazir Uddin , Ahmad Mainuddin
Published: May 2011

Key words: malnutrition; infancy; skin changesDOI: 10.3329/jcmcta.v21i1.7679 Journal of Chittagong Medical College Teachers' Association 2010: 21(1):50-55
Treatment of a nonunion, secondary to gunshot fracture, of the distal radius with circular external fixation and rhBMP-2 in a cat
Authors: Maitre P. , Cachon T. , Carozzo C. , Fau D. , Genevois J-. P. , Viguier E. , Arnault F.
Published: May 2011

Objective: To report the successful use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in the treatment of an ante-brachial non-union, secondary to gunshot fracture, stabilized with circular external fixation in a cat.

Procedure: Following a diagnosis of a highly comminuted gunshot fracture of the distal right radius and ulna, the fracture was stabilized with a circular external fixation. A two-ring frame was placed in closed fashion.

Results: The skin wound healed uneventfully by second intention in 21 days. Twenty-eight weeks after external fixation, bone healing was absent. 0.8mL of 0.2mg/mL of rhBMP-2 in two collagen sponges was placed in the bone defect. Eight weeks after rhBMP-2 implantation, an early bone healing response was noted on radiographic evaluation. Sixteen weeks after rhBMP-2 implantation, fracture union was achieved.

Discussion: To the authors’ knowledge, 160 ±g is the lowest reported dose of rhBMP-2 that leads to bony union in a cat. However as an individual case study, this report can not be used as evidence that rhBMP-2 at this lower dose is appropriate for use in all cats. Further studies are needed to establish the minimum efficient dose of rhBMP-2 in cats.
Competitiveness of Southern African Development Community as a Tourist Destination
Authors: Manwa Haretsebe
Published: May 2011

Southern African Development Community (SADC) is a regional economic grouping of 14 countries. The region receives the majority of tourists to Africa. However, it has not managed to make a significant impact in terms of tourism arrivals as it attracts only 3.2% of the world's tourism
receipts. This article is based on the review of literature on SADC. The findings indicate that there are a number of factors that militate against successful marketing of SADC as a unique tourist destination. There are multiple stakeholders with competing interests; countries in the SADC
region are at different stages of the destination lifecycle; there is stiff competition among SADC countries for the international tourists; lack of resources; South Africa's domination of tourism industry in the region; lack of uniform standards as well as lack of uniformity in grading and
classification of tourism facilities in the region. RETOSA with the responsibility of marketing and developing regional tourism was found to be highly ineffective. There are also exogenous factors that make the region uncompetitive.
Stereogenic boron in 2-amino-1,1-diphenylethanol-based boronate–imine and amine complexes
Authors: Schlecht Sebastian , Frank Walter , Braun Manfred
Published: May 2011

Racemic boronate–imine and boronate–amine complexes 8 and 10, both featuring a stereogenic boron atom were synthesized from 2-amino-1,1-diphenylethanol (5) and characterized by crystal structure analyses. Proof of enantiomerism at the boron center for the novel boronate–amine complex 10 was established by separation of the enantiomers. Racemization barriers were found to be in the same range for both amine and imine complexes (100–110 kJ/mol).
Improving Data Quality in Relational Databases: Overcoming Functional Entanglements
Authors: Chen Tennyson , Meyer Martin , Ganapathi Nanthini , Liu Shuangquan , Cirella Jonathan
Published: May 2011

The traditional vertical decomposition methods in relational database normalization fail to prevent common data anomalies. Although a database may be highly normalized, the quality of the data stored in this database may still deteriorate because of potential data anomalies. In this paper, we first discuss why practitioners need to further improve their databases after they apply the traditional normalization methods, because of the existence of functional entanglement, a phenomenon we defined. We outline two methods for identifying functional entanglements in a normalized database as the first step toward data quality improvement. We then analyze several practical methods for preventing common data anomalies by eliminating and restricting the effects of functional entanglements. The goal of this paper is to reveal shortcomings of the traditional database normalization methods with respect to the prevention of common data anomalies, and offer practitioners useful techniques for improving data quality.
Le contrôle de constitutionnalité de la loi en Allemagne : quelques comparaisons avec le système français
Authors: Grewe Constance
Published: May 2011

Résumé Bien plus que le contrôle de constitutionnalité de la loi en France, le système allemand est influencé par l’évolution de la justice constitutionnelle allant d’une protection de la loi vers une protection des droits. Dès lors, la spécialisation et la séparation des contentieux constitutionnels tendent à s’effacer ; le contrôle abstrait surtout mais également le contrôle concret des normes régressent au profit du recours constitutionnel. La question est de savoir dans quelle mesure la QPC opère un rapprochement ou éloigne encore les deux systèmes.
Systemizing Local and Regional Cooperation Efforts to Combat Sex Slavery
Authors: McGaha Johnny
Published: May 2011

Les histoires horribles relatées par les survivants de la traite sexuelle, qu'ils soient mineurs ou adultes, avivent les passions et incitent les décideurs et ceux qui sont impliqués dans le mouvement anti-traite à agir. De nombreux pays à travers le monde ont adopté des lois strictes en matière de lutte contre la traite et obligent à l'application de la loi, des procureurs et des services d’aide aux victimes travaillant ensemble pour éradiquer ce terrible crime. Les États-Unis, qui ont déjà voté la loi sur la protection contre la traite de 2000, ont affecté plusieurs millions de dollars pour lutter contre le trafic à l’intérieur et à l’extérieur des frontières. Malheureusement une grande partie de cet effort a été fait en vain en raison du manque de coordination au niveau local. Ce document présente un modèle réussi de groupe de travail multi-agences qui est basé sur un « système » qui requiert que toutes les parties prenantes travaillent ensemble au niveau local et régional selon un modèle de collaboration qui aidera à trouver le succès.
The Faculty Learning About Geriatrics (FLAG) Program: Bringing Together Experts in Geriatric Nursing Education
Authors: Edelstein Janice A. , Cheung Corjena K. , Voss Jo A. , Kaas Merrie J.
Published: May 2011

Strengthening geriatric content in schools of nursing is a key initiative for the Minnesota Hartford Center of Geriatric Nursing Excellence. The first Faculty Learning About Geriatrics (FLAG) program was implemented in the summer of 2008. Selected nursing faculty from across the Upper Midwest and tribal colleges have successfully completed the FLAG program in the last 2 years. Participants completed a 5-day summer institute at the University of Minnesota and a 1-year mentorship program. The FLAG program is designed to broaden expertise in geriatric nursing through building teaching and academic leadership skills and to increase content knowledge through collaboration with academic and geriatric leaders. This article provides an overview of the educational experience of FLAG participants who have earned the title of FLAG program fellow. The perspectives of the FLAG mentors and fellows are highlighted.
Nurses’ Perception of Evidence-Based Practice at the National University Hospital of Singapore
Authors: Foo Schubert , Majid Shaheen , Mokhtar Intan Azura , Zhang Xue , Luyt Brendan , Chang Yun-Ke , Theng Yin-Leng
Published: May 2011

Background:

A study was conducted at Singapore’s National University Hospital to elicit registered nurses’ attitudes, knowledge, barriers, facilitating factors, education, and training regarding evidence-based practice.

Methods:

A 13-question survey that was administered to all registered nurses yielded 1,114 (75.4%) usable returns for analysis.

Results:

Findings showed that Singapore nurses had a positive and supportive attitude toward evidence-based practice but lacked the competence and knowledge to conduct it. Time constraints were identified as the main barrier to implementing evidence-based practice. There is a need for proper training, mentoring by senior nurses, and adequate time for evidence-based practice. Nurses with a higher level of nursing education who indicated the greatest perceived barriers tended to have less difficulty applying evidence-based practice but identified a need for more training in information skills.

Conclusion:

Evidence-based practice is still in its infancy in Singapore compared with hospitals in other developed countries.
Effect of a Perioperative Intra-Articular Injection on Pain Control and Early Range of Motion Following Bilateral TKA
Authors: Fajardo Marc , Collins Jason , Landa Joshua , Adler Edward , Meere Patrick , Di Cesare Paul E.
Published: May 2011

Pain control after total knee arthroplasty (TKA) is integral in the immediate postoperative period for early rehabilitation. Numerous different methods of postoperative analgesia are available, but each has its own risk of adverse side effects. This study was performed to prospectively evaluate the benefits of an intra-articular analgesic injection in patients undergoing bilateral TKA.

Thirty consecutive patients undergoing bilateral TKA were enrolled in this prospective, randomized, controlled study. Each patient was randomized to receive (1) a perioperative intra-articular mixture of morphine, bupivacaine with epinephrine, and ketorolac in 1 knee, and (2) injectable sterile saline in the contralateral knee. Each patient acted as his or her own internal control. The pharmacologically injected knee had statistically significantly less pain immediately postoperatively when compared to the control knee and displayed significantly increased range of motion within the first week of rehabilitation.

The use of an intraoperative intra-articular injection with the above drug combination significantly reduces patient pain and increases postoperative mobility with no apparent risks following bilateral TKA.
Recession Wedge Osteotomy of the Greater Tuberosity for Proximal Humeral Varus
Authors: Aoki Stephen K. , Anderson Lucas A. , Marchese Joseph W.
Published: May 2011

Proximal humeral varus has multiple etiologies and may lead to impingement and reduced shoulder range of motion, particularly abduction and forward elevation. Valgus osteotomies have been described at the level of the surgical neck yielding acceptable results. This article describes a case of a male electrician who was treated for symptoms associated with proximal humeral varus of the right shoulder. He underwent an osteotomy of the greater tuberosity designed to reduce impingement and improve range of motion. The patient had previously undergone two separate surgical procedures for a simple bone cyst, but continued to have reduced shoulder function secondary to a prominent greater tuberosity. Preoperative and follow-up radiographs, physical examinations, and shoulder function were retrospectively reviewed for 32 months. Following treatment, active forward elevation improved from 130° preoperatively to 170°, abduction from 90° to 170°, external rotation from 45° to 70°, and internal rotation from T10 to T7. The patient reported relief of pain, impingement-free range of motion, and full symmetric function equal to that of his contralateral shoulder. Radiographs demonstrated osteotomy union, improved greater tuberosity/acromial clearance, and no impingement with abduction. Postoperative stiffness was the only complication noted for which a shoulder manipulation was performed under anesthesia. Thus, recession wedge osteotomy of the prominent greater tuberosity may serve as a viable surgical approach to reducing impingement and improving clinical function in proximal humeral varus.
Surgical Treatment and Prognosis of Acetabular Fractures Associated with Ipsilateral Femoral Neck Fractures
Authors: Wei Li , Sun Jun-Ying , Wang Yong , Yang Xing
Published: May 2011

Combined ipsilateral acetabular and femoral neck fractures are the result of high-energy trauma. Satisfactory treatment for this injury pattern remains a challenge, since traditional open reduction and internal fixation (ORIF) is always accompanied by a high prevalence of posttraumatic arthritis and avascular necrosis of the femoral head. Eight of 502 acetabular fractures from 1990 to 2008 were diagnosed with combined ipsilateral femoral neck fracture, in which 5 patients’ fractures were associated with hip dislocation. These patients were injured from falls, traffic accidents, or crushing accidents. Radiographs and computed tomography scans were taken to check acetabular and femoral neck fractures. All of the patients underwent surgery using appropriate approaches and techniques. Postoperative radiographs demonstrated anatomic or satisfactory reduction for acetabular fractures as well as excellent or good reduction for femoral neck fractures in all of the patients. Follow-up radiographs showed femoral head necrosis in the 5 patients with femoral head dislocations, but not in the other 3 patients. We have seen few patients with this injury pattern, which makes us unable to detect significant differences between the patients associated with femoral head dislocation and those without femoral head dislocation. But by considering the results of our study and those reported in the literature, we believe that for patients with ipsilateral acetabular and femoral neck fractures without hip dislocation, satisfactory results could be expected after ORIF. But for those cases associated with hip dislocation, alternative methods such as acute THR as primary treatment are worthy of consideration.
Review of the Current Literature as a Preparatory Tool for the Trauma Content of the Orthopaedic In-Training Examination
Authors: Farjoodi Payam , Marker David R. , McCallum Jeremy R. , Frassica Frank J. , Mears Simon C.
Published: May 2011

Currently, the only standardized evaluation of trauma knowledge throughout orthopedic training is found in the Orthopaedic In-Training Examination, which is administered annually to all residents by the American Academy of Orthopaedic Surgeons. Our goals were to assess the Orthopaedic In-Training Examination to (1) determine the content of the trauma questions, (2) identify the content of the 3 most frequently referenced journals on the answer keys, and (3) evaluate the correlation between those contents.

We reviewed the trauma-related Orthopaedic In-Training Examination questions and answer keys for 2002 through 2007. Content for test questions and cited literature was assessed with the same criteria: (1) category type, (2) anatomic location, (3) orthopedic focus, and (4) treatment type. For each of the 3 most frequently referenced journals, we weighted content by dividing the number of times it was referenced by the number of its trauma-related articles. We then compared the journal data individually and collectively to the data from the Orthopaedic In-Training Examination trauma questions. A chi-square analysis with Yates correction was used to determine differences. Questions and literature were similar in the most frequently addressed items in each of the 4 areas: category type (taxonomy 3, treatment), 52.4% and 60.7%, respectively; anatomic location (femur), 23.3% and 27.7%, respectively; orthopedic focus (fracture), 51.0% and 56.5%, respectively; and treatment type (multiple/nonspecific), 39.0% and 35.4%, respectively.

The content correlation found between the questions and literature supports the idea that reviewing current literature may help prepare for the trauma content on the Orthopaedic In-Training Examination.
Changes in the Interpupillary Distance Following General Anesthesia in Children With Intermittent Exotropia: A Predictor of Surgical Outcomes
Authors: Bae Hyoung Won , Chung Seung Ah , Yoon Jin Sook , Lee Jong Bok
Published: May 2011

Purpose:

To determine whether changes in ocular alignment following general anesthesia, as measured by interpupillary distance, can be used as a predictor for surgical outcomes in children with intermittent exotropia.

Methods:

The authors obtained digital photographs of 40 children with exotropia and 20 children with epiblepharon (control group) before and immediately after induction of general anesthesia in the primary supine position. Differences in the anatomic interpupillary distance (aIPD) for each patient were measured and compared with the preoperative angles of deviation. They were also correlated with surgical outcomes on the first day and 1 year after surgery.

Results:

All 60 patients demonstrated an increase in aIPD following general anesthesia. The mean change in aIPD in patients with exotropia was similar to that in patients with epiblepharon (3.78% ± 2.53% and 3.15% ± 1.05%, respectively). In patients with exotropia, there was a significant positive linear correlation between the preoperative distance deviation (P) and the change in eye position (A): A = 0.362 P – 4.488, r
2
= 0.476 (
P
< .001). Five (71%) of seven patients whose changes were outside the 80% confidence interval for expected values had poor surgical outcomes on the first postoperative day and four had unsatisfactory results 1 year after surgery.

Conclusions:

Changes in aIPD following general anesthesia were strongly correlated with preoperative angle of deviation. Therefore, they may be a useful predictor of surgical outcomes in children with exotropia.
Using Art to Empower Clients During a Facility Move
Authors: Osborn Lawrence A. , Tate Frederic B.
Published: May 2011

Eastern State Hospital, a state psychiatric facility in Williamsburg, Virginia, moved from its old campus into a single new building in 2010. Adult clients were given the opportunity to decorate a portion of the new facility with ceramic tiles they designed using permanent markers. The purpose of this project was to empower the clients so they felt involved in the transition. This article describes the project from inception to fruition and is accented with images and descriptions of some of the tiles.
Differential Effects of Sumoylation on the Activities of CCAAT Enhancer Binding Protein alpha (C/EBPα) p42 versus p30 May Contribute in Part, to Aberrant C/EBPα Activity in Acute Leukemias
Authors: Hankey William , Silver Matthew , Sun Hong , Zibello Terry , Berliner Nancy , Khanna-Gupta Arati
Published: May 2011

In this study, we have examined the role of post-translational modification of the myeloid master regulator C/EBPα by small ubiquitin-related modifier (SUMO). We have used transient transfection analysis, oligonucleotide pulldown assays and chromatin immunoprecititation in all-trans retinoic acid (ATRA)-inducible promyelocytic cell lines MPRO and NB4. We demonstrate that sumoylated wildtype p42-C/EBPαis associated with negative regulation of the myeloid specific lactoferrin (LF) gene in early myeloid cells and that a reduction in p42-C/EBPα sumoylation coincides with expression of the LF gene in maturing myeloid cells. In the acute promyelocytic leukemia cell line NB4 however, sumoylated p42 remains persistently bound to the LF promoter following ATRA-induction. This correlates with lack of lactoferrin expression in these cells. Changes in sumoylation status of C/EBPα thus appear to contribute to a switch that regulates transcriptional activity of this master regulator during normal neutrophil development. We also demonstrate that sumoylation of the AML associated dominant negative p30-C/EBPα isoform does not alter transactivation activity of the LF promoter. This may be because the p30 C/EBPα isoform binds to the LF promoter much less efficiently than its full length counterpart. Our data suggest that the activity of p42-C/EBPα in the developing neutrophil is more sensitive to changes in sumoylation than the p30 isoform. This difference may contribute to the leukemogenic potential of p30-C/EBPα.
Electroconvulsive treatment of a patient with Parkinson's disease and moderate depression
Authors: Berg John E.
Published: May 2011

Depression is a usual comorbidity in patients with Parkinson's disease. It has been known for more than 50 years that electroconvulsive treatment (ECT) has a positive effect on the muscular symptoms of Parkinson's disease. Many countries do not allow giving ECT for this indication. We have recently treated a resident patient in an acute psychiatric facility referred to the hospital with moderate depressive symptoms and strong suicidal ideation. Before and after a series of ECT he filled out the Beck Depression Inventory and the Antonovsky Sense of Coherence test. The scores before ECT were 20 and 2.69, respectively, and after 12 treatments 14 and 3.38. Both test results indicate improvement regarding level of depression and coping in life. The physiotherapists treating him observed that his rigidity was reduced and his gait improved. Muscular tonus was reduced and increased his tendency of falling as he had less tonus in muscles close to joints. Self help efficiency in daily tasks improved. He got cognitive impairment during and in the weeks after ECT. Electroconvulsive treatment should be offered to more patients with Parkinson disease and depression in order to lessen the burden of both depression and Parkinson symptoms.
Is radical cystectomy mandatory in every patient with variant histology of bladder cancer
Authors: Shapur Nandakishore Kamalakar , Katz Ran , Pode Dov , Shapiro Amos , Yutkin Vladimir , Pizov Galina , Appelbaum Liat , Zorn Kevin C. , Duvdevani Mordechai , Landau Ezekiel H. , Gofrit Ofer N.
Published: May 2011

Urothelial carcinomas have an established propensity for divergent differentiation. Most of these variant tumors are muscle invasive but not all. The response of non muscle invasive variant tumors to intravesical immunotherapy with BCG is not established in the literature, and is reported here. Between June 1995 and December 2007, 760 patients (mean age of 67.5 years) underwent transurethral resection of first time bladder tumors in our institution. Histologically variant tumors were found in 79 patients (10.4%). Of these 57 patients (72%) of them had muscle-invasive disease or extensive non-muscle invasive tumors and remaining 22 patients (28%) were treated with BCG immunotherapy. These included 7 patients with squamous differentiation, 4 with glandular, 6 with nested, 4 with micropapillary and 1 patient with sarcomatoid variant. The response of these patients to immunotherapy was compared with that of 144 patients having high-grade conventional urothelial carcinomas. Median follow-up was 46 months. The 2 and 5-year progression (muscle-invasion) free survival rates were 92% and 84.24% for patients with conventional carcinoma compared to 81.06% and 63.16% for patients with variant disease (P=0.02). The 2 and 5-year disease specific survival rates were 97% and 91.43% for patients with conventional carcinoma compared to 94.74 % and 82% for patients with variant disease (P=0.33). 5 patients (22.7%) of variant group and 13 patients (9.03%) of conventional group underwent cystectomy during follow-up (P=0.068).

Patients with non-muscle invasive variants of bladder cancers can be managed with intravesical immunotherapy if tumor is not bulky (>4 cm). Although progression to muscle invasive disease is more common than in conventional group and occurs in about 40% of the patients, life expectancy is similar to patients with conventional high-grade urothelial carcinomas provided that follow-up is meticulous.
Norm One Idempotent cb-Multipliers with Applications to the Fourier Algebra in the cb-Multiplier Norm
Authors: Forrest Brian E. , Runde Volker
Published: May 2011

For a locally compact group G, let A(G) be its Fourier algebra, let McbA(G) denote the completely bounded multipliers of A(G), and let AMcb (G) stand for the closure of A(G) in McbA(G). We characterize the norm one idempotents in McbA(G): the indicator function of a set E ⊂ G is a norm one idempotent in McbA(G) if and only if E is a coset of an open subgroup of G. As applications, we describe the closed ideals of AMcb (G) with an approximate identity bounded by 1, and we characterize those G for which AMcb (G) is 1-amenable in the sense of B. E. Johnson. (We can even slightly relax the norm bounds.)
Domains of Injective Holomorphy
Authors: Gauthier P. M. , Nestoridis V.
Published: May 2011

A domain Ω is called a domain of injective holomorphy if there exists an injective holomorphic function ƒ: Ω → ℂ that is non-extendable. We give examples of domains that are domains of injective holomorphy and others that are not. In particular, every regular domain is a domain of injective holomorphy, and every simply connected domain is a domain of injective holomorphy as well.
Asymptotic Properties of Solutions to Semilinear Equations Involving Multiple Critical Exponents
Authors: Kang Dongsheng
Published: May 2011

In this paper, we investigate a semilinear elliptic equation that involves multiple Hardy-type terms and critical Hardy–Sobolev exponents. By the Moser iteration method and analytic techniques, the asymptotic properties of its nontrivial solutions at the singular points are investigated.